bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Do Smoking Status and Smoking Cessation Efforts Affect TB Recurrence After Successful Completion of Anti-TB Treatment? A Multicenter, Prospective Cohort Study With a 7-Year Follow-up in China
Authors: Lin Haoxiang , Lin Yan , Xiao Lixin , Chen Yongming , Zeng Xianglin , Chang Chun 
Published: May 2021

Abstract

Introduction
Many important risk factors are associated with tuberculosis (TB) recurrence; among them, smoking is the most common and modifiable behavioral factor. We aimed to assess the association of smoking status and cessation support during anti-TB treatment with subsequent TB recurrence.

Aims and Methods
A 7-year prospective cohort study was performed on 634 TB patients in China. The participants were grouped by smoking status at baseline. Cox proportional hazards models were applied to analyze the association between baseline characteristics and TB recurrence. The cumulative incidence of TB recurrence was estimated by Kaplan–Meier curves.

Results
Multivariable analysis showed that patients who continued smoking during anti-TB treatment were at higher risk for TB recurrence (hazard ratio = 3.45; 95% confidence interval: 1.54–7.73) than nonsmokers. Moreover, this risk remained significant even in those who stopped smoking during anti-TB treatment (hazard ratio = 2.75; 95% confidence interval: 1.47–5.14) than nonsmokers. The association between smoking and TB recurrence was stronger for smear-positive TB patients than for smear-negative TB patients. Among all the subgroups, patients who continued smoking had a higher TB recurrence rate over the 7-year follow-up than those who successfully quit during their anti-TB treatment (log-rank statistic, p &lt; .01). With the increase in the number of cigarettes smoked daily, the TB recurrence risk also increased accordingly (log-rank statistic, p = .02).

Conclusions
Our findings highlight the importance of incorporating effective smoking cessation intervention measures into TB services and call for continuous monitoring of TB recurrence. Among patients who continue smoking or have a history of smoking, special attention should be given to smear-positive patients and heavy smokers when monitoring recurrence.

Implications
This study provides a comprehensive picture of the association of smoking behavior and cessation efforts with TB recurrence. It shows that patients who are nonsmokers have the lowest risk of recurrence and that ex-smokers have a lower risk of recurrence than current smokers. Moreover, patients who successfully quit smoking during TB treatment have a lower risk of recurrence than those who continue smoking. Health workers should provide cessation intervention, focus on TB patients with a history of smoking, and continuously monitor TB recurrence after the completion of anti-TB treatment, particularly for smear-positive TB patients.
Mathematical and Computational Models for Pain: A Systematic Review
Authors: Lang Victoria Ashley , Lundh Torbjörn , Ortiz-Catalan Max 
Published: May 2021

AbstractObjectiveThere is no single prevailing theory of pain that explains its origin, qualities, and alleviation. Although many studies have investigated various molecular targets for pain management, few have attempted to examine the etiology or working mechanisms of pain through mathematical or computational model development. In this systematic review, we identified and classified mathematical and computational models for characterizing pain.MethodsThe databases queried were Science Direct and PubMed, yielding 560 articles published prior to January 1st, 2020. After screening for inclusion of mathematical or computational models of pain, 31 articles were deemed relevant.ResultsMost of the reviewed articles utilized classification algorithms to categorize pain and no-pain conditions. We found the literature heavily focused on the application of existing models or machine learning algorithms to identify the presence or absence of pain, rather than to explore features of pain that may be used for diagnostics and treatment.ConclusionsAlthough understudied, the development of mathematical models may augment the current understanding of pain by providing directions for testable hypotheses of its underlying mechanisms. Additional focus is needed on developing models that seek to understand the underlying mechanisms of pain, as this could potentially lead to major breakthroughs in its treatment.
Ultrasound Versus Fluoroscopy for Stellate Ganglion Block: A Cadaveric Study
Authors: Hughey Scott , Schafer Jeffrey , Cole Jacob , Booth Gregory , Tuttle Ralph , Stedje-Larsen Eric 
Published: May 2021

Abstract

Objective
Post-Traumatic Stress Disorder (PTSD) is a common psychiatric disorder. Recent investigations have demonstrated effectiveness of Stellate Ganglion Blocks (SGB) for reducing symptoms associated with PTSD. Both fluoroscopic guided and ultrasound guided SGB have been described and are regularly used in clinical practice. This study sought to evaluate differences in block performance when comparing fluoroscopic versus ultrasound guided SGB.

Design
Cadaveric Pilot Study.

Setting
Academic Research Laboratory.

Subjects
Ten Soft-Cured Human Cadavers.

Methods
Ten soft-cured human cadavers were used after being at room temperature for 3 hours. Fluoroscopic and ultrasound guided injections were both performed on each cadaver, randomized to left or right sidedness. In total, 7 mL of omnipaque and methylene blue (5:1) was injected in each side. Injectate spread was assessed by measuring vertebral body spread under fluoroscopy. Successful staining of the sympathetic trunk was assessed under cadaveric dissection, with visualization of the sympathetic trunk stained with methylene blue.

Results
Ultrasound guided injections resulted in successful staining in 9 of 10 injections, while 6 of 10 for fluoroscopic guidance (P = .3034). The average spread in the ultrasound group was 4.0 compared with 5.2 for the fluoroscopic group (P =.088). In the four fluoroscopic guided injections which failed to stain, the injection occurred posterior to the prevertebral fascia. In the single ultrasound guided block that failed to stain, the injection was in the carotid sheath.

Conclusions
While there appeared to be a trend favoring ultrasound guidance, no statistical significance was achieved. This was likely due to this being a limited pilot study. Numerous limitations exist in cadaveric studies, and future investigations should be completed to further study this comparison. That said, the use of the SGB may provide significant relief for patients suffering with PTSD.
The Female Penalty for Novelty and the Offsetting Effect of Alternate Status Characteristics
Authors: Trapido Denis 
Published: May 2021

Abstract
Research has shown that audiences penalize novelty in women’s work but also that such penalty may vary. This study builds on theories of uncertainty and status signaling to identify contingencies that may account for the variation in the female penalty for novelty, particularly in the production of technological and scientific knowledge. Drawing on theories of expectation states and gender status beliefs, I posit that peer audiences have a baseline bias against novelty in women’s work and penalize novelty in female authors’ contributions. However, when authors possess status characteristics that are more task-relevant than gender, this penalty erodes. I identify two academic status characteristics, prestigious graduate degrees and prestigious mentors, which offset the female penalty for novelty. Longitudinal multi-source data on the productivity of academic engineers show that female engineers who have these characteristics face no significant citation penalty for the novelty of their work. Implications of these findings for gender inequality and for policies that aim to reduce it are discussed.
Single-Cell RNA Sequencing Reveals a Unique Monocyte Population in Bronchoalveolar Lavage Cells of Mice Challenged With Afghanistan Particulate Matter and Allergen
Authors: Berman Reena , Min Elysia , Huang Jie , Kopf Katrina , Downey Gregory P , Riemondy Kent , Smith Harry A , Rose Cecile S , Seibold Max A , Chu Hong Wei , Day Brian J 
Published: May 2021

Abstract
Upon returning from deployment to Afghanistan, a substantial number of U.S. military personnel report deployment-related lung disease (DRLD) symptoms, including those consistent with an asthma-like airways disease. DRLD is thought to be caused by prolonged inhalation of toxic desert particulate matter, which can persist in the postdeployment setting such as exposure to common household allergens. The goal of this study was to define the transcriptomic responses of lung leukocytes of mice exposed to Afghanistan desert particulate matter (APM) and house dust mite (HDM). C57BL/6 mice (n = 15/group) were exposed to filtered air or aerosolized APM for 12 days, followed by intranasal PBS or HDM allergen challenges for 24 h. Bronchoalveolar lavage (BAL) cells were collected for single-cell RNA sequencing (scRNAseq), and assessment of inflammation and airway hyper-responsiveness. Unsupervised clustering of BAL cell scRNAseq data revealed a unique monocyte population induced only by both APM and allergen treatments. This population of monocytes is characterized by the expression of genes involved in allergic asthma, including Alox15. We validated Alox15 expression in monocytes via immunostaining of lung tissue. APM pre-exposure, followed by the HDM challenge, led to significantly increased total respiratory system resistance compared with filtered air controls. Using this mouse model to mimic DRLD, we demonstrated that inhalation of airborne PM during deployment may prime airways to be more responsive to allergen exposure after returning home, which may be linked to dysregulated immune responses such as induction of a unique lung monocyte population.
Warming and elevated CO2 alter tamarack C fluxes, growth and mortality: evidence for heat stress-related C starvation in the absence of water stress
Authors: Murphy Bridget K , Way Danielle A 
Published: May 2021

Abstract
Climate warming is increasing the frequency of climate-induced tree mortality events. While drought combined with heat is considered the primary cause of this mortality, little is known about whether moderately high temperatures alone can induce mortality, or whether rising CO2 would prevent mortality at high growth temperatures. We grew tamarack (Larix laricina) under ambient (400 p.p.m.) and elevated (750 p.p.m.) CO2 concentrations combined with ambient, ambient +4 °C and ambient +8 °C growth temperatures to investigate whether high growth temperatures lead to carbon (C) limitations and mortality. Growth at +8 °C led to 40% mortality in the ambient CO2 (8TAC) treatment, but no mortality in the elevated CO2 treatment. Thermal acclimation of respiration led to similar leaf C balances across the warming treatments, despite a lack of photosynthetic acclimation. Photosynthesis was stimulated under elevated CO2, increasing seedling growth, but not leaf C concentrations. However, growth and foliar C concentrations were lowest in the +8 °C treatments, even with elevated CO2. Dying 8TAC seedlings had lower needle C concentrations and lower ratios of photosynthesis to respiration than healthy 8TAC seedlings, indicating that C limitations were likely the cause of seedling mortality under high growth temperatures.
Postoperative opioid-free ureteroscopy discharge: A quality initiative pilot protocol
Authors: Kasman Alex M. , Schmidt Bogdana , Spradling Kyle , Chow Charlene , Hunt Rebecca , Wu Mechele , Sockol Alexa , Liao Joseph , Leppert John T. , Shah Jay , Conti Simon L. 
Published: May 2021

Abstract

Background:
Opioids are commonly prescribed after ureteroscopy. With an increasing adoption of ureteroscopy for management of urolithiasis, this subset of patients is at high risk for opioid dependence. We sought to pilot an opioid-free discharge protocol for patients undergoing ureteroscopy for urolithiasis.

Materials and methods:
A prospective cohort study was performed of all patients undergoing ureteroscopy for urolithiasis and compared them to a historical control group. An opioid-free discharge protocol was initiated targeting all areas of surgical care from June 20th, 2019 to September 20th, 2019 as part of an institutional quality improvement initiative. Demographic and surgical data were collected as were morphine equivalent doses (MEDs) prescribed at discharge, postoperative measures including phone calls, clinic visits, and emergency room visits for pain.

Results:
Between October 1st, 2017 and February 1st, 2018, a total of 54 patients who underwent ureteroscopy were identified and comprised the historical control cohort while 54 prospective patients met the inclusion criteria since institution of the quality improvement initiative. There were no statistically significant differences in baseline patient demographics or surgical characteristics between the 2 patient groups. Total 37% of the intervention group had a preexisting opioid prescription versus 42.6% of the control group with no difference in preoperative MED (p = 0.55). The intervention group had a mean MED of 12.03 at discharge versus 110.5 in the control cohort (p ≤ 0.001). At discharge 3.7% of the intervention group received an opioid prescription versus 88.9% of the control group (p < 0.001). Overall, there was no difference in postoperative pain related phone calls (p = 1.0) or emergency room visits (p = 1.0).

Conclusions:
An opioid-free discharge protocol can dramatically reduce opioid prescription at discharge following ureteroscopy for urinary calculi without affecting postoperative measures such as phone calls, clinic visits, or subsequent prescriptions.
On a Quantitative Approach to Clinical Neuroscience in Psychiatry: Lessons from the Kuramoto Model
Authors: Anyaeji Chinedu I. , Cabral Joana , Silbersweig David 
Published: May 2021

Abstract
The human brain is a complex system comprising subregions that dynamically exchange information between its various parts through synchronization. These dynamic, complex interactions ultimately play a role in perception, emotion, cognition, and behavior, as well as in various maladaptive neurologic and psychiatric processes. It is therefore important to understand how brain dynamics might be implicated in these processes. Over the past few years, network neuroscience and computational neuroscience have highlighted the importance of measures such as metastability (a property whereby members of an oscillating system tend to linger at the edge of synchronicity without permanently becoming synchronized) in quantifying brain dynamics. Altered metastability has been implicated in various psychiatric illnesses, such as traumatic brain injury and Alzheimer’s disease. Computational models, which range in complexity, have been used to assess how various parameters affect metastability, synchronization, and functional connectivity. These models, though limited, can act as heuristics in understanding brain dynamics. This article (aimed at the clinical psychiatrist who might not possess an extensive mathematical background) is intended to provide a brief and qualitative summary of studies that have used a specific, highly simplified computational model of coupled oscillators (Kuramoto model) for understanding brain dynamics—which might bear some relevance to clinical psychiatry.
Outcomes of Primary Trabeculectomy From Two Same-centre Cohorts 10 Years Apart
Authors: Shiwani Haaris A. , Naqvi Salman , Cristian Cristina , Au Leon , Spencer Anne F. , Fenerty Cecilia H. , Mercieca Karl J. 
Published: May 2021

Precis:
Trabeculectomy can effectively lower intraocular pressure (IOP). A more junior surgeon profile is emerging. Mitomycin C (MMC) has replaced 5-fluorouracil (5-FU) intraoperatively with comparable success rates and a decrease in postoperative antimetabolite administration.

Purpose:
We compare 2-year outcomes for primary trabeculectomy in 2 cohorts, 10 years apart, performed at a large UK teaching hospital.

Methods:
Consecutive case series of trabeculectomies at Manchester Royal Eye Hospital between 2004-2005 (Cohort 1/C1) and 2014-2015 (Cohort 2/C2). Preoperative and postoperative data was collected for IOP outcomes and complications. Success was defined as IOP ≥6 and ≤21, ≤18, ≤16, ≤14, or ≤12 mm Hg with/without a ≥20% decrease from preoperative IOP. The need for and absence of postoperative antihypertensive medication defined qualified and complete success, respectively.

Results:
A total of 186 cases were analyzed [52 (C1), 134 (C2)]. Mean preoperative IOP was 24±10 mm Hg (C1) and 21±7 mm Hg (C2) (P=0.01). Overall, 34 (79%), 33 (77%), 33 (77%), 29 (67%), and 25 (58%) patients in C1 and 88 (70%), 82 (65%), 73 (58%), 64 (51%), and 40 (32%) patients in C2 achieved complete success for IOP ≤21 mm Hg (P=0.33), ≤18 mm Hg (P=0.22), ≤16 mm Hg (P=0.04), ≤14 mm Hg (P=0.09), or ≤12 mm Hg (P=0.004). Similarly, 43 (93%), 40 (87%), 40 (87%), 35 (76%), and 27 (59%) in C1 and 123 (98%), 116 (92%), 106 (84%), 87 (69%), and 58 (49%) in C2 achieved qualified success (P=0.34, 0.37, 0.83, 0.48, and 0.19). In all, 32 (74%), 31 (72%),31 (72%), 28 (65%), and 24 (56%) in C1 and 64 (51%), 63 (50%), 61 (48%), 54 (43%), and 39 (31%) in C2 achieved complete success with ≥20% reduction from preoperative IOP and IOP of ≤21 mm Hg (P=0.01), ≤18 mm Hg (P=0.02), ≤16 mm Hg (P=0.01), ≤1 mm Hg (P=0.02), or ≤12 mm Hg (P=0.006). By same definition, 37 (80%), 36 (78%), 36 (78%), 33 (72%), and 26 (57%) in C1 and 94 (75%), 93 (74%), 90 (71%), 75 (60%), and 58 (46%) in C2 achieved qualified success (P=0.55, 0.69, 0.48, 0.20, and 0.30). Mean IOP at 2 years was 13±5 mm Hg (C1) and 13±4 mm Hg (C2) (P=0.35). Overall, 62% had intraoperative 5-FU in C1; only MMC was used in C2 (P<0.0001). Postoperative 5-FU was administered in 54% versus 22% in C1 and C2, respectively (P<0.0001). Needling rates were not statistically different [42% (C1), 54% (C2)] (P=0.22).

Conclusions:
Trabeculectomy is effective in lowering IOP with success comparable across various definitions. MMC replaced 5-FU as intraoperative antimetabolite resulting in reduced need for postoperative antimetabolite but not increased complications.
Clinical PET/CT utilization during the COVID-19 pandemic: initial experience at Yale University
Authors: Adin Mehmet Emin , Uezono Haruka , Isufi Edvin , Pang Yulei , Zucconi William , Saperstein Lawrence , Pucar Darko 
Published: May 2021

Objective
To determine temporal changes in PET/CT utilization during the COVID-19 pandemic and examine the impact of epidemiologic, demographic and oncologic factors on PET/CT utilization.

Methods
Clinical PET-CT utilization between 1 January 2020 and 15 June 2020 at a tertiary academic center was assessed using change-point-detection (CPD) analysis. COVID-19 epidemiologic trend was obtained from Connecticut Department of Public Health records. Demographic and oncologic data were gathered from electronic medical records and PET-CT scans by four reviewers in consensus.

Results
A total of 1685 cases were reviewed. CPD analysis identified five distinct phases of PET-CT utilization during COVID-19, with a sharp decline and a gradual recovery. There was a 62.5% decline in case volumes at the nadir. These changes correlated with COVID-19 epidemiologic changes in the state of Connecticut, with a negative correlation between COVID-19 cases and PET-CT utilization (τ = −0.54; P value < 0.001). Statistically significant differences in age, race, cancer type and current and prior scan positivity were observed in these five phases. A greater percentage of young patients and minorities were scanned during the pandemic relative to baseline. PET/CT scanning was less impacted for hematologic malignancies than for solid cancers, with less profound decline and better recovery.

Discussion
PET-CT cancer imaging was vulnerable to the COVID-19 pandemic at our institution. Epidemiologic, demographic and oncologic factors affected PET-CT utilization.
How Positive Are Conversion Disorder Diagnoses?
Authors: Nikrad Ehsan , Kanaan Richard A. 
Published: May 2021

Abstract
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria for conversion disorder have replaced the criterion of evidence of a “psychogenic” etiology with a criterion that patients must be “positively” diagnosed on the basis of their neurological assessment. We retrospectively studied referrals to a specialist functional neurology clinic to see how commonly the new criteria were met since DSM-5's introduction. Positive signs were reported in a quarter of referrals (26.5%), which was associated with diagnosticians' confidence (p = 0.001) and with the clinic confirming the diagnosis (p = 0.01). Our clinic found positive signs in 28.6% of the referrals. In 13 (13.3%) patients, the new criterion was not met. In conclusion, positive signs are diagnostically helpful but are only reported in a minority of assessments. A significant group of those currently believed to have conversion disorder would not meet the revised diagnostic criteria based on this.
Kinetics of emergence of liver complications in hepatitis C virus infected patients and advanced fibrosis, with and without HIV-coinfection, after sustained virological response
Authors: Corma-Gómez Anaïs , Macías Juan , Téllez Francisco , Morano Luis , Rivero Antonio , Serrano Miriam , Ríos María José , Vera-Méndez Francisco Jesús , Santos Marta , Real Luis Miguel , Palacios Rosario , Santos Ignacio de Los , Geijo Paloma , Imaz Arkaitz , Merino Dolores , Galindo Maria José , Reus-Bañuls Sergio , López-Ruz Miguel Ángel , Galera Carlos , Pineda Juan A. 
Published: May 2021

Objective:
There is scarce available evidence on the distribution over time of liver complications emergence in hepatitis C virus (HCV)-infected patients who achieve sustained virological response (SVR) with direct-acting antiviral (DAA)-based therapy. Therefore, we aimed at describing the kinetics of liver-related events appearance in this setting.

Design:
A multicentric prospective cohort study.

Methods:
HCV-monoinfected and HIV/HCV-coinfected patients from GEHEP-011 cohort, whose inclusion criteria were had achieved SVR with DAA-based therapy; liver stiffness prior to starting treatment at least 9.5 kPa; and available liver stiffness measurement at SVR. SVR was considered as the baseline time-point.

Results:
One thousand and thirty-five patients were included, 664 (64%) coinfected with HIV. Before DAA-based therapy, 63 (6.1%) individuals showed decompensated cirrhosis. After SVR, 51 (4.9%) patients developed liver complications. Median (Q1-Q3) time to the emergence of hepatic events was hepatic encephalopathy 11 (7–24) months, ascites 14 (6–29) months, hepatocellular carcinoma (HCC) 17 (11–42) months and portal hypertension gastrointestinal bleeding (PHGB) 28 (22–38) months (P = 0.152). We define two profiles of liver complications: those emerging earlier (encephalopathy and ascites) and, those occurring continuously during the follow-up (HCC, PHGB) [median (Q1-Q3) time to emergence 12.7 (6.6–28.2) months vs. 25.4 (12.5–41.53) months, respectively (P = 0.026)].

Conclusion:
The vast majority of HCV-infected patients who develop liver complications after reaching SVR with DAA do it within 3 years after SVR time-point. Specifically, hepatic encephalopathy and ascites do not usually emerge after this period. Conversely, HCC and PHGB may occur in longer term. It is critical to identify patients at risk of developing hepatic events to continue performing surveillance for them.