bluuebunny/crossref_metadata_2025_split huggingface dataset:
School Performance After Pediatric Intensive Care—Association of Mental Well-Being, Chronic Illnesses, and Family Socioeconomic Status
Authors: Kyösti Elina , Peltoniemi Outi , Liisanantti Janne H. , Ohtonen Pasi , Ebeling Hanna , Spalding Michael , Rautiainen Paula , Kataja Janne , Ala-Kokko Tero I. 
Published: August 2020

Objectives:
To describe school performance in pediatric intensive care survivors, as well as the influence of chronic diseases, psychological well-being, and family socioeconomic status on poor school performance.

Design:
Register-based observational descriptive follow-up study.

Setting:
A multicenter national study.

Patients:
All pediatric patients who were admitted to an ICU in Finland in 2009–2010. Children and adolescents of or beyond school age.

Interventions:
None.

Measurements and Main Results:
Questionnaires regarding the child’s coping in school classes, chronic illnesses, as well as family socioeconomic factors were sent to every child alive 6 years after discharge from intensive care in Finland. Mental well-being was measured with the Strengths and Difficulties Questionnaire. There were 1,109 responders in an ICU group of 3,674 children. Seven-hundred fifty-three of the respondents were of school age or older. Of these, 13% (101/753) demonstrated poor school performance. Children with difficulties in school more often had a need for regular medication (71.3% vs 32.4%; p < 0.001), healthcare visits (91.1% vs 80.6%; p = 0.01), some regular therapy (60.4% vs 13.7%; p < 0.001), chronic illnesses (86.3% vs 48.4%; p < 0.001), or additional ICU admissions (36.5% vs 14.9%; p = 0.003). Schooling difficulties were reported more often in children with abnormal Strengths and Difficulties Questionnaire scores compared to those with normal or borderline scores (24.8% vs 5.4%; p < 0.001). In an adjusted logistic regression model, which included age, number of chronic diseases, and need for therapy, poor school performance was predicted by abnormal Strengths and Difficulties Questionnaire scores, nonacademic parental education, and paternal manual labor status.

Conclusions:
Difficulties in school were more frequent when the child had chronic comorbid illnesses, especially neurologic or chromosomal abnormalities, had poor mental health, father was employed in manual labor, or parents were uneducated.
Voluntary Separations and Workforce Planning: How Intent to Leave Public Health Agencies Manifests in Actual Departure in the United States
Authors: Leider Jonathon P. , Sellers Katie , Bogaert Kyle , Liss-Levinson Rivka , Castrucci Brian C. 
Published: August 2020

Objectives:
To ascertain levels of turnover in public health staff between 2014 and 2017 due to retirement or quitting and to project levels of turnover for the whole of the state and local governmental public health in the United States nationally.

Design:
Turnover outcomes were analyzed for 15 128 staff from public health agencies between 2014 and 2017. Determinants of turnover were assessed using a logit model, associated with actually leaving one's organization. A microsimulation model was used to project expected turnover onto the broader workforce.

Results:
Between 2014 and 2017, 33% of staff left their agency. Half of the staff who indicated they were considering leaving in 2014 had done so by 2017, as did a quarter of the staff who had said they were not considering leaving. Staff younger than 30 years constituted 6% of the workforce but 13% of those who left (P < .001).

Conclusions:
Public health agencies are expected to experience turnover in 60 000 of 200 000 staff positions between 2017 and 2020.

Implications:
As much as one-third of the US public health workforce is expected to leave in the coming years. Retention efforts, especially around younger staff, must be a priority. Succession planning for those retiring is also a significant concern.
Effects of Prism Adaptation on Unilateral Neglect After Stroke
Authors: Qiu Huaide , Wang Jiayue , Yi Wenchao , Yin Zhifei , Wang Hongxing , Li Jianan 
Published: August 2020

Objective
The aim of this study was to investigate the effects of prism adaptation (PA) on unilateral neglect after stroke.

Methods
Randomized clinical trials, published up to January 31, 2020, comparing PA with neutral goggles or no goggles were systematically searched and included. Two independent reviewers performed data extraction and assessed the quality of studies using the Physiotherapy Evidence Database scale.

Results
A total of seven randomized trials, involving 211 participants, satisfied the inclusion criteria. There was no significant immediate benefit of PA as measured by Behavioral Inattention Test (BIT) (weighted mean difference [WMD], 5.10; [95% confidence interval (CI), −6.68 to 16.88]), behavioral subset (BIT-B; WMD, 3.40 [95% CI, −3.97 to 10.76), conventional subset (BIT-C; WMD, 9.98 [95% CI, −0.42 to 20.38]), and Catherine Bergego Scale (WMD, −0.52 [95% CI, −1.98 to 0.93]). No statistical difference was observed between PA and control on the long-term effect (BIT: WMD, 1.92 [95% CI, −9.34 to 13.18]; BIT-B: WMD, −3.28 [95% CI, −11.89 to 5.34]; BIT-C: WMD, 2.66 [95% CI, −10.35 to 11.67]; Catherine Bergego Scale: WMD, −1.22 [95% CI, −3.05 to 0.62]).

Conclusions
PA did not show a greater improvement on neglect symptoms in post-stroke patients with unilateral neglect, compared with placebo or no treatment. These findings do not support the routine use of PA in patients with unilateral neglect after stroke.
The Essentials of Brain Anatomy for Physiatrists
Authors: Choo Yoo Jin , Boudier-Revéret Mathieu , Chang Min Cheol 
Published: August 2020

Abstract
Detailed knowledge of the brain anatomy is important for the treatment of patients with brain disorders. In this study, we conducted a review of essential parts of human brain anatomy based on magnetic resonance imaging of the brain. Using T2-weighted brain magnetic resonance imaging, we explained how to recognize several structures in each brain lobe (the frontal, parietal, temporal, and occipital lobes). We depicted the boundary of each structure on brain magnetic resonance imaging and described their functions. The limbic system controls various functions such as emotion, motivation, behavior, memory, and olfaction. Broca’s and Wernicke’s areas and arcuate fasciculus are important structures for human language functions. Emotion, memory, and language function are one of the main functions of human. Therefore, the anatomical knowledge of the limbic system and language-related structures is important for physiatrists. We described the anatomical location and function of each substructure of the limbic system and language centers. In addition, we indicated the exact points of motor- and sensory-related neural tracts (corticospinal tract, corticoreticular pathway, medial lemniscus, and spinothalamic tract) on brain magnetic resonance imaging. We believe that our review on brain anatomy would be helpful for physiatrists to accurately identify the damage of each function from brain disorders and elucidate proper plan for rehabilitative treatment.
Gray Matter Nucleus Hyperintensity After Monthly Triple-Dose Gadopentetate Dimeglumine With Long-term Magnetic Resonance Imaging
Authors: DeBevits John J. , Munbodh Reshma , Bageac Devin , Wu Rong , DiCamillo Paul A. , Hu Chaoran , Wang Lihong , Naismith Robert T. , Karimeddini David , Dhib-Jalbut Suhayl , Redko Sviatoslav , Cook Stuart D. , Cadavid Diego , Wolansky Leo 
Published: August 2020

Objectives
Gadolinium deposition is widely believed to occur, but questions regarding accumulation pattern and permanence remain. We conducted a retrospective study of intracranial signal changes on monthly triple-dose contrast-enhanced magnetic resonance imaging (MRI) examinations from the previously published Betaseron vs. Copaxone in Multiple Sclerosis With Triple-Dose Gadolinium and 3-Tesla MRI Endpoints Trial (N = 67) to characterize the dynamics of gadolinium deposition in several deep brain nuclei and track persistence versus washout of gadolinium deposition on long-term follow-up (LTFU) examinations (N = 28) obtained approximately 10 years after enrollment in the Betaseron vs. Copaxone in Multiple Sclerosis With Triple-Dose Gadolinium and 3-Tesla MRI Endpoints Trial.

Materials and Methods
Using T2 and proton density images and using image analysis software (ITK-SNAP), manual regions of interest were created ascribing boundaries of the caudate nucleus, dentate nucleus, globus pallidus, pulvinar, putamen, white matter, and air. Intensity analysis was conducted on T1-weighted fat-saturated (fat-sat) images using the FSL package. A linear rigid-body transform was calculated from the fat-sat image at each target time point to the region of interest segmentation reference time point fat-sat image. Serial MRI signal was analyzed using linear mixed regression modeling with random intercept. Annual MRI signal changes including LTFU scans were assessed with t test.

Results
During monthly scanning, all gray matter structures demonstrated a significant (P < 0.0001) increase in contrast-to-noise ratio. Yearly changes in deposition showed distinctive patterns for the specific nucleus: globus pallidus showed complete retention, pulvinar showed partial washout, while dentate, caudate, and putamen returned to baseline (ie, complete washout).

Conclusions
Monthly increased contrast-to-noise ratio in gray matter nuclei is consistent with gadolinium deposition over time. The study also suggests that some deep gray matter nuclei permanently retain gadolinium, whereas others demonstrate washout of soluble gadolinium.
A Solution for Homogeneous Liver Enhancement in Computed Tomography
Authors: Martens Bibi , Wildberger Joachim E. , Hendriks Babs M.F. , Van Kuijk Sander M.J. , Nijssen Estelle C. , Peters Nicky H.G.M. , De Vos-Geelen Judith , Mihl Casper 
Published: August 2020

Objectives
The aim of the study was to reach homogeneous enhancement of the liver, irrespective of total body weight (TBW) or tube voltage. An easy-to-use rule of thumb, the 10-to-10 rule, which pairs a 10 kV reduction in tube voltage with a 10% decrease in contrast media (CM) dose, was evaluated.

Materials and Methods
A total of 256 patients scheduled for an abdominal CT in portal venous phase were randomly allocated to 1 of 4 groups. In group 1 (n = 64), a tube voltage of 120 kV and a TBW-adapted CM injection protocol was used: 0.521 g I/kg. In group 2 (n = 63), tube voltage was 90 kV and the TBW-adapted CM dosing factor remained 0.521 g I/kg. In group 3 (n = 63), tube voltage was reduced by 20 kV and CM dosing factor by 20% compared with group 1, in line with the 10-to-10 rule (100 kV; 0.417 g I/kg). In group 4 (n = 66), tube voltage was decreased by 30 kV paired with a 30% decrease in CM dosing factor compared with group 1, in line with the 10-to-10 rule (90 kV; 0.365 g I/kg). Objective image quality was evaluated by measuring attenuation in Hounsfield units (HU), signal-to-noise ratio, and contrast-to-noise ratio in the liver. Overall subjective image quality was assessed by 2 experienced readers by using a 5-point Likert scale. Two-sided P values below 0.05 were considered significant.

Results
Mean attenuation values in groups 1, 3, and 4 were comparable (118.2 ± 10.0, 117.6 ± 13.9, 117.3 ± 21.6 HU, respectively), whereas attenuation in group 2 (141.0 ± 18.2 HU) was significantly higher than all other groups (P < 0.01). No significant difference in attenuation was found between weight categories 80 kg or less and greater than 80 kg within the 4 groups (P ≥ 0.371). No significant differences in subjective image quality were found (P = 0.180).

Conclusions
The proposed 10-to-10 rule is an easily reproducible method resulting in similar enhancement in portal venous CT of the liver throughout the patient population, irrespective of TBW or tube voltage.
Magnetization Transfer Imaging Predicts Porcine Kidney Recovery After Revascularization of Renal Artery Stenosis
Authors: Afarideh Mohsen , Jiang Kai , Ferguson Christopher M. , Woollard John R. , Glockner James F. , Lerman Lilach O. 
Published: August 2020

Objectives
Magnetization transfer imaging is a novel noninvasive tool for the detection of kidney fibrosis, but its association with kidney function and hemodynamics is unclear. Renovascular disease (RVD) associated with metabolic derangements elicits renal fibrosis and is often unresponsive to percutaneous transluminal angioplasty (PTRA), but tools to predict therapeutic success are unavailable. We hypothesized that magnetization transfer imaging predicts kidney recovery after PTRA in swine with unilateral RVD.

Materials and Methods
Stenotic kidney (STK) and contralateral kidney magnetization transfer ratios (MTRs; M
t/M
0) were measured at 3.0-T magnetic resonance imaging, at offset frequencies of 600 and 1000 Hz, before and 1 month post-PTRA in 7 RVD pigs. Stenotic kidney MTR was correlated to renal perfusion, renal blood flow (RBF), and glomerular filtration rate (GFR), determined using multidetector computed tomography and with ex vivo renal fibrosis (trichrome staining). Untreated RVD (n = 6) and normal pigs (n = 7) served as controls.

Results
Renovascular disease induced hypertension and renal dysfunction. Blood pressure and renal perfusion were unchanged post-PTRA, but GFR and RBF increased. Baseline cortical STK-MTR predicted post-PTRA renal perfusion and RBF, and MTR changes associated inversely with changes in perfusion and normalized GFR. Stenotic kidney MTR at 600 Hz showed closer association with renal parameters, but both frequencies predicted post-PTRA cortical fibrosis.

Conclusions
Renal STK-MTR, particularly at 600 Hz offset, is sensitive to hemodynamic changes after PTRA in swine RVD and capable of noninvasively predicting post-PTRA kidney perfusion, RBF, and fibrosis. Therefore, STK-MTR may be a valuable tool to predict renal hemodynamic and functional recovery, as well as residual kidney fibrosis after revascularization in RVD.
Measured Multipoint Ultra-High b-Value Diffusion MRI in the Assessment of MRI-Detected Prostate Lesions
Authors: Tavakoli Anoshirwan Andrej , Kuder Tristan Anselm , Tichy Diana , Radtke Jan Philipp , Görtz Magdalena , Schütz Viktoria , Stenzinger Albrecht , Hohenfellner Markus , Schlemmer Heinz-Peter , Bonekamp David 
Published: August 2020

Objectives
The aim of this study was to assess quantitative ultra-high b-value (UHB) diffusion magnetic resonance imaging (MRI)–derived parameters in comparison to standard clinical apparent diffusion coefficient (SD-ADC-2b-1000, SD-ADC-2b-1500) for the prediction of clinically significant prostate cancer, defined as Gleason Grade Group greater than or equal to 2.

Materials and Methods
Seventy-three patients who underwent 3-T prostate MRI with diffusion-weighted imaging acquired at b = 50/500/1000/1500s/mm2 and b = 100/500/1000/1500/2250/3000/4000 s/mm2 were included. Magnetic resonance lesions were segmented manually on individual sequences, then matched to targeted transrectal ultrasonography/MRI fusion biopsies. Monoexponential 2-point and multipoint fits of standard diffusion and of UHB diffusion were calculated with incremental b-values. Furthermore, a kurtosis fit with parameters D
app and K
app with incremental b-values was obtained. Each parameter was examined for prediction of clinically significant prostate cancer using bootstrapped receiver operating characteristics and decision curve analysis. Parameter models were compared using Vuong test.

Results
Fifty of 73 men (age, 66 years [interquartile range, 61–72]; prostate-specific antigen, 6.6 ng/mL [interquartile range, 5–9.7]) had 64 MRI-detected lesions. The performance of SD-ADC-2b-1000 (area under the curve, 0.82) and SD-ADC-2b-1500 (area under the curve, 0.82) was not statistically different (P = 0.99), with SD-ADC-2b-1500 selected as reference. Compared with the reference model, none of the 19 tested logistic regression parameter models including multipoint and 2-point UHB-ADC, D
app, and K
app with incremental b-values of up to 4000 s/mm2 outperformed SD-ADC-2b-1500 (all P's > 0.05). Decision curve analysis confirmed these results indicating no higher net benefit for UHB parameters in comparison to SD-ADC-2b-1500 in the clinically important range from 3% to 20% of cancer threshold probability. Net reduction analysis showed no reduction of MR lesions requiring biopsy.

Conclusions
Despite evaluation of a large b-value range and inclusion of 2-point, multipoint, and kurtosis models, none of the parameters provided better predictive performance than standard 2-point ADC measurements using b-values 50/1000 or 50/1500. Our results suggest that most of the diagnostic benefits available in diffusion MRI are already represented in an ADC composed of one low and one 1000 to 1500 s/mm2 b-value.
Added Value of CT Arterial Subtraction Images in Liver Imaging Reporting and Data System Treatment Response Categorization for Transcatheter Arterial Chemoembolization-Treated Hepatocellular Carcinoma
Authors: Huh Jimi , Kim Bohyun , Lee Jei Hee , Won Je Hwan , Kim Jinoo , Kwon Yohan , Kim Jai Keun 
Published: August 2020

Objectives
The aim of this study was to assess the benefit of adding arterial subtraction images from computed tomography (CT) to the Liver Imaging Reporting and Data System (LI-RADS) v2018 treatment response (LR-TR) categorization in patients treated with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

Materials and Methods
This retrospective study included 115 patients with 151 HCCs treated by TACE using an emulsion of doxorubicin and iodized oil who underwent multiphasic CT protocol that additionally generated arterial subtraction images based on nonrigid anatomic correction algorithm. Of 151 HCCs, 67 (44.4%) were viable and 84 (55.6%) were nonviable. Two independent readers assessed the per-lesion LR-TR categories in set 1 of multiphasic CT images alone and set 2 including both set 1 and CT arterial subtraction images, besides diagnostic confidence, and the quality of subtraction images. The sensitivity and specificity of LR-TR viable category between the sets were compared using the generalized estimating equation. Interobserver agreements of LR-TR categorization in each set and the quality of subtraction images were assessed by Cohen κ.

Results
The quality of subtraction images was mostly good to perfect (98.7%) with good interobserver agreement (κ = 0.71), and none were nondiagnostic. For detecting viable HCC, LR-TR viable category showed sensitivity of 53.7% to 56.7% and specificity of 96.4% to 98.8% in set 1. In comparison, set 2 showed significantly higher sensitivity of 88.1% to 89.6% (P < 0.002) and equivalent specificity of 94% to 95.2% (P > 0.13) for the same category. In sets 1 and 2, 31.3% to 34.3% and 9% to 10.4% of viable HCC were miscategorized as LR-TR nonviable, respectively. LR-TR equivocal category was less assigned in set 2 (1.3%) than in set 1 (6.6%–7.9%). Set 2 showed slightly higher level of confidence for LR-TR categorization compared with set 1 (3.4 ± 0.8 vs 3.8 ± 0.5). Interobserver agreement was excellent in both sets (κ = 0.85 in set 1 and 0.97 in set 2).

Conclusions
The LR-TR viable category is highly specific but inadequately sensitive for detecting viable tumor in TACE-treated HCC on conventional multiphasic CT. Adding arterial subtraction images to the conventional CT images significantly increases sensitivity without compromising the specificity and improves the diagnostic confidence of LR-TR viable category.
Association Between Intravenous Fluid Resuscitation and Hospital Mortality in Post Cardiac Arrest Patients: A Retrospective Study
Authors: Gul Fahad , Peterson Eric , Dejoy Robert , Albano Jeri , Chaudhary Siddique , Valestra Paul , Azmaiparashvili Zurab , Lo Kevin Bryan , Rangaswami Janani , Patarroyo-Aponte Gabriel 
Published: August 2020

ABSTRACT

Objective:
To assess the role for intravenous fluid (IVF) resuscitation in the postarrest state. Primary outcome was survival to hospital discharge and 30-day mortality. Secondary outcomes were associations with amount of vasopressor use and mechanical ventilation days.

Design:
Retrospective study design.

Setting:
Single-center tertiary hospital in Philadelphia, Pennsylvania.

Patients:
All patients admitted to the intensive care unit between 2018 and 2019.

Interventions:
Patients were divided into two groups based on amount of IVF received within 24 h <30 mL/kg (restricted) and over 30 mL/kg (liberal).

Measurements and Main Results:
A total of 264 patients were included in the study, with 200 included in the restrictive (<30 mL/kg) group and 64 included in the liberal (>30 mg/kg) group. There was no difference in 30-day mortality between the two groups with 146 (73%) deaths in the restrictive groups and 44 (69%) deaths in the liberal group (P = 0.53). There was also no significant difference between those who survived to hospital discharge in the liberal and restrictive groups on Kaplan–Meier analysis (Log-rank = 1.476 P = 0.224). However, there was a significant difference between restrictive and liberal groups with the duration of mechanical ventilation (4 ± 6 days vs. 6 ± 9 days; P = 0.03) and in the rates of two or more vasopressor use (38% vs. 59%; P = 0.002). End-stage renal disease (ESRD) (OR = 2.39; P = 0.03) and volume of fluids in mL/kg/24 h (OR = 1.025; P < 0.0001) were independently associated with higher vasopressor need. Volume of fluid in mL/kg/24 h (P = 0.01), ESRD (P = 0.015), and chronic obstructive pulmonary disease (P = 0.04) were significantly associated with duration of mechanical ventilation, even after adjusting for demographic factors, comorbidities, and mortality.

Conclusions:
A liberal strategy of IVF used in resuscitation after cardiac arrest is not associated with higher mortality. However, it predicts higher vasopressor use and duration of mechanical ventilation.
The Septic Neutrophil—Friend or Foe
Authors: Wei Yibing , Kim Jiyoun , Ernits Harri , Remick Daniel 
Published: August 2020

ABSTRACT
Neutrophils play a critical role in the eradication of pathogenic organisms, particularly bacteria. However, in the septic patient the prolonged activation and accumulation of neutrophils may augment tissue and organ injury. This review discusses the different activation states and chemotaxis of neutrophils in septic patients. Neutrophil killing of bacteria and the formation of neutrophil extracellular traps represent important components of the innate immune response and they become dysregulated during sepsis, possibly through changes in their metabolism. Delayed neutrophil apoptosis may contribute to organ injury, or allow better clearance of pathogens. Neutrophils provide a friendly immune response to clear infections, but excessive activation and recruitment has the potential to turn them into potent foes.