bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macroeconomic conditions and health‐related outcomes in the United States: A metropolitan and micropolitan statistical area‐level analysis between 2004 and 2017
Authors: Peng Lizhong , Chen Jie , Guo Xiaohui 
Published: September 2021

AbstractWe study the relationship between macroeconomic conditions and health in the United States using data from the Behavioral Risk Factor Surveillance System between 2004 and 2017. Unlike many existing studies that use state or county as the level of aggregation, our analysis uses a sample of metropolitan and micropolitan statistical areas. Our results suggest strong associations between worsening macroeconomic conditions and reduced access to care and health insurance coverage. While we do not detect any robust relationships between business cycles and health outcomes in the general population, we do find consistent evidence of worse self‐reported health during economic downturns among minorities and less‐educated individuals. In addition, there is some suggestive evidence of countercyclicality of healthier lifestyle choices. However, the findings for health behavior outcomes are not robust to adjusting for multiple hypothesis testing.
Melanoma differentiation—Associated gene 5 protects against NASH in mice
Authors: Zhang Xin , Yang Hailong , Zeng Shan , Tian Song , Hu Sha , Yang Ling , Ma Tengfei , Liu Zhen , Wan Juan , Zhong Yiming , Li Hongliang 
Published: September 2021

Abstract

Background and Aims
NASH is a complicated disease characterized by hepatocyte steatosis, inflammation infiltration, and liver fibrosis. Accumulating evidence suggests that the innate immunity plays a key role in NASH progression. Here, we aimed to reveal the role of melanoma differentiation–associated gene 5 (MDA5, also known as Ifih1), a conventional innate immune regulator following viral infection, in the progression of NASH and investigate its underlying mechanism.

Approach and Results
We first examined the expression of MDA5 and found that MDA5 was markedly down‐regulated in the livers with NASH in human individuals and mice models. MDA5 overexpression significantly inhibits the free fatty acid–induced lipid accumulation and inflammation in hepatocyte in vitro, whereas MDA5 knockdown promotes hepatocyte lipotoxicity. Using hepatocyte‐specific Mda5 gene knockout and transgenic mice, we found that diet‐induced hepatic steatosis, inflammation, and liver fibrosis were markedly exacerbated by Mda5 deficiency but suppressed by Mda5 overexpression. Mechanistically, we found that the activation of apoptosis signal‐regulating kinase 1 (ASK1)–mitogen‐activated protein kinase pathway was significantly inhibited by MDA5 but enhanced by MDA5 deletion. We further validated that MDA5 directly interacted with ASK1 and suppressed its N‐terminal dimerization. Importantly, blockage of ASK1 with adenovirus‐expressing dominant negative ASK1 obviously reversed the lipid accumulation and ASK1 pathway activation when Mda5 was knocked out.

Conclusions
These data indicate that MDA5 is an essential suppressor in NASH. The findings support MDA5 as a regulator of ASK1 and a promising therapeutic target for NASH.
Numerical investigation on entropy generation in the dropwise condensation inside an inclined pipe
Authors: Zolfaghari Abbas , Aminian Ehsan , Saffari Hamid 
Published: September 2021

AbstractIn this paper, the entropy generation analysis in dropwise condensation in an inclined pipe is carried out. As the vapor passes through the inclined pipe, the flow of the droplets occurs due to the interfacial shear and gravity. Three distinct zones considered in the numerical study include the saturated vapor flowing in the axial direction, saturated liquid traveling through the bottom of the pipe, and the condensate droplet flowing on the inner side of the pipe wall. With the aim of achieving optimal geometrical conditions of the pipe and flow, the entropy generation was calculated for various cases. The results show that the minimum entropy generation of 0.0754 W·K−1 occurs in a configuration with a diameter of 9.5 mm and an inclination angle of 1°. Finally, the Bejan number, irreversibility distribution ratio, and variation according to the flow conditions were presented.
Intra‐annual variability of urban effects on streamflow
Authors: Diem Jeremy E. , Pangle Luke A. , Milligan Richard A. , Adams Ellis A. 
Published: September 2021

AbstractWhile considerable research has established the impacts of urbanization on streamflow, there has been little emphasis on how intra‐annual variations in streamflow can deepen the understanding of hydrological processes in urban watersheds. This study fills this critical research gap by examining, at the monthly scale, correlations between land‐cover and streamflow, differences in streamflow metrics between urban and rural watersheds, and the potential for the inflow and infiltration (I&I) of extraneous water into sewers to reduce streamflow. We use data from 90 watersheds in the Atlanta, GA region over the 2013–2019 period to accomplish our objectives. Similar to other urban areas in temperate climates, Atlanta has a soil‐water surplus in winter and a soil‐water deficit in summer. Our results show urban watersheds have less streamflow seasonality than do rural watersheds. Compared to rural watersheds, urban watersheds have a much larger frequency of high‐flow days during July–October. This is caused by increased impervious cover decreasing the importance of antecedent soil moisture in producing runoff. Urban watersheds have lower baseflows than rural watersheds during December–April but have baseflows equal to or larger than baseflows in rural watersheds during July–October. Intra‐annual variations in effluent data from wastewater treatment plants provide evidence that I&I is a major cause of the relatively low baseflows during December–April. The relatively high baseflows in urban watersheds during July–October are likely caused by reduced evapotranspiration and the inflow of municipal water. The above seasonal aspects of urban effects on streamflow should be applicable to most urban watersheds with temperate climates.
The experience of diagnostic radiography students during the early stages of the COVID‐19 pandemic – a cross‐sectional study
Authors: Lawson Jones Gaynor , York Helen , Lawal Olanrewaju , Cherrill Richard , Mercer Sarah , McCarthy Zoe 
Published: September 2021

AbstractIntroductionThe rationale for this study was to ascertain the impact of the COVID‐19 pandemic on Undergraduate B.Sc (Hons) Diagnostic Radiography students at the University of Hertfordshire in the UK. This would provide an ideal opportunity for students to reflect on their experience and indicate if they required additional support from the University.MethodsAn online anonymous cross‐sectional survey was deployed to all year groups (n = 283) during the first nationwide lockdown in May 2020, eliciting qualitative responses on questions about the effect of the pandemic; emotions experienced; support required and consideration of their choice of a career in the health sector.ResultsTwo hundred and one students responded to the survey, with many having experienced the illness or loss of a loved one. Trying to balance family commitments and study was a concern to some students, as well as struggling with the financial burden of job losses or furlough. Many students commented that educational support was a requirement with the move to online teaching and assessment. The main focus of student responses was the emotions that they had experienced, many of which were negative. Anxiety and fear were commonly expressed feelings, along with sadness and feelings of isolation. A small number of students reported feeling grateful, happy and relieved. An overwhelming majority of respondents commented that they were proud to be healthcare students and they were resolute in wanting to continue the course and join the frontline of the NHS workforce.ConclusionSome students have been deeply affected by their experiences of the pandemic, and University support mechanisms should be refined to better assist with their ongoing challenges.
Diagnostic accuracy of severe periodontitis case definitions: Comparison of the CDC/AAP, EFP/AAP, and CPI criteria
Authors: Brito Liana F. , Taboza Zuila A. , Silveira Virginia R. , Teixeira Ana K. , Rego Rodrigo O. 
Published: September 2021

AbstractBackgroundThis cross‐sectional study aimed to evaluate the diagnostic accuracy of severe periodontitis by three different case definitions.MethodsPatients aged >35 years (n = 243, mean age = 47.8 ± 9.3 years) were evaluated by periodontal examinations and classified in patients with severe periodontitis according to the case definition proposed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Academy of Periodontology (AAP)—CDC/AAP, the new periodontal disease classification proposed jointly by the AAP and the European Federation of Periodontology (EFP/AAP), and the Community Periodontal Index (CPI). The primary outcome was to compare the diagnostic accuracy of severe periodontitis between the three case definitions. Sensitivity (SS), specificity (SP), and area under the receiver operating characteristic (ROC) curve were used to analyze the accuracy.ResultsThe proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 47.3%, type III and IV periodontitis (EFP/AAP) = 43.2% and CPI code 4 = 44.4%. When comparing the CDC/AAP case definitions with the EFP/AAP classification, SS, SP, and ROC of 81.7%, 91.4%, and 0.866 (CI, 95%: 0.816 to 0.916), respectively, were obtained. Similarly, when comparing CDC/AAP to CPI code 4, SS, SP, and ROC of 81.7%, 89.1%, and 0.854 (CI, 95%: 0.802 to 0.906), respectively, were obtained. When type III and IV periodontitis (EFP/AAP) was compared with CPI code 4, the values were 92.4%, 92%, and 0.922 (CI, 95%: 0.883 to 0.961), respectively.ConclusionsThe EFP/AAP classification and the CPI demonstrated high diagnostic accuracy with the CDC/AAP case definition to diagnose severe periodontitis.
A 3‐Decade, Single‐Center Experience of Liver Transplantation for Cholangiocarcinoma: Impact of Era, Tumor Size, Location, and Neoadjuvant Therapy
Authors: Ito Takahiro , Butler James R. , Noguchi Daisuke , Ha Minah , Aziz Antony , Agopian Vatche G. , DiNorcia Joseph , Yersiz Hasan , Farmer Douglas G. , Busuttil Ronald W. , Hong Johnny C. , Kaldas Fady M. 
Published: September 2021

Liver transplantation (LT) for cholangiocarcinoma (CCA) remains limited to a small number of centers. Although the role of neoadjuvant therapy (NAT) has been explored over time, an in‐depth analysis of NAT strategies remains limited. Furthermore, controversy exists regarding acceptable tumor size during patient selection for LT. This study explores the impact of era, tumor size, and NAT strategy on LT outcomes for CCA. We conducted a retrospective review of 53 patients with CCA treated with LT from 1985 to 2019; 19 hilar CCA (hCCA) and 30 intrahepatic CCA (iCCA) were included. The relative contributions of varying NAT (neoadjuvant chemotherapy [NAC], neoadjuvant local therapy [NALT], and combined NAC and NALT [NACLT]) as well as the implication of tumor size and era were analyzed. The primary endpoint was overall survival (OS). Compared with the old era (1985‐2007), 5‐year OS in patients who underwent LT in the recent era (2008‐2019) showed a superior trend. The 5‐year OS from initial treatment in patients receiving NACLT for hCCA and iCCA were 88% and 100% versus 9% and 41% in patients without it, respectively (P = 0.01 for hCCA; P = 0.02 for iCCA), whereas NAC or NALT alone did not show significant differences in OS versus no NAT (P > 0.05). Although 33 patients had large‐size tumors (hCCA ≥ 30 mm, n = 12, or iCCA ≥ 50 mm, n = 21), tumor size had no impact on survival outcomes. Outcomes of LT for CCA seem to have improved over time. Multimodal NAT is associated with improved survival in LT for both iCCA and hCCA regardless of tumor size.
Impact of the Kasai Procedure and the Length of Native Liver Survival Time on Outcomes of Liver Transplantation for Biliary Atresia
Authors: Liu Liwei , Wei Lin , Qu Wei , Liu Ying , Zeng Zhigui , Zhang Haiming , Li Min , Liu Jimin , Wang Hanlin L. , Li Kexin , He Yafei , Jia Jidong , Sun Liying , Zhao Xinyan , Zhu Zhijun 
Published: September 2021

The aim is to explore the impact of the Kasai procedure (KP) and the length of native liver survival time (NLST) on outcomes of liver transplantation (LT). Patients with biliary atresia (BA), who underwent LT in Beijing Friendship Hospital from January 2017 to December 2019, were enrolled and divided into non‐KP (N‐KP) and post‐KP (P‐KP) groups. The patients in the P‐KP group were further divided into early failure (KP‐EF) defined by NLST <1 year, medium failure (KP‐MF, NLST 1‐5 years), and late failure (KP‐LF, NLST >5 years) subgroups. Clinical data at baseline and during follow‐up were collected. The inverse probability of treatment weighting method was used to evaluate the independent effect of KP and the length of NLST on clinical outcomes. Among 197 patients with BA, the N‐KP group accounted for 43 (21.8%), KP‐EF 71 (46.1%), KP‐MF 59 (38.3%), and KP‐LF 24 (15.6%) cases, respectively. The N‐KP and KP‐EF groups had significantly longer hospitalization and intensive care unit stays after LT. Graft and overall survival rates were 93.0% in the N‐KP group and 97.4% in P‐KP group, respectively. The mortality rate in the P‐KP group were significantly lower compared with that of the N‐KP group with a hazard ratio (HR) of 0.2 (P = 0.02). The risks of biliary and vascular complications and cytomegalovirus (CMV) infection after LT were significantly higher in KP‐EF group than those in the KP‐MF and KP‐LF groups (HRs = 0.09, 0.2, and 0.3, respectively; all P < 0.001). The KP significantly improved after LT overall survival. Patients with early native liver failure after KP have significantly higher risks for biliary and vascular complications and CMV infection.
THE CASE FOR PURPOSEFUL LEADERSHIP
Authors: Joly Hubert 
Published: September 2021

AbstractThe author, now a senior lecturer at Harvard Business School, describes leadership lessons from his experience as the former Chairman and Chief Executive Officer of the electronics retailer Best Buy. While beginning to lead the company, he “learned that much of what I had been taught at business school and as a consultant and young executive is either wrong, outdated, or incomplete.” He debunks in detail what he describes as three myths of leadership, which in his words are: Myth #1: leaders are superheroes. Myth # 2: People are born leaders. Myth #3: You cannot change. For instance, within that point, Joly writes “I once believed that leadership was about a top‐down management approach driven by data and analytics; I now focus on purpose and human magic.” He further outlines a five point leadership model, which in his words: (1) Be clear about your purpose, the purpose of people around you, and how it connects with the purpose of the company. (2) Be clear about your role as a leader. (3) Be clear about whom you serve. (4) Be driven by values. (5) Be authentic. Within point 4, he quotes a former colleague: “Tell the truth and do what’s right.”
Feasibility study of fiducial marker localization using microwave radar
Authors: Han‐Oh Sarah , Ding Kai , Song Daniel , Narang Amol , Wong John , Rong Yu , Bliss Daniel 
Published: September 2021

AbstractPurposeWe explore the potential use of radar technology for fiducial marker tracking for monitoring of respiratory tumor motion during radiotherapy. Historically microwave radar technology has been widely deployed in various military and civil aviation applications to provide detection, position, and tracking of single or multiples objects from far away and even through barriers. Recently, due to many advantages of the microwave technology, it has been successfully demonstrated to detect breast tumor, and to monitor vital signs in real time such as breathing signals or heart rates. We demonstrate a proof‐of‐concept for radar‐based fiducial marker tracking through the synthetic human tissue phantom.MethodsWe performed a series of experiments with the vector network analyzer (VNA) and wideband directional horn antenna. We considered the frequency range from 2.0 to 6.0 GHz, with a maximum power of 3 dBm. A horn antenna, transmitting and receiving radar pulses, was connected to the vector network analyzer to probe a gold fiducial marker through a customized synthetic human tissue phantom, consisting of 1‐mm thickness of skin, 5‐mm fat, and 25‐mm muscle layers. A 1.2 × 10‐mm gold fiducial marker was exploited as a motion surrogate, which was placed behind the phantom and statically positioned with an increment of 12.7 mm to simulate different marker displacements. The returned signals from the marker were acquired and analyzed to evaluate the localization accuracy as a function of the marker position.ResultsThe fiducial marker was successfully localized at various measurement positions through a simplified phantom study. The averaged localization accuracy across measurements was 3.5 ± 1.3 mm, with a minimum error of 1.9 mm at the closest measurement location and a maximum error of 4.9 mm at the largest measurement location.ConclusionsWe demonstrated that the 2–6 GHz radar can penetrate through the attenuating tissues and localize a fiducial marker. This successful feasibility study establishes a foundation for further investigation of radar technology as a non‐ionizing tumor localization device for radiotherapy.
Technical note: A fast and accurate analytical dose calculation algorithm for 125I seed‐loaded stent applications
Authors: Liu Bo , Xiong Tianyu , Lu Jian , Li Shengwei , Bai Xiangzhi , Zhou Fugen , Wu Qiuwen 
Published: September 2021

AbstractPurposeThe safety and clinical efficacy of 125I seed‐loaded stent for the treatment of portal vein tumor thrombosis (PVTT) have been shown. Accurate and fast dose calculation of the 125I seeds with the presence of the stent is necessary for the plan optimization and evaluation. However, the dosimetric characteristics of the seed‐loaded stents remain unclear and there is no fast dose calculation technique available. This paper aims to explore a fast and accurate analytical dose calculation method based on Monte Carlo (MC) dose calculation, which takes into account the effect of stent and tissue inhomogeneity.MethodsA detailed model of the seed‐loaded stent was developed using 3D modeling software and subsequently used in MC simulations to calculate the dose distribution around the stent. The dose perturbation caused by the presence of the stent was analyzed, and dose perturbation kernels (DPKs) were derived and stored for future use. Then, the dose calculation method from AAPM TG‐43 was adapted by integrating the DPK and appropriate inhomogeneity correction factors (ICF) to calculate dose distributions analytically. To validate the proposed method, several comparisons were performed with other methods in water phantom and voxelized CT phantoms for three patients.ResultsThe stent has a considerable dosimetric effect reducing the dose up to 47.2% for single‐seed stent and 11.9%–16.1% for 16‐seed stent. In a water phantom, dose distributions from MC simulations and TG‐43‐DP‐ICF showed a good agreement with the relative error less than 3.3%. In voxelized CT phantoms, taking MC results as the reference, the relative errors of TG‐43 method can be up to 33%, while those of TG‐43‐DP‐ICF method were less than 5%. For a dose matrix with 256 × 256 × 46 grid (corresponding to a phantom of 17.2 × 17.2 × 11.5 cm3) for 16‐seed‐loaded stent, it only takes 17 s for TG‐43‐DP‐ICF to compute, compared to 25 h for the full MC calculation.ConclusionsThe combination of DPK and inhomogeneity corrections is an effective approach to handle both the presence of stent and tissue heterogeneity. Exhibiting good agreement with MC calculation and computational efficiency, the proposed TG‐43‐DP‐ICF method is adequate for dose evaluation and optimization in seed‐loaded stent implantation treatment planning.
Seed‐based test–retest reliability of resting state functional magnetic resonance imaging at 3T and 7T
Authors: Nemani Ajay , Lowe Mark J. 
Published: September 2021

AbstractPurposeUltrahigh field (UHF) resting state functional magnetic resonance imaging (rsfMRI) has become increasingly available for clinical and basic research, bringing improvements in resolution and contrast over standard high field imaging. Despite these improvements, UHF connectivity studies present several challenges, including increased sensitivity to physiological confounds and a vastly increased data burden. We present a direct quantitative assessment of test–retest reliability of functional connectivity in several standard functional networks between subjects scanned at 3T and 7T.MethodsFive healthy subjects were scanned over four sessions each in a scan‐rescan design at both 3T and 7T field strengths. Resting state fMRI data were segmented into four major intrinsic connectivity networks, and seed‐based peak correlations within and between these networks examined. The reliability of these correlations was assessed using intra‐class correlation coefficients (ICC).ResultsAcross all data, over 4000 peak correlations were extracted for assessment. The reliability over all intrinsic networks was greater at 7T than 3T (median ICC 0.40 vs. 0.33, p ≤ 0.0014), with each network individually showing improvement. Inter‐network reliability was stronger than intra‐network reliability, but intra‐network reliability showed the greatest improvement between field strengths.ConclusionWe demonstrate significantly increased reliability of resting state connectivity at UHF strengths over conventional field strengths using a novel hybrid seed‐based analysis. This result adds to the growing body of work supporting the migration of functional imaging studies to UHFs.
Tetrahedron beam imaging with a multi‐pixel thermionic emission X‐ray source and a photon‐counting detector: A benchtop experimental study
Authors: Chen Qinghao , Zhou Shuang , Tan Yuewen , Hao Yao , Zhang Zhongwei , Mazur Tom , Zhang Tiezhi 
Published: September 2021

AbstractPurposeA tetrahedron beam (TB) X‐ray system with a linear X‐ray source array and a linear detector array positioned orthogonal to each other may overcome the X‐ray scattering problem of traditional cone‐beam X‐ray systems. We developed a TB imaging benchtop system using a linear array X‐ray source to demonstrate the principle and benefits of TB imaging.MethodsA multi‐pixel thermionic emission X‐ray (MPTEX) source with 48 focal spots in 4‐mm spacing was developed in‐house. The X‐ray beams are collimated to a stack of fan beams that are converged to a 6‐mm wide multi‐row photon‐counting detector (PCD). The data collected with a sequential scan of the sources at a fixed view angle were synthesized to a 2D radiography image by a shift‐and‐add algorithm. The data collected with a full rotation of the system were reconstructed into 3D TB CT (TBCT) images using an Feldkamp, Davis, and Kress (FDK)‐based computed tomography (CT) algorithm modified for the TB geometry.ResultsWith an 18.8‐cm long source array and a 35‐cm long detector array, the TB benchtop system provides a 25‐cm cross‐sectional and 8‐cm axial field of view (FOV). The scatter‐to‐primary ratio (SPR) was approximately 17% for TB, as compared with 120% for cone beam geometry. The TBCT system enables reconstructions in two‐dimensional radiography and three‐dimensional volumetric CT. The TBCT images were free of “cupping” artifacts and have similar image quality as diagnostic helical CT.ConclusionsA TB imaging benchtop imaging system was successfully developed with MPTEX source and PCD. Phantom and animal cadaver imaging demonstrated that the TB system can produce satisfactory radiographic X‐ray images and 3D CT images with image quality comparable to diagnostic helical CTs.