bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Vaping on Primary Spontaneous Pneumothorax Outcomes
Authors: Shah Mohsin , Bryant Mary K. , Mody Gita N. , Maine Rebecca G. , Williams Judson B. , Upham Trevor C. 
Published: October 2021

Introduction Cigarette smoking is associated with primary spontaneous pneumothorax (PSP). Electronic cigarettes (E-cigarettes) are touted as a healthier alternative to cigarettes; however, the impact E-cigarette use has on PSP management is not known. The goal of this study was to determine if E-cigarette use is associated with inferior outcomes after PSP, compared to never smokers and cigarette smokers. Methods We conducted a retrospective cohort study of patients in a large tertiary care hospital system in an urban area who presented with PSP from September 2015 through February 2019. Primary spontaneous pneumothorax patients were identified from the institutional Society of Thoracic Surgeon (STS) database. Patients with pneumothoraces from traumatic, iatrogenic, and secondary etiologies were excluded. Baseline clinical and demographic data and outcomes including intervention(s) required, length of stay, and recurrence were evaluated. Results Identified were 71 patients with PSP. Seventeen (24%) had unverifiable smoking history. Of the remaining, 7 (13%) currently vaped, 27(50%) currently smoked cigarettes, and 20(37%) were never smokers. Mean age was 33 years; 80% male. All vapers required tube thoracostomy vs 74% of current smokers and 75% of never smokers. Vaping was associated with increased odds of recurrence compared to never smokers (OR 2.00, 95% CI 0.35,11.44). Vapers had the shortest median time to recurrence after initial hospitalization (10 d[4,18] v 20 d[5,13] cigarette smokers v 27 d[13 275] never smokers, P < .001). Conclusion Vaping may complicate PSP outcomes. As vaping use increases, especially among adolescents, it is imperative that the manner of tobacco use is documented and considered when caring for patients, especially those with pulmonary problems.
The Effectiveness of a Formal Financial Education Program at Primary Schools and the Role of Informal Financial Education
Authors: Coda Moscarola Flavia , Kalwij Adriaan 
Published: October 2021

Objectives: This study examines the effectiveness of a formal financial education program for improving the financial literacy of primary school children and how this effectiveness is influenced by informal financial education provided by parents, such as giving pocket money and discussing money matters. Method: A quasi field experiment was carried out at the Museum of Saving in Turin where children participated in a financial education program (the treatment). The first two out of three classes that arrived at the museum were assigned to the treatment group and the third one to the comparison group. Difference-in-differences models are estimated using financial literacy data from a pretest taken about 1 week before the visit to the museum and a posttest taken on the day of the visit; just before starting with the program at the museum for the comparison group and just after program completion for the treatment group. Results: In line with previous studies, we find that our formal financial education program had a positive effect on the financial literacy of primary school children. The empirical findings provide weak evidence that this effect of formal financial education is stronger for children who received informal financial education from their parents. Conclusions: Our study contributes to the previous literature by presenting further evidence that a short extra-curricular course can be effective in increasing economic and financial literacy among students. Furthermore, we present suggestive evidence—worth of further research—that informal financial education can reinforce the effect of formal financial education. JEL Codes: A29, C93, G40.
Clinical evaluation of AI software for rib fracture detection and its impact on junior radiologist performance
Authors: Liu Xiang , Wu Dijia , Xie Huihui , Xu Yufeng , Liu Lin , Tao Xiaofeng , Wang Xiaoying 
Published: October 2021

Background The detection of rib fractures (RFs) on computed tomography (CT) images is time-consuming and susceptible to missed diagnosis. An automated artificial intelligence (AI) detection system may be helpful to improve the diagnostic efficiency for junior radiologists. Purpose To compare the diagnostic performance of junior radiologists with and without AI software for RF detection on chest CT images. Materials and methods Six junior radiologists from three institutions interpreted 393 CT images of patients with acute chest trauma, with and without AI software. The CT images were randomly split into two sets at each institution, with each set assigned to a different radiologist First, the detection of all fractures (AFs), including displaced fractures (DFs), non-displaced fractures and buckle fractures, was analyzed. Next, the DFs were selected for analysis. The sensitivity and specificity of the radiologist-only and radiologist-AI groups at the patient level were set as primary endpoints, and secondary endpoints were at the rib and lesion level. Results Regarding AFs, the sensitivity difference between the radiologist-AI group and the radiologist-only group were significant at different levels (patient-level: 26.20%; rib-level: 22.18%; lesion-level: 23.74%; P < 0.001). Regarding DFs, the sensitivity difference was 16.67%, 14.19%, and 16.16% at the patient, rib, and lesion levels, respectively ( P < 0.001). No significant difference was found in the specificity between the two groups for AFs and DFs at the patient and rib levels ( P > 0.05). Conclusion AI software improved the sensitivity of RF detection on CT images for junior radiologists and reduced the reading time by approximately 1 min per patient without decreasing the specificity.
Role of hypermethylated-lncRNAs in the prognosis of bladder cancer patients
Authors: Luo Junhua , Xu Jinming , Ou Longhua , Zhou Yingchen , Yun Haichao , Yang Yu , Wu Xionghui , Wang Yan 
Published: October 2021

Objective To explore the hypermethylated long non-coding (lnc)RNAs involved in bladder carcinogenesis and prognosis. Methods Reduced representation bisulfite sequencing and RNA sequencing were performed on five paired tumor and adjacent normal tissue samples from bladder cancer patients. The differentially methylated regions around transcription start sites and differentially expressed genes, including lncRNAs, were analyzed. Correlations between DNA methylation modifications and the expression of lncRNAs were examined. Survival analysis was surveyed on the GEPIA web server. Results We identified 19,560 hypomethylated and 68,781 hypermethylated differentially methylated regions around transcription start sites in bladder cancer tissues. In total, 2321 differentially expressed genes were found in bladder tumors, among which, 367 were upregulated and 1954 were downregulated. There were 141 downregulated genes involving eight lncRNAs that were consistently hypermethylated, while 24 upregulated genes were consistently hypomethylated. Survival analysis demonstrated that hypermethylation of lncRNAs LINC00683 and MSC-AS1 were associated with poor overall survival in bladder cancer patients. Conclusion Some lncRNAs are controlled by DNA methylation in bladder cancer and they might be important factors in bladder carcinogenesis. Hypermethylated lncRNAs including LINC00683 and MSC-AS1 have the potential to be prognostic biomarkers for bladder cancer.
Atrial Strain by Feature-Tracking Cardiac Magnetic Resonance Imaging in Takotsubo Cardiomyopathy. Features, Feasibility, and Reproducibility
Authors: Cau Riccardo , Bassareo Pierpaolo , Caredda Gloria , Suri Jasjit S. , Esposito Antonio , Saba Luca 
Published: October 2021

Objectives: The purpose of this study was to investigate whether there may be a bi-atrial dysfunction in Takotsubo syndrome (TS) during the transient course of the disease, using cardiac magnetic resonance imaging feature tracking (CMR-FT) in analyzing bi-atrial strain. Method: Eighteen TS patients and 13 healthy controls were studied. Reservoir, conduit, and booster bi-atrial functions were analyzed by CMR-FT. The correlation between LA and RA strain parameters was assessed. Intra- and inter-observer reproducibility was evaluated for all strain and strain rate (SR) parameters using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Results: Atrial strain were feasible in all patients and controls. Takotsubo patients showed an impaired LA Reservoir strain (∊s), LA Reservoir strain rate (SRs), LA and RA Conduit strain(∊e), LA and RA conduit strain rate (SRe) in comparison with controls (P < 0.001 for all of them), while no differences were found as to LA and RA booster deformation parameters (∊a and SRa). Analysis of correlation showed that LA ∊s, SRs, ∊e, and SRe were positively correlated with corresponding RA strain measurements (P < 0.001, r = 0.61 and P = 0,03, r = 0,54, respectively). Reproducibility was good to excellent for all atrial strain and strain rate parameters (ICCs ranging from 0,50 to 0,96). Conclusion: Atrial strain analysis using CMR-FT may be a useful tool to reveal new pathophysiological insights in Takotsubo cardiomyopathy. Additional studies, with a larger number of patients, are needed to confirm the possible role of these advanced CMR tools in characterizing TS patients.
The Quality of Local Institutions: The Case of Poland
Authors: Michalak Magdalena Maria , Nowakowska Aleksandra , Antczak Elżbieta 
Published: October 2021

There is a growing consensus within both policy and academic circles, including various schools of political, legal, and economic thought, that institutions matter and that the quality of institutions and governments makes an important difference for economic development. However, while the institutional literature has extensively discussed different types of institutions and their importance, only a few quantitative measures of formal institutions and their quality are available. What is more, most analyses referring to the quality of public institutions concern the national or regional level and the issue at the local level is relatively understudied. The purpose of the article is to fill this gap in two ways. The first one is to identify territorial differentiation of the quality of public institutions at the local level in Poland; the second one, to explain the reasons of the differentiation of institutional capacities in the context of historical, cultural, and social factors. The research has shown that the quality of public institutions is highly related to historical circumstances. However, although their impact is strong, the historical conditions are definitely not the only factor influencing local institutional capital in Poland, as they appear to be deeply affected also by the level of urbanization and the degree of human capital.
Ethnic Minority and Majority Social Workers Working with Ethnic Minority Clients: Culture-Bound Professional Interventions and Burnout among Arab and Jewish Israeli Social Workers
Authors: Tartakovsky Eugene 
Published: October 2021

Purpose This study tests a new bicultural model of social work with ethnic minority clients. We examined how often social workers applied professional interventions rooted in the minority and majority cultures and how the choice of interventions affected the social workers' burnout. Methods: The study was conducted in Israel, and the research samples included Arab ( n = 300) and Jewish ( n = 210) social workers. Results: We found that Arab and Jewish social workers more often used interventions rooted in the minority than in the majority culture. More frequent application of both types of interventions was associated with a higher level of personal accomplishment in both groups of social workers. However, the connection between interventions rooted in the majority culture and burnout was positive among Jewish and negative among Arab social workers. Discussion: The implementation of the obtained results in social work practice with ethnic minorities is discussed.
Periocular intravascular papillary endothelial hyperplasia: A retrospective study
Authors: Maktabi Azza MY , Almater Abdullah I , Alkatan Hind M 
Published: October 2021

Introduction: Intravascular papillary endothelial hyperplasia (IPEH) is a rare proliferation of endothelial cells with uncertain etiology related to thrombus formation. Diagnosis is usually confirmed histopathologically. This condition has been previously described in the periocular region but not in the conjunctiva. Methods: It is a retrospective case series in which we evaluated seven patients with histopathologically confirmed IPEH cases. Data regarding the demographics, clinical presentation, radiological description, histopathological features including any IHC staining, suspected underlying vascular etiology, management options, and follow up outcome were collected. Results: A total of seven cases of histologically confirmed IPEH were included. Five out of seven patients were male (71.4%). The age range was between 6 and 69 years with a median age of 36 years. Three cases involved the eyelid (42.8%) and another three were found in the conjunctiva (42.8%). Pre-existing underlying vascular lesions were observed in all patients, five malformations (mostly lymphatic-venous) and two conjunctival hemorrhagic lymphangiectasis. All cases were treated with excisional biopsy with no signs of recurrence within an average of 7 months follow up. Conclusions: Periocular IPEH is a rare tumor that is likely to coexist with underlying vascular lesions and thrombus formation. We are reporting its existence in the conjunctiva for the first time. Therefore, pathologists should be aware of the histopathological spectrum of this lesion.
Radiographic and Clinical Results of Minimally Invasive Chevron Akin Osteotomy for Moderate to Severe Hallux Valgus Deformities
Authors: Kurashige Toshinori 
Published: October 2021

Background: Few studies have reported results of minimally invasive chevron Akin osteotomy (MICA) for moderate to severe hallux valgus correction. This study aims to evaluate MICA for moderate to severe hallux valgus radiographically and clinically. Methods: Forty feet were prospectively reviewed. Twenty-eight feet (70%) had a severe deformity (hallux valgus angle (HVA) ≥40° and/or first intermetatarsal angle (IMA) ≥18°). We measured HVA, IMA, lateral shape of the metatarsal head (round sign), tibial sesamoid position, first metatarsal shortening on anteroposterior weightbearing radiographs, and inclination angle of first metatarsal on lateral weightbearing radiographs. We evaluated the Japanese Society for Surgery of the Foot hallux scale and Self-Administered Foot Evaluation Questionnaire responses preoperatively and at the most recent follow-up. Results: All measurements except shortening and inclination angle improved significantly. Both clinical scale and all subscores significantly improved. Conclusions: MICA improved moderate to severe hallux valgus both radiographically and clinically. Level of Evidence: Level IV: case series
Pulsed Electromagnetic Field Attenuates Osteoarthritis Progression in a Murine Destabilization-Induced Model through Inhibition of TNF-α and IL-6 Signaling
Authors: Yang Xiaotian , Guo Hua , Ye Wenwen , Yang Lin , He Chengqi 
Published: October 2021

Objective To investigate the anti-inflammatory effects and mechanisms of pulsed electromagnetic field (PEMF) in the treatment of osteoarthritis (OA) in the destabilization of the medial meniscus (DMM) mice. Design Ten-week-old male wild-type (WT), interleukin (IL)-6−/− and tumor necrosis factor (TNF)-α−/− mice undergoing DMM surgery were randomly divided into 2 groups ( n = 10 each): mice with PEMF exposure and mice with sham PEMF exposure. PEMF (75 Hz, 3.8 mT, 1 h/day) or sham PEMF was applied for 4 weeks. Pain behavior of mice, histological assessment of cartilage and synovium, micro-CT (computed tomography) analysis of bone, real-time polymerase chain reaction, and immunohistochemical staining of cartilage were performed. Results After DMM surgery, PEMF had a beneficial effect on pain, cartilage degeneration, synovitis, and trabecular bone microarchitecture in WT mice; these protective effects were reduced in IL-6−/− and TNF-α−/− mice. In addition, PEMF downregulated IL-6 and TNF-α expression in cartilage. PEMF also ameliorated cartilage matrix, chondrocyte apoptosis, and autophagy, while deletion of IL-6 or TNF-α suppressed the effects. Conclusions PEMF attenuates structural and functional progression of OA through inhibition of TNF-α and IL-6 signaling. The protective effects of PEMF on chondrocyte apoptosis and autophagy are regulated by TNF-α and IL-6 signaling.
Safety of apixaban in Indian patients undergoing elective total knee replacement or total hip replacement surgery: A multi-center, phase-IV study
Authors: Panchal Himanshu , Agashe Abhijit , Sancheti Parag K , Kulkarni Namrata B , Taur Santosh R 
Published: October 2021

Background: Venous thromboembolism is a significant source of morbidity and mortality following total hip replacement and total knee replacement. Apixaban has been proven to be efficacious without increased risk of bleeding in phase-III trials in patients undergoing total knee replacement and total hip replacement. Due to paucity of data on safety of apixaban in Indian patients, this phase-IV study was conducted to evaluate safety of apixaban in patients undergoing total knee replacement and total hip replacement. Methods: In this non-comparative phase-IV clinical trial, patients undergoing elective total knee replacement or total hip replacement surgery, or a revision of at least one component of total knee replacement or total hip replacement, were enrolled. The eligible patients were given the approved dosage of apixaban 12 to 24 h after completing the skin wound closure. The primary safety outcome was the composite of the International Society on Thrombosis and Haemostasis–defined major bleeding and clinically relevant non-major bleeding events at the end of the treatment. The secondary efficacy endpoint was the composite of venous thromboembolism/all-cause death at the end of the treatment. Results: A total of 498 patients received apixaban prophylaxis therapy. Six (1.2%) bleeding adverse events were observed during the treatment period. Only one bleeding event was adjudicated as an International Society on Thrombosis and Haemostasis–defined clinically relevant non-major bleeding event (moderate severity). There were no fatal bleeding events and no deaths following the treatment. One venous thromboembolism event, that is, symptomatic distal left leg DVT, was reported in a total knee replacement patient and was adjudicated during the treatment period. Conclusion: Apixaban demonstrated a favorable safety profile for venous thromboembolism prevention in Indian patients undergoing total knee replacement or total hip replacement.
“We All Held Our Own”: Job Demands and Resources at Individual, Leader, Group, and Organizational Levels During COVID-19 Outbreak in Health Care. A Multi-Source Qualitative Study
Authors: Giusino Davide , De Angelis Marco , Mazzetti Greta , Christensen Marit , Innstrand Siw Tone , Faiulo Ilaria Rita , Chiesa Rita 
Published: October 2021

Background: Interventions tackling COVID-19 impact on health care workers’ mental health would benefit from being informed by validated and integrated assessment frameworks. This study aimed to explore the fitness of integrating the Job Demands-Resources (JD-R) model and the Individual-Group-Leader-Organization (IGLO) framework to investigate the pandemic’s impact on health care workers’ mental health. Methods: Qualitative data were collected via 21 semi-structured interviews with senior and middle managers and four focus groups with employees (doctors, nurses, health care assistants) from three areas (Department of Emergency, Department of Medicine, Research Institute of Neuroscience) of a large health care institution facing the first wave of COVID-19. NVivo deductive content analysis of text data was performed. Findings: Several COVID-19-related job demands and resources were found at IGLO levels. Individual-level demands included emotional load, while resources included resilience and motivation. Group-level demands included social distancing, while resources included team support and cohesion. Leader-level demands included managers’ workload, while resources included leader support. Organizational-level demands included work reorganization, while resources included mental health initiatives. Conclusions/Application to Practice: Integrating JD-R and IGLO proved feasible, as job demands and resources could be categorized according to the individual, group, leader, and organization framework. The findings expand previous studies by filling the lack of knowledge on how job demands and resources might unfold at different workplace levels during a pandemic. Results provide unit-level evidence for designing and implementing multilevel interventions to manage health care workers’ mental health during COVID-19 and future pandemics. Our findings offer occupational health practitioners a suitable approach to perform workplace mental health assessment activities.
The effects of root canal perforation repair materials on the bond strength of fiber posts
Authors: Tavsan Oğuz , Simsek Neslihan 
Published: October 2021

Introduction: This study aimed to evaluate the effect of calcium hydroxide and bioceramics used in perforation repair on the bonding strength of fiber posts via a push-out test. Methodology: This study used 106 extracted single-rooted human mandibular premolar teeth. Root canal preparations were performed with a rotary file system and perforations were created in the middle third of each tooth. The samples were randomized into two main experimental groups, one with calcium hydroxide and one without. Each group had four subgroups in which different bioceramic cements were applied ( n = 11) and a control group ( n = 9). The root canals perforations were repaired using MTA, Biodentine, Bioaggregate, and Endosequence BC root repair material. A fiber post was applied to each tooth and a push-out test was performed. The samples were examined at 40× magnification with a digital microscope in order to identify fracture type. Results: Bonding strength was calculated in MPa. A statistical analysis showed that the calcium hydroxide had no effect on the bonding strength of the fiber posts. A comparison of the perforation repair materials revealed that Biodentine in the calcium hydroxide group and Bioaggregate in both groups decreased the bonding strength compared to the other materials ( p < 0.05). The most common failure type was adhesive failure between the dentin and resin cement (38.16%). Conclusions: The use of different perforation repair materials can affect the bonding strength of fiber posts. Therefore, the choice of perforation repair material should be made on an individual basis.