bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neural rhythmic underpinnings of intergroup bias: implications for peace-building attitudes and dialogue
Authors: Levy Jonathan , Goldstein Abraham , Influs Moran , Masalha Shafiq , Feldman Ruth 
Published: September 2021

Abstract
Intergroup bias is a ubiquitous socio-cognitive phenomenon that, while sustaining human dependence on group living, often leads to prejudice, inequity, and violence; yet, its neural underpinnings remain unclear. Framed within the Israeli–Palestinian conflict and targeting youth, this study utilized magnetoencephalography to describe intrinsic neural oscillatory processes that represent the intergroup bias and may link with engagement in peacemaking in order to shed further light on the neural mechanisms underpinning intergroup conflict. Across the oscillatory spectrum, from very low to very high frequency bands, the only rhythm found to underlie the intergroup bias was the alpha rhythm. Alpha rhythm was continuously activated across the task and integrated a rapid perceptual component in the occipital cortex with a top-down cognitive-control component in the medial cingulate cortex. These components were distinctly associated with the real-life intergroup dialogue style and expressed attitudes that promote active engagement in peacemaking. Our findings suggest that the cortical alpha rhythm plays a crucial role in sustaining intergroup bias and addresses its impact on concrete intergroup experiences. The results highlight the need to provide opportunities for active peace-building dialogue to youth reared amidst intractable conflicts.
CE: Hypertensive Emergencies: A Review
Authors: Mathews Essie P. , Newton Faith , Sharma Kartavya 
Published: September 2021

ABSTRACT:
While acute blood pressure elevations are commonly seen in the ED, not all require emergency treatment. True hypertensive emergencies are characterized by a rapid elevation in blood pressure to a level above 180/120 mmHg and are associated with acute target organ damage, which requires immediate hospitalization for close hemodynamic monitoring and IV pharmacotherapy. Recognizing the clinical signs and symptoms of hypertensive emergency, which may vary widely depending on the target organ involved, is critical. High blood pressure levels that produce no signs or symptoms of target organ damage may be treated without hospitalization through an increase in or reestablishment of previously prescribed oral antihypertensive medication. However, all patients presenting with blood pressure this high should undergo evaluation to confirm or rule out impending target organ damage, which differentiates hypertensive emergency from other hypertensive crises and is vital in facilitating appropriate emergency treatment. Drug therapy for hypertensive emergency is influenced by end-organ involvement, pharmacokinetics, potential adverse drug effects, and patient comorbidities. Frequent nursing intervention and close monitoring are crucial to recuperation. Here, the authors define the spectrum of uncontrolled hypertension; discuss the importance of distinguishing hypertensive emergencies from hypertensive urgencies; and describe the pathophysiology, clinical manifestations, and management of hypertensive emergencies.
A Low-threshold Comprehensive Shared Medical Appointment Program for Perinatal Substance Use in an Underserved Population
Authors: Ganetsky Valerie S. , Heil Jessica , Yates Brianna , Jones Iris , Hunter Krystal , Rivera Brandon , Wilson Lindsay , Salzman Matthew , Baston Kaitlan E. 
Published: September 2021

Objectives
We describe retention in care, medication for opioid use disorder (MOUD) prescribing, and urine toxicology outcomes of a comprehensive perinatal shared medical appointment model that combined medication, group-based counseling, and recovery supports.

Methods
We conducted a retrospective study of program retention between 11/1/16 and 3/31/20 in pregnant and postpartum women with substance dependence or use disorder. Disengagement reasons, MOUD prescribing, and urine toxicology were abstracted from medical records. A Cox proportional hazards model was used to evaluate risk factors for program disengagement.

Results
Approximately 87% of patients had OUD and 80% were pregnant at the initial visit (N = 140). Retention at 3 months, 6 months, 1 year, and 2 years was approximately 86%, 78%, 66%, and 48%, respectively. Over 97% of patients were prescribed MOUD and 88% of all urine toxicology results were negative for non-prescribed opioids. Patients enrolled after initiation of wraparound services (HR 0.52, 95% CI 0.28 – 0.96) and those attending more shared medical appointments (HR 0.90, 95% CI 0.87 – 0.93) had a lower hazard of disengagement after controlling for other covariates. Loss to follow-up was the most common disengagement reason.

Conclusions
A low-threshold, comprehensive perinatal shared medical appointment program had high retention rates, increased access to evidence-based MOUD, and high rates of opioid-negative urine toxicology. Participants enrolled after wraparound services began had a lower hazard of disengagement. Future research in perinatal substance use should evaluate the most optimal and cost-effective components of comprehensive programs to inform standard of care.
Subtrochanteric Femur Fractures Treated With Femoral Nail: The Effect of Cerclage Wire Augmentation on Complications, Fracture Union, and Reduction: A Systematic Review and Meta-Analysis of Comparative Studies
Authors: Hoskins Wayne , McDonald Laura , Spelman Tim , Bingham Roger 
Published: September 2021

Objective:
To perform a systematic review and meta-analysis of subtrochanteric femur fractures treated with an intramedullary nail, augmented with or without cerclage wiring, comparing the risk of reoperation, nonunion, loss of fixation, and implant failure; fracture reduction and time to union.

Data Source:
A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed through MEDLINE, EMBASE, PubMed, Web of Science, and Scopus databases using a combination of controlled vocabulary and keywords on September 30, 2020.

Study Selection:
All comparative (prospective and retrospective) studies of subtrochanteric fractures managed with intramedullary nail, that compared the addition of cerclage wire to without in patients 16 years of age or older were included. Pathological, atypical bisphosphonate, and segmental fractures were excluded, as were non-English literature.

Data Extraction:
Data from each study were independently recorded by 2 investigators.

Data Synthesis:
Agreement was obtained on 18 studies (all retrospective) for final inclusion, with 378 patients receiving cerclage wire and 911 without. A random-effects meta-analysis was used to analyze the pooled aggregate data.

Conclusions:
There is no statistically significant advantage in using cerclage wire with femoral intramedullary nail when treating subtrochanteric femur fractures regarding risk of reoperation, nonunion, loss of fixation, and implant failure or time to union. An advantage favoring cerclage wire was seen for accuracy of fracture reduction. Cerclage wiring was used more often in cases associated with high-energy trauma. Given the relatively small number of events available to be modelled, a clinical benefit for cerclage wiring may still exist for certain fracture types.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Applied Anatomy of the Quadriceps Tendon Related to the Technique of Harvesting the Quadriceps Tendon Graft
Authors: Thi Cao , Ha Nguyen Dang Phu 
Published: September 2021

Introduction:
The quadriceps tendon (QT) is a common autologous graft for anterior cruciate ligament reconstruction. However, the best way to harvest it is still undefined. This study aims to determine the QT’s anatomical structures as a graft for anterior cruciate ligament reconstruction and the ideal harvest site.

Methods:
Thirty fresh frozen knees from 15 cadavers were dissected, and the QT was analyzed. The length, depth, and width of the QT were measured in a standardized manner for each cadaver.

Results:
The QT superficial morphology showed 2 distinct peaks, with the maximum length correlating with the real lateral peak. The full length of the tendon was located at 64.3%±5.4% of the width from the medial border of the insertion. The maximum length of the QT was 79.4±4.5 mm. The mean width at its insertion onto the patella was 36.0±4.3 mm. The thickness at its maximum length on patella insertion was 7.2±0.4 mm. The mean diameter of the QT graft was 8.5±0.5 mm, with a mean cross-sectional area of 64.7±4.1 mm2.

Conclusion:
QT graft harvest should begin by locating the apex (maximum length) of the tendon (64.3% of the distance from the patella’s medial edge). The surgeon should then harvest a 10 mm wide graft medially to the maximum length, harvesting 70 mm long and full-thickness tendon.
Perspectives of Canadian Rural Consultant Pediatricians on Diagnosing Autism Spectrum Disorder: A Qualitative Study
Authors: Das Jennifer , Hartman Laura , King Gillian , Jones-Stokreef Nicola , Moore Hepburn Charlotte , Penner Melanie 
Published: September 2021

ABSTRACT:

Background:
Consultant pediatricians represent a potential resource for increasing autism spectrum disorder (ASD) diagnostic capacity; however, little is known about how they perceive their roles in ASD diagnosis.

Objective:
The objective of this study was to examine the perspectives of rural consultant pediatricians regarding their perceived roles, facilitators, and barriers in ASD diagnosis.

Methods:
We performed a qualitative study using thematic analysis. Consultant pediatricians from 3 small-sized and medium-sized Ontario communities were recruited. Semistructured interviews were conducted, transcribed, coded, and analyzed.

Results:
Fourteen pediatricians participated in this study. Participants all considered ASD diagnosis to be in their scope of practice. The major theme identified was the process of diagnosing ASD, which occurred in 3 stages: preassessment (gathering information before the first clinic visit), diagnosis, and service access. All these stages are influenced by ecological factors consisting of characteristics of the child, family, individual physician, pediatric group practice, and the broader system of ASD care.

Conclusion:
Consultant pediatricians practicing in nonurban Ontario communities see ASD diagnosis as part of their scope of practice and collaboratively work within groups to address the needs of their communities. Strategies aimed at increasing diagnostic capacity should target salaried group practices and improve the efficiency of assessments through preclinic information gathering.
Developmental and Behavioral Problems of Preschool-Age Children with Chronic Rheumatic Diseases
Authors: Çelen Yoldaş Tuba , Özdel Semanur , Karakaya Jale , Bülbül Mehmet 
Published: September 2021

ABSTRACT:

Objective:
Juvenile idiopathic arthritis (JIA) is the most common autoimmune and familial Mediterranean fever (FMF) the most common autoinflammatory chronic rheumatic disease in childhood. We aimed first to identify developmental and behavioral problems of preschool-age children with common chronic rheumatic diseases, second to compare the diagnostic categories, and third to elucidate the associated factors with these difficulties.

Method:
Of the 91 participants included in this study, 46 were children with rheumatic diseases (27 with JIA and 19 with FMF) and 45 were healthy children. The general developmental and emotional/behavioral problems of each child were evaluated by the Ages and Stages Questionnaire and Child Behavior Checklist-1½-5, respectively. The State-Trait Anxiety Inventory and Beck Depression Inventory were used for maternal well-being.

Results:
Internalizing problem scores were increased, and the percentage of children who failed at least 1 developmental domain and experienced delays in fine motor and problem-solving domains were higher in children with chronic rheumatic diseases when compared with healthy children. Being in the group of rheumatic diseases, fewer maternal education years and higher screen time were found to be independent risk factors significantly associated with any developmental delay in the multivariable model. Maternal trait anxiety scores were positively associated with internalizing and total problems only in FMF.

Conclusion:
Preschool-age children with a diagnosis of chronic rheumatic diseases were more vulnerable for developmental and behavioral problems compared with healthy children. The management of chronic rheumatic diseases in the early years should include the screening of developmental and behavioral problems.
Joint Environmental Radiation Survey by JAEA and KAERI Around the Fukushima Daiichi Nuclear Power Plant: Performance of Mobile Gamma-Ray Spectrometry Using Backpack and Carborne Survey Platforms
Authors: Ji Young-Yong , Ochi Kotaro , Hong Sang Bum , Nakama Shigeo , Sanada Yukihisa , Mikami Satoshi 
Published: September 2021

Abstract
According to the implementing arrangement between the Japan Atomic Energy Agency (JAEA) and the Korea Atomic Energy Research Institute (KAERI) in the field of radiation protection and environmental radiation monitoring, a joint survey program was performed to assess ground deposition of radioactive cesium in areas surrounding the Fukushima Daiichi Nuclear Power Plants. The purpose of this joint survey was to evaluate the field applications of the developed survey systems and methodologies. Understanding the performance of each system within a cesium-deposited contaminated zone is important for ensuring an appropriate response following a nuclear accident. The results of the measured ambient dose rates determined using each survey method were compared. Two kinds of survey system were used in the mobile gamma-ray spectrometry, which were MARK-M1 (Monitoring of Ambient Radiation of KAERI—the 1st Multipurpose system) based on two LaBr3(Ce) detectors of KAERI and KURAMA-II (Kyoto University Radiation Mapping - II) system with one CsI(Tl) detector of JAEA. First, mobile gamma-ray spectrometry using a backpack survey platform was conducted to assess the distribution of dose rates around specific survey sites, which were expected to be slightly contaminated by radioactive cesium in Minamisoma and Tomioka. A carborne survey using two gamma-ray spectrometers loaded inside a vehicle was successfully conducted to compare the measured dose rates in routes from site to site and verify evaluation methods, including attenuation correction.
MULTISCALE CORRELATION OF MICROVASCULAR CHANGES ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY WITH RETINAL SENSITIVITY IN DIABETIC RETINOPATHY
Authors: Levine Emily S. , Moult Eric M. , Greig Eugenia Custo , Zhao Yi , Pramil Varsha , Gendelman Isaac , Alibhai Agha Y. , Baumal Caroline R. , Witkin Andre J. , Duker Jay S. , Fujimoto James G. , Waheed Nadia K. 
Published: September 2021

Purpose:
To assess global, zonal, and local correlations between vessel density changes measured by optical coherence tomography angiography and retinal sensitivity measured by microperimetry across diabetic retinopathy severity.

Methods:
Diabetic patients and nondiabetic controls underwent optical coherence tomography angiography imaging and microperimetry testing. Pearson's correlation was used to assess associations between average sensitivity and skeletonized vessel density (SVD) or foveal avascular zone area centrally. Linear mixed effects modeling was used to assess relationships between local SVD measurements and their spatially corresponding retinal sensitivity measurements.

Results:
Thirty-nine eyes from 39 participants were imaged. In all slabs, there was a statistically significant positive correlation between retinal sensitivities and SVDs on both global and zonal scales. No statistically significant correlation was found between central retinal sensitivities and the foveal avascular zone areas. Assessment of 1,136 spatially paired retinal sensitivity and SVD measurements revealed a statistically significant local relationship; this seemed to be driven by eyes with proliferative diabetic retinopathy that had reduced retinal sensitivities.

Conclusion:
This study supports positive correlations between SVD and retinal sensitivity at global and zonal spatial scales in diabetic eyes. However, our analysis did not find evidence of statistically significant correlations between retinal sensitivity and SVD on a local scale until advanced diabetic retinopathy.
EN-FACE IMAGING OF ATYPICAL EPIRETINAL TISSUE IN LAMELLAR MACULAR HOLE
Authors: Eun Jun Soo , Choi Young Joo , Kang Se Woong , Choi Kyung Jun , Kim Sang Jin , Roh Hyeon Cheol 
Published: September 2021

Purpose:
To elucidate the significance of en-face optical coherence tomography imaging of atypical epiretinal tissue (AET) in the lamellar macular hole (LMH).

Methods:
This study involved 29 eyes of 29 patients who underwent surgical treatment for LMH with AET. Best-corrected visual acuity, metamorphopsia assessment (M-score), and optical coherence tomography were evaluated before and 6 months after surgery. The novel en-face optical coherence tomography parameters, such as the area of AET and hyperreflective fringe, were correlated with clinical factors before and after LMH surgery.

Results:
Preoperatively, hyperreflective fringe was noted in 25 (86.2%) patients. The splitting of the inner retina, disruption of the ellipsoid zone, the extent of foveal cavitation, symptom duration, and change in best-corrected visual acuity were correlated with the area of AET (all P < 0.05). Multivariate regression analysis revealed that a larger area of AET was associated with longer symptom duration and less improvement in postoperative vision (all P < 0.05).

Conclusion:
The area of AET may represent the chronicity of LMH and is significantly associated with visual outcomes after LMH surgery. This novel en-face optical coherence tomography parameter can be used as a predictive factor for surgical outcomes in LMH with AET.
Neural and behavioral correlates of human pain avoidance in participants with and without episodic migraine
Authors: Gandhi Wiebke , de Vos Cecile C. , Becker Susanne , Hoge Richard D. , Hoeppli Marie-Eve , Schweinhardt Petra 
Published: September 2021

Abstract
The innate motivation to avoid pain can be disrupted when individuals experience uncontrollable stress, such as pain. This can lead to maladaptive behaviors, including passivity, and negative affect. Despite its importance, motivational aspects of pain avoidance are understudied in humans and their neural mechanisms vastly unknown. Rodent models suggest an important role of the periaqueductal gray, but it is unknown whether it subserves a similar role in humans. Furthermore, it is unclear whether pain avoidance is associated with individual differences in pain coping. Using functional magnetic resonance imaging, networks underlying pain avoidance behavior were examined in 32 participants with and without episodic migraine. Pain avoidance behavior was assessed using an adaptation of the incentive delay task. In each trial of the task, participants tried to avoid a painful stimulus and receive a nonpainful one instead while the difficulty to succeed varied across trials (3 difficulty levels: safe, easy, and difficult). After unsuccessful pain avoidance on the preceding trial, participants showed reduced pain avoidance behavior, especially in the difficult condition. This reduction in behavior was associated with higher helplessness scores only in participants with migraine. Higher helplessness in participants with migraine was further correlated with a stronger decrease in activation of cortical areas associated with motor behavior, attention, and memory after unsuccessful pain avoidance. Of these areas, specifically posterior parietal cortex activation predicted individual's pain avoidance behavior on the next trial. The results link individual pain coping capacity to patterns of neural activation associated with altered pain avoidance in patients with migraine.
Long-term Hearing Preservation and Speech Perception Performance Outcomes With the Slim Modiolar Electrode
Authors: Shew Matthew A. , Walia Amit , Durakovic Nedim , Valenzuela Carla , Wick Cameron C. , McJunkin Jonathan L. , Buchman Craig A. , Herzog Jacques A. 
Published: September 2021

Objective:
Describe audiologic outcomes in hearing preservation (HP) cochlear implant candidates using a slim modiolar electrode (SME).

Study Design:
Retrospective.

Setting:
Tertiary referral center.

Patients:
Two hundred three adult cochlear implant patients with preoperative low-frequency pure-tone average (LFPTA) ≤ 80 dB HL that received the SME.

Intervention:
Implantation with a SME electrode.

Main Outcome Measures:
Primary outcome was postoperative HP, defined as LFPTA ≤80 dB HL. HP status was analyzed at “early” (activation or 3 mo) and “long-term” (6 or 12 mo) time frames using the patient's worst audiogram. Speech perception tests were compared between HP and non-HP cohorts.

Results:
Of the 203 HP candidates, the tip fold-over rate was 7.4%. The mean shifts in LFPTA at the “early” and “long-term” time points were 25.9 ± 16.2 dB HL and 29.6 ± 16.9 dB HL, respectively. Of 117 patients with preoperative LFPTA ≤60 dB HL, the early and long-term mean LFPTA shifts were 19.5 ± 12.3 dB HL and 32.6 ± 17.2 dB HL, respectively; early and long-term HP rates were 61.1% and 50.8%, respectively. For patients with preoperative LFPTA ≤80 dB HL, early and long-term HP rates were 45.5% and 43.7%, respectively. No significant difference was observed in postoperative speech perception performance (CNC, AzBio, HINT) at 3, 6, or 12 months between HP versus non-HP groups.

Conclusions:
HP is feasible using the SME. While electroacoustic stimulation was not studied in this cohort, HP provided no clear advantage in speech perception abilities in this group of patients. The current reporting standard of what constitutes HP candidacy (preoperative LFPTA ≤80 dB HL) should be reconsidered.
Pediatric Primary Tympanoplasty Outcomes With Autologous and Non-autologous Grafts
Authors: Cass Nathan D. , Hebbe Annika L. , Meier Maxene R. , Kaizer Alexander M. , Kalmanson Olivia A. , Stevens Christina , Tholen Kaitlyn E. , Haville Salina , Handley Elyse , Francom Christian R. , Herrmann Brian W. 
Published: September 2021

Objective:
To compare rates of successful tympanic membrane (TM) closure in primary pediatric tympanoplasty between various autologous and non-autologous tissues.

Methods:
A retrospective chart review was performed examining all primary pediatric tympanoplasties over a 20-year period at a single institution.

Results:
In 564 pediatric tympanoplasties, no statistically significant difference existed between success rates of autologous and non-autologous grafts (p = 0.083). Compared with fascia, the hazard ratios (and 95% confidence intervals [CI]) for failure for each graft were as follows: human pericardial collagen (HR 0.90, CI 0.54–1.50, p = 0.680), porcine submucosal collagen (HR 1.07, CI 0.56–2.05, p = 0.830), human acellular dermal collagen (HR 1.66, CI 0.95–2.87, p = 0.073), and “multiple grafts” (HR 0.72, CI 0.26–1.98, p = 0.520). Survival curves demonstrated that 75% of graft failures occurred by 6 months after surgery, the rest occurring between 6 and 12 months postoperatively. Larger perforations encompassing more than or equal to 50% of the TM had lower success rates (HR 1.50, CI 1.02–2.21, p = 0.041) than smaller perforations encompassing less than 50% of the TM. Age was not correlated with success (HR 0.98, CI 0.93–1.03, p = 0.390).

Conclusion:
This study found that non-autologous collagen grafts provide equivalent rates of healing when compared with autologous tissue in primary pediatric tympanoplasty. In addition to the potential for reduced operative time and donor site morbidity, these materials provide a viable graft alternative in fascia-depleted ears.

Level of Evidence: Level 4