bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence based on automated breast volume scanner (ABVS) in breast nodules:A deep learning model for diagnosis
Authors: Jiang Wei , Yang Yi , Zhu Ting , Deng Xiaoji , Fang Jing 
Published: February 2022

Abstract
Objectives We aimed to explore the use of artificial intelligence (AI) in differential diagnosis of benign and malignant breast nodules with automated breast volume scanner (ABVS). Methods The AI model used in this study is based on the VNet, trained with a collection of breast nodules. Another collection of breast nodules were used to test the diagnostic accuracy among AI model, radiologists with different experiences, and AI-assisted junior radiologist. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the curve (AUC) were used as indices to evaluate the efficiency on distinguishing between benign and malignant breast nodules of four different diagnostic groups. Results The training cohort includes 100 breast nodules, the validation cohort includes 47 breast nodules. Among these 147 cases, 92 cases were benign (62.6%), 55 cases were malignant (37.4%). The AUC values of AI diagnosis, independent diagnosis by senior radiologist, independent diagnosis by junior radiologist, and AI-assisted diagnosis by junior radiologist were 0.839(95%CI, 0.703-0.930), 0.956(95%CI, 0.853-0.994), 0.814(95%CI, 0.674-0.912), and 0.963(95%CI, 0.863-0.996), respectively. The diagnostic efficiency of junior radiologist improved with the assistance of AI (AUC = 0.814 vs 0.963, Z=2.772, p <0.01). No significant difference in diagnostic ability was found between the AI-assisted junior radiologist and the senior radiologists (AUC = 0.963 vs 0.956, Z=0.158, p > 0.05). Conclusions The AI model could distinguish between benign and malignant breast nodules with ABVS. AI model is the fastest diagnosis method with equivalent diagnosis efficiency with experienced radiologists, and could improve the diagnostic ability of junior radiologist.
NET Rounding: A Novel Approach to Efficient and Effective Rounds for the Modern Clinical Learning Environment
Authors: Chan Shirley J. , Archibald Hannah L. , Conner Stephanie M. 
Published: February 2022

Abstract
Background: Rounds are a foundational practice in patient care and education in the inpatient healthcare environment, but increased demands on inpatient teams have led to dissatisfaction with inefficient, ineffective rounds. In this study, we describe the design, implementation, and evaluation of a novel rounding framework (“NET Rounding”) that provides behaviorally-based strategies to inpatient teams to achieve efficient rounds while preserving patient safety and education.Methods: NET Rounding consists of nine recommendations divided into three categories: Novel rounding strategies, shared Expectations, and Time management. This framework was introduced as a bundled intervention at a single-site, quaternary-care, academic hospital from March-May 2021. 83 residents and 64 attendings rotated on the inpatient teaching service during the intervention period. Participants were surveyed before, during, and after their rotation about rounding’s contribution to educational value, patient safety, resident duty hour violations and rotation experience. Additionally, rounding duration was recorded daily by team attendings.Results: 32 residents (38.5%) and 45 attendings (79%) completed post-intervention surveys. Rounding duration was recorded on 529/626 rounding days (80.6%) and resulted in achieving efficient rounds on 412/529 days (77.9%). Residents reported improvement in perceived patient safety (54% to 84%, p=0.0131) and educational value of rounds (38% to 69%, p=0.0213) due to NET Rounding; no change was observed amongst attendings in these areas (79% to 84% and 70% to 80%, p=0.7083 and 0.4237, respectively). Overall, 29/32 residents (91%) and 33/45 attendings (73%) reported a positive impact on rotation experience.Conclusions: NET Rounding enabled inpatient teaching teams to complete rounds more efficiently while preserving patient safety and education.
Impact of a Patient-centered Medical Home on Healthcare Utilization for Patients With Complex Needs in Singapore: a Matched Cohort Study
Authors: Sim Silvia Yu Hui , Chay Junxing , Ho Soon Hoe , Ginting Mimaika Luluina , Lim Zoe Zon Be , Sum Grace , Yoong Joanne , Wong Chek Hooi 
Published: February 2022

Abstract
Background: Patients with complex needs require greater biopsychosocial support. Fragmented services often result in gaps, duplication or incompatibility in treatments, leading to poorer health outcomes and higher utilization of costly hospital-based healthcare services. Patient-Centred Medical Home (PCMH) is a primary care model reform advocated as more appropriate for patients with complex needs. This analysis assessed the impact of a PCMH demonstration on healthcare utilization for patients with complex needs in Singapore. Methods: This study assessed the Community for Successful Ageing (ComSA)-PCMH in Singapore that was launched in Nov’2016. ComSA-PCMH serves adults aged 40 and above with complex needs, delivering care integrated between its primary care clinic, home-based care management, an acute hospital and other community-based services. This was a matched cohort analysis that used a difference-in-difference approach to compare quarterly healthcare utilization of PCMH study participants and controls. 165 PCMH study participants enrolled between Oct’2017 and Apr’2019 were compared against 5,385 controls selected using Coarsened Exact Matching from a neighbouring geographical precinct. Healthcare utilization data spanning Oct’2014 to Mar’2020 were extracted from a public regional health system, including primary care, specialist outpatient clinic and emergency department utilization, and inpatient admissions. Two-part models were fitted, with controls for socio-demographics, Charlson Comorbidity Index, secular trends including effect of COVID-19, and between-group differences. Statistical inferences were based on cluster-robust standard errors at the individual level.Results: At ≥4 four quarters post-enrolment, PCMH study participants had sustained reductions of 1.08 polyclinic visits (p<0.001), 0.37 SOC visits (p=0.047), 0.04 ED visits (p=0.013) and 0.02 inpatient admissions (p=0.093) per person-quarter, compared to the quarter before enrolment and controls.Conclusions: ComSA-PCMH study participants reduced healthcare utilization after enrolment into the programme, adding to a growing global body of evidence supporting the benefits of PCMH for patients with complex needs and pointing to its potential in Asia.Trial registration: This analysis is part of the ComSA Patient-Centered Care (COPACC) study, retrospectively registered with ClinicalTrials.gov in October 2020 (Protocol ID: NCT04594967; https://clinicaltrials.gov/ct2/show/NCT04594967).
C2 Fracture Operative and Non-Operative Management Outcomes in Large Database Review
Authors: Foote Christopher , Doan Xuan-Lan , Vanier Cheryl , Betancourt Alejandro , Palacio Carlos 
Published: February 2022

Abstract
Background:Odontoid fractures are common and projected to increase. Comorbidities compound risk of surgery and balancing the risk of non-operative management is controversial. Stable fractures are managed based on patient comorbidity with suspected clinical prognosis. Type I and III fractures are typically managed safely with cervical orthoses. Management decisions of type II fractures however, come under frequent debate. This paper evaluates overall morbidity and mortality, and outcomes of operative and non-operative management. Methods:We performed national database review of C2 fractures from January 2014 to December 2019. Patients were divided into categories based on Glasgow Coma Scale (GCS) and Injury Severity Score (ISS). Outcomes data considered hospital admission, Intensive Care Unit (ICU) admission, hospital length of stay (LOS), ICU LOS, and mortality. Logistic regression was used for mortality, hospital admission, and ICU admission. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from the logistic regression models. The Kruskal-Wallis test was used to compare the hospital and ICU LOS based on surgery overall, and by GCS and ISS.Results:42,003 patients were identified, 9,187 had surgery with overall mortality rate of 0.7%. There was a younger operative median age (67) and interquartile range (IQR: 47, 78) than non-operative group (73, IQR: 56, 83). Both had the same median ISS score (10). Surgery was associated with lower rates of mortality, from 0.1% to 0.9% mortality for non-operative. Mild or moderate GCS mortality improved operative (0.07%) to non-operative (0.23%). Severe GCS patients with surgery had significantly improved mortality rates patients without (0.29% vs 7.69%, respectively). Surgery increased ICU admissions for every ISS category. Severe GCS had higher chances of ICU admission, but no interaction with surgery. Operative patients had longer hospital and ICU stays. For all GCS and ISS categories, hospital and ICU LOS was longer for operative patients.Conclusions:This review demonstrates significant improvement in mortality with operative management. Standard non-operative management of type I and III C2 fractures is appropriate. Surgeons should consider operating on type II odontoid fractures unless patient cannot undertake the surgical risks of induction with general anesthesia.Level of evidence: Level IV
Diethylcarbamazine, TRP channels and Ca2+ signaling in cells of the Ascaris intestine
Authors: Williams Paul D. E. , Kashyap Sudhanva S. , McHugh Mark A. , Robertson Alan P. , Martin Richard J. 
Published: February 2022

Abstract
The nematode parasite intestine absorbs nutrients, is involved in innate immunity, can metabolize xenobiotics and as we show here, is also a site of action of the anthelmintic, diethylcarbamazine. Diethylcarbamazine (DEC) is used to treat lymphatic filariasis and activates TRP-2, GON-2 & CED-11 TRP channels in Brugia malayi muscle cells producing spastic paralysis. DEC also has effects on ascarid nematode parasites. Using PCR techniques, we detected, in A. suum intestine, message for: Asu-trp-2, Asu-gon-2, Asu-ced-11, Asu-ocr-1, Asu-osm-9 and Asu-trpa-1. Comparison of amino-acid sequences of the TRP channels of B. malayi, and A. suum revealed noteworthy similarity, suggesting that the intestine of Ascaris will also be sensitive to DEC. We used Fluo-3AM as a Ca2+ indicator and observed characteristic unsteady time-dependent increases in the Ca2+ signal in the intestine in response to DEC. Application of the TRP channel inhibitor, 2APB, prevented DEC mediated increases in intracellular Ca2+. These observations are important because they emphasize that the nematode intestine, in addition of muscle, is a site of action of DEC as well as other anthelmintics. DEC may also enhance the Ca2+ toxicity effects of other anthelmintics acting on the intestine or, increase the effects of other anthelmintics that are metabolized and excreted by the nematode intestine.
Young Children with A Minor Traumatic Head Injury: Clinical Observation or CT Scan?
Authors: Niele Nicky , Plötz Frans B. , Tromp Ellen , Boersma Bart , Biezeveld Maarten , Douma Matthijs , Heitink Katja , Tusscher Gavin ten , Goudoever Hans B. van , Houten Marlies A. van 
Published: February 2022

Abstract
Purpose: In young children with minor traumatic head injuries (MTHI) classified as intermediate risk (IR) either clinical observation or computed tomography (CT) scan is recommended. In this study we describe clinicians’ choice and which factors contribute to this decision. Methods: This was a planned sub-study of a prospective multicentre observational study that enrolled 1,006 children younger than 18 years with MTHI who presented to six emergency departments in The Netherlands. Results: Of those, 280 children classified as IR group fulfilling one or more minor criteria, leaving the clinician with the choice between clinical observation or a CT scan. In our cohort 228/280 (81,4%) children were admitted for clinical observation, 15/280 (5,4%) received a CT scan, 6/280 (2,1%) received a CT scan and were admitted for observation, and 31/280 (11,1%) children were discharged from the emergency department without any intervention. Three objective factors were found in favour for a CT scan; namely age above two years, the presence of any loss of consciousness (LOC) and presentation on weekend days. Conclusion: In children with MTHI in an IR group, clinicians prefer clinical observation above performing a CT scan.
Lignin ammoxidation: Synthesis of nitrogen releasing soil conditioning products from waste pulp liquor and their pot trial evaluation
Authors: Tyhoda Luvuyo , Ngiba Qiniso , Görgens Johann F. 
Published: February 2022

Abstract
Purpose This study investigated the ammoxidation of three industrial lignins of which two were respectively precipitated from kraft and soda liquors, and the third one, a filtered sodium lignosulfonate for the synthesis of soil conditioning materials.Method The industrial lignins were characterized for structural properties and ammoxidized in a 1 L Parr reactor at 80 oC, 10 barg, for 4 hours, with 7 wt. % ammonia and 10 wt. % lignin in the reaction mixture. A plant trial assessment of the products was conducted over four weeks.Results N-lignins with C/N ratios of 12.30, 15.81, and 14.64 were obtained from kraft, soda and sodium lignosulfonate against a standard requirement of a C/N < 20. However, soda lignin and sodium lignosulfonate could not meet the criteria for N-lignins (C/N < 20) under standard reaction conditions, requiring an additional pre-oxidation with 5% hydrogen peroxide prior to ammoxidation. In the plant trial, N-modified kraft (3.50 t/ha) and soda lignin (3.21 t/ha) recorded crop yields that were 71% and 57% higher than the control (2.04 t/ha), respectively. The sodium lignosphonate, while it met the requirements for use as a soil fertilizing material in terms of nitrogen content, resulted in complete crop failure. Further characterization showed that due to its high pH (8.81 pH) and a high salt index (63.62%) due to the pulping technique used in its isolation, was unsuitable as a raw material for soil fertilizing materials.Conclusion Kraft and soda lignins could be successfully ammoxidized to synthesize N-lignins that are suitable for use as soil conditioning materials.
Non-invasive Measurement of Hemoglobin for Rural India using Artificial Intelligence
Authors: Mude Shoban 
Published: February 2022

Abstract
The body sensor networks includes the nodes of ECG and PPG sensors, with the aim to investigate a novel technique for cuffless Blood Pressure estimation with better exactness. The sensor networks performance in the BSN, correlates various PTTs determined from ECG and PPG, with the reference BP recorded at various postures. The outcome shows that SBP and DBP have better connection with PTTs determined ECG to PPG sensors. The interesting thing is values of PTT acquired from ECG to PPG sensor at fingertip are better when compared with regular methods. Later this circuit is embedded with Bluetooth module and monitors fully automatic and continuous measurement Blood Pressure, SpO2 and Hemoglobin.
Global Mapping of Optometry Workforce
Authors: Naidoo Kovin , Govender-Poonsamy Pirindhavellie , Morjaria Priya , Block Sandra S , Chan Ving Fai , Yong Ai Chee , Bilotto Luigi 
Published: February 2022

Abstract
BACKGROUND:The growing global burden of vision impairment makes it imperative that there are appropriately trained human resources. Optometrists play a critical role in alleviating this burden, but the low number of optometrists available or the numbers in different countries has always been a challenge for eye care planning. Despite this, there have been limited studies conducted to quantify the deficits in the number of optometrists globally. Methods:A standardised English language questionnaire was used in this cross-sectional study to determine the number and distribution of optometrists globally between February 2017 and May 2020. The survey was translated where necessary and completed by key informants. Using the World Council of Optometry’s scope of practice guidelines, optometrists were defined at levels 2 to 4. Optometrist-to-population ratios were calculated for all countries and regions and compared to targets of 1:50 000 (in developing contexts) or 1:10 000 (in developed contexts).Results:An overall response rate of 80.9% was achieved with responses from 123 of the 152 countries invited. Most (40.7%) key informants were academics. The total number of optometrists across 21 Global Burden of Disease (GBD) regions was 331,781 as of 2019. Sixty-six (53.7%) of 123 countries met the 1:50,000 Optometrist-to-population ratio. A strong (r=0.7) direct positive relationship existed between age-standardised prevalences of blindness and mild- and severe-vision impairment and optometrist-to-population ratios. Strong inverse relationships were observed between country GDP and optometrist-to-population ratio.Conclusion:High-income countries met the target for optometrist-to-patient ratios, while low-to-, middle-income countries and low-income countries did not meet the targets. Low optometrist-to-patient ratios were strongly associated with a higher magnitude of blindness and vision impairment.
Asterarcys quadricellulare (Chlorophyceae) protects H9c2 cardio-myoblasts from H2O2-induced oxidative stress
Authors: Saadaoui Imen , Bounnit Touria , Mraiche Fatima , Joseph Jensa M. , Cherif Maroua , Jabri Hareb Al 
Published: February 2022

Abstract
Oxidative stress is recently identified as an important mediator of cardiovascular diseases. The need to find efficient antioxidant molecules is essential in the disease’s prevention. Therefore, the present study aimed to evaluate the potential of microalgae bioactive in protecting H9c2 cardiomyo-blasts from H2O2-induced oxidative stress. Four microalgal species were investigated for their antiox-idant capacity. A qualitative assessment of oxidative stress in H9c2 cardiomyoblasts stained with DCFH-DA, treated with the highly active microalgae extracts, was performed. The protein expression of total caspase-3 was also examined to investigate whether extract protects H9c2 cardimyoblasts from H2O2-induced apoptosis. High antioxidant activity was observed for the hexanoic extracts after 10 days of cultivation. Asterarcys quadricellulare exhibited the highest antioxidant capacity of 110.59 ± 1.75 mg TE g−1 dry weight and was tested against H9c2 cardiomyoblasts, which were initially subjected to H2O2-induced oxidative stress. This hexanoic extract protected against H2O2 induced oxida-tive stress with a similar scavenging capacity as N-Acetylcysteine. Furthermore, total caspase-3, was increased following treatment with the hexanoic extract, suggesting that A. quadricellulare also had anti-apoptotic properties. The outcome of our study highlighted the possible use of the local A. quadricellulare strain QUCCCM10 as a natural, safe, and efficient antioxidant to prevent cardiovascular diseases.
Production and Partial Purification of Pectinases Produced by Three Novel Cladosporium Species Isolated from Egypt
Authors: Moharram Ahmed Mohamed , Zohri Abdel-Naser Ahmed , Hesham Abd El-Latif , Maher Mohamed Al-Amin , Al-Bedak Osama Abdel-Hafeez 
Published: February 2022

Abstract
Based on phenotypic characters and sequencing of the internal transcribed spacers (ITS), 28S Large Subunit (LSU) and partial actin (ACT), three novel species of Cladosporium were described in this study as C. parasphaerospermum, C. chlamydosporum, and C. compactisporum. Activities of pectinases produced by the three strains were 5700, 3720, and 3480 U mg− 1 enzymes, at the optimum pH (6.0, 7.0, and 8.0) and temperature (35, 30, and 35 ºC), respectively. The ions potassium and manganese had a strong activating impact on the activity of C. compactisporum pectinase (124.4 and 172%, respectively). When tested under optimal conditions, EDTA and the other metal ions inhibited the activity of the pectinases in varied degrees. The strongest inhibitory effects of C. parasphaerospermum, C. chlamydosporum, and C. compactisporum pectinases were with Ni+ 2, Zn+ 2, and EDTA, respectively. Cladosporium species have a long history of biotechnological uses, and here we add another: pectinase makers. We offer three unique suppliers of low-temperature active fungal pectinases for biotechnological applications such as the management of Pectinacious wastes in the juice industry.
International registry of congenital porto-systemic shunts A multi-centre, retrospective and prospective registry of neonates, children and adults with congenital porto-systemic shunts
Authors: KORFF Simona , Mostaguir Khaled , Beghetti Maurice , D’Antiga Lorenzo , Debray Dominique , Franchi-Abella Stéphanie , Gonzales Emmanuel , Guerin Florent , Hachulla Anne-Lise , Lambert Virginie , Makrythanasis Periklis , Roduit Nicolas , Savale Laurent , Senat Marie-Victoire , Spaltenstein Joël , Steenbeek Frank van , Wildhaber Barbara E. , Zwahlen Marcel , McLin Valérie A. 
Published: February 2022

Abstract
Background: Congenital portosystemic shunts (CPSS) are rare vascular malformations associated with the risk of life-threatening systemic conditions, which remain underdiagnosed and often are identified after considerable diagnostic delay. CPSS are characterized by multiple signs and symptoms, often masquerading as other conditions, progressing over time if the shunt remains patent. Which patients will benefit from shunt closure remains to be clarified, as does the timing and method of closure. In addition, the etiology and pathophysiology of CPSS are both unknowns. This rare disorder needs the strength of numbers to answer these questions, which is the purpose of the international registry of CPSS (IRCPSS). Method: A retrospective and prospective registry was designed using secuTrial® by the ISO certified Clinical Research Unit. Given that a significant number of cases entered in the registry are retrospective, participants have the opportunity to use a semi-structured minimal or complete data set to facilitate data entry. In addition, the design allows subjects to be entered into the IRCPSS according to clinically relevant events. Emphasis is on longitudinal follow-up of signs and symptoms, which is paramount to garner clinically relevant information to eventually orient patient management. The IRCPSS includes also three specific forms to capture essential radiological, surgical, and cardiopulmonary data as many times as relevant, which are completed by the specialists themselves. Finally, connecting the clinical data registry with a safe image repository, using state-of-the-art pseudonymization software, was another major focus of development. Data quality and stewardship is ensured by a steering committee. All centers participating in the IRCPSS have signed a memorandum of understanding and obtained their own ethical approval. Conclusion: Through state-of-the-art management of data and imaging, we have developed a practical, user-friendly, international registry to study CPSS in neonates, children, and adults. Via this multicenter and international effort, we will be ready to answer meaningful and urgent questions regarding the management of patients with CPSS, a condition often ridden with significant diagnostic delay contributing to a severe clinical course. We look forward to working with an ever expanding network of collaborators.