bluuebunny/crossref_metadata_2025_split huggingface dataset:
State-Level Masking Mandates and COVID-19 Outcomes in the United States
Authors: Wong Angus K. , Balzer Laura B. 
Published: December 2021

Background:
We sought to investigate the effect of public masking mandates in US states on COVID-19 at the national level in Fall 2020. Specifically, we aimed to evaluate how the relative growth of COVID-19 cases and deaths would have differed if all states had issued a mandate to mask in public by 1 September 2020 versus if all states had delayed issuing such a mandate.

Methods:
We applied the Causal Roadmap, a formal framework for causal and statistical inference. We defined the outcome as the state-specific relative increase in cumulative cases and in cumulative deaths 21, 30, 45, and 60 days after 1 September. Despite the natural experiment occurring at the state-level, the causal effect of masking policies on COVID-19 outcomes was not identifiable. Nonetheless, we specified the target statistical parameter as the adjusted rate ratio (aRR): the expected outcome with early implementation divided by the expected outcome with delayed implementation, after adjusting for state-level confounders. To minimize strong estimation assumptions, primary analyses used targeted maximum likelihood estimation with Super Learner.

Results:
After 60 days and at a national level, early implementation was associated with a 9% reduction in new COVID-19 cases (aRR = 0.91 [95% CI = 0.88, 0.95]) and a 16% reduction in new COVID-19 deaths (aRR = 0.84 [95% CI = 0.76, 0.93]).

Conclusions:
Although lack of identifiability prohibited causal interpretations, application of the Causal Roadmap facilitated estimation and inference of statistical associations, providing timely answers to pressing questions in the COVID-19 response.
Clinical and Molecular Outcomes After Combined Intense Pulsed Light Therapy With Low-Level Light Therapy in Recalcitrant Evaporative Dry Eye Disease With Meibomian Gland Dysfunction
Authors: D'Souza Sharon , Padmanabhan Nair Archana , Iyappan Gowtham , Dickman Mor M. , Thakur Prashansa , Mullick Ritika , Kundu Gairik , Sethu Swaminathan , Ghosh Arkasubhra , Shetty Rohit 
Published: December 2021

Purpose:
Dry eye disease (DED) is a leading cause of ocular morbidity worldwide. This study evaluates the effects of combined light therapy [intense pulsed light (IPL) and low-level light therapy (LLLT)] on clinical and molecular outcomes in evaporative DED with meibomian gland dysfunction (MGD).

Methods:
This prospective study evaluated 94 eyes (47 subjects) with chronic MGD treated with combined light therapy. Patients underwent a detailed evaluation of MGD and DED using the Ocular Surface Disease Index, dry eye tests—tear breakup time and Schirmer test, ocular surface staining, meibomian gland expressibility scoring, and meibography. Patients underwent a single session of combined light therapy (IPL + LLLT treatment) using the Eye-light device. All these tests were repeated at 3 and 6 months after treatment. Tear fluid and ocular surface wash samples were collected from a subset of patients before and after treatment for cellular and secreted immune factor profiling by flow cytometry.

Results:
Combined light therapy (IPL + LLLT) demonstrated a marked improvement in the clinical metrics studied. Three months after treatment, Ocular Surface Disease Index showed a significant reduction in 95.6% (P < 0.0001), tear breakup time increased in 72.3% (P < 0.0001), and meibomian gland expressibility scoring increased in 80.8% (P < 0.0001) of the eyes. These effects were observed to be sustained during the 6-month follow-up visit. Significant (P < 0.05) reduction in tear fluid levels of interleukin-1β, interleukin-17F, and MMP9; MMP9/TIMP1 ratio; and ocular surface B-cell proportions was observed.

Conclusions:
Combined light therapy shows promising results in patients with chronic MGD and DED, even in recalcitrant cases. Clinical and molecular factor alterations support the improved symptomatology and reduced inflammation.
The clinical impacts of molecular subtyping by multigene assay on hormone receptor-positive breast cancers
Authors: Liu Yeng-Ling , Hsu Chih-Yi , Feng Chin-Jung , Lien Pei-Ju , Huang Chi-Cheng , Lin Yen-Shu , Wang Yu-Ling , Chao Ta-Chung , Liu Chun-Yu , Chiu Jen-Hwey , Tsai Yi-Fang , Tseng Ling-Ming 
Published: December 2021

Background:
Multigene assays, such as MammaPrint and BluePrint, provide additional information other than conventional immunohistochemistry (IHC) to help making decision of treatment. This study aims to compare the clinical correlation between molecular subtyping (MS) versus surrogate pathological subtyping (PS).

Methods:
A database from patients receiving MS evaluation in Taipei Veterans General Hospital from 2013 to 2018 was reviewed retrospectively. Patients were categorized as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) and basal type from MS results and also centrally assessed according to PS (estrogen receptor [ER], progesterone receptor [PgR], HER2, and Ki-67). The clinical correlation between two different subtyping methodologies was analyzed, and the application of chemotherapy was compared.

Results:
From 2013 to 2018, a total of 130 patients received MS testing in our institute, and 132 tumor samples were sent for analysis. From MammaPrint, 64 (48.5%) and 55 (41.7%) samples were defined as low and high risks, respectively. The other 13 (9.8%) tumor samples were identified as late recurrence low risk. MS restratified 44 tumors as subtype shifting including 20 tumors from A to B in intrinsic subtypes and 24 tumors from B to A after MS evaluation. Chemotherapy was conducted in only one (1.3%) patient with MS-luminal A but in 87.8% (n = 43) of MS-luminal B subtypes.

Conclusion:
The MS results restratify the subtypes of hormone receptor positive breast cancer and dominate decision-making of adjuvant therapy. The role of surrogate biomarkers as an alternative tool needs further elucidation. The treatment outcome in different subtypes categorized by MS or PS will be the interesting focus of research.
Safety and tolerability of regadenoson compared with dipyridamole in myocardial perfusion imaging in patients scheduled to undergo medium to high-risk noncardiac surgery: a randomized controlled study
Authors: Stavrou Petros Z. , Polytarchou Kali , Giannopoulou Chariklia , Pantos Kostas , Mourouzis Iordanis , Datseris Ioannis , Manolis Antonis S. 
Published: December 2021

Objective
Regadenoson is the first Food and Drug Administration-approved selective A2A adenosine receptor agonist used in myocardial perfusion imaging. Its main benefits are its simplified and brief protocol, along with the ability to be administered safely in patients with asthma or chronic obstructive pulmonary disease of moderate severity. This study aims to identify any potential benefits of regadenoson, regarding the frequency of adverse reactions and its tolerability, over dipyridamole.

Methods
This is a randomized controlled study of 200 patients scheduled for medium to high-risk noncardiac surgery, of whom 100 were stressed with regadenoson (study group) and the rest with dipyridamole (control group).

Results
A greater proportion of adverse reactions was recorded in the regadenoson group as compared to the dipyridamole group (53 vs. 36%; P = 0.023), though the duration of most adverse reactions was shorter in the regadenoson group. Dyspnea (P < 0.001) and gastrointestinal disturbances (P = 0.001) were significantly more frequent in the regadenoson group. The use of aminophylline in patients who developed any adverse events was similar in the two groups (P > 0.05). When multiple regression analyses were performed, differences in adverse reactions between the two groups were no longer significant (odds ratio = 1.96; 95% confidence interval, 0.88–3.25; P = 0.11).

Conclusion
In our group of patients scheduled for myocardial perfusion imaging for preoperative assessment, the two agents, regadenoson and dipyridamole, have no significant differences in the frequency of mild adverse reactions and in aminophylline use, with regadenoson also having the advantage of faster symptom resolution. Nevertheless, dipyridamole can be considered as a well-tolerated and low-cost alternative.
Prediction of pathological response using 18F FDG PET/CT derived metabolic parameters in locally advanced breast cancer patients
Authors: Abd El-Gaid Salwa , AbdelHafez Marwa Nabil , Mohamed Ghada , Elazab Mohamed Samy Saied , Elahmadawy Mai Amr 
Published: December 2021

Aim of work
This study aims to assess the value of flurodeoxyglucose (FDG)-PET derived metabolic parameters for prediction of pathologic response in LABC postneoadjuvant therapy.

Methods
Totally 47 patients with LABC underwent initial and postneoadjuvant therapy PET scans. ΔSUVmax%, ΔTLG% and ΔMTV% were calculated. Post-therapy histopathologic therapeutic response was assessed.

Results
In total 91.5% of patients had invasive duct carcinoma and the remaining (8.5%) had invasive lobular carcinoma. Postneoadjuvant PET/CT was able to detect 91.7% of patients with pathologically proven complete response in primary tumor, 69% of those with Pathologic partial response and 88.3% of those with pathological no response (P value <0.001). However, 40 out of the 47 patients had regional nodal metastases. PET/CT was able to predict 57.1% of the patients with pathologically nonresponding nodal deposits and 93.9% of those revealed pathologic therapeutic effect (P value <0.001). Receiver operating characteristic curve (ROC) curve marked Δ1ry SUVmax of 26.25% (P value 0.003), Δ1ry TLG of 48.5% (P value 0.018). PET and pathological response correlated well with ΔSUVmax%, and Δ1ry TLG% correlated well with PET, pathologic response and expression of HER II receptors (P value <0.001, 0.003 and 0.037 respectively). ROC curve marked ΔLN SUVmax% of 80.15% (P value 0.012), ΔLN TLG% of 86.6% (P value 0.002), whereas for ΔLN MTV% cut off point of 55% (P value 0.003). ΔSUVmax%, ΔTLG % and ΔMTV% for regional nodal metastases, were significantly correlated with PET (P values <0.001, <0.001 and 0.003, respectively) and pathologic (P values 0.018, 0.001 and 0.002, respectively) response.

Conclusion
FDG–PET is a useful tool for monitoring the neoadjuvant therapeutic effect for primary and regional nodes in patients with LABC.
Surgical Patient Compliance With Healthcare Facility–Provided In-home Opioid Disposal Products: A Systematic Review
Authors: Edwards John M. , Evans Hallie , Dollar Stace D. , Odom-Forren Jan , Johnson Bill 
Published: December 2021

OBJECTIVE
The aim of this study was to review the literature regarding the use of an in-home opioid disposal product on unused opioids after surgery.

BACKGROUND
The opioid epidemic in the United States is a major cause of concern for healthcare facilities. The misuse and diversion of retained opioids after a surgical procedure continues to contribute to this problem.

METHODS
A comprehensive search of the Cumulative Index of Nursing and Allied Health Literature, OVID, and PubMed databases with keywords including opioid, analgesics, narcotics, medical waste disposal, medical disposal, refuse disposal, and opioid disposal resulted in 286 articles. Articles were screened based on strict inclusion and exclusion criteria.

RESULTS
Eight studies determined that an in-home opioid disposal product provided by a healthcare facility produced rates of opioid disposal between 19% and 71%.

CONCLUSIONS
The provision of an in-home opioid disposal product by a healthcare facility is likely to increase the disposal of unused opioid medications in the postoperative surgical patient population.
Factors Associated With Diagnostic Delay of Axial Spondyloarthritis in Colombian Patients
Authors: Parada-Arias Luisa , Vargas Juan F. , Ahcar Nassin S. , Rojas-Villarraga Adriana , Mantilla Rubén-Darío 
Published: December 2021

Background/Objective
The diagnostic delay of axial spondyloarthritis (axSpA) is globally reported to be between 3 and 11 years. Early diagnosis and treatment have long-term benefits for patients and the health care system. Several international studies have evaluated some factors associated with diagnostic delay, but there are no known studies in the Colombian population. This study assesses the factors associated with diagnostic delay of axSpA in a rheumatology center in Bogota, Colombia.

Methods
This monocentric analytical cross-sectional study was done in a specialized rheumatology center. Patients who fulfilled the 2009 Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axSpA were included. Information was obtained from medical records and a phone call. Bivariate and multivariate analyses were done to assess the associated factors with diagnostic delay.

Results
One hundred one patients were included, 54 were women (53.5%). The median diagnostic delay was 2 years (interquartile range, 1–7). The bivariate analysis showed that a younger age at diagnosis (p = 0.042) and previous diagnosis of lumbar degenerative disease (p = 0.029) were associated with a longer diagnostic delay. The logistical regression showed that previous lumbar degenerative disc disease (odds ratio, 2.8; 95% confidence interval, 1.09–7.53) and fibromyalgia (odds ratio, 4.0; 95% confidence interval, 1.2–13.1) diagnosis were both associated with a longer diagnostic delay.

Conclusions
Factors associated with a longer diagnostic delay were previous diagnosis of lumbar degenerative disc disease and fibromyalgia. Additional studies are needed so that the reasons for diagnostic delay are understood and early diagnosis and management of axSpA are enabled.
CT-Based Modeling of the Dentition for Craniomaxillofacial Surgical Planning
Authors: Abramson Zachary , Scoggins Matthew A. , Burton Christiane , Choudhri Asim F. , Holladay Chris , Briant Nancy Rose Pont , Sheyn Anthony , Susarla Srinivas 
Published: December 2021

Abstract:
Historically, the accuracy of imaging teeth by computed tomography (CT) has been suboptimal and deemed inadequate for surgical planning of orthognathic procedures. However, recent advances in CT hardware and software have significantly improved the accuracy of imaging occlusal anatomy. This technical note describes a quantitative means of evaluating the accuracy of CT-based modeling of teeth. Three-dimensional models of the dentition were created from a CT scan obtained of a craniomaxillofacial skeleton. Multiple reconstruction algorithms and modeling parameters were applied. The dentition of the same skeleton was scanned using a handheld optical scanning device to serve as the “gold standard.” Semi-automated registrations of CT and optically acquired models were performed and deviation analysis was conducted. On average, the deviation of the CT model with the optical scan measured 0.19 to 0.25 mm across the various reconstruction and modeling parameters, with a mean of 0.22 mm. Computed tomography underestimated contours at cusp tips, while overestimating contours in occlusal groves. The use of bone reconstruction algorithms and decreased model smoothing resulted in more accurate models, though greater surface noise. Future studies evaluating the clinical effectiveness of CT-based occlusal splints should take this finding into account.
Patho-Mechanisms for Hemorrhage/Sepsis-Induced Indirect Acute Respiratory Distress Syndrome: A Role for Lung TIE1 and Its Regulation by Neutrophils
Authors: Zhu Jiali , Li Jinbao , Chung Chun-Shiang , Lomas-Neira Joanne L. , Ayala Alfred 
Published: December 2021

ABSTRACT

Introduction:
Severe hemorrhage (Hem) has been shown to be causal for the development of extra-pulmonary/indirect acute respiratory distress syndrome (iARDS) and is associated with severe endothelial cell (EC) injury. EC growth factors, Angiopoietin (Ang)-1 and -2, maintain vascular homeostasis via tightly regulated competitive interaction with the tyrosine kinase receptor, Tie2, expressed on ECs.

Objective:
Since it has been reported that the orphan receptor, Tie1, may be able to play a role in Ang:Tie2 signaling; we chose to examine Tie1's capacity to alter the lung Ang:Tie2 interaction in response to the sequential insults of shock/sepsis (cecal ligation and puncture [CLP]), culminating in iARDS.

Methods:
Male mice were subjected to Hem alone or sequential Hem followed 24 hours later by CLP that induces iARDS. Changes in lung and/or plasma levels of Tie1, Tie2, Ang-1, Ang-2, various systemic cytokine/chemokines and indices of lung injury/inflammation were then determined. The role of Tie1 was established by intravenous administration of Tie1 specific or control siRNA at 1 h post-Hem. Alternatively, the contribution of neutrophils was assessed by pre-treating mice with anti-neutrophil antibody depletion 48 h prior to Hem.

Results:
Lung tissue levels of Tie1 expression elevated over the first 6 to 24 h post-Hem alone. Subsequently, we found that treatment of Hem/CLP mice with Tie1-specific siRNA not only decreased Tie1 expression in lung tissue compared to control siRNA, but, suppressed the rise in lung inflammatory cytokines, lung MPO and the rise in lung protein leak. Finally, much as we have previously shown that neutrophil interaction with resident pulmonary vascular ECs contribute significantly to Ang-2 release and EC dysfunction, central to the development of iARDS. Here, we report that depletion of neutrophils also decreased lung tissue Tie1 expression and increased Tie2 activation in Hem/CLP mice.

Conclusion:
Together, these data imply that shock-induced increased expression of Tie1 can contribute to EC activation by inhibiting Ang:Tie2 interaction, culminating in EC dysfunction and the development of iARDS.
The use of predefined scales and scores with eye-tracking devices for symptom identification in critically ill nonverbal patients
Authors: Ull Christopher , Hamsen Uwe , Weckwerth Christina , Schildhauer Thomas Armin , Gaschler Robert , Jansen Oliver , Waydhas Christian 
Published: December 2021

BACKGROUND
Eye tracking (ET) may be a novel tool to enable nonverbal communication. We hypothesized that ET could be used successfully by intensive care unit (ICU) patients with artificial airways to express their levels of pain and mood, quality of life, and self-esteem with predefined scales and scores.

METHODS
Prospective, monocentric, observational study, including patients with an endotracheal tube or tracheostomy tube and a history of mechanical ventilation for more than 48 hours without delirium, and inadequate nonverbal communication skills. The ICU patients' pain was assessed with a numeric rating scale, their mood was tested with a smiley analog scale. Quality of life and self-esteem were measured with the European quality of life-5 dimensions-5 levels-score and the visual analog self-esteem scale.

RESULTS
A total of 75 patients with a mean age of 58.3 years were included. Main diagnoses for ICU admission were major trauma (45.3%), nonabdominal sepsis (22.6%), and acute abdomen (13.3%). Patients showed moderate levels of pain and sadness with a median of 4 (interquartile range, 3–5.5) on the numeric rating scale and a median of 4 (interquartile range, 3–4) on the smiley analog scale. The general health status on the European quality of life-5 dimensions-5 levels-score was rated as poor. Reporting on the visual analog self-esteem scale, most of the included patients felt trapped (90.7%) and not confident (72%), were frustrated (64%) or did not feel understood (56%). However, despite their severe illness, many patients classified themselves as intelligent (30.6%), not mixed up (38.6%), outgoing (38.6%), and optimistic (44%).

CONCLUSION
Eye tracking enables symptom identification in critically ill voiceless patients with impaired communication options. The results of our study may provide guidance for improvement measures in the care of voiceless ICU patients. We believe that ET is useful for symptom identification and therefore may be capable of improving patient-medical team interaction and patient satisfaction.

LEVEL OF EVIDENCE
Diagnostic Test or Criteria, Level III.
Epidemiology, patterns of care and outcomes of traumatic brain injury in deployed military settings: Implications for future military operations
Authors: Dengler Bradley A. , Agimi Yll , Stout Katharine , Caudle Krista L. , Curley Kenneth C. , Sanjakdar Sarah , Rone Malena , Dacanay Brian , Fruendt Jonathan C. , Phillips James B. , Meyer Ana-Claire L. 
Published: December 2021

BACKGROUND
Traumatic brain injury (TBI) is prevalent and highly morbid among Service Members. A better understanding of TBI epidemiology, outcomes, and care patterns in deployed settings could inform potential approaches to improve TBI diagnosis and management.

METHODS
A retrospective cohort analysis of Service Members who sustained a TBI in deployed settings between 2001 and 2018 was conducted. Among individuals hospitalized with TBI, we compared the demographic characteristics, mechanism of injury, injury type, and severity between combat and noncombat injuries. We compared diagnostic tests and procedures, evacuation patterns, return to duty rates and days in care between individuals with concussion and those with severe TBI.

RESULTS
There were 46,309 service members with TBI and 9,412 who were hospitalized; of those hospitalized, 55% (4,343) had isolated concussion and 9% (796) had severe TBI, of whom 17% (132/796) had multiple injuries. Overall mortality was 2% and ranged from 0.1% for isolated concussion to 18% for severe TBI. The vast majority of TBI were evacuated by rotary wing to role 3 or higher, including those with isolated concussion. As compared with severe TBI, individuals with isolated concussion had fewer diagnostic or surgical procedures performed. Only 6% of service members with severe TBI were able to return to duty as compared with 54% of those with isolated concussion. Traumatic brain injury resulted in 123,677 lost duty days; individuals with isolated concussion spent a median of 2 days in care and those with severe TBI spent a median of 17 days in care and a median of 6 days in the intensive care unit.

CONCLUSION
While most TBI in the deployed setting are mild, TBI is frequently associated with hospitalization and multiple injuries. Overtriage of mild TBI is common. Improved TBI capabilities applicable to forward settings will be critical to the success of future multidomain operations with limitations in air superiority.

LEVEL OF EVIDENCE
Prognostic and Epidemiologic; Level III.
Pseudomarimonas arenosa gen. nov., sp. nov. isolated from marine sand
Authors: Weerawongwiwat Veeraya , Kim Jong-Hwa , Yoon Jung-Hoon , Lee Jung-Sook , Sukhoom Ampaitip , Kim Wonyong 
Published: December 2021

A novel Gram-negative, aerobic, non-motile, rod-shaped, bacterial strain (CAU 1598T) was isolated from marine sand. Strain CAU 1598T grew well at 30 °C, pH 6.5–7.0 and with 3 % NaCl (w/v). Phylogeny results based on 16S rRNA gene sequencing indicated that the identified strain had the highest similarity (94.3%) to

Pseudoxanthomonas putridarboris

, indicating that strain CAU 1598T belongs to the family

Xanthomonadaceae

. Further, the fatty acid profile of the strain was primarily composed of C16:0, iso-C15 : 0, iso-C16 : 0, summed feature 3 (consisting of C16 : 1
ω7c/iso-C15 : 0 2-OH) and summed feature 9 (consisting of iso-C17 : 1
ω9c and/or C16 : 0 10-methyl), with ubiquinone-8 as the major isoprenoid quinone. The polar lipid profile included diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphoglycolipid, an unidentified aminolipid and an unidentified lipid. The G+C content of the bacterial genome was 62.6 mol% and its 5.4 Mb length encompassed 144 contigs and 4236 protein-coding genes. These phenotypic, chemotaxonomic and phylogenetic data indicate that CAU 1598T belongs to a new genus and species, for which the name Pseudomarimonas arenosa gen. nov., sp. nov. is proposed. The type strain is CAU 1598T (=KCTC 82406T=MCCC 1K05673T).