bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of emergency physicians’ self-estimates of CT scan utilization and its potential effect on an audit and feedback intervention: a randomized trial
Authors: Larkin Celine , Sanseverino Alexandra M. , Joseph James , Eisenhauer Lauren , Reznek Martin A. 
Published: July 2021

Abstract
Background
Audit and feedback (A&F) has been used as a strategy to modify clinician behavior with moderate success. Although A&F is theorized to work by improving the accuracy of clinicians’ estimates of their own behavior, few interventions have included assessment of clinicians’ estimates at baseline to examine whether they account for intervention success or failure. We tested an A&F intervention to reduce computed tomography (CT) ordering by emergency physicians, while also examining the physicians’ baseline estimates of their own behavior compared to peers.

Methods
Our study was a prospective, multi-site, 20-month, randomized trial to examine the effect of an A&F intervention on CT ordering rates, overall and by test subtype. From the electronic health record, we obtained 12 months of baseline CT ordering per 100 patients treated for every physician from four emergency departments. Those who were randomized to receive A&F were shown a de-identified graph of the group’s baseline CT utilization, asked to estimate wherein the distribution of their own CT order practices fell, and then shown their actual performance. All participants also received a brief educational intervention. CT ordering rates were collected for all physicians for 6 months after the intervention. Pre-post ordering rates were compared using independent and repeated measures t tests.

Results
Fifty-one of 52 eligible physicians participated. The mean CT ordering rate increased significantly in both experimental conditions after the intervention (intervention pre = 35.7, post = 40.3, t = 4.13, p < 0.001; control pre = 33.9, post = 38.9, t = 3.94, p = 0.001), with no significant between-group difference observed at follow-up (t = 0.43, p = 0.67). Within the intervention group, physicians had poor accuracy in estimating their own ordering behavior at baseline: most overestimated and all guessed that they were in the upper half of the distribution of their peers. CT ordering increased regardless of self-estimate accuracy.

Conclusions
Our A&F intervention failed to reduce physician CT ordering: our feedback to the physicians showed most of them that they had overestimated their CT ordering behavior, and they were therefore unlikely to reduce it as a result. After “audit,” it may be prudent to assess baseline clinician awareness of behavior before moving toward a feedback intervention.
Prescribing antipsychotic medication for adults with intellectual disability: shared responsibilities between mental health services and primary care
Authors: Paton Carol , Roy Ashok , Purandare Kiran , Rendora Olivia , Barnes Thomas R. E. 
Published: July 2021

Aims and methodWe conducted a secondary analysis of data from a Prescribing Observatory for Mental Health audit to assess the quality of requests from intellectual disability services to primary care for repeat prescriptions of antipsychotic medication.ResultsForty-six National Health Service Trusts submitted treatment data on 977 adults with intellectual disability, receiving antipsychotic medication for more than a year, for whom prescribing responsibility had been transferred to primary care. Therapeutic effects had been monitored in the past 6 months in 80% of cases with a documented communication indicating which service was responsible for this and 72% of those with no such communication. The respective proportions were 69% and 42% for side-effect monitoring, and 79% and 30% for considering reducing/stopping antipsychotic medication.Clinical implicationsWhere continuing antipsychotic medication is prescribed in primary care for people with intellectual disability, lack of guidance from secondary care regarding responsibilities for monitoring its effectiveness may be associated with inadequate review.
Racial Disintegration: Biomedical Futurity at the Environmental Limit
Authors: Huang Michelle N. 
Published: July 2021

AbstractIlluminating how biomedical capital invests in white and Asian American populations while divesting from Black surplus populations, this article proposes recent Asian American dystopian fiction provides a case study for analyzing futurities where healthcare infrastructures intensify racial inequality under terms that do not include race at all. Through a reading of Chang-rae Lee’s On Such a Full Sea (2014) and other texts, the article develops the term studious deracination to refer to a narrative strategy defined by an evacuated racial consciousness that is used to ironize assumptions of white universalism and uncritical postracialism. Studious deracination challenges medical discourse’s “color-blind” approach to healthcare and enables a reconsideration of comparative racialization in a moment of accelerating social disintegration and blasted landscapes. Indeed, while precision medicine promises to replace race with genomics, Asian American literature is key to showing how this “postracial” promise depends on framing racial inequality as a symptom, rather than an underlying etiology, of infrastructures of public health.
TFAM-deficient mouse skin fibroblasts – an ex vivo model of mitochondrial dysfunction
Authors: Del Rey Manuel J. , Meroño Carolina , Municio Cristina , Usategui Alicia , Mittelbrunn María , García-Consuegra Inés , Criado Gabriel , Pablos José L. 
Published: July 2021

ABSTRACT
Mitochondrial dysfunction associates with several pathological processes and contributes to chronic inflammatory and ageing-related diseases. Mitochondrial transcription factor A (TFAM) plays a critical role in maintaining mtDNA integrity and function. Taking advantage of Tfamfl/fl UBC-Cre/ERT2+/+ mice to investigate mitochondrial dysfunction in the stromal cell component, we describe an inducible in vitro model of mitochondrial dysfunction by stable depletion of TFAM in primary mouse skin fibroblasts (SK-FBs) after 4-hydroxytamoxifen (4-OHT) administration. Tfam gene deletion caused a sustained reduction in Tfam and mtDNA-encoded mRNA in Cre(+) SK-FBs cultured for low (LP) and high (HP) passages that translated into a loss of TFAM protein. TFAM depletion led to a substantial reduction in mitochondrial respiratory chain complexes that was exacerbated in HP SK-FB cultures. The assembly pattern showed that the respiratory complexes fail to reach the respirasome in 4-OHT-treated Cre(+) SK-FBs. Functionally, mito-stress and glycolysis-stress tests showed that mitochondrial dysfunction developed after long-term 4-OHT treatment in HP Cre(+) SK-FBs and was compensated by an increase in the glycolytic capacity. Finally, expression analysis revealed that 4-OHT-treated HP Cre(+) SK-FBs showed a senescent and pro-inflammatory phenotype.
Current situation of vaccine injury compensation program and a future perspective in light of COVID-19 and emerging viral diseases
Authors: Crum Tommie , Mooney Kirsten , Tiwari Birendra R. 
Published: July 2021

Background: Vaccines have had a great impact on disease prevention and mortality reduction. Very rarely, vaccines also can result in serious adverse effects. In consideration of this fact, vaccine injury compensation programs have been implemented in many countries to compensate a vaccinee for associated adverse effects. The existing vaccine injury compensation system addresses routine immunization schemes. However, there are rising concerns about the compensation for adverse effects caused by new vaccines such as those developed for coronavirus disease 2019 (COVID-19). The objective of this article is to review the existing vaccine injury compensation programs in different countries. The review also highlights the necessity to include all upcoming new vaccines for COVID-19 and other emerging viral diseases in the compensation schemes. Methods: Published articles relating to vaccine compensation injury programs, vaccines, injuries, disabilities, illnesses, and deaths resulting from vaccination were searched in data bases. Through a careful review of the abstracts, 25 relevant articles were selected for analysis. Results: We identified 27 countries on four continents with vaccine injury compensation schemes: 17 countries in Europe, 7 countries in Asia, the United States, a Canadian Province and New Zealand. No programs were identified in Africa and in South America. Program design, funding, and eligibility for compensation vary vastly between countries. We identified 17 countries operating well-established vaccine injury compensation programs. However, minimal information is available on numerous other countries. Conclusion: We have identified 27 countries operating vaccine injury compensation programs. In Canada, Quebec is the only province with a scheme; however, discussions are ongoing in Canada for nationwide implementation in light of COVID 19. Study limitations include limited scientific material, which hindered our research. Additional data concerning payout for each type of injury and the number of claimants related to a specific vaccine injury worldwide could provide a more comprehensive analysis.
Efficacy of COVID-19 vaccination in individuals designated as clinically extremely vulnerable in Scotland
Authors: McKeigue Paul M , McAllister David A , Bishop Jen , Hutchinson Sharon , Robertson Chris , Lone Nazir , McMenamin Jim , Goldberg David , Colhoun Helen M 
Published: July 2021

Background: Although COVID-19 vaccines have been shown to have high efficacy in the general population, it has not been established whether this applies to vulnerable groups. The objective of this study was to estimate the efficacy of vaccination in reducing the risk of severe COVID-19 among those designated as clinically extremely vulnerable in Scotland. Methods: In a matched case-control design (REACT-SCOT), all 111295 cases of COVID-19 in Scotland diagnosed from 1 December 2020 to 16 March 2021 were matched for age, sex and primary care practice to 1093449 controls from the general population. This was linked to national data on vaccinations and those designated as clinically extremely vulnerable and thus eligible for shielding support. Severe COVID-19 was defined as cases with entry to critical care or fatal outcome. Rate ratios associated with vaccination within risk groups were estimated by conditional logistic regression. Results: The rate ratio for severe COVID-19 associated with vaccination at least 14 days before was 0.29 (95% CI 0.22 to 0.37) in those eligible for shielding, compared with 0.29 (95% CI 0.25 to 0.34) in those ineligible for shielding. The rate ratio for hospitalized or fatal COVID-19 was 0.39 (95% CI 0.33 to 0.46) in those eligible and 0.37 (95% CI 0.33 to 0.41) in those not eligible for shielding. Examined by specific shielding conditions, the rate ratio for hospitalized or fatal COVID-19 ranged from 0.33 (95% CI 0.21 to 0.51) in those with specific cancers to 0.74 (95% CI 0.36 to 1.51) in solid organ transplant recipients, and 0.53 (95% CI 0.33 to 0.84) in others on immunosuppressants (excluding solid organ transplant recipients). Conclusions: These results are reassuring with respect to efficacy in clinically vulnerable individuals including immunocompromised individuals, but studies in larger populations are needed to estimate efficacy in solid organ transplant recipients.
The effect induced by alternated mechanical loading on Notch-1 in mandibular condylar cartilage of growing rabbits
Authors: Yan Fan , Feng Jianying , Yang Liu , Shi Changjin 
Published: July 2021

Aims The aim of our study is to investigate the effect induced by alternated mechanical loading on Notch-1 in mandibular condylar cartilage (MCC) of growing rabbits. Methods A total of 64 ten-day-old rabbits were randomly divided into two groups according to dietary hardness: normal diet group (pellet) and soft diet group (powder). In each group, the rabbits were further divided into four subgroups by feeding time: two weeks, four weeks, six weeks, and eight weeks. Animals would be injected 5-bromo-2′-deoxyuridine (BrdU) every day for one week before sacrificing. Histomorphometric analysis of MCC thickness was performed through haematoxylin and eosin (HE) staining. Immunochemical analysis was done to test BrdU and Notch-1. The quantitative real-time polymerase chain reaction (qRT-PCR) and western blot were used to measure expression of Notch-1, Jagged-1, and Delta-like 1 (Dll-1). Results The thickness of MCC in the soft diet group was thinner than the one in normal diet group. Notch-1 was restricted in fibrous layer, proliferative layer, and hypertrophic layer. The expression of Notch-1 increased from two weeks to six weeks and then fell down. Notch-1 in normal diet group was higher than that in soft diet group in anterior part of MCC. The statistical differences of Notch-1 were shown at two, four, and six weeks (p < 0.05). The result of western blot and quantitative real-time PCR (qRT-PCR) showed the expression of Dll-1 and Jagged-1 rose from two to four weeks and started to decrease at four weeks. BrdU distributed in all layers of cartilage and subchondral bone. The number of BrdU-positive cells, which were less in soft diet group, was decreasing along with the experiment period. The significant difference was found at four, six, and eight weeks in anterior and posterior parts (p < 0.05). Conclusion The structure and proliferation of MCC in rabbits were sensitive to dietary loading changes. The proper mechanical loading was essential for transduction of Notch signalling pathway and development of mandibular condylar cartilage. Cite this article: Bone Joint Res 2021;10(7):437–444.
Comparison of cell therapy and other novel adjunctive therapies combined with core decompression for the treatment of osteonecrosis of the femoral head
Authors: Zhu Shibai , Zhang Xiaotian , Chen Xi , Wang Yiou , Li Shanni , Qian Wenwei 
Published: July 2021

Aims The value of core decompression (CD) in the treatment of osteonecrosis of the femoral head (ONFH) remains controversial. We conducted a systematic review and meta-analysis to evaluate whether CD combined with other treatments could improve the clinical and radiological outcomes of ONFH patients compared with CD alone. Methods We searched the PubMed, Embase, Web of Science, and Cochrane Library databases until June 2020. All randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing CD alone and CD combined with other measures (CD + cell therapy, CD + bone grafting, CD + porous tantalum rod, etc.) for the treatment of ONFH were considered eligible for inclusion. The primary outcomes of interest were Harris Hip Score (HHS), ONFH stage progression, structural failure (collapse) of the femoral head, and conversion to total hip arthroplasty (THA). The pooled data were analyzed using Review Manager 5.3 software. Results A total of 20 studies with 2,123 hips were included (CD alone = 768, CD combined with other treatments = 1,355). The combination of CD with other therapeutic interventions resulted in a higher HHS (mean difference (MD) = 6.46, 95% confidence interval (CI) = 2.10 to 10.83, p = 0.004) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (MD = −10.92, 95% CI = -21.41 to -4.03, p = 0.040) and a lower visual analogue scale (VAS) score (MD = −0.99, 95% CI = -1.56 to -0.42, p < 0.001) than CD alone. For the rates of disease stage progression, 91 (20%) progressed in the intervention group compared to 146 (36%) in the control group (odds ratio (OR) = 0.32, 95% CI = 0.16 to 0.64, p = 0.001). In addition, the intervention group had a more significant advantage in delaying femoral head progression to the collapsed stage (OR = 0.32, 95% CI = 0.17 to 0.61, p < 0.001) and reducing the odds of conversion to THA (OR = 0.35, 95% CI = 0.23 to 0.55, p < 0.001) compared to the control group. There were no serious adverse events in either group. Subgroup analysis showed that the addition of cell therapy significantly improved clinical and radiological outcomes compared to CD alone, and this approach appeared to be more effective than other therapies, particularly in precollapse (stage I to II) ONFH patients. Conclusion There was marked heterogeneity in the studies. There is a trend towards improved clinical outcomes with the addition of stem cell therapy to CD. Cite this article: Bone Joint Res 2021;10(7):445–458.
Application of the Gaussian modeling algorithm to a Shack–Hartmann wavefront sensor for daylight adaptive optics
Authors: Xu Li , Wang Jianli , Yao Kainan , Yang Leqiang 
Published: July 2021

Daytime use of Shack–Hartmann wavefront sensor (SHWS)-based adaptive optics (AO) at a telescope is hindered by the fluctuating bright sky background. Therefore, we propose a Gaussian modeling centroid extraction algorithm that performs real-time daylight AO closed-loop corrections. The algorithm is executed in the process of modeling and updating each pixel of the consecutive SHWS images. The simulation results show that our method can provide a lower centroid estimation error (CEE) for bright sky background conditions. We also performed a field experiment on a 2 m ground-based telescope and achieved a daylight AO correction of 2.1 times diffraction limit for a star with a visual magnitude of 4.7 (HIP113116) when the elevation angle of the sun was 7.7°. This represents the first publicly reported daylight natural guide star AO correction result on a 2 m class telescope.
Dipeptidyl peptidase III as a DNA marker to investigate epidemiology and taxonomy of Old World Leishmania species
Authors: Bel Hadj Ali Insaf , Chouaieb Hamed , Saadi Ben Aoun Yusr , Harigua-Souiai Emna , Souguir Hejer , Yaacoub Alia , El Dbouni Oussaïma , Harrat Zoubir , Mukhtar Maowia M. , Ben Said Moncef , Haddad Nabil , Fathallah-Mili Akila , Guizani Ikram 
Published: July 2021

BackgroundDipeptidyl peptidase III(DPPIII) member of M49 peptidase family is a zinc-dependent metallopeptidase that cleaves dipeptides sequentially from the N-terminus of its substrates. InLeishmania,DPPIII, was reported with other peptidases to play a significant role in parasites’ growth and survival. In a previous study, we used a coding sequence annotated asDPPIIIto develop and evaluate a PCR assay that is specific to dermotropic Old World (OW)Leishmaniaspecies. Thus, our objective was to further assess use of this gene forLeishmaniaspecies identification and for phylogeny, and thus for diagnostic and molecular epidemiology studies of Old WorldLeishmaniaspecies.MethodologyOrthologousDDPIIIgenes were searched in allLeishmaniagenomes and aligned to design PCR primers and identify relevant restriction enzymes. A PCR assays was developed and seventy-twoLeishmaniafragment sequences were analyzed using MEGA X genetics software to infer evolution and phylogenetic relationships of studied species and strains. A PCR-RFLP scheme was also designed and tested on 58 OWLeishmaniastrains belonging to 8Leishmaniaspecies and evaluated on 75 human clinical skin samples.FindingsSequence analysis showed 478 variable sites (302 being parsimony informative). Test of natural selection (dN-dS) (-0.164, SE = 0.013) inferred a negative selection, characteristic of essential genes, corroborating theDPPIIIimportance for parasite survival. Inter- and intra-specific genetic diversity was used to develop universal amplification of a 662bp fragment. Sequence analyses and phylogenies confirmed occurrence of 6 clusters congruent toL.major,L.tropica,L.aethiopica,L.arabica,L.turanica,L.tarentolaespecies, and one to theL.infantumandL.donovanispecies complex.A PCR-RFLP algorithm forLeishmaniaspecies identification was designed using double digestions withHaeIII andKpnI and withSacI andPvuII endonucleases. Overall, this PCR-RFLP yielded distinct profiles for each of the speciesL.major,L.tropica,L.aethiopica,L.arabicaandL.turanicaand theL. (Sauroleishmania) L.tarentolae. The speciesL.donovani, andL.infantumshared the same profile except for strains of Indian origin. When tested on clinical samples, theDPPIIIPCR showed sensitivities of 82.22% when compared to direct examination and was able to identify 84.78% of the positive samples.ConclusionThe study demonstrates thatDPPIIIgene is suitable to detect and identifyLeishmaniaspecies and to complement other molecular methods for leishmaniases diagnosis and epidemiology. Thus, it can contribute to evidence-based disease control and surveillance.
The burden of scrub typhus in India: A systematic review
Authors: Devasagayam Emily , Dayanand Divya , Kundu Debasree , Kamath Mohan S. , Kirubakaran Richard , Varghese George M. 
Published: July 2021

Background
Scrub typhus, a vector-borne zoonotic infection caused by the bacteria Orientia tsutsugamushi, is one of the most common and clinically important rickettsial infections worldwide. An estimated one million cases occur annually with a high case fatality rate. Although scrub typhus is a major public health threat in India, the burden and distribution remains unclear. We aimed to estimate the burden of scrub typhus in India.

Methodology
We performed a systematic review of published literature on scrub typhus from India to extract information on epidemiology, morbidity, and mortality. Important databases were searched using keywords and appropriate combinations. We identified observational, interventional, and population-based studies and extracted the data to evaluate the number of cases diagnosed using serology or PCR and the number of deaths due to scrub typhus. We conducted a systematic narrative synthesis to summarize included studies.

Principal findings
In the last decade, there were 18,781 confirmed scrub typhus cases reported in 138 hospital-based studies and two community-based studies. IgM ELISA was used in 122 studies to confirm the cases in majority (89%). The proportion of scrub typhus among acute undifferentiated febrile illness (AUFI) studies was 25.3%, and community seroprevalence was 34.2%. Ninety studies had data published on multiple organ involvement out of which 17.4% of cases had multiple organ dysfunction syndromes, 20.4% patients required ICU admission, and 19.1% needed ventilation. The overall case-fatality rate was 6.3%, and the mortality among those with multi-organ dysfunction syndrome was as high as 38.9%.

Conclusion/significance
Scrub typhus, a common acute febrile illness in India causing severe morbidity, accounts for a large number of deaths. The burden of the disease has been underappreciated. Early diagnosis and prompt treatment can significantly reduce complications and mortality. Establishing good surveillance and instituting appropriate control measures are urgently needed.