bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Utero MRI Identifies Impaired Second Trimester Subplate Growth in Fetuses with Congenital Heart Disease
Authors: Wu Yao , Lu Yuan-Chiao , Kapse Kushal , Jacobs Marni , Andescavage Nickie , Donofrio Mary T , Lopez Catherine , Quistorff Jessica Lynn , Vezina Gilbert , Krishnan Anita , du Plessis Adré J , Limperopoulos Catherine 
Published: September 2021

Abstract The subplate is a transient brain structure which plays a key role in the maturation of the cerebral cortex. Altered brain growth and cortical development have been suggested in fetuses with complex congenital heart disease (CHD) in the third trimester. However, at an earlier gestation, the putative role of the subplate in altered brain development in CHD fetuses is poorly understood. This study aims to examine subplate growth (i.e., volume and thickness) and its relationship to cortical sulcal development in CHD fetuses compared with healthy fetuses by using 3D reconstructed fetal magnetic resonance imaging. We studied 260 fetuses, including 100 CHD fetuses (22.3–32 gestational weeks) and 160 healthy fetuses (19.6–31.9 gestational weeks). Compared with healthy fetuses, CHD fetuses had 1) decreased global and regional subplate volumes and 2) decreased subplate thickness in the right hemisphere overall, in frontal and temporal lobes, and insula. Compared with fetuses with two-ventricle CHD, those with single-ventricle CHD had reduced subplate volume and thickness in right occipital and temporal lobes. Finally, impaired subplate growth was associated with disturbances in cortical sulcal development in CHD fetuses. These findings suggested a potential mechanistic pathway and early biomarker for the third-trimester failure of brain development in fetuses with complex CHD.Significance StatementOur findings provide an early biomarker for brain maturational failure in fetuses with congenital heart disease, which may guide the development of future prenatal interventions aimed at reducing neurological compromise of prenatal origin in this high-risk population.
Minimally Invasive Tissue Sampling as an Alternative to Complete Diagnostic Autopsies in the Context of Epidemic Outbreaks and Pandemics: The Example of Coronavirus Disease 2019 (COVID-19)
Authors: Bassat Quique , Varo Rosauro , Hurtado Juan Carlos , Marimon Lorena , Ferrando Melania , Ismail Mamudo R , Carrilho Carla , Fernandes Fabiola , Castro Pedro , Maixenchs Maria , Rodrigo-Calvo Maria Teresa , Guerrero José , Martínez Antonio , Lacerda Marcus V G , Mandomando Inacio , Menéndez Clara , Martinez Miguel J , Ordi Jaume , Rakislova Natalia 
Published: September 2021

Abstract

Background
Infectious diseases’ outbreak investigation requires, by definition, conducting a thorough epidemiological assessment while simultaneously obtaining biological samples for an adequate screening of potential responsible pathogens. Complete autopsies remain the gold-standard approach for cause-of-death evaluation and characterization of emerging diseases. However, for highly transmissible infections with a significant associated lethality, such as COVID-19, complete autopsies are seldom performed due to biosafety challenges, especially in low-resource settings. Minimally invasive tissue sampling (MITS) is a validated new approach based on obtaining postmortem samples from key organs and body fluids, a procedure that does not require advanced biosafety measures or a special autopsy room.

Methods
We aimed to review the use of MITS or similar procedures for outbreak investigation up to 27 March 2021 and their performance for evaluating COVID-19 deaths.

Results
After a literature review, we analyzed in detail the results of 20 studies conducted at international sites, whereby 216 COVID-19–related deaths were investigated. MITS provided a general and more granular understanding of the pathophysiological changes secondary to the infection and high-quality samples where the extent and degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related damage could be evaluated.

Conclusions
MITS is a useful addition in the investigation and surveillance of infections occurring in outbreaks or epidemics. Its less invasive nature makes the tool more acceptable and feasible and reduces the risk of procedure-associated contagion, using basic biosafety measures. Standardized approaches protocolizing which samples should be collected—and under which exact biosafety measures—are necessary to facilitate and expand its use globally.
A Multi-Objective Randomly Updated Beetle Swarm and Multi-Verse Optimization for Brain Tumor Segmentation and Classification
Authors: Kumar Katukuri Arun , Boda Ravi 
Published: September 2021

Abstract
This paper plans to develop the optimal brain tumor classification model with diverse intelligent methods. The main phases of the proposed model are ‘(a) image pre-processing, (b) skull stripping, (c) tumor segmentation, (d) feature extraction and (e) classification’. At first, pre-processing of the image is performed by converting the image from red green blue to gray followed by median filtering. Further, skull stripping is done for removing the extra-meningeal tissue from the head image, which is done by Otsu thresholding. As the main contribution, the tumor segmentation is done by the optimized threshold-based tumor segmentation using multi-objective randomly updated beetle swarm and multi-verse optimization (RBS-MVO). The objective constraints considered for the segmentation of the tumor is entropy and variance. Next, the feature extraction techniques like gray level co-occurrence matrix, local binary pattern and gray-level run length matrix is accomplished to extract the set of features. The classification side uses the combination of neural network (NN) and deep learning model called convolutional neural network (CNN) for tumor classification. The extracted features are subjected to NN, and the segmented image is taken as input to CNN. In addition, the weight function of NN and hidden neurons of CNN is optimized by the RBS-MVO.
The utility of implantable loop recorders in patient management: an age- and indication-stratified study in the outpatient-implant era
Authors: Sanghvi Mihir M , Jones Daniel M , Kalindjian Jeremy , Monkhouse Christopher , Providencia Rui , Schilling Richard J , Ahluwalia Nikhil , Earley Mark J , Finlay Malcolm 
Published: September 2021

Abstract

Aim
Implantable loop recorders (ILRs) are now routinely implanted for long-term cardiac monitoring in the clinical setting. The aim of this study was to examine the real-world performance of these devices focusing on the management changes made in response to ILR-recorded data.

Methods and results
This was a single-centre, prospective observational study of consecutive patients undergoing ILR implantation. All patients who underwent implantation of a Medtronic Reveal LINQ device from September 2017 to June 2019 at Barts Heart Centre were included. Five hundred and one patients were included. Three hundred and two (60%) patients underwent ILR implantation for an indication of pre-syncope/syncope, 96 (19%) for palpitations, 72 (14%) for atrial fibrillation (AF) detection with a history of cryptogenic stroke, and 31 (6%) for high risk of serious cardiac arrhythmia. The primary outcome of this study was that an ILR-derived diagnosis altered management in 110 patients (22%). Secondary outcomes concerned subgroup analyses by indication: in patients who presented with syncope/pre-syncope, a change in management resulting from ILR data was positively associated with age [hazard ratio (HR) 1.04, 95% confidence interval 1.02–1.06; P &lt; 0.001] and negatively associated with a normal electrocardiogram at baseline (HR 0.54 [0.31–0.93]; P = 0.03). Few patients (1/57, 2%) aged &lt;40 years in this group underwent device implantation, compared to 19/62 patients (31%) aged 75 years and over (P = 0.0024). Out of 183 (12%) patients, 22 in the 40–74 age range had a device implanted. Among patients who underwent ILR insertion following cryptogenic stroke, 13/72 (18%) had AF detected, leading to a decision to commence anticoagulation.

Conclusion
These results inform the utility of ILR in the clinical setting. Diagnoses provided by ILR that lead to changes in management are rare in patients under age 40, particularly following syncope, pre-syncope, or palpitations. In older patients, new diagnoses are frequently made and trigger important changes in treatment.
The evidence for the implantable loop recorder in patients with inherited arrhythmia syndromes: a review of the literature
Authors: Balfe Christopher , Durand Rory , Crinion Derek , Ward Deirdre , Sheahan Richard 
Published: September 2021

Abstract
Risk stratification of patients with inherited arrhythmia syndromes (IASs) can be challenging. Recent guidelines acknowledge a place for considering the implantable loop recorder (ILR) to outrule malignant arrhythmia as a cause of syncope in certain inherited arrhythmia patients who are at low risk of sudden cardiac death. In this comprehensive literature review, we evaluate the available evidence for the use of the ILR in the IASs and in relatives of victims of sudden arrhythmic death syndrome.
Challenging German physical education teacher educators’ health-related beliefs through Cooperative Planning
Authors: Hapke Julia , Töpfer Clemens , Lohmann Julia 
Published: September 2021

AbstractPhysical education teacher educators’ health-related beliefs can impact public health. An interactive knowledge-to-action approach, such as Cooperative Planning, might challenge the health-related beliefs of physical education teacher educators, thus contributing to innovation in teacher education. We investigated what health-related beliefs physical education teacher educators had before a Cooperative Planning intervention, how these developed throughout the intervention and how teacher educators’ perceptions of Cooperative Planning can explain the identified changes and continuities. We established two Cooperative Planning groups that included physical education teacher educators (university lecturers and teacher trainers), researchers, study course coordinators and prospective teachers. The data of 13 teacher educators were collected before (t0) and after (t1) the Cooperative Planning using two methods: observations of teaching practice and interviews. The data analysis was based on the following categories: (i) epistemic beliefs about health (e.g. salutogenic understanding), (ii) beliefs about the health topic in physical education (e.g. health-related knowledge and understanding), (iii) beliefs about the health topic in physical education teacher education (e.g. health-related pedagogical content knowledge) and (iv) process-related beliefs about Cooperative Planning. The findings revealed that teacher educators’ health-related beliefs were rather stable but could be challenged through a Cooperative Planning intervention. Epistemic beliefs about health remained, whereas more practice-related beliefs about the health topic in physical education and physical education teacher education changed in individual ways. Here, a change in beliefs was more likely when the participants were open to change and when Cooperative Planning offered opportunities to engage in concrete lesson planning.
Availability, supply, and aggregation of prey (Calanusspp.) in foraging areas of the North Atlantic right whale (Eubalaena glacialis)
Authors: Sorochan K A , Plourde S , Baumgartner M F , Johnson C L 
Published: September 2021

AbstractThe North Atlantic right whale (NARW), Eubalaena glacialis, resides primarily on western North Atlantic continental shelves where this endangered species is susceptible to vessel strike and entanglement in fishing gear. Mitigation of these threats is dependent on the ability to predict variations in NARW occurrence. North of the Mid-Atlantic Bight, the distribution of NARWs is influenced by their prey, mainly copepods of the genus Calanus. We review factors that promote suitable foraging habitat from areas where NARWs have been observed feeding. We then synthesize our findings within a conceptual framework in which availability (i.e. shallow prey depth), supply, and aggregation of prey occur together to facilitate suitable foraging habitat. By definition, the depth of prey on the shelf is constrained to ≤200 m and other mechanisms may occur locally that further enhance prey availability. Enhanced production of prey occurs in coastal currents, which transport the copepods to NARW foraging areas. Prey concentrating mechanisms are not well-characterized. Information gaps that impede rapid and dynamic prediction of suitable foraging habitat include limited data on the spatial and temporal variation of prey and environmental conditions at local scales (i.e. 0.1–1 km), motility of prey, and diving behaviour of NARWs.
Model-based geostatistics enables more precise estimates of neglected tropical-disease prevalence in elimination settings: mapping trachoma prevalence in Ethiopia
Authors: Amoah Benjamin , Fronterre Claudio , Johnson Olatunji , Dejene Michael , Seife Fikre , Negussu Nebiyu , Bakhtiari Ana , Harding-Esch Emma M , Giorgi Emanuele , Solomon Anthony W , Diggle Peter J 
Published: September 2021

Abstract

Background
As the prevalences of neglected tropical diseases reduce to low levels in some countries, policymakers require precise disease estimates to decide whether the set public health targets have been met. At low prevalence levels, traditional statistical methods produce imprecise estimates. More modern geospatial statistical methods can deliver the required level of precision for accurate decision-making.

Methods
Using spatially referenced data from 3567 cluster locations in Ethiopia in the years 2017, 2018 and 2019, we developed a geostatistical model to estimate the prevalence of trachomatous trichiasis and to calculate the probability that the trachomatous trichiasis component of the elimination of trachoma as a public health problem has already been achieved for each of 482 evaluation units. We also compared the precision of traditional and geostatistical approaches by the ratios of the lengths of their 95% predictive intervals.

Results
The elimination threshold of trachomatous trichiasis (prevalence ≤ 0.2% in individuals aged ≥15 years) is met with a probability of 0.9 or more in 8 out of the 482 evaluation units assessed, and with a probability of ≤0.1 in 469 evaluation units. For the remaining five evaluation units, the probability of elimination is between 0.45 and 0.65. Prevalence estimates were, on average, 10 times more precise than estimates obtained using the traditional approach.

Conclusions
By accounting for and exploiting spatial correlation in the prevalence data, we achieved remarkably improved precision of prevalence estimates compared with the traditional approach. The geostatistical approach also delivers predictions for unsampled evaluation units that are geographically close to sampled evaluation units.
Nonlinear Diffusion in Transparent Media
Authors: Giacomelli Lorenzo , Moll Salvador , Petitta Francesco 
Published: September 2021

AbstractWe consider a prototypical nonlinear parabolic equation whose flux has three distinguished features: it is nonlinear with respect to both the unknown and its gradient, it is homogeneous, and it depends only on the direction of the gradient. For such equation, we obtain existence and uniqueness of entropy solutions to the Dirichlet problem, the homogeneous Neumann problem, and the Cauchy problem. Qualitative properties of solutions, such as finite speed of propagation and the occurrence of waiting-time phenomena, with sharp bounds, are shown. We also discuss the formation of jump discontinuities both at the boundary of the solutions’ support and in the bulk.
Correlates of Protection for Cholera
Authors: Iyer Anita S , Harris Jason B 
Published: September 2021

Abstract
A correlate of protection (CoP) is a measured adaptive immune response to vaccination or infection that is associated with protection against disease. However, the degree to which a CoP can serve as a surrogate end point for vaccine efficacy should depend on the robustness of this association. While cholera toxin is a dominant target of the human antibody response to Vibrio cholerae infection, antitoxin responses are not associated with long-term immunity, and are not effective CoPs for cholera. Instead, protection appears to be mediated by functional antibodies that target the O-polysaccharide coated V. cholerae outer membrane. Vibriocidal antibodies, which are complement-dependent bactericidal antibodies, remain the most accepted CoP for cholera and are used as surrogate end points in some vaccine studies. However, the association between vibriocidal antibody titers and immunity is not absolute, and they are unlikely to reflect a mechanistic correlate of protection against cholera.
Antibiotic stewardship in direct-to-consumer telemedicine: translating interventions into the virtual realm
Authors: Li Lucy X , Szymczak Julia E , Keller Sara C 
Published: September 2021

Abstract
Direct-to-consumer (DTC) telemedicine is an increasingly popular modality for delivery of medical care via a virtual platform. As most DTC telemedicine visits focus on infection-related complaints, there is growing concern about the magnitude of antibiotic use associated with this setting. However, there is limited scholarship regarding adapting and implementing antibiotic stewardship principles in this setting as most efforts have been focused on hospitals with more recent work in long-term care facilities and primary care settings. We discuss utilizing the core elements for outpatient antibiotic stewardship as a framework for DTC antibiotic stewardship efforts moving forward.
Recommendation Reversals in Gastroenterology Clinical Practice Guidelines
Authors: Gholami Reza , Khan Rishad , Ramkissoon Anushka , Alabdulqader Abdulrahman , Gimpaya Nikko , Bansal Rishi , Scaffidi Michael A , Prasad Vinay , Detsky Allan S , Baker Jeffrey P , Grover Samir C 
Published: September 2021

Abstract

Background
Recommendations in clinical practice guidelines (CPGs) may be reversed when evidence emerges to show they are futile or unsafe. In this study, we identified and characterized recommendation reversals in gastroenterology CPGs.

Methods
We searched CPGs published by 20 gastroenterology societies from January 1990 to December 2019. We included guidelines which had at least two iterations of the same topic. We defined reversals as when (a) the more recent iteration of a CPG recommends against a specific practice that was previously recommend in an earlier iteration of a CPG from the same body, and (b) the recommendation in the previous iteration of the CPG is not replaced by a new diagnostic or therapeutic recommendation in the more recent iteration of the CPG. The primary outcome was the number of recommendation reversals. Secondary outcomes included the strength of recommendations and quality of evidence cited for reversals.

Results
Twenty societies published 1022 CPGs from 1990 to 2019. Our sample for analysis included 129 unique CPGs. There were 11 recommendation reversals from 10 guidelines. New evidence was presented for 10 recommendation reversals. Meta-analyses were cited for two reversals, and randomized controlled trials (RCTs) for seven reversals. Recommendations were stronger after the reversal for three cases, weaker in two cases, and of similar strength in three cases. We were unable to compare recommendation strengths for three reversals.

Conclusion
Recommendation reversals in gastroenterology CPGs are uncommon but highlight low value or harmful practices.
When is Offspring Viability Fitness a Measure of Paternal Fitness and When is it not?
Authors: Fitzpatrick Courtney L , Wade Michael J 
Published: September 2021

AbstractWe use population genetics to model the evolution of a gene with an indirect effect owing to paternal care and with a second pleiotropic, direct effect on offspring viability. We use the model to illustrate how the common empirical practice of considering offspring viability as a component of parent fitness can confound a gene’s direct and indirect fitness effects. We investigate when this confounding results in a distorted picture of overall evolution and when it does not. We find that the practice has no effect on mean fitness, W, but it does have an effect on the dynamics of gene frequency change, ∆q. We also find that, for some regions of parameter space associated with fitness trade-offs, the distortion is not only quantitative but also qualitative, obscuring the direction of gene frequency change. Because it affects the evolutionary dynamics, it also affects the expected amount of genetic variation at mutation-selection balance, an important consideration in molecular evolution. We discuss empirical techniques for separating direct from indirect effects and how field studies measuring the value of male paternal care might be improved by using them.
Reassessing the Legislative Veto: The Statutory President, Foreign Affairs, and Congressional Workarounds
Authors: Bradley Curtis A 
Published: September 2021

Abstract
A chief reason that the President is insufficiently constrained when exercising statutorily-delegated power, it is claimed, is the Supreme Court’s disallowance of legislative vetoes in its decision in INS v. Chadha, a claim that intensified during the Trump administration. This article challenges this account, arguing that the availability of the legislative veto was less important before Chadha to congressional-executive relations than legal scholars commonly assume, and that, to the extent that the legislative veto was (or would have become) important for checking some exercises of statutorily-delegated authority, Congress has developed a host of effective workarounds in the years since Chadha.
Treatment Patterns, Outcomes, and Costs Associated With Localized Upper Tract Urothelial Carcinoma
Authors: Fero Katherine E , Shan Yong , Lec Patrick M , Sharma Vidit , Srinivasan Aditya , Movva Giri , Baillargeon Jacques , Chamie Karim , Williams Stephen B 
Published: September 2021

Abstract

Background
Upper tract urothelial carcinoma (UTUC) is a heterogeneous disease that presents a clinical management challenge for the urologic surgeon. We assessed treatment patterns, costs, and survival outcomes among patients with nonmetastatic UTUC.

Methods
We identified 4114 patients diagnosed with nonmetastatic UTUC from 2004 to 2013 in the Survival Epidemiology, and End Results–Medicare population-based database. Patients were stratified into low- or high-risk disease groups. Median total costs from 30 days prior to diagnosis through 365 days after diagnosis were compared between groups. Overall and cancer-specific survival were evaluated using Cox proportional hazards regression. All statistical tests were 2-sided.

Results
After risk stratification, 1027 (24.9%) and 3087 (75.0%) patients were classified into low- vs high-risk UTUC groups. Most patients underwent at least 1 surgical intervention (95.1%); 68.4% underwent at least 1 endoscopic intervention. Patients diagnosed with high- vs low-risk UTUC were more likely to undergo nephroureterectomy (83.6% vs 72.0%; P &lt; .001); few patients with low-risk disease were exclusively managed endoscopically (16.9%). At 365 days after diagnosis, costs of care for high- vs low-risk UTUC were statistically significantly higher ($108 520 vs $91 233; median difference $16 704, 95% confidence interval [CI] = $11 619 to $21 778; P &lt; .001). Those with high-risk UTUC had worse cancer-specific and overall survival compared with patients with low-risk UTUC (cancer-specific survival hazard ratio [HR] = 4.14, 95% CI = 3.19 to 5.37; overall survival HR = 1.78, 95% CI = 1.62 to 1.96).

Conclusions
UTUC continues to be managed primarily with nephroureterectomy, regardless of risk stratification, and patients with high-risk UTUC have worse overall and cancer-specific survival. Substantial costs are associated with management of low- and high-risk UTUC, with the latter being more costly up to 1 year from diagnosis.