bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Ultrasound Education for Medical Students
Authors: Rosenfeldt Nielsen Mathias , Kristensen Erik Qvist , Jensen Rune Overgaard , Mollerup Anne Milther , Pfeiffer Thorbjørn , Graumann Ole 
Published: May 2021

Abstract
The primary aim was to evaluate the effect of immersive virtual reality learning for training medical students in basic clinical ultrasound. Secondary outcomes were to explore if virtual reality learning had an effect on hand-eye coordination skills and if the medical students wanted more virtual reality learning.
This pilot study was a double-blind, parallel-group, block-randomized, controlled trial. Participants (n = 20) were blinded and randomized to virtual reality or e-learning for basic ultrasound education. Medical students with no previous ultrasound education were recruited voluntarily from the University of Southern Denmark. Data were collected during introductory courses on ultrasound from March to May 2019. Participants were assessed with Objective Structured Assessment on Ultrasound Skills. Assessing supervisors were blinded.
The virtual reality group (n = 11) scored a significantly higher Objective Structured Assessment on Ultrasound Skills score (143 [95% confidence interval {CI}, 135 to 151]) compared with the e-learning group (n = 9; 126 [95% CI, 113 to 138]; mean difference, 17 points [95% CI, 4 to 30]; P < 0.01). No significant effect on the hand-eye score was found (mean difference, 3 points [95 % CI, −3 to 9]; P = 0.32). Ninety-one percent of the virtual reality group wanted more virtual reality learning.
Immersive virtual reality learning improved medical students’ ultrasound skills significantly compared with e-learning. The hand-eye score was higher in the virtual reality group, although not at a significant level. Students wanted more virtual reality learning. Further research is needed to clarify immersive virtual reality's educational role in the future.
Comparison of the Effectiveness of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Breast Masses
Authors: Uysal Emine , Öztürk Mehmet , Kilinçer Abidin , Koplay Mustafa 
Published: May 2021

Abstract
This study aims to determine the diagnostic performance of superb microvascular imaging (SMI) and shear wave elastography methods in evaluating breast lesions. We will also compare the effectiveness of the stiffness, velocity, and vascular index (VI) parameters in distinguishing malignancy.
From January to June 2019, 121 patients with 121 solid breast masses (category 4 and 5 lesions according to the Breast Imaging-Reporting and Data System) detected during the routine grayscale sonographic examination were included in the study. Stiffness and velocity values were obtained using shear wave elastography for all lesions, and VI was obtained using SMI. The receiver operating characteristic curves were obtained to set the best cutoff values for the stiffness, velocity, and VI to differentiate patients with malignant breast lesions.
All 121 lesions were pathologically verified by US-guided core needle biopsy. Forty-seven (38.9%) of the lesions were malignant, and 74 (61.1%) were benign. Median stiffness, velocity, and VI values were significantly lower in benign masses compared with malignant masses (P < 0.001). The optimum cutoff values for the stiffness, velocity, and VI were determined to be 58.3 kPa, 4.5 m/s, and 1.1%, respectively. The areas under the curves were 0.897 for stiffness, 0.884 for velocity, and 0.687 for VI.

Shear wave elastography and SMI are noninvasive methods that may be used to evaluate breast masses. Although both methods' quantitative data are beneficial in differentiating malignant from benign masses, stiffness is the best parameter to be used.
Toward Ergonomic Design in Ultrasound Scanning
Authors: Kliewer Mark , Walker Tim , Bagley Anjuli R. 
Published: May 2021

Abstract
Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands. In addition, although the issue has attracted the attention of professional sonographer societies, equipment manufacturers, and governmental agencies, such as the OSHA (Occupational Safety and Health), the causative mechanisms by which sonographers are injured remain inadequately addressed. A definitive ergonomic solution has been elusive.
With the help of occupational therapists and biomechanical engineers, we have developed a number of possible ergonomic modifications of ultrasound equipment. We explain the rationale behind these approaches to transducer design and assess the strengths and deficiencies of each.
Craniofacial Injuries From Personal Watercraft Accidents
Authors: Mirsky Nicholas , Kim Minji , Plotsker Ethan , Thaller Seth R. 
Published: May 2021

Abstract
Personal watercraft (PWC) use is a popular leisure activity. Although injuries associated with PWCs have been examined broadly, there is a lack of investigation into craniofacial injuries within this setting. This paper reviews the literature discussing PWC incidents and PWC-related craniofacial injuries. A comprehensive literature search of the MEDLINE, EMBASE, Google Scholar, and National Library of Medicine databases was conducted for studies published through January 2021. Articles were selected if they contained information on PWC accidents and related craniofacial injuries. We also examined 3 patient cases of PWC-related craniofacial injuries. Overall, our review suggests that over the past 20 years, injuries and accidents have decreased significantly whereas fatalities have decreased to a lesser extent. Most PWC-related craniofacial injuries result from blunt trauma and a notable number of deaths and traumatic brain injuries occur in adolescents. Given the increasing number of PWC sales, PWC-related craniofacial injuries may be more prevalent, which prompts improved regulations and protective gears. Existing state laws on PWCs vary dramatically. As of now, there is no uniform policy that requires protective equipment use like helmets or instruction before PWC use. There also should be limitations on alcohol consumption as well as age of the riders. Overall, our review indicates that more research is needed to reduce the number of craniofacial injuries among PWC riders.
An Ovine Model of Hemorrhagic Shock and Resuscitation, to Assess Recovery of Tissue Oxygen Delivery and Oxygen Debt, and Inform Patient Blood Management
Authors: Dyer Wayne B. , Tung John-Paul , Li Bassi Gianluigi , Wildi Karin , Jung Jae-Seung , Colombo Sebastiano Maria , Rozencwajg Sacha , Simonova Gabriela , Chiaretti Sara , Temple Fergal T. , Ainola Carmen , Shuker Tristan , Palmieri Chiara , Shander Aryeh , Suen Jacky Y. , Irving David O. , Fraser John F. 
Published: May 2021

ABSTRACT

Background:
Aggressive fluid or blood component transfusion for severe hemorrhagic shock may restore macrocirculatory parameters, but not always improve microcirculatory perfusion and tissue oxygen delivery. We established an ovine model of hemorrhagic shock to systematically assess tissue oxygen delivery and repayment of oxygen debt; appropriate outcomes to guide Patient Blood Management.

Methods:
Female Dorset-cross sheep were anesthetized, intubated, and subjected to comprehensive macrohemodynamic, regional tissue oxygen saturation (StO2), sublingual capillary imaging, and arterial lactate monitoring confirmed by invasive organ-specific microvascular perfusion, oxygen pressure, and lactate/pyruvate levels in brain, kidney, liver, and skeletal muscle. Shock was induced by stepwise withdrawal of venous blood until MAP was 30 mm Hg, mixed venous oxygen saturation (SvO2) < 60%, and arterial lactate >4 mM. Resuscitation with PlasmaLyte® was dosed to achieve MAP > 65 mm Hg.

Results:
Hemorrhage impacted primary outcomes between baseline and development of shock: MAP 89 ± 5 to 31 ± 5 mm Hg (P < 0.01), SvO2 70 ± 7 to 23 ± 8% (P < 0.05), cerebral regional tissue StO2 77 ± 11 to 65 ± 9% (P < 0.01), peripheral muscle StO2 66 ± 8 to 16 ± 9% (P < 0.01), arterial lactate 1.5 ± 1.0 to 5.1 ± 0.8 mM (P < 0.01), and base excess 1.1 ± 2.2 to −3.6 ± 1.7 mM (P < 0.05). Invasive organ-specific monitoring confirmed reduced tissue oxygen delivery; oxygen tension decreased and lactate increased in all tissues, but moderately in brain. Blood volume replacement with PlasmaLyte® improved primary outcome measures toward baseline, confirmed by organ-specific measures, despite hemoglobin reduced from baseline 10.8 ± 1.2 to 5.9 ± 1.1 g/dL post-resuscitation (P < 0.01).

Conclusion:
Non-invasive measures of tissue oxygen delivery and oxygen debt repayment are suitable outcomes to inform Patient Blood Management of hemorrhagic shock, translatable for pre-clinical assessment of novel resuscitation strategies.
End-tidal Carbon Dioxide as an Indicator of Partial REBOA and Distal Organ Metabolism in Normovolemia and Hemorrhagic Shock in Anesthetized Pigs
Authors: Sadeghi Mitra , Hurtsén Anna Stene , Tegenfalk Josephine , Skoog Per , Jansson Kjell , Hörer Tal M. , Nilsson Kristofer F. 
Published: May 2021

ABSTRACT

Introduction:
It is difficult to estimate the ischemic consequences when using partial resuscitative endovascular balloon occlusion of the aorta (REBOA). The aim was to investigate if end-tidal carbon dioxide (ETCO2) is correlated to degree of aortic occlusion, measured as distal aortic blood flow, and distal organ metabolism, estimated as systemic oxygen consumption (VO2), in a porcine model of normovolemia and hemorrhagic shock.

Materials and methods:
Nine anesthetized pigs (25–32 kg) were subjected to incremental steps of zone 1 aortic occlusion (reducing distal aortic blood flow by 33%, 66%, and 100%) during normovolemia and hemorrhagic grade IV shock. Hemodynamic and respiratory variables, and blood samples, were measured. Systemic VO2 was correlated to ETCO2 and measures of partial occlusion previously described.

Results:
Aortic occlusion gradually lowered distal blood flow and pressure, whereas ETCO2, VO2 and carbon dioxide production decreased at 66% and 100% aortic occlusion. Aortic blood flow correlated significantly to ETCO2 during both normovolemia and hemorrhage (R = 0.84 and 0.83, respectively) and to femoral mean pressure (R = 0.92 and 0.83, respectively). Systemic VO2 correlated strongly to ETCO2 during both normovolemia and hemorrhage (R = 0.91 and 0.79, respectively), blood flow of the superior mesenteric artery (R = 0.77 and 0.85, respectively) and abdominal aorta (R = 0.78 and 0.78, respectively), but less to femoral blood pressure (R = 0.71 and 0.54, respectively).

Conclusion:
ETCO2 was correlated to distal aortic blood flow and VO2 during incremental degrees of aortic occlusion thereby potentially reflecting the degree of aortic occlusion and the ischemic consequences of partial REBOA. Further studies of ETCO2, and potential confounders, in partial REBOA are needed before clinical use.
Targeted Regional Optimization: Increasing the Therapeutic Window for Endovascular Aortic Occlusion In Traumatic Hemorrhage
Authors: Ronaldi Alley E. , Madurska Marta J. , Bozzay Joseph D. , Polcz Jeanette E. , Baer David G. , Burmeister David M. , White Paul W. , Rasmussen Todd E. , White Joseph M. 
Published: May 2021

ABSTRACT
Resuscitative endovascular balloon occlusion of the aorta (REBOA) allows for effective temporization of exsanguination from non-compressible hemorrhage (NCTH) below the diaphragm. However, the therapeutic window for aortic occlusion is time-limited given the ischemia-reperfusion injury generated. Significant effort has been put into translational research to develop new strategies to alleviate the ischemia-reperfusion injury and extend the application of endoaortic occlusion. Targeted regional optimization (TRO) is a partial REBOA strategy to augment proximal aortic and cerebral blood flow while targeting minimal threshold of distal perfusion beyond the zone of partial aortic occlusion. The objective of TRO is to reduce the degree of ischemia caused by complete aortic occlusion while providing control of distal hemorrhage. This review provides a synopsis of the concept of TRO, pre-clinical, translational experiences with TRO and early clinical outcomes. Early results from TRO strategies are promising; however, further studies are needed prior to large-scale implementation into clinical practice.
Homelessness: care for the most vulnerable – a narrative review of risk factors, health needs, stigma, and intervention strategies
Authors: Schreiter Stefanie , Speerforck Sven , Schomerus Georg , Gutwinski Stefan 
Published: May 2021

Purpose of review
To summarize the most recent literature on risk factors of homelessness, mental, and somatic health needs, healthcare use, stigma as well as intervention strategies for people experiencing homelessness.

Recent findings
Studies identified adverse life events as well as mental health problems like drug use or suicidality as significant predictors of becoming homeless. Prevalence rates of mental disorders, especially substance use disorders, psychotic disorders, and depression are high. Barriers of healthcare use are financial resources and insurance status as well as experiences of discrimination. Aspects of trust and safety as well as age and gender were identified of high importance in the design of interventions. Strategies of permanent supportive housing like Housing First have shown a stable positive effect on housing stability, but not mental health outcomes. Peer support, forms of intensive case management, and harm reduction strategies are the most promising approaches to address these further needs.

Summary
Exploration into the relationship of homelessness and mental health as well as adequate intervention strategies is far from being conclusive. Especially, the development of effective interventions addressing issues of trauma, stigma and discrimination, community integration, and mental health needs is still in its infancy.
Opioids in the United Kingdom: safety and surveillance during COVID-19
Authors: Osborne Vicki 
Published: May 2021

Purpose of review
Opioid use is prevalent in the United Kingdom and prior to the COVID-19 pandemic it had been recognized that the safety of opioids was an important issue to be monitored by the UK medicines regulatory agency. With the emergence of COVID-19, this requirement has been even greater. This review was undertaken to determine the impact of the pandemic on safety and surveillance of opioids in the United Kingdom.

Recent findings
During the COVID-19 pandemic, the surveillance of opioids in the United Kingdom continued, although primary research was often conducted with data prior to the pandemic. Of those studies that were conducted while the pandemic was ongoing, access to opioids (or opioid substitution therapy) and the subsequent effect on patient safety was the main theme.

Summary
In the United Kingdom, changes in accessibility to the healthcare system and how healthcare providers operated during the COVID-19 pandemic may have had unintended consequences on use and safety of opioids, due to the shift in focus to preventing COVID-19 from overwhelming the healthcare system. The findings from this review support the need to continue surveillance in the United Kingdom, including the impact of the COVID-19 pandemic on opioid utilization and safety.
The cultural evolution of cultural evolution
Authors: Birch Jonathan , Heyes Cecilia 
Published: May 2021

What makes fast, cumulative cultural evolution work? Where did it come from? Why is it the sole preserve of humans? We set out a self-assembly hypothesis: cultural evolution evolved culturally. We present an evolutionary account that shows this hypothesis to be coherent, plausible, and worthy of further investigation. It has the following steps: (0) in common with other animals, early hominins had significant capacity for social learning; (1) knowledge and skills learned by offspring from their parents began to spread because bearers had more offspring, a process we call CS1 (or Cultural Selection 1); (2) CS1 shaped attentional learning biases; (3) these attentional biases were augmented by explicit learning biases (judgements about what should be copied from whom). Explicit learning biases enabled (4) the high-fidelity, exclusive copying required for fast cultural accumulation of knowledge and skills by a process we call CS2 (or Cultural Selection 2) and (5) the emergence of cognitive processes such as imitation, mindreading and metacognition—‘cognitive gadgets' specialized for cultural learning. This self-assembly hypothesis is consistent with archaeological evidence that the stone tools used by early hominins were not dependent on fast, cumulative cultural evolution, and suggests new priorities for research on ‘animal culture'.This article is part of the theme issue ‘Foundations of cultural evolution’.
Drosophila Evolution over Space and Time (DEST) - A New Population
Genomics Resource
Authors: Kapun Martin , Nunez Joaquin C. B. , Bogaerts-Márquez María , Murga-Moreno Jesús , Paris Margot , Outten Joseph , Coronado-Zamora Marta , Tern Courtney , Rota-Stabelli Omar , Guerreiro Maria P. García , Casillas Sònia , Orengo Dorcas J. , Puerma Eva , Kankare Maaria , Ometto Lino , Loeschcke Volker , Onder Banu S. , Abbott Jessica K. , Schaeffer Stephen W. , Rajpurohit Subhash , Behrman Emily L , Schou Mads F. , Merritt Thomas J.S. , Lazzaro Brian P , Glaser-Schmitt Amanda , Argyridou Eliza , Staubach Fabian , Wang Yun , Tauber Eran , Serga Svitlana V. , Fabian Daniel K. , Dyer Kelly A. , Wheat Christopher W. , Parsch John , Grath Sonja , Veselinovic Marija Savic , Stamenkovic-Radak Marina , Jelic Mihailo , Buendía-Ruíz Antonio J. , Gómez-Julián M. Josefa , Espinosa-Jimenez M. Luisa , Gallardo-Jiménez Francisco D. , Patenkovic Aleksandra , Eric Katarina , Tanaskovic Marija , Ullastres Anna , Guio Lain , Merenciano Miriam , Guirao-Rico Sara , Horváth Vivien , Obbard Darren J. , Pasyukova Elena , Alatortsev Vladimir E. , Vieira Cristina P. , Vieira Jorge , Torres J. Roberto , Kozeretska Iryna , Maistrenko Oleksandr M. , Montchamp-Moreau Catherine , Mukha Dmitry V. , Machado Heather E. , Barbadilla Antonio , Petrov Dmitri , Schmidt Paul , Gonzalez Josefa , Flatt Thomas , Bergland Alan O. 
Published: May 2021

Abstract
Drosophila melanogaster is a leading model in
population genetics and genomics, and a growing number of whole-genome datasets
from natural populations of this species have been published over the last 20
years. A major challenge is the integration of these disparate datasets, often
generated using different sequencing technologies and bioinformatic pipelines,
which hampers our ability to address questions about the evolution and
population structure of this species. Here we address these issues by developing
a bioinformatics pipeline that maps pooled sequencing (Pool-Seq) reads from
D. melanogaster to a hologenome consisting of fly
and symbiont genomes and estimates allele frequencies using either a heuristic
(PoolSNP) or a probabilistic variant caller (SNAPE-pooled). We use this pipeline
to generate the largest data repository of genomic data available for
D. melanogaster to date, encompassing 271
population samples from over 100 locations in >20 countries on four
continents based on a combination of 121 unpublished and 150 previously
published genomic datasets. Several of these locations have been sampled at
different seasons across multiple years. This dataset, which we call
Drosophila Evolution over Space and Time (DEST),
is coupled with sampling and environmental meta-data. A web-based genome browser
and web portal provide easy access to the SNP dataset. Our aim is to provide
this scalable platform as a community resource which can be easily extended via
future efforts for an even more extensive cosmopolitan dataset. Our resource
will enable population geneticists to analyze spatio-temporal genetic patterns
and evolutionary dynamics of D. melanogaster
populations in unprecedented detail.
Opioid Prescribing Mediating State Policy Intervention Effects on Drug Overdose Mortality
Authors: Rich Jacob James , Capodilupo Robert 
Published: May 2021

AbstractThe Centers for Disease Control and Prevention reported 70 630 drug overdose deaths for 2019 in the United States, 70.5% of which were opioid-related. Preliminary estimates now warn that drug overdose deaths likely surpassed 86 000 during 2020. Despite a 57.4% decrease in opioid prescribing since a peak in 2012, the opioid death rate has increased 105.8% through 2019, as the share of those deaths involving fentanyl increased from 16.4% to 72.9%. This letter seeks to determine whether the opioid prescribing and mortality paradox is robust to accepted methods of causal policy analysis and if prescribing rates mediate the effects of policy interventions on overdose deaths. Using loge-loge ordinary least squares with three different specifications as sensitivity analyses for all 50 states and Washington, DC for the period 2001-2019, the elasticities from the regressions with all control variables report operational prescription drug monitoring programs (PDMPs) reduce prescribing rates 8.7%, while mandatory PDMPs increase death rates from opioids 16.6%, heroin and fentanyl 19.0%, cocaine 17.3% and all drugs 10.5%. There is also weak evidence that recreational marijuana laws reduce prescribing, increases in prescribing increase pain reliever deaths, pill mill laws increase cocaine deaths, and medical marijuana laws increase total overdose deaths, with demographic variables suggesting states with more male, less non-Hispanic white, and older citizens experience more overdoses. Weak mediation effects were observed for pain reliever, cocaine, and illicit opioid deaths, while broad reductions in prescribing have failed to reduce opioid overdoses.
Transcriptional landscape of human microglia reveals robust gene expression signatures that implicates age, sex and APOE-related immunometabolic pathway perturbations
Authors: Patel Tulsi , Carnwath Troy P. , Wang Xue , Allen Mariet , Lincoln Sarah J. , Lewis-Tuffin Laura J. , Quicksall Zachary S. , Lin Shu , Tutor-New Frederick Q. , Ho Charlotte C.G. , Min Yuhao , Malphrus Kimberly G. , Nguyen Thuy T. , Martin Elizabeth , Garcia Cesar A. , Alkharboosh Rawan M. , Grewal Sanjeet , Chaichana Kaisorn , Wharen Robert , Guerrero-Cazares Hugo , Quinones-Hinojosa Alfredo , Ertekin-Taner Nilüfer 
Published: May 2021

AbstractMicroglia have fundamental roles in health and disease, however effects of age, sex and genetic factors on human microglia have not been fully explored. We applied bulk and single cell approaches to comprehensively characterize human microglia transcriptomes and their associations with age, sex and APOE. We identified a novel microglial signature, characterized its expression in bulk tissue and single cell microglia transcriptomes. We discovered microglial co-expression network modules associated with age, sex and APOE-ε4 that are enriched for lipid and carbohydrate metabolism genes. Integrated analyses of modules with single cell transcriptomes revealed significant overlap between age-associated module genes and both pro-inflammatory and disease-associated microglial clusters. These modules and clusters harbor known neurodegenerative disease genes including APOE, PLCG2 and BIN1. Meta-analyses with published bulk and single cell microglial datasets further supported our findings. Thus, these data represent a well-characterized human microglial transcriptome resource; and highlight age, sex and APOE-related microglial immunometabolism perturbations with potential relevance in neurodegeneration.