bluuebunny/crossref_metadata_2025_split huggingface dataset:
JUUL E-Cigarette Quit Attempts and Cessation Perceptions in College Student JUUL E-Cigarette Users
Authors: Pulvers Kim , Correa John B. , Krebs Paul , El Shahawy Omar , Marez Crystal , Doran Neal , Myers Mark 
Published: December 2020

Purpose: This study describes the frequency of JUUL e-cigarette (referred to as JUUL) quit attempts and identifies characteristics associated with confidence in quitting and perceived difficulty quitting JUUL. Design: Cross-sectional study from a self-administered online survey. Setting: Two public southern California universities. Participants: A total of 1,001 undergraduate students completed the survey from February to May 2019. Measures: Self-report measures about JUUL included use, history of quit attempts, time to first use, perceived difficulty with cessation/reduction, and confidence in quitting. Analysis: Binary logistic regressions were used to identify demographic and tobacco-related behavioral correlates of JUUL cessation-related perceptions and behaviors. Results: Nearly half of ever-JUUL users (47.8%) reported a JUUL quit attempt. Adjusting for demographic factors and other tobacco product use, shorter time to first JUUL use after waking was associated with lower confidence in quitting JUUL (aOR = 0.02, 0.00-0.13) and greater perceived difficulty in quitting JUUL (aOR = 8.08, 2.15-30.35). Previous JUUL quit attempt history was also associated with greater odds of perceived difficulty quitting JUUL (aOR = 5.97, 1.74-20.53). Conclusions: History of JUUL quit attempts among college students was common. Those who had previously tried quitting were more likely to perceive difficulty with cessation. Time to first JUUL use, a marker of dependence, was linked with greater perceived cessation difficulty and lower confidence in quitting. These findings suggest that there is a need for cessation and relapse prevention support for college student JUUL users.
The uncertainty trope: the duty to treat during a pandemic
Authors: Zubaran Carlos , Freeman Alexander 
Published: December 2020

Background: Past guidance in the codes of practice urged doctors to provide treatment even in the context of extreme adversities. Despite the significant societal changes of recent times, contemporary guidance regarding the duty to treat during a pandemic has been limited. Objective: The authors herewith examine deontological aspects pertaining to the duty to treat during a pandemic and the potential disruptions to health care services. Conclusion: The ethical, legal and professional guidance for duty of care during a pandemic is uncertain and demands further debate.
Readmission and Utilization After Repair of Ruptured Abdominal Aortic Aneurysms in the United States
Authors: Braet Drew J. , Taaffe John P. , Singh Priyanka , Bath Jonathan , Kruse Robin L. , Vogel Todd R. 
Published: December 2020

Objectives: Endovascular aneurysm repair (EVAR) has emerged as a less invasive alternative to open repair for ruptured Abdominal Aortic Aneurysms (rAAA), but comparisons to traditional open rAAA repair and late complications leading to readmission are limited. Materials and Methods: Hospitalizations for patients undergoing repair for rAAA were selected from the Nationwide Readmissions Database (NRD). In-hospital mortality, complications, 30-day readmission, readmission diagnoses, and charges were evaluated. Design-adjusted chi-square, Wilcoxon test, and logistic regression were used for analysis. Results: During 2014-2016, 3,629 open rAAA and 5,037 EVAR were identified. The index mortality rate was 21.4% for EVAR vs. 33.5% for open (p < .0001). Median index length of stay (LOS) was 4.9 days for EVAR vs. 8.6 days for open repair (p < 0.001). All-cause 30-day readmission after rAAA was higher following EVAR (18.9%) than open (14.3%, p = .007). Time to readmission and charges for readmission stays did not differ between procedure groups. Respiratory complications were more common following open repair than EVAR (20.4% vs 11.4%, respectively; p = .008). Patients who underwent open repair suffered more infectious complications than patients treated with EVAR during readmission (49.2% vs 39.8%, respectively; p = 0.054). In multivariable analysis, factors associated with readmission included having EVAR during the index stay (Odds ratio [OR] = 1.46, 95% confidence interval [CI] 1.14-1.88; p = .003), increased length of index stay (OR = 1.01; 95% CI 1.01-1.02; p = 0.002), chronic kidney disease (OR = 1.51; 95% CI 1.18-1.94; p = .001), and coronary artery disease (OR = 1.32; 95% CI 1.02-1.71; p = .034). Aggregate readmission charges totaled $79 million. Readmissions were most often infectious complications for both repair types. Conclusions: EVAR was used more often than open repair for rAAA. In-hospital mortality and length of the index stay were significantly lower following EVAR. After multivariable adjustment, the odds of readmission were 1.5 times higher after EVAR, costing the health system more over time when prevalence and readmission are considered. Coronary artery disease, chronic kidney disease, and index length of stay were also associated with 30-day readmission. Further investigation into reasons why a less invasive procedure, EVAR, has a higher readmission rate and understanding post-discharge infectious complications may help lower overall health care utilization after rAAA.
Surgical and Endovascular Management of Isolated Internal Iliac Artery Aneurysms: A Systematic Review and Meta-Analysis
Authors: Perini Paolo , Mariani Erica , Fanelli Mara , Ucci Alessandro , Rossi Giulia , Massoni Claudio Bianchini , Freyrie Antonio 
Published: December 2020

Objectives: The purpose of this paper is to report the different modalities for the treatment of isolated internal iliac artery aneurysms (IIIAA), as well as their outcomes. Methods: We performed a systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library; last search: April 2020). We included articles reporting on the outcomes for IIIAA interventions comprising at least 5 patients. Studies were included when presenting extractable outcome data regarding intraoperative and/or early results. We performed meta-analyses of proportions for different outcomes, using random effects model. Results: Thirteen non-randomized studies were included (192 patients with 202 IIIAA). IIIAA were symptomatic in the 18.1% (95%CI 9.3-26.9; I2 54.46%, P = .019). Estimated mean IIIAA diameter was 46.28 mm (95%CI 39.72-52.85; I2 88.85%, P < .001). Open repair was performed in 21/202 cases. Endovascular treatments were: embolization (81/181), embolization and hypogastric artery coverage (79/181), hypogastric artery coverage by stent-grafting (15/181), stent-grafting in the hypogastric artery (6/181). Overall estimated technical success (TS) rate was 91.6% (95% CI 86.8-95.5; I2 45.82%, P = .031). TS rate was 94.5% for open surgery (95%CI 85.3-100; I2 0%, P = .907), and 89.7% for endovascular repair (95%CI 83.8-95.6; I2 55.43%, P = .006). Estimated overall 30-day mortality was 3.1% (95%CI 0.8-5.4; I2 0%, P = .969). Mortality rates after open surgery and endovascular repair were 8.2% (95%CI 3.4-19.8; I2 0%, P = .545) and 2.8% (95%CI 0.5-5.1; I2 0%, P = .994), respectively. Estimated mean follow-up was 32.63 months (95%CI 21.74-43.53; I2 94.45%, P < .001). During this timeframe, IIIAA exclusion was preserved in 92.8% of the patients (95%CI 89.3-96.2; I2 0%, P = .797). Buttock claudication occurred in 13.9% of the patients (95%CI 8.7-19.2; I2 0%, P = .622). Conclusions: IIIAA are frequently large, and symptomatic at presentation. Several treatments are proposed in literature, open and endovascular, both with good results. The endovascular treatment is the preferred method of treatment in literature, since it offers good short- to mid-term results and low early mortality. Buttock claudication after hypogastric artery exclusion is a common complication.
A comprehensive analysis of microRNAs as diagnostic biomarkers for asthma
Authors: Xu Li , Yi Minhan , Tan Yun , Yi Zixun , Zhang Yuan 
Published: December 2020

Background: It is unclear whether microRNAs could be a potential diagnostic biomarker for asthma or not. The objective of this study is to figure out the diagnostic value of microRNAs in asthma. Methods: Literature retrieval, screening of publications, specific data extraction, and quality evaluation were conducted according to the standard criteria. Stata 14.0 software was used to analyze the diagnostic value of microRNA for asthma, including the combined sensitivity (Sen), specificity (Spe), the area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Results: A total of 72 studies, containing 4143 cases and 2188 controls, were included for this comprehensive analysis. None of the included publications were rated low in quality. We summarized that, compared with controls, more than 100 miRNAs were reported differently expressed in asthma, although the expression trends were inconsistent. Besides, there were five studies among these 72 articles that applied the diagnostic evaluation of microRNAs in asthma. We found that the pooled Sen, Spe, and AUC for the combination of miR-185-5p, miR-155, let-7a, miR-21, miR-320a, miR-1246, miR-144-5p, and miR-1165-3p in asthma were 0.87 (95%CI: 0.72–0.95), 0.84 (95%CI: 0.74–0.91), and 0.93 (95%CI: 0.89–0.94) individually, and the PLR, NLR, and DOR were 5.5 (95%CI: 3.1–9.7), 0.15 (95%CI: 0.07–0.36), and 35 (95%CI: 10–127) in asthma, respectively. In terms of subgroup analyses, we found that the Sen for these combination miRNAs from serum was higher than that in plasma, while the Spe in plasma worked better than that in serum. Furthermore, compared with children, the combination of above miRNAs from adults had higher Spe and similar Sen. Conclusions: From our analysis, the combination of miR-185-5p, miR-155, let-7a, miR-21, miR-320a, miR-1246, miR-144-5p, and miR-1165-3p from peripheral blood could potentially act as a diagnostic biomarker for asthma. The reviews of this paper are available via the supplemental material section.
Improving Hospital Glucometrics, Workflow, and Outcomes with a Computerized Intravenous Insulin Dose Calculator Built into the Electronic Health Record
Authors: Shelden Daniel , Ateya Mohammed , Jensen Angela , Arnold Patrick , Bellomo Tiffany , Gianchandani Roma 
Published: December 2020

Objective: To adjust for dynamic insulin requirements in critically ill patients, intravenous (IV) insulin infusions allow for titration of the dose according to a prespecified algorithm. Despite the adaptability of IV insulin protocols, human involvement in dose calculation allows for error. We integrated a previously validated IV insulin calculator into our electronic health record (Epic) and instituted it in the cardiovascular intensive care unit (CVICU). We aim to describe the design of the calculator, the implementation process, and evaluate the calculator’s impact. Method: Employing an aggressive training program and user acceptance testing prior to significant elbow support at the time of institution, we successfully integrated the insulin calculator in our CVICU. We evaluated the glucometrics before and after implementation as well as nursing satisfaction following calculator implementation. Results: Overall, our implementation led to increased frequency of blood sugar at various glycemic targets, a trend toward less hypoglycemia or hyperglycemia. For severe hypoglycemia, our preintervention cohort had 0.02% of blood sugars less than 40 mg/dL but no blood sugars less than 40 mg/dL were identified in our patient’s postintervention. For the CVICU target blood glucose of 70-180 mg/dL, 87.97% blood sugars at baseline met goal compared to 91.39% at one month, 91.24% at three months, and 90.87% at six months postintervention. Conclusion: By utilizing an aggressive education campaign championing superusers and making adjustments to the calculator based on early problems that were encountered, we were able to improve glycemic control and limit glucose variability at our institution.
Research in the Healthcare Design Practice: Design Practitioners’ Perspective
Authors: Bayramzadeh Sara , Patel Tina 
Published: December 2020

Objective: This study explores design practitioners’ level of knowledge about research, their attitude toward research integration into the design practice, and the barriers to its application in the design process. Background: Design practitioners tend to heavily rely on previous design experience and precedents rather than utilization and application of research. Research can facilitate the evaluation and creation of innovative design solutions. Integrating research has been a challenge for the design industry. Methodology: The study utilized an online survey to solicit feedback from architects and interior designers in the healthcare sector through a snowball sampling approach. The survey comprised closed-ended and open-ended questions categorized into three distinct sections, each focusing on one of the study objectives. A total of 115 participants completed the questionnaire. Results: Practitioners tend to integrate research into the early design phases and programming. It is recognized as a tool for design enhancement by 62%, while 7% considered it to be a hindrance to their creativity. Primary data collection methods include collaboration with colleagues and user groups rather than journals and trade magazines. Cost, time, and lack of expertise are the top three hurdles in applying research in practice. Conclusions: Practitioners have a positive attitude toward research, perceive it as an impactful design enhancement tool, and use it to promote their credibility. Lack of research expertise hinders the use and conduct of research. According to design practitioners, research is costly and time-consuming and impedes their ability to fulfill clients’ goals and the project timeline.
Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020
Authors: Sun Xiao-fei , Wang Yuan , Sun Jing-chuan , Xu Xi-ming , Kong Qing-jie , Chen Yu , Yang Hai-song , Liu Yang , Guo Yong-fei , Shi Guo-dong , Chen Xiong-sheng , Chen De-yu , Shen Yong , Hao Ding-jun , Shen Hong-xing , Zhu Qing-san , Yuan Wen , Jia Lian-shun , Shi Jian-gang 
Published: December 2020

Purpose: The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL). Method: Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement. Results: Cervical OPLL can cause various degrees of neurological symptoms, an it’s thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article. Conclusion: In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.
A lightweight convolutional neural network for assessing an EEG risk marker for sudden unexpected death in epilepsy
Authors: Zhu Cong , Kim Yejin , Jiang Xiaoqian , Lhatoo Samden , Jaison Hampson , Zhang Guo-Qiang 
Published: December 2020

Abstract
Background
Convolutional neural network (CNN) has achieved state-of-art performance in many electroencephalogram (EEG) related studies. However, the application of CNN in prediction of risk factors for sudden unexpected death in epilepsy (SUDEP) remains as an underexplored area. It is unclear how the trade-off between computation cost and prediction power varies with changes in the complexity and depth of neural nets.

Methods
The purpose of this study was to explore the feasibility of using a lightweight CNN to predict SUDEP. A total of 170 patients were included in the analyses. The CNN model was trained using clips with 10-s signals sampled from the original EEG. We implemented Hann function to smooth the raw EEG signal and evaluated its effect by choosing different strength of denoising filter. In addition, we experimented two variations of the proposed model: (1) converting EEG input into an “RGB” format to address EEG channels underlying spatial correlation and (2) incorporating residual network (ResNet) into the bottle neck position of the proposed structure of baseline CNN.

Results
The proposed baseline CNN model with lightweight architecture achieved the best AUC of 0.72. A moderate noise removal step facilitated the training of CNN model by ensuring stability of performance. We did not observe further improvement in model’s accuracy by increasing the strength of denoising filter.

Conclusion
Post-seizure slow activity in EEG is a potential marker for SUDEP, our proposed lightweight architecture of CNN achieved satisfying trade-off between efficiently identifying such biomarker and computational cost. It also has a flexible interface to be integrated with different variations in structure leaving room for further improvement of the model’s performance in automating EEG signal annotation.
Scaling-up Health-Arts Programmes: the largest study in the world bringing arts-based mental health interventions into a national health service
Authors: Estevao Carolina , Fancourt Daisy , Dazzan Paola , Chaudhuri K. Ray , Sevdalis Nick , Woods Anthony , Crane Nikki , Bind Rebecca , Sawyer Kristi , Rebecchini Lavinia , Hazelgrove Katie , Manoharan Manonmani , Burton Alexandra , Dye Hannah , Osborn Tim , Jarrett Lucinda , Ward Nick , Jones Fiona , Podlewska Aleksandra , Premoli Isabella , Derbyshire-Fox Fleur , Hartley Alison , Soukup Tayana , Davis Rachel , Bakolis Ioannis , Healey Andy , Pariante Carmine M. 
Published: December 2020

SummaryThe Scaling-up Health-Arts Programme: Implementation and Effectiveness Research (SHAPER) project is the world's largest hybrid study on the impact of the arts on mental health embedded into a national healthcare system. This programme, funded by the Wellcome Trust, aims to study the impact and the scalability of the arts as an intervention for mental health. The programme will be delivered by a team of clinicians, research scientists, charities, artists, patients and healthcare professionals in the UK's National Health Service (NHS) and the community, spanning academia, the NHS and the charity sector. SHAPER consists of three studies – Melodies for Mums, Dance for Parkinson's, and Stroke Odysseys – which will recruit over 800 participants, deliver the interventions and draw conclusions on their clinical impact, implementation effectiveness and cost-effectiveness. We hope that this work will inspire organisations and commissioners in the NHS and around the world to expand the remit of social prescribing to include evidence-based arts interventions.
Oxytocin, Dopamine, and Opioid Interactions Underlying Pair Bonding: Highlighting a Potential Role for Microglia
Authors: Loth Meredith K , Donaldson Zoe R 
Published: December 2020

AbstractPair bonds represent some of the strongest attachments we form as humans. These relationships positively modulate health and well-being. Conversely, the loss of a spouse is an emotionally painful event that leads to numerous deleterious physiological effects, including increased risk for cardiac dysfunction and mental illness. Much of our understanding of the neuroendocrine basis of pair bonding has come from studies of monogamous prairie voles (Microtus ochrogaster), laboratory-amenable rodents that, unlike laboratory mice and rats, form lifelong pair bonds. Specifically, research using prairie voles has delineated a role for multiple neuromodulatory and neuroendocrine systems in the formation and maintenance of pair bonds, including the oxytocinergic, dopaminergic, and opioidergic systems. However, while these studies have contributed to our understanding of selective attachment, few studies have examined how interactions among these 3 systems may be essential for expression of complex social behaviors, such as pair bonding. Therefore, in this review, we focus on how the social neuropeptide, oxytocin, interacts with classical reward system modulators, including dopamine and endogenous opioids, during bond formation and maintenance. We argue that an understanding of these interactions has important clinical implications and is required to understand the evolution and encoding of complex social behaviors more generally. Finally, we provide a brief consideration of future directions, including a discussion of the possible roles that glia, specifically microglia, may have in modulating social behavior by acting as a functional regulator of these 3 neuromodulatory systems.
Comparison of the image quality and radiation dose of different scanning modes in head-neck CT angiography
Authors: Zhang Tianle , Geng Xue , Li Dongxue , Xu Yize , Zhao Yongxia 
Published: December 2020

Objectives: To analyze and compare the radiation dose and image quality of different CT scanning modes on head-neck CT angiography. Methods: A total of 180 patients were divided into Group A and Group B. The groups were further subdivided according to different scanning modes: subgroups A1, A2, A3, B1, B2, and B3. Subgroups A1 and B1 used conventional CT protocol, subgroups A2 and B2 used the kV-Assist scan mode, and subgroups A3 and B3 used the dual-energy gemstone spectral imaging protocol. The CT dose index and dose–length product were recorded. The objective image quality and subjective image evaluation was conducted by two independent radiologists. Results: The signal-to-noise ratios, contrast-to-noise ratios, and subjective scores of subgroups A3 and B3 were higher than the other subgroups. In subgroups B1 and B2, the subjective scores of 9 patients and 12 patients were lower than 3, respectively. The subjective scores of subgroups B1 and B2 were lower than the other subgroups. There was no statistically significant difference in signal-to-noise ratios, contrast-to-noise ratios, and subjective scores between subgroups A1 and A2. The effective dose of subgroup A2 was 41.7 and 36.4% lower than that in subgroups A1 and A3, respectively (p < 0.05). In Group B, there were no statistically significant differences in CT dose indexvol, dose–length product, and ED among the subgroups (p > 0.05). Conclusion: In the head-neck CT angiography, the kV-Assist scan mode is recommended for patients with body mass index between 18.5 and 34.9 kg m−2; gemstone spectral imaging scanning mode is recommended for patients with body mass index ≥34.9 kg m−2.