bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening of Common Retinal Diseases Using Six-Category Models Based on EfficientNet
Authors: Zhu Shaojun , Lu Bing , Wang Chenghu , Wu Maonian , Zheng Bo , Jiang Qin , Wei Ruili , Cao Qixin , Yang Weihua 
Published: February 2022

PurposeA six-category model of common retinal diseases is proposed to help primary medical institutions in the preliminary screening of the five common retinal diseases.MethodsA total of 2,400 fundus images of normal and five common retinal diseases were provided by a cooperative hospital. Two six-category deep learning models of common retinal diseases based on the EfficientNet-B4 and ResNet50 models were trained. The results from the six-category models in this study and the results from a five-category model in our previous study based on ResNet50 were compared. A total of 1,315 fundus images were used to test the models, the clinical diagnosis results and the diagnosis results of the two six-category models were compared. The main evaluation indicators were sensitivity, specificity, F1-score, area under the curve (AUC), 95% confidence interval, kappa and accuracy, and the receiver operator characteristic curves of the two six-category models were compared in the study.ResultsThe diagnostic accuracy rate of EfficientNet-B4 model was 95.59%, the kappa value was 94.61%, and there was high diagnostic consistency. The AUC of the normal diagnosis and the five retinal diseases were all above 0.95. The sensitivity, specificity, and F1-score for the diagnosis of normal fundus images were 100, 99.9, and 99.83%, respectively. The specificity and F1-score for RVO diagnosis were 95.68, 98.61, and 93.09%, respectively. The sensitivity, specificity, and F1-score for high myopia diagnosis were 96.1, 99.6, and 97.37%, respectively. The sensitivity, specificity, and F1-score for glaucoma diagnosis were 97.62, 99.07, and 94.62%, respectively. The sensitivity, specificity, and F1-score for DR diagnosis were 90.76, 99.16, and 93.3%, respectively. The sensitivity, specificity, and F1-score for MD diagnosis were 92.27, 98.5, and 91.51%, respectively.ConclusionThe EfficientNet-B4 model was used to design a six-category model of common retinal diseases. It can be used to diagnose the normal fundus and five common retinal diseases based on fundus images. It can help primary doctors in the screening for common retinal diseases, and give suitable suggestions and recommendations. Timely referral can improve the efficiency of diagnosis of eye diseases in rural areas and avoid delaying treatment.
Physiological Changes in Subjects Exposed to Accidental Hypothermia: An Update
Authors: Bjertnæs Lars J. , Næsheim Torvind O. , Reierth Eirik , Suborov Evgeny V. , Kirov Mikhail Y. , Lebedinskii Konstantin M. , Tveita Torkjel 
Published: February 2022

BackgroundAccidental hypothermia (AH) is an unintended decrease in body core temperature (BCT) to below 35°C. We present an update on physiological/pathophysiological changes associated with AH and rewarming from hypothermic cardiac arrest (HCA).Temperature Regulation and MetabolismTriggered by falling skin temperature, Thyrotropin-Releasing Hormone (TRH) from hypothalamus induces release of Thyroid-Stimulating Hormone (TSH) and Prolactin from pituitary gland anterior lobe that stimulate thyroid generation of triiodothyronine and thyroxine (T4). The latter act together with noradrenaline to induce heat production by binding to adrenergic β3-receptors in fat cells. Exposed to cold, noradrenaline prompts degradation of triglycerides from brown adipose tissue (BAT) into free fatty acids that uncouple metabolism to heat production, rather than generating adenosine triphosphate. If BAT is lacking, AH occurs more readily.Cardiac OutputAssuming a 7% drop in metabolism per °C, a BCT decrease of 10°C can reduce metabolism by 70% paralleled by a corresponding decline in CO. Consequently, it is possible to maintain adequate oxygen delivery provided correctly performed cardiopulmonary resuscitation (CPR), which might result in approximately 30% of CO generated at normal BCT.Liver and CoagulationAH promotes coagulation disturbances following trauma and acidosis by reducing coagulation and platelet functions. Mean prothrombin and partial thromboplastin times might increase by 40–60% in moderate hypothermia. Rewarming might release tissue factor from damaged tissues, that triggers disseminated intravascular coagulation. Hypothermia might inhibit platelet aggregation and coagulation.KidneysRenal blood flow decreases due to vasoconstriction of afferent arterioles, electrolyte and fluid disturbances and increasing blood viscosity. Severely deranged renal function occurs particularly in the presence of rhabdomyolysis induced by severe AH combined with trauma.ConclusionMetabolism drops 7% per °C fall in BCT, reducing CO correspondingly. Therefore, it is possible to maintain adequate oxygen delivery after 10°C drop in BCT provided correctly performed CPR. Hypothermia may facilitate rhabdomyolysis in traumatized patients. Victims suspected of HCA should be rewarmed before being pronounced dead. Rewarming avalanche victims of HCA with serum potassium &gt; 12 mmol/L and a burial time &gt;30 min with no air pocket, most probably be futile.
Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study
Authors: Li Xiaodong , Li Zhonglin , Zou Zhi , Wu Xiaolin , Gao Hui , Wang Caiyun , Zhou Jing , Qi Fei , Zhang Miao , He Junya , Qi Xin , Yan Fengshan , Dou Shewei , Zhang Hongju , Tong Li , Li Yongli 
Published: February 2022

BackgroundChronic insomnia disorder (CID) is considered a major public health problem worldwide. Therefore, innovative and effective technical methods for studying the pathogenesis and clinical comprehensive treatment of CID are urgently needed.MethodsReal-time fMRI neurofeedback (rtfMRI-NF), a new intervention, was used to train 28 patients with CID to regulate their amygdala activity for three sessions in 6 weeks. Resting-state fMRI data were collected before and after training. Then, voxel-based degree centrality (DC) method was used to explore the effect of rtfMRI-NF training. For regions with altered DC, we determined the specific connections to other regions that most strongly contributed to altered functional networks based on DC. Furthermore, the relationships between the DC value of the altered regions and changes in clinical variables were determined.ResultsPatients with CID showed increased DC in the right postcentral gyrus, Rolandic operculum, insula, and superior parietal gyrus and decreased DC in the right supramarginal gyrus, inferior parietal gyrus, angular gyrus, middle occipital gyrus, and middle temporal gyrus. Seed-based functional connectivity analyses based on the altered DC regions showed more details about the altered functional networks. Clinical scores in Pittsburgh sleep quality index, insomnia severity index (ISI), Beck depression inventory, and Hamilton anxiety scale decreased. Furthermore, a remarkable positive correlation was found between the changed ISI score and DC values of the right insula.ConclusionsThis study confirmed that amygdala-based rtfMRI-NF training altered the intrinsic functional hubs, which reshaped the abnormal functional connections caused by insomnia and improved the sleep of patients with CID. These findings contribute to our understanding of the neurobiological mechanism of rtfMRI-NF in insomnia treatment. However, additional double-blinded controlled clinical trials with larger sample sizes need to be conducted to confirm the effect of rtfMRI-NF from this initial study.
Decreased Risk of Anxiety in Diabetic Patients Receiving Glucagon-like Peptide-1 Receptor Agonist: A Nationwide, Population-Based Cohort Study
Authors: Tsai Wen-Hsuan , Sung Fung-Chang , Chiu Lu-Ting , Shih Ying-Hsiu , Tsai Ming-Chieh , Wu Shu-I 
Published: February 2022

Background: Previous findings on using Glucagon-like peptide-1 receptor agonist (GLP1-RA) as an antidepressant were conflicting, lacking large-scale studies. We used population-based data to investigate depression and anxiety risk in diabetic patients receiving the medication.Methods: From claims records of the National Health Insurance Research Database (NHIRD) of Taiwan, we identified cohorts of 10,690 GLP1-RA users and 42,766 propensity score-matched patients without GLP1-RA use from patients with diabetes mellitus (DM) diagnosed in 2011–2017, matched by age, gender, index year, occupation, urbanization, comorbidities, and medications. Incidence, hazard ratios (HR) and 95% confidence interval (CI) of depression and/or anxiety were estimated by the end of 2017.Results: The overall combined incidence of anxiety and/or depression was lower in GLP1-RA users than in non-users (6.80 versus 9.36 per 1,000 person-years), with an adjusted HR adjusted hazard ratio (aHR) of 0.8 (95% CI: 0.67–0.95) after controlling for covariates. The absolute incidence reduction was greater in anxiety (2.13 per 1,000 person-years) than in depression (0.41 per 1,000 person-years). The treatment effectiveness was significant for women. Patients taking GLP1-RA for longer than 180 days had the incidence of anxiety reduced to 2.93 per 1,000 person-years, with an aHR of 0.41 (95%CI: 0.27–0.61), compared to non-users. Dulaglutide could significantly decrease risks of both anxiety and depression.Conclusion: Patients with DM receiving GLP1-RA therapy have a greater reduction of the risk of anxiety than that of depression. Our findings strengthen previous research that advocated possible anti-depressant or anxiolytic effects of GLP1-RA and may lead to improved treatment adherence among patients with DM.
The Role of Trabectedin in Soft Tissue Sarcoma
Authors: Nakamura Tomoki , Sudo Akihiro 
Published: February 2022

Background: Systemic chemotherapy for advanced disease is another therapeutic option in the management of metastases in soft tissue sarcoma (STS). Doxorubicin either alone or in combination with ifosfamide has been used as first-line chemotherapy. Furthermore, in the past decade, new drugs have been shown to be effective in the treatment of advanced STS after the failure of first-line anthracycline-based chemotherapy: trabectedin, pazopanib and eribulin. However, the appropriate usage of these agents has not been established.Methods: We summarized clinical trials of trabectedin focusing on the efficacy and toxicity of trabectedin in the treatment of STS.Results: Trabectedin can be administered safely and effectively to the patients with advanced STS at second line setting or later. Although trabectedin may be effective as first-line treatment in selected patients, anthracycline-based chemotherapy should be recommended because no regimen in addition to trabectedin has proved to be unequivocally superior to doxorubicin as the first-line treatment for locally advanced or metastatic STS. Nucleotide excision repair (NER) and homologous recombination (HRe) repair may be of particular importance as efficacy of trabectedin.Conclusion: Trabectedin has shown a favorable toxicity profile and is an alternative therapeutic option in patients with advanced STS.
Effect of Information Framing on Wearing Masks During the COVID-19 Pandemic: Interaction With Social Norms and Information Credibility
Authors: Peng Lihong , Jiang Hao , Guo Yi , Hu Dehua 
Published: February 2022

ObjectiveThe main objectives of this study were to use the effect of information framing (different expressions of the same issue, e.g., positive messages and negative messages) to explore key factors that influence the attitude of and intention of the public toward wearing masks and to understand the internal and external factors of intervention on information framing perception.MethodsThis study performed an online questionnaire survey to explore the influence of demographic characteristics, information framing, social norms, and information credibility on the attitude of the public toward masks and their intention to wear them.Results(1) Information framing had a significant impact on the attitudes of people toward masks and their intention to wear them, and the persuasion effect of gain-framed messages was higher than that of loss-framed messages. (2) Gender, income, occupation, educational background, and residence have no significant difference in attitude and intention to wear masks. There was a significant correlation between age and wearing of masks (p = 0.041 &lt; 0.05). (3) Social norms affected people's perception of information framing and their attitude toward wearing masks, but only the impact of loss-framed messages on intention was significant. (4) Information framing affected people's perception of information credibility, which had a positive impact on their intention to wear masks; however, information credibility only had a significant impact on attitude toward wearing masks under the gain-framed messages and played an intermediary role.ConclusionThe impact of information framing on the attitude of people toward masks and their intention to wear them varies. Individuals involved in the publicity of health information related to this issue should pay attention to the influence of information framing and content on the public wearing masks as a means of enhancing public health awareness.
Advance Directives: Knowledge of the Topic Among Psychiatrists
Authors: Domingues Vania Novelli , Castro Luísa , Monteiro Monica Domingues , Cordero da Silva José Antonio , Rego Francisca , Rego Guilhermina 
Published: February 2022

ObjectiveAdvance directives are becoming increasingly important as health technologies evolve. We sought to assess psychiatrists' knowledge of advance directives, as this knowledge is fundamental to the implementation and drafting of these personal documents.MethodsA previously published questionnaire that evaluated the knowledge of medical professors was used. The sample, composed of psychiatrists from Rio de Janeiro, Brazil, originated from a publicly available list. During the search process, the COVID-19 pandemic affected Brazil and the rest of the world, which influenced our methodology and results.ResultsA total of 40 psychiatrists participated in the study. The results obtained, although not significant, suggested that psychiatrists with an increased time of practice had more knowledge of advance directives. Nevertheless, less than half of the participants had knowledge about this topic.ConclusionThe number of psychiatrists surveyed indicates the need for further studies on the subject. The influence of the COVID-19 pandemic on this study led to findings such as a change in sensitivity when addressing the topic and greater difficulty in contacting professionals.
Explore the Application Value of Prospective Monitoring Model in the Nursing Management of Breast Cancer Patients During Perioperative Period
Authors: Zhang Huan , Duan Yu , Zhou Fengming 
Published: February 2022

PurposeTo explore the application value of prospective monitoring model in the nursing management of breast cancer patients during perioperative period.Methods300 perioperative breast cancer patients admitted to our hospital from January to August 2021 were randomly divided into the control group (n = 150) and the model group (n = 150). Both groups used routine nursing management, and the model group added nursing management based on a prospective monitoring model. The quality of surgical nursing, circumference of the upper limbs, and the scores of disability of arm-shoulder-hand (DASH), exerciseofself-care agencyscale (ESCA), social self-esteem scale (SSES), multidimensional fatigue symptom inventory-short form (MFSI-SF) and functional assessment of cancer therapy-breast cancer (FACT-B) were compared of the two groups.ResultsPostoperatively, the quality of surgical nursing was better in the model group than in the control group (P &lt; 0.05). At 3 months postoperatively, the number of cases of upper limb lymphedema was higher in both groups than before (P &lt; 0.05), but there was no statistical difference between the two groups in the preoperative and 3 months postoperative comparisons (P &gt; 0.05). At 3 months postoperatively, the total DASH score was higher than preoperatively in both groups, but lower in the model group than in the control group (P &lt; 0.05). After nursing, the ESCA and SSES scores of each dimension were higher in both groups than before, and the model group was higher than the control group (P &lt; 0.05). At 3 months postoperatively, the total MFSI-SF score was lower than preoperatively in both groups, and lower in the model group than in the control group (P &lt; 0.05). At 3 months postoperatively, the FACT-B scores of each dimensions were higher in the model group than in the control group (P &lt; 0.05).ConclusionThe implementation of nursing management based on a prospective monitoring model for breast cancer patients during the perioperative period has important clinical value in improving the quality of surgical nursing and improving postoperative upper limb lymphedema, upper limb function, self-care ability, social self-esteem, cancer-related fatigue symptoms, quality of life, etc.
Neotropical Studies on Hymenochaetaceae: Unveiling the Diversity and Endemicity of Phellinotus
Authors: Salvador-Montoya Carlos A. , Elias Samuel G. , Popoff Orlando F. , Robledo Gerardo L. , Urcelay Carlos , Góes-Neto Aristóteles , Martínez Sebastián , Drechsler-Santos Elisandro R. 
Published: February 2022

Phellinotus, a neotropical genus of wood-decay fungi commonly found on living members of the Fabaceae family, was initially described as containing two species, P. neoaridus and P. piptadeniae. The members of this genus, along with six other well-established genera and some unresolved lineages, are the current representatives of the ‘phellinotus clade’. On the other hand, based on a two-loci phylogenetic analysis, some entities/lineages of the ‘phellinotus clade’ have been found in Fomitiporella s.l. In this work, we performed four-loci phylogenetic analyses and based on our results the genera of the ‘phellinotus clade’ are shown to be monophyletic groups. In addition to the natural groups confirmed as different genera, morphological revisions, phylogenetic relationships, and host distribution of different specimens resembling P. neoaridus and P. piptadeniae revealed three new species in the Phellinotus genus, referred to here as P. magnoporatus, P. teixeirae and P. xerophyticus. Furthermore, for P. piptadeniae a narrower species concept was adopted with redefined morphological characters and a more limited distribution range. Both P. neoaridus and P. teixeirae have a distribution range restricted to seasonally dry tropical forests in South America. Additionally, based on detailed morphological revisions Phellinus badius, Phellinus resinaceus, and Phellinus scaber are transferred to the Phellinotus genus. The geographic distribution and host range of the genus are then discussed.
Concerns regarding tablet splitting: a systematic review
Authors: Saran Aanchal K , Holden Natalie A , Garrison Scott R 
Published: February 2022

BackgroundTablet splitting can provide dose flexibility and cost savings; however, pharmaceutical representatives typically discourage the practice.AimTo identify and summarise all published concerns related to tablet splitting and to present the experimental evidence that investigates those concerns.Design & settingSystematic review and qualitative synthesis of tablet-splitting concerns and evidence.MethodMedline and EMBASE databases were searched over all years of publication for articles in English discussing the splitting of tablets. Eligible articles included original research, narrative reviews, systematic reviews, and expert opinion.ResultsAfter removing duplicates, 1837 potentially relevant articles underwent dual review, whereupon 1612 articles were excluded based on title and abstract. After examination of 225 full texts, 138 articles were included (one systematic review, four narrative reviews, 101 original research articles, and 32 opinion articles). The described concerns included difficulty breaking tablets, loss of mass, weight variability, chemical instability, overly rapid dosing if sustained-release medications are split, non-compliance, and patient confusion resulting in medication errors. No substantive evidence was found to support concerns regarding loss of mass, weight variability, chemical instability, or non-compliance. Evidence does support some older adults struggling to split tablets without tablet splitters, and the inappropriateness of splitting sustained-release preparations, given the potential for alteration of the rate of drug release for some products.ConclusionWith the exception of sustained-release tablets, which should not be split, and excepting those older people who may struggle to split tablets based on physical limitations, there is little evidence to support tablet-splitting concerns.
The Rise of China’s Influence in Melanesian Spearhead Group (MSG): Threat to Indonesia’s Border Issues
Authors: Prakoso Septyanto Galan , Surya Negara Rameez Ali , Reynaldi Rheyno , Ahmad Damar Priambodo , Sayekti Niki Wahyu 
Published: February 2022

This article or writing aims to discuss the rising influence of China over the Melanesian Spearhead Group (MSG) which could become a potential threat to Indonesia. It was worth to note that MSG has been involved directly to the effort for West Papua. Meanwhile, Indonesia and China relation has a strained relation in the South China Sea dispute. Hence, Indonesia is now facing two problems at once, one on the northern side of its border and the other one on the eastern side of its border. The problem is focused on how China can use the West Papua issue to pressure Indonesia regarding the South China Sea dispute by using their influence over the MSG countries. The analysis conducted in this research will analyze and explain the situation faced by the Indonesian government based on the facts. In order to approach this problem the theory of Hegemony is used. The data is collected through library research and analyzed qualitatively. This study concludes that due to China’s rising influence on the MSG, China had the much-needed leverage on Indonesia in South China Sea dispute and Indonesia is at the disadvantaged position where it has to face two problems at once those are regarding West Papua and South China Sea.