bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predoctoral substance use disorders curricula: A survey analysis and experiential pedagogy
Authors: Odusola Folarin , Kaufman Joshua , Turrigiano Eva , Aydinoglo Nicole , Shulman Matisyahu , Kidd Jeremy , Hu Mei‐Chen , Levin Frances R. 
Published: June 2021

AbstractSubstance Use Disorders (SUD) are chronic health conditions with heritability characteristics, environmental influences, long‐term management considerations and they cooccur. The US opioid epidemic is a crisis of both prescription and nonprescription opioid use. Clinicians now have access to evidence‐based practices but the evolving trends require continuous attention including curriculum initiatives for dental schools. The purpose of this study was to obtain information about the content and educational strategies of current SUD curricula, beneficial educational products for a standardized curriculum and perceived barriers toward standardization. Invitations were sent to 64 US dental schools describing the purpose of this study and a link to complete the survey was provided. Fully completed responses were received from 32 (50.0%) of the schools. Descriptive statistics was used to analyze the data. Most dental schools surveyed (81.3%) have a curriculum for SUD with classroom lectures being the most commonly used teaching method (96.2%), followed by online modules (42.3%). About 30% of the responding schools provided additional educational experiences. Instruction occurred mostly in second (73.1%) and third (77.0%) academic years. Opioids, alcohol, nicotine, and marijuana were the most frequently taught substance classes. Curriculum standardization with online modules (81.3%), case‐based exercises (59.4%), and simulation with standardized patients (43.8%) was considered desirable to improve student competency in the management of patients with SUD. Lack of time (62.5%), space (56.3%), and faculty (50.0%) were cited as the most common barriers to curriculum initiatives. Experiential and achievable options for improving SUD curriculum were highlighted.
Initial experience of endoscopic ultrasound‐guided antegrade covered stent placement with long duodenal extension for malignant distal biliary obstruction (with video)
Authors: So Hoonsub , Oh Dongwook , Takenaka Mamoru , Minaga Kosuke , Uemura Shinya , Iwashita Takuji , Saito Tomotaka , Nakai Yousuke , Kim Seon Ok , Park Do Hyun 
Published: June 2021

AbstractBackground/PurposeThis study aimed to evaluate the feasibility of endoscopic ultrasound (EUS)‐guided antegrade covered stent placement with long duodenal extension (EASL) for malignant distal biliary obstruction (MDBO) with duodenal obstruction (DO) or surgically altered anatomy (SAA) after failed endoscopic retrograde cholangiopancreatography (ERCP).MethodsOutcomes were technical and clinical success, reintervention rate, adverse events, stent patency, and overall survival. Inverse probability of treatment weighting (IPTW) and competing‐risk analysis were performed to compare with conventional EUS‐BD.ResultsTwenty‐five patients (DO, n = 18; SAA, n = 7) were included. The technical and clinical success rates were 96% and 84%, respectively. Reintervention occurred in two patients (8.3%). Adverse events occurred in six patients (24%; two cholangitis, 16%; four mild postprocedural pancreatitis [24% (n = 4/17) in patients with non‐pancreatic cancers]). The median patency was 9.4 months, and the overall survival was 2.73 months. After IPTW adjustment, the median patency in the EASL (n = 25) and conventional EUS‐BD (n = 29) were 10.1 and 6.5 months, respectively (P = .018).ConclusionsEASL has acceptable clinical outcomes with a low reintervention rate but higher rate of postprocedural pancreatitis in patients with non‐pancreatic cancers. Randomized trials comparing EASL and conventional EUS‐BD for MDBO with pancreatic cancers and DO/SAA after failed ERCP are needed to validate our findings.
Quantifying Bone Marrow Fat Fraction and Iron by MRI for Distinguishing Aplastic Anemia from Myelodysplastic Syndromes
Authors: Zeng Zhaolong , Ma Xiangzheng , Guo Yifan , Ye Baodong , Xu Maosheng , Wang Wei 
Published: June 2021

BackgroundBone marrow of patients with aplastic anemia (AA) is different from that of patients with myelodysplastic syndrome (MDS) and is difficult to identify by blood examination. IDEAL‐IQ (iterative decomposition of water and fat with echo asymmetry and least‐squares estimation) imaging might be able to quantify fat fraction (FF) and iron content in bone tissues.PurposeTo determine if IDEAL‐IQ measurements of bone marrow FF and iron content can distinguish between patients with AA and MDS.Study TypeRetrospective.PopulationFifty‐seven patients with AA, 21 patients with MDS, and 24 healthy controls.Field Strength/Sequence3.0 T, IDEAL‐IQ sequence.AssessmentThree independent observers evaluated the IDEAL‐IQ images and measured FF and R2* in the left posterior superior iliac spine.Statistical TestsKruskal–Wallis test, linear correlations, and Bland–Altman analysis were used. A P‐value of <0.05 was considered statistically significant.ResultsThe FF in patients with AA (79.46% ± 15.00%) was significantly higher than that in patients with MDS (42.78% ± 30.09%) and control subjects (65.50% ± 14.73%). However, there was no significant difference in FF between control subjects and patients with MDS (P = 0.439). The R2* value of AA, MDS, and controls was 145.38 ± 53.33, (171.13 ± 100.89, and 135.99 ± 32.41/second, respectively, with no significant difference between the three groups (P = 0.553).Data ConclusionQuantitative IDEAL‐IQ magnetic resonance imaging may facilitate the diagnosis of AA and distinguish it from MDS.Level of Evidence3Technical Efficacy Stage2
Nutrition competencies for undergraduate medical education: Results of an international interdisciplinary consensus
Authors: Cardenas Diana , Díaz Gustavo , Fuchs‐Tarlovsky Vanessa , Cristina Gonzalez Maria , Carrasco Fernando , Cano Angélica María Pérez , Bermúdez Charles , Maza Claudia , Ferraresi Eduardo , Lipovestky Fernando , Villafana Haydee , Arenas‐Márquez Humberto , Calvo Isabel , Cordova Ludwig Roberto Alvarez , Canicoba Marisa , Sánchez Paola , Santana Sergio , Tihista Serrana , Adrianza de Baptista Gertrudis M. , Garcia Yawelida , Correia Maria Isabel Toulson Davisson 
Published: June 2021

AbstractBackgroundThe gap between the nutrition education provided to medical students and the nutrition competencies and attitudes needed for physicians to provide adequate nutrition care is a global concern. There is no universally accepted benchmark on nutrition competencies for doctors. The objective of this study was to establish, by expert consensus, the objectives of undergraduate nutrition medial education, the nutrition core competencies, and strategies for curriculum development in medical nutrition education.MethodsWe administered a Delphi survey to systematically gather the opinion of a panel of Latin American experts in nutrition. The survey questionnaire was constructed considering scientific literature by using a 5‐point Likert scale. Consensus was defined as >70% agreement on the importance of an item (Likert scale 4 and 5).ResultsA four‐round Delphi survey was conducted for this research. In the second, third, and fourth rounds, we validated a total of 130 competencies by consensus, which were distributed into four different thematic areas: (1) basic nutrition concepts, (2) public nutrition and nutrition prevention throughout the life cycle, (3) nutrition status and disease, and (4) nutrition care process.ConclusionThe curricula for general physician education in medical school must include health promotion, prevention, and treatment of diseases related to nutrition. This goal can be reached by integrating ≤130 competencies into four different fundamental areas.
Clinico‐pathological significance of suspicious peritoneal cytology in endometrial cancer
Authors: Matsuo Koji , Matsuzaki Shinya , Miller Heather , Nusbaum David J. , Walia Saloni , Matsuzaki Satoko , Shimada Muneaki , Klar Maximilian , Roman Lynda D. 
Published: June 2021

AbstractBackground and ObjectivesSuspicious peritoneal cytology refers to the result of peritoneal cytology testing that is insufficient in either quality or quantity for a definitive diagnosis of malignancy. This study examined characteristics and survival outcomes related to suspicious peritoneal cytology in endometrial cancer.MethodsA population‐based retrospective study by querying the National Cancer Institute's Surveillance, Epidemiology, and End Results Program was conducted. A total of 41,229 women with Stage I–III endometrial cancer who had peritoneal cytologic sampling at hysterectomy from 2010 to 2016 were examined. A Cox proportional hazard regression model and a competing risk analysis with Fine‐Gray model were fitted to assess survival outcome related to suspicious peritoneal cytology.ResultsSuspicious peritoneal cytology was seen in 702 (1.7%) cases. In multivariable models, suspicious peritoneal cytology was associated with increased risk of endometrial cancer mortality (subdistribution‐hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.29–2.20, p < 0.001) and all‐cause mortality (adjusted‐HR: 1.55, 95% CI: 1.27–1.90, p < 0.001) compared with negative peritoneal cytology. Sensitivity analysis demonstrated that suspicious peritoneal cytology had discrete overall survival improvement compared with malignant peritoneal cytology in a propensity score weighting model (HR: 0.85, 95% CI: 0.72–0.99, p = 0.049).ConclusionOur study suggests that suspicious peritoneal cytology may be a prognostic factor for decreased survival in endometrial cancer.
Recent advances of the ionic chiral selectors for chiral resolution by chromatography, spectroscopy and electrochemistry
Authors: Wu Datong , Ma Cong , Fan Gao‐Chao , Pan Fei , Tao Yongxin , Kong Yong 
Published: June 2021

AbstractIonic chiral selectors have been received much attention in the field of asymmetric catalysis, chiral recognition, and preparative separation. It has been shown that the addition of ionic chiral selectors can enhance the recognition efficiency dramatically due to the presence of multiple intermolecular interactions, including hydrogen bond, π–π interaction, van der Waals force, electrostatic ion‐pairing interaction, and ionic‐hydrogen bond. In the initial research stage of the ionic chiral selectors, most of work center on the application in chromatographic separation (capillary electrophoresis, high‐performance liquid chromatography, and gas chromatography). Differently, more and more attention has been paid on the spectroscopy (nuclear magnetic resonance, fluorescence, ultraviolet and visible absorption spectrum, and circular dichroism spectrum) and electrochemistry in recent years. In this tutorial review as regards the ionic chiral selectors, we discuss in detail the structural features, properties, and their application in chromatography, spectroscopy, and electrochemistry.
Predictors of Respiratory Dysfunction at Diagnosis of Robin Sequence
Authors: Duarte Daniele W. , Schweiger Claudia , Manica Denise , Fagondes Simone , Fleith Iran J. , Rojas Juan J. C. , Zanin Eduardo M. , Portinho Ciro P. , Collares Marcus V. M. 
Published: June 2021

Objectives/HypothesisRobin sequence (RS) consists of associated micrognathia, glossoptosis, and respiratory dysfunction, with or without cleft palate. Studies on how different patient characteristics impact the severity of respiratory dysfunction are scarce and contradictory; this study investigates how different features affect respiratory obstruction severity at diagnosis of RS in controlled analysis.Study DesignRetrospective cohort study that enrolled 71 RS patients under 90 days old who received care in our institution from 2009 to 2020.MethodsThe primary outcome, respiratory dysfunction, was categorized into four severity groups and analyzed using a multinomial logistic regression model that considered age, sex, mandible length, cleft palate, syndromic diagnosis, other airway anomalies, and degree of glossoptosis.ResultsMandible length, syndromic diagnosis, and Yellon grade 3 glossoptosis were related to poorer respiratory outcomes (need for respiratory support). In univariate analysis, for each additional 1 mm of mandible length at diagnosis, a mean reduction of 28% in the risk of needing respiratory support was observed (OR = 0.72; 0.58–0.89); syndromic diagnosis and grade 3 glossoptosis also raised the risk (OR = 6.50; 1.59–26.51 and OR = 12.75; 1.03–157.14, respectively). In multivariate analysis, only mandible length significantly maintained its effects (OR = 0.73; 0.56–0.96), a 27% reduction.ConclusionsMandible length was an independent predictor for more severe respiratory dysfunction in RS patients, with larger mandibles showing protective effects. Syndromic diagnosis and Yellon grade 3 glossoptosis are also likely to be associated with poorer respiratory outcomes, although this was not demonstrated in multivariate analysis.Level of Evidence4 Laryngoscope, 131:2811–2816, 2021
Fundamental Limitations of Huygens’ Metasurfaces for Optical Beam Shaping
Authors: Gigli Carlo , Li Qitong , Chavel Pierre , Leo Giuseppe , Brongersma Mark L. , Lalanne Philippe 
Published: June 2021

AbstractOptical dielectric metasurfaces composed of arrayed nanostructures are expected to enable arbitrary spatial control of incident wavefronts with subwavelength spatial resolution. For phase modulation, one often resorts to two physical effects to implement a 2π‐phase excursion. The first effect relies on guidance by tall nanoscale pillars and the second one exploits resonant confinement by nanoresonators with two degenerate Mie resonances. The first approach requires high aspect ratios, while the second one, known as Huygens’ metasurfaces, is much flatter, and thus easier to manufacture. The two approaches are compared, more focusing on conceptual rather than technological issues, and fundamental limitations with the latter are identified. The origin of the limitations based on general arguments are explained, such as reciprocity, multimode/monomode operation, and symmetry breaking.
Utility of Preoperative Computed Tomography–Based Body Metrics in Relation to Postoperative Complications in Pediatric Liver Transplantation Recipients
Authors: Verhagen Martijn V. , Levolger Stef , Hulshoff Jan Binne , Werner Maureen J. M. , van der Doef Hubert P. J. , Viddeleer Alain R. , de Kleine Ruben H. , de Haas Robbert J. 
Published: June 2021

Computed tomography (CT)‐derived body metrics such as skeletal muscle index (SMI), psoas muscle index (PMI), and subcutaneous fat area index (ScFI) are measurable components of sarcopenia, frailty, and nutrition. While these body metrics are advocated in adults for predicting postoperative outcomes after liver transplantation (LT), little is known about their value in pediatric populations. This study assessed the relation between preoperative CT‐based body metrics and postoperative short‐term outcomes in pediatric LT recipients. Patients aged 0‐18 years who underwent a primary LT were retrospectively included (n = 101; median age 0.5 years; range 0.2‐17.1). SMI, PMI, and ScFI were derived from preoperative axial CT slices. Postoperative outcomes and complications within 90 days were correlated with the CT‐based body metrics. To classify postoperative infections, the Clavien‐Dindo (CD) classification was used. Subgroup analyses were performed for age groups (<1, 1‐10, and >10 years old). An optimal threshold for test performance was defined using Youden’s J‐statistic and receiver operating characteristic curve as appropriate. ScFI was significantly (P = 0.001) correlated with moderate to severe postoperative infections (CD grade 3‐5) in children aged <1 year, with the optimal ScFI threshold being ≤27.1 cm2/m2 (sensitivity 80.4% and specificity 77.8%). A weak negative correlation between SMI and the total duration of hospital stay (R = −0.3; P = 0.01) and intensive care unit (ICU) stay (R = −0.3; P = 0.01) was observed in children aged <1 year. No other associations between CT‐based body metrics and postoperative outcomes were shown. In children aged <1 year with cirrhotic liver disease undergoing LT, preoperative CT‐based body metrics were correlated with moderate to severe postoperative infections (ScFI) and with longer duration of hospital and ICU stay (SMI), and thus can be considered important tools for pre‐LT risk assessment.
Medicaid Expansion Association With End‐Stage Liver Disease Mortality Depends on Leniency of Medicaid Hepatitis C Virus Coverage
Authors: Wahid Nabeel A. , Lee Jihui , Kaplan Alyson , Fortune Brett E. , Safford Monika M. , Brown Robert S. , Rosenblatt Russell 
Published: June 2021

The Affordable Care Act expanded Medicaid around the same time that direct‐acting antivirals became widely available for the treatment of hepatitis C virus (HCV). However, there is significant variation in Medicaid HCV treatment eligibility criteria between states. We explored the combined effects of Medicaid expansion and leniency of HCV coverage under Medicaid on liver outcomes. We assessed state‐level end‐stage liver disease (ESLD) mortality rates, listings for liver transplantation (LT), and listing‐to‐death ratios (LDRs) for adults aged 25 to 64 years using data from United Network for Organ Sharing and Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research. States were divided into 4 nonoverlapping groups based on expansion status on January 1, 2014 (expansion versus nonexpansion) and leniency of Medicaid HCV coverage (lenient versus restrictive coverage). Joinpoint regression analysis evaluated the significant changes in slope over time (joinpoints) during the pre‐expansion (2009‐2013) and postexpansion (2014‐2018) time periods. We found significant changes in the annual percent change for population‐adjusted ESLD deaths between 2014 and 2015 in all cohorts except for the nonexpansion/restrictive cohort, in which deaths increased at the same annual percent change from 2009 to 2018 (annual percent change of +2.5%; 95% confidence interval [CI], 1.8‐3.3]). In the expansion/lenient coverage cohort, deaths increased at an annual percent change of +2.6% (95% CI, 1.8‐3.5) until 2014 and then tended to decrease at an annual percent change of −0.4% (95% CI, −1.5 to 0.8). LT listings tended to decrease over time for all cohorts. For LDRs, only the expansion/lenient and expansion/restrictive cohorts had statistically significant joinpoints. Improvements in ESLD mortality and LDRs were associated with both Medicaid expansion and leniency of HCV coverage under Medicaid. These findings suggest the importance of implementing more lenient and widespread public health insurance to improve liver disease outcomes, including mortality.
Meglumine Antimoniate‐Loaded Aqueous‐Core PLA Nanocapsules: Old Drug, New Formulation against Leishmania‐Related Diseases
Authors: Cosco Donato , Bruno Federica , Castelli Germano , Puleio Roberto , Bonacci Sonia , Procopio Antonio , Britti Domenico , Fresta Massimo , Vitale Fabrizio , Paolino Donatella 
Published: June 2021

AbstractLeishmaniasis is a human and animal disease endemic in tropical and subtropical areas treated by means of pentavalent antimony as first‐line approach. Unfortunately, the formulations available on the market are characterized by significant side effects and a total remission of the disease is difficult to be obtained. The aim of this investigation is to describe the development and characterization of aqueous‐core poly‐l‐lactide (PLA) nanocapsules containing glucantime (meglumine antimoniate, MA) with the aim of increasing the pharmacological efficacy of the active compound. The polymeric systems characterized by a mean diameter of ≈300 nm exert a great interaction with murine macrophages. MA‐loaded PLA nanocapsules show a great antileishmanial activity on mice infected with Leishmania infantum with respect to the free drug, favoring a decrease of the administration times. The biodistribution profiles demonstrate a lower renal accumulation of MA after its nanoencapsulation and a significant increase of its plasmatic half‐life. The parasite load evaluated by immunohistochemistry shows a significant decrease in liver, spleen, and kidneys when mice are treated with MA‐loaded PLA nanocapsules especially after 45 days. The obtained results demonstrate the potential application of MA‐loaded PLA nanocapsules as novel nanomedicine for the treatment of leishmaniasis.
Regenerating Critical Size Rat Segmental Bone Defects with a Self‐Healing Hybrid Nanocomposite Hydrogel: Effect of Bone Condition and BMP‐2 Incorporation
Authors: van Houdt Claire I. A. , Koolen Marianne K. E. , Lopez‐Perez Paula M. , Ulrich Dietmar J. O. , Jansen John A. , Leeuwenburgh Sander C. G. , Weinans Harrie H. , van den Beucken Jeroen J. J. P. 
Published: June 2021

AbstractThe aim of the current study is to assess the biological performance of self‐healing hydrogels based on calcium phosphate (CaP) nanoparticles and bisphosphonate (BP) conjugated hyaluronan (HA) in a critical size segmental femoral bone defect model in rats. Additionally, these hydrogels are loaded with bone morphogenetic protein 2 (BMP‐2) and their performance is compared in healthy and osteoporotic bone conditions. Treatment groups comprise internal plate fixation and placement of a PTFE tube containing hydrogel (HABP‐CaP) or hydrogel loaded with BMP‐2 in two dosages (HABP‐CaP‐lowBMP2 or HABP‐CaP‐highBMP2). Twelve weeks after bone defect surgery, bone formation is analyzed by X‐ray examination, micro‐CT analysis, and histomorphometry. The data show that critical size, segmental femoral bone defects cannot be healed with HABP‐CaP gel alone. Loading of the HABP‐CaP gel with low dose BMP‐2 significantly improve bone formation and resulted in defect bridging in 100% of the defects. Alternatively, high dose BMP‐2 loading of the HABP‐CaP gel does not improve bone formation within the defect area, but leads to excessive bone formation outside the defect area. Bone defect healing is not affected by osteoporotic bone conditions.
Nanoengineering Branched Star Polymer‐Based Formulations: Scope, Strategies, and Advances
Authors: Yong Hui Wen , Kakkar Ashok 
Published: June 2021

AbstractSoft nanoparticles continue to offer a promising platform for the encapsulation and controlled delivery of poorly water‐soluble drugs and help enhance their bioavailability at targeted sites. Linear amphiphilic block copolymers are the most extensively investigated in formulating delivery vehicles. However, more recently, there has been increasing interest in utilizing branched macromolecules for nanomedicine, as these have been shown to lower critical micelle concentrations, form particles of smaller dimensions, facilitate the inclusion of varied compositions and function‐based entities, as well as provide prolonged and sustained release of cargo. In this review, it is aimed to discuss some of the key variables that are studied in tailoring branched architecture‐based assemblies, and their influence on drug loading and delivery. By understanding structure–property relationships in these formulations, one can better design branched star polymers with suitable characteristics for efficient therapeutic interventions. The role played by polymer composition, chain architecture, crosslinking, stereocomplexation, compatibility between polymers and drugs, drug/polymer concentrations, and self‐assembly methods in their performance as nanocarriers is highlighted.