bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity Indices of the King-Devick Concussion Test in Hockey Players
Authors: Krause David A. , Hollman John H. , Breuer Logan T. , Stuart Michael J. 
Published: May 2021

Objective:
To compare the validity indices of the King-Devick (KD) test in hockey players using any increase in test time over baseline to a 6-second increase as a positive concussion test. We hypothesized the KD test using the 6-second change would yield greater validity indices.

Design:
Prospective observational cohort study.

Setting:
Sports complex.

Participants:
Sixty-five male hockey players aged 13 to 20 years.

Independent Variable:
Concussion diagnosis.

Main Outcome Measures:
Time to complete the KD test. Sensitivity (SN), specificity (SP), and the positive likelihood ratios (LRs+) were calculated using 2 thresholds for a positive test: (1) any increase in time and (2) an increase of 6 seconds or greater.

Results:
Eighteen players (27.7%) were diagnosed with a concussion. Using any increase in time as a positive test yielded the following: SN 72.2%, SP 78.7%, LR+ 3.4, and LR− 0.4. Using the 6-second threshold yielded the following: SN 44.4%, SP 93.6%, LR+ 7.0, and LR− 0.6. A receiver operator curve analysis confirmed 6.40 seconds or greater maximized the LR+.

Conclusions:
A 6-second or greater increase in the KD test performance provides greater validity in diagnosing concussion as compared with any increase in performance time.
Sleep disruptions and bone health: what do we know so far?
Authors: Swanson Christine M. 
Published: May 2021

Purpose of review
This review briefly summarizes the growing body of literature addressing the skeletal consequences of sleep and circadian disruption.

Recent findings
The most recent data in the field suggest that the diurnal variation in bone turnover markers are because of endogenous circadian rhythmicity linked to clock genes in all bone cells; in a small human intervention study, cumulative sleep restriction with concurrent circadian disruption negatively alter bone turnover markers in a way that could explain the lower BMD and increased fracture risk identified in some prior night shift work studies; abnormal sleep duration and obstructive sleep apnea are associated with low BMD and increased fracture risk in some but not all studies.

Summary
Normal physiology and some animal and human intervention studies suggest that sleep and circadian disruptions, such as night shift work, abnormal sleep durations and obstructive sleep apnea are detrimental to skeletal health. However, additional research in this area is needed to determine which sleep/circadian disturbances are most detrimental to skeletal health, the reversibility of such impairments, and underlying mechanisms.
Cellular components of the hematopoietic niche and their regulation of hematopoietic stem cell function
Authors: Ghosh Joydeep , Koussa Roy El , Mohamad Safa F. , Liu Jianyun , Kacena Melissa A. , Srour Edward F. 
Published: May 2021

Purpose of review
Development and functions of hematopoietic stem cells (HSC) are regulated by multiple cellular components of the hematopoietic niche. Here we review the recent advances in studying the role of three such components -- osteoblasts, osteomacs, and megakaryocytes and how they interact with each other in the hematopoietic niche to regulate HSC.

Recent findings
Recent advances in transgenic mice models, scRNA-seq, transcriptome profile, proteomics, and live animal imaging have revealed the location of HSC within the bone and signaling molecules required for the maintenance of the niche. Interaction between megakaryocytes, osteoblasts and osteomacs enhances hematopoietic stem and progenitor cells (HSPC) function. Studies also revealed the niche as a dynamic entity that undergoes cellular and molecular changes in response to stress. Aging, which results in reduced HSC function, is associated with a decrease in endosteal niches and osteomacs as well as reduced HSC--megakaryocyte interactions.

Summary
Novel approaches to study the cellular components of the niche and their interactions to regulate HSC development and functions provided key insights about molecules involved in the maintenance of the hematopoietic system. Furthermore, these studies began to build a more comprehensive model of cellular interactions and dynamics in the hematopoietic niche.
Decreases in Reported Sexually Transmitted Infections During the Time of COVID-19 in King County, WA: Decreased Transmission or Screening?
Authors: Berzkalns Anna , Thibault Christina S. , Barbee Lindley A. , Golden Matthew R. , Khosropour Christine , Kerani Roxanne P. 
Published: May 2021

Background
In response to the COVID-19 pandemic, Washington State's Stay Home, Stay Healthy (SHSH) order was implemented on March 24, 2020. We hypothesized that pandemic mitigation measures might reduce sexually transmitted infection (STI) screening and/or transmission.

Methods
We used King County, WA STI surveillance and sexual health clinic (SHC) data from January 1, 2019, to July 31, 2020. We calculated mean weekly case counts for gonorrhea, primary and secondary (P&S) syphilis, male urethral gonorrhea, and early latent (EL) syphilis for 3 periods in 2020: pre-SHSH (January 1–March 23), SHSH (March 24–June 5), and reopening (June 6–July 31). Primary and secondary syphilis and male urethral gonorrhea were used as proxies for sexual behavior, and EL syphilis was used as a proxy for STI screening. We compared SHC visits (2019 vs. 2020) and SHC gonorrhea treatment practices (across 2020 periods).

Results
Compared with January to July 2019, from January to July 2020, reported cases of gonorrhea, male urethral gonorrhea, P&S syphilis, and EL syphilis decreased by 9%, 5%, 16%, and 22%, respectively. Mean weekly case counts of gonorrhea, male urethral gonorrhea, and EL syphilis decreased pre-SHSH to SHSH, but all returned to pre-SHSH levels during reopening. Sexual health clinic visits during SHSH were 55% lower in 2020 than in 2019. In the SHC during SHSH, ceftriaxone treatment of gonorrhea decreased, whereas cefixime/cefpodoxime treatment and gonorrhea treatment with no testing increased.

Conclusions
Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.
Continuous Renal-Replacement Therapy in Critically Ill Children: Practice Changes and Association With Outcome
Authors: Chen ZhiJiang , Wang HuiLi , Wu Zhu , Jin Ming , Chen YiTing , Li Jun , Wei QiuJu , Tao ShaoHua , Zeng Qiyi 
Published: May 2021

OBJECTIVES:
This study was designed to evaluate practice changes and outcomes over a 10-year period in a large single-center PICU cohort that received continuous renal-replacement therapy.

DESIGN:
Retrospective study design.

SETTING:
A multidisciplinary tertiary PICU of a university-affiliated hospital in Guangzhou, China.

PATIENTS:
All critically ill children who were admitted to our PICU from January 2010 to December 2019 and received continuous renal-replacement therapy were included in this study.

MEASUREMENTS AND MAIN RESULTS:
A total of 289 patients were included in the study. Of the two study periods, 2010–2014 and 2015–2019, the proportion of continuous renal-replacement therapy initiation time greater than 24 hours was significantly reduced ([73/223] 32.73% vs. [40/66] 60.60%, p < 0.001), the percentage of fluid overload at continuous renal-replacement therapy initiation was lower (3.8% [1.6–7.2%] vs. 12.1% [6.6–23.3%], p < 0.001), the percentage of regional citrate anticoagulation protocol was increased ([223/223] 100% vs. [15/66] 22.7%, p < 0.001), and the ICU survival rate was significantly improved ([24/66] 36.4% vs. [131/223] 58.7%, p = 0.001) in the latter period compared with the former. In addition, subgroup analysis found that survival were higher in patients with continuous renal-replacement therapy initiation time less than 24 hours, regional citrate anticoagulation protocol, and fluid overload less than 10%.

CONCLUSIONS:
The survival rate of patients received continuous renal-replacement therapy treatment in our center has improved over past 10 years, and some changes have taken place during these periods. Among them, early initiation of continuous renal-replacement therapy, lower fluid overload, and regional citrate anticoagulation method seems to be related to the improvement of outcome. Ongoing evaluation of the practice changes and quality improvement of continuous renal-replacement therapy for critically ill pediatric patients still need attention.
Compliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study*
Authors: Karsies Todd , Tarquinio Keiko , Shein Steven L. , Beardsley Andrew L , Prentice Elizabeth , Karam Oliver , Fontela Patricia , Moore-Clingenpeel Melissa , Willson Douglas F. 
Published: May 2021

OBJECTIVES:
To evaluate a guideline for antibiotic decisions in children with suspected ventilator-associated infection.

DESIGN:
Prospective, observational cohort study conducted in 22 PICUs in the United States and Canada.

SETTING:
PICUs in 22 hospitals from April 2017 to January 2019.

SUBJECTS:
Children less than 3 years old on mechanical ventilation greater than 48 hours who had respiratory secretions cultured and antibiotics initiated for suspected ventilator-associated infection.

INTERVENTIONS:
After baseline data collection in children with suspected ventilator-associated infection (Phase 1), a consensus guideline was developed for advising antibiotic continuation or stopping at 48–72 hours (Phase 2) and implemented (Phase 3). Guideline-based antibiotic recommendations were provided to the treating clinicians once clinical and microbiologic data were available. Demographic and outcome data were collected, and guideline compliance and antibiotic utilization evaluated for Phase 1 and Phase 3.

MEASUREMENTS AND MAIN RESULTS:
Despite education and implementation efforts, guideline-concordant antibiotic management occurred in 158 of 227 (70%) Phase 3 subjects compared with 213 of 281 (76%) in Phase 1. Illness severity and positive respiratory cultures were the primary determinants of antibiotic continuation. For subjects with a positive respiratory culture but a score for which antibiotic discontinuation was recommended (score ≤ 2), only 27% of Phase 3 subjects had antibiotics discontinued. Antibiotic continuation was not associated with improved outcomes in these subjects and was associated with significantly longer duration of ventilation (median 5.5 d longer) and PICU stay (5 d longer) in the overall study population. Positive respiratory cultures were not associated with outcomes irrespective of antibiotic treatment.

CONCLUSIONS:
Antibiotic guideline efficacy and safety remain uncertain due to clinician failure to follow the guideline, instead primarily relying on respiratory culture results. Strategies to overcome clinician perceptions of respiratory cultures and other barriers will be vital for improving guideline adherence and antibiotic use in suspected ventilator-associated infection in future studies.
HPV vaccination to prevent recurrence of anal intraepithelial neoplasia in HIV+ MSM
Authors: Gosens Karien C.M. , van der Zee Ramon P. , van Heukelom Matthijs L. Siegenbeek , Jongen Vita W. , Cairo Irina , van Eeden Arne , van Noesel Carel J.M. , Quint Wim G.V. , Pasmans Hella , Dijkgraaf Marcel G.W. , de Vries Henry J.C. , Prins Jan M. 
Published: May 2021

Objective:
Anal cancer precursor lesions high-grade anal intraepithelial neoplasia (HGAIN) are highly prevalent among HIV+ MSM. Treatment of HGAIN is frustrated by high recurrence rates. We investigated the efficacy of the quadrivalent human papillomavirus (qHPV) vaccine as posttreatment adjuvant in preventing HGAIN recurrence in HIV+ MSM.

Design:
Randomized, double-blind, placebo-controlled, multicentre trial.

Setting:
Three HIV outpatient clinics in Amsterdam, the Netherlands.

Subjects:
HIV+ MSM with CD4+ cell count more than 350 cells/μl, biopsy-proven intra-anal HGAIN successfully treated in the past year, and lesions still in remission at enrolment, as assessed by high-resolution anoscopy (HRA).

Intervention:
Participants were randomized to three doses of qHPV (Gardasil-4, MSD) or placebo with vaccinations at 0, 2, and 6 months. HRA was repeated at 6, 12, and 18 months.

Main outcome measure:
The primary outcome was cumulative, biopsy-proven HGAIN recurrence rate at 18 months, evaluated in an intention-to-treat (ITT) (received all vaccinations) and per-protocol analysis (all vaccinations and complete follow-up).

Results:
We randomized 126 participants of which 64 (50.8%) received qHPV and 62 (49.2%) placebo. All participants received three vaccinations, and in both groups for two participants follow-up was incomplete. We found no difference (P = 0.38) in cumulative HGAIN recurrence rates between the qHPV (44/64, 68.8%) and placebo group (38/62, 61.3%) in the ITT analysis [absolute risk reduction −7.5 (95% confidence interval (CI) −24.1 to 9.2)]. This was similar in the per-protocol analysis.

Conclusion:
Despite adequate serological responses to qHPV vaccination, short-term recurrence of HGAIN was not prevented. These findings do not support qHPV vaccination as a treatment adjuvant to prevent HGAIN recurrence in HIV+ MSM.
Broadly neutralizing antibody-mediated protection of macaques against repeated intravenous exposures to simian-human immunodeficiency virus
Authors: Garber David A. , Guenthner Patricia , Mitchell James , Ellis Shanon , Gazumyan Anna , Nason Martha , Seaman Michael S. , McNicholl Janet M. , Nussenzweig Michel C. , Heneine Walid 
Published: May 2021

Objective:
The opioid epidemic has increased parentally acquired HIV infection. To inform the development of a long-acting prevention strategy, we evaluated the protective efficacy of broadly neutralizing antibodies (bNAbs) against intravenous simian-human immunodeficiency virus (SHIV) infection in macaques.

Design:
Five cynomolgus macaques were injected once subcutaneously with 10-1074 and 3BNC117 (10 mg each kg−1) and were repeatedly challenged intravenously once weekly with SHIVAD8-EO (130 TCID50), until infection was confirmed via plasma viral load assay. Two control macaques, which received no antibody, were challenged identically.

Methods:
Plasma viremia was monitored via RT-qPCR assay. bNAb concentrations were determined longitudinally in plasma samples via TZM-bl neutralization assays using virions pseudotyped with 10-1074-sensitive (X2088_c9) or 3BNC117-sensitive (Q769.d22) HIV envelope proteins.

Results:
Passively immunized macaques were protected against a median of five weekly intravenous SHIV challenges, as compared to untreated controls, which were infected following a single challenge. Of the two bNAbs, 10-1074 exhibited relatively longer persistence in vivo. The median plasma level of 10-1074 at SHIV breakthrough was 1.1 μg ml−1 (range: 0.6–1.6 μg ml−1), whereas 3BNC117 was undetectable. Probit modeling estimated that 6.6 μg ml−1 of 10-1074 in plasma corresponded to a 99% reduction in per-challenge infection probability, as compared to controls.

Conclusions:
Significant protection against repeated intravenous SHIV challenges was observed following administration of 10-1074 and 3BNC117 and was due primarily to 10-1074. Our findings extend preclinical studies of bNAb-mediated protection against mucosal SHIV acquisition and support the possibility that intermittent subcutaneous injections of 10-1074 could serve as long-acting preexposure prophylaxis for persons who inject drugs.
The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis
Authors: Ciccarone Daniel 
Published: May 2021

Purpose of review
This review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment.

Recent findings
Overdose due to illicit synthetic opioids (e.g. fentanyl and fentanyl analogs) continues to rise in the US both preceding and during the COVID-19 pandemic. Fentanyl-related overdose is rising in new geographic areas e.g. the western USA. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose. Other medical consequences of injection drug use are rising including HIV and hepatitis C infections. Medication approaches to treating opioid use disorder remain the standard of care and there are new promising pharmacological approaches to treating methamphetamine use disorder.

Summary
A ‘fourth wave’ of high mortality involving methamphetamine and cocaine use has been gathering force in the USA. Availability and use of illicit fentanyls are still the major drivers of overdose deaths and the current rise in stimulant-related deaths appears entwined with the ongoing opioid epidemic.
Synergistic tomographic image reconstruction: part 1
Authors: Tsoumpas Charalampos , Jørgensen Jakob Sauer , Kolbitsch Christoph , Thielemans Kris 
Published: May 2021

This special issue focuses on synergistic tomographic image reconstruction in a range of contributions in multiple disciplines and various application areas. The topic of image reconstruction covers substantial inverse problems (Mathematics) which are tackled with various methods including statistical approaches (e.g. Bayesian methods, Monte Carlo) and computational approaches (e.g. machine learning, computational modelling, simulations). The issue is separated in two volumes. This volume focuses mainly on algorithms and methods. Some of the articles will demonstrate their utility on real-world challenges, either medical applications (e.g. cardiovascular diseases, proton therapy planning) or applications in material sciences (e.g. material decomposition and characterization). One of the desired outcomes of the special issue is to bring together different scientific communities which do not usually interact as they do not share the same platforms (such as journals and conferences).
This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
Fusing electrical and elasticity imaging
Authors: Hauptmann Andreas , Smyl Danny 
Published: May 2021

Electrical and elasticity imaging are promising modalities for a suite of different applications, including medical tomography, non-destructive testing and structural health monitoring. These emerging modalities are capable of providing remote, non-invasive and low-cost opportunities. Unfortunately, both modalities are severely ill-posed nonlinear inverse problems, susceptive to noise and modelling errors. Nevertheless, the ability to incorporate complimentary datasets obtained simultaneously offers mutually beneficial information. By fusing electrical and elastic modalities as a joint problem, we are afforded the possibility to stabilize the inversion process via the utilization of auxiliary information from both modalities as well as joint structural operators. In this study, we will discuss a possible approach to combine electrical and elasticity imaging in a joint reconstruction problem giving rise to novel multi-modality applications for use in both medical and structural engineering.
This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
Physics-based reconstruction methods for magnetic resonance imaging
Authors: Wang Xiaoqing , Tan Zhengguo , Scholand Nick , Roeloffs Volkert , Uecker Martin 
Published: May 2021

Conventional magnetic resonance imaging (MRI) is hampered by long scan times and only qualitative image contrasts that prohibit a direct comparison between different systems. To address these limitations, model-based reconstructions explicitly model the physical laws that govern the MRI signal generation. By formulating image reconstruction as an inverse problem, quantitative maps of the underlying physical parameters can then be extracted directly from efficiently acquired k-space signals without intermediate image reconstruction—addressing both shortcomings of conventional MRI at the same time. This review will discuss basic concepts of model-based reconstructions and report on our experience in developing several model-based methods over the last decade using selected examples that are provided complete with data and code.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
Evaluation of synergistic image registration for motion-corrected coronary NaF-PET-MR
Authors: Mayer Johannes , Jin Yining , Wurster Thomas-Heinrich , Makowski Marcus R. , Kolbitsch Christoph 
Published: May 2021

Coronary artery disease (CAD) is caused by the formation of plaques in the coronary arteries and is one of the most common cardiovascular diseases. NaF-PET can be used to assess plaque composition, which could be important for therapy planning. One of the main challenges of NaF-PET is cardiac and respiratory motion which can strongly impair diagnostic accuracy. In this study, we investigated the use of a synergistic image registration approach which combined motion-resolved MR and PET data to estimate cardiac and respiratory motion. This motion estimation could then be used to improve the NaF-PET image quality. The approach was evaluated with numerical simulations andin vivoscans of patients suffering from CAD. In numerical simulations, it was shown, that combining MR and PET information can improve the accuracy of motion estimation by more than 15%. For thein vivoscans, the synergistic image registration led to an improvement in uptake visualization. This is the first study to assess the benefit of combining MR and NaF-PET for cardiac and respiratory motion estimation. Further patient evaluation is required to fully evaluate the potential of this approach.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
(An overview of) Synergistic reconstruction for multimodality/multichannel imaging methods
Authors: Arridge Simon R. , Ehrhardt Matthias J. , Thielemans Kris 
Published: May 2021

Imaging is omnipresent in modern society with imaging devices based on a zoo of physical principles, probing a specimen across different wavelengths, energies and time. Recent years have seen a change in the imaging landscape with more and more imaging devices combining that which previously was used separately. Motivated by these hardware developments, an ever increasing set of mathematical ideas is appearing regarding how data from different imaging modalities or channels can be synergistically combined in the image reconstruction process, exploiting structural and/or functional correlations between the multiple images. Here we review these developments, give pointers to important challenges and provide an outlook as to how the field may develop in the forthcoming years.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.