bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF ORGAN ABSORBED DOSES IN WHOLE-BODY COMPUTED TOMOGRAPHY SCANS OF PAEDIATRIC AND ADULT PATIENT MODELS ESTIMATED BY DIFFERENT METHODS
Authors: Chipiga Larisa , Golikov Vladislav , Vodovatov Aleksandr , Bernhardsson Christian 
Published: June 2021

Abstract
This study aimed to identify the uncertainty in estimations of organ absorbed dose using dedicated software by comparing with corresponding doses measured in physical phantoms. The comparison was performed for whole-body computed tomography (CT) obtained as part of positron emission tomography. Whole-body CT scans provide an advantage in terms of comparison because all organs are in the primary beam of the irradiated area. Organ doses estimated by the different software programs (CT-Expo, VirtualDose and NCICT) were compared by thermoluminescent detector measurements in anthropomorphic phantoms in 1-y-old, 5-y-old and adult patients. Differences were within ~15% in 12 major organs. However, differences of ~30% were observed in organs located at slightly different positions in the computational models compared to the physical phantoms. All investigated programs were deemed suitable for accurate estimation of organ absorbed dose.
Event-related potentials in insomnia reflect altered perception of sleep
Authors: Feige Bernd , Baglioni Chiara , Boehm Philipp , Heinrich Anna , Trumm Samuel , Benz Fee , Nissen Christoph , Domschke Katharina , Frase Lukas , Riemann Dieter 
Published: June 2021

AbstractStudy ObjectivesInsomnia is defined by the subjective complaint of poor sleep as well as daytime impairments. Since polysomnography (PSG) typically shows only modest sleep impairment, some still unidentified property of sleep, not mirrored in PSG, may be modified in insomnia.One possible mechanistic hypothesis is that insomnia patients may be more sensitive to inevitably occurring internal or external stimuli during the night, causing brief sleep disruptions then perceived as wake time.MethodsAuditory event-related potentials (ERP) to low intensity (50 dB SPL) synthesized guitar tones played continuously throughout two nights of polysomnographically registered sleep were obtained in fifty patients with insomnia disorder (ID, without comorbidities) and 50 age- and sex-matched good sleeper controls (GSC) for each sleep stage and NREM/REM cycle. Phasic and tonic REM were treated as separate stages. Latencies and amplitudes of components P1, N1 and P2 were measured and analyzed by multivariate repeated-measures ANCOVA including effects of group, night, cycle, and age.ResultsID showed reduced P2 amplitudes relative to GSC specifically in phasic REM sleep. The same reduction also correlated with the amount of sleep misperception across groups. Independent component analysis showed a frontal negativity to contribute most to this group difference.ConclusionsThe present finding can be interpreted as increased mismatch negativity (MMN) in ID, reflecting automated detection of change in the auditory system and a concomitant orienting response. Specifically phasic REM sleep appears to be vulnerable to sensory afferences in ID patients, possibly contributing to the perception of being awake.Clinical Trial InformationShort name “PERSLEEP 2,” URL https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00008965, Registration DRKS00008965.
Chitin Deacetylases Are Required for Epichloë festucae Endophytic Cell Wall Remodeling During Establishment of a Mutualistic Symbiotic Interaction with Lolium perenne
Authors: Noorifar Nazanin , Savoian Matthew S. , Ram Arvina , Lukito Yonathan , Hassing Berit , Weikert Tobias W. , Moerschbacher Bruno M. , Scott Barry 
Published: June 2021

Epichloë festucae forms a mutualistic symbiotic association with Lolium perenne. This biotrophic fungus systemically colonizes the intercellular spaces of aerial tissues to form an endophytic hyphal network and also grows as an epiphyte. However, little is known about the cell wall–remodeling mechanisms required to avoid host defense and maintain intercalary growth within the host. Here, we use a suite of molecular probes to show that the E. festucae cell wall is remodeled by conversion of chitin to chitosan during infection of L. perenne seedlings, as the hyphae switch from free-living to endophytic growth. When hyphae transition from endophytic to epiphytic growth, the cell wall is remodeled from predominantly chitosan to chitin. This conversion from chitin to chitosan is catalyzed by chitin deacetylase. The genome of E. festucae encodes three putative chitin deacetylases, two of which (cdaA and cdaB) are expressed in planta. Deletion of either of these genes results in disruption of fungal intercalary growth in the intercellular spaces of plants infected with these mutants. These results establish that these two genes are required for maintenance of the mutualistic symbiotic interaction between E. festucae and L. perenne. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Comparison of Patient Preference, Understanding, and Sentiment for Minimally Invasive Versus Open Spine Surgery
Authors: White Christopher A. , Patel Akshar V. , Butler Liam R. , Amakiri Uchechukwu O. , Yeshoua Brandon J. , Steinberger Jeremy M. , Cho Samuel K. , Kim Jun S. 
Published: May 2021

Study Design.
Retrospective questionnaire analysis.

Objective.
The goal of this study was to analyze patients’ understanding and preferences for minimally invasive spine (MIS) versus open spine surgery.

Summary of Background Data.
MIS surgery is increasing in prevalence. However, there is insufficient literature to evaluate how the availability of MIS surgery influences the patients’ decision-making process and perceptions of spine procedures.

Methods.
A survey was administered to patients who received a microdiscectomy or transforaminal lumbar interbody fusion between 2016 and 2020. All eligible patients were stratified into two cohorts based on the use of minimally invasive techniques. Each cohort was administered a survey that evaluated patient preferences, perceptions, and understanding of their surgery.

Results.
One hundred fifty two patients completed surveys (MIS: 88, Open: 64). There was no difference in time from surgery to survey (MIS: 2.1 ± 1.4 yrs, Open: 1.9 ± 1.4 yrs; P = 0.36) or sex (MIS: 56.8% male, Open: 53.1% male; P = 0.65). The MIS group was younger (MIS: 53.0 ± 16.9 yrs, Open: 58.2 ± 14.6 yrs; P = 0.05). More MIS patients reported that their technique influenced their surgeon choice (MIS: 64.0%, Open: 37.5%; P
< 0.00001) and increased their preoperative confidence (MIS: 77.9%, Open: 38.1%; P
< 0.00001). There was a trend towards the MIS group being less informed about the intraoperative specifics of their technique (MIS: 35.2%, Open: 23.4%; P = 0.12). More of the MIS cohort reported perceived advantages to their surgical technique (MIS: 98.8%, Open: 69.4%; P < 0.00001) and less reported disadvantages (MIS: 12.9%, Open: 68.8%; P < 0.00001). 98.9% and 87.1% of the MIS and open surgery cohorts reported a preference for MIS surgery in the future.

Conclusion.
Patients who received a MIS approach more frequently sought out their surgeons, were more confident in their procedure, and reported less perceived disadvantages following their surgery compared with the open surgery cohort. Both cohorts would prefer MIS surgery in the future. Overall, patients have positive perceptions of MIS surgery.

Level of Evidence: 3
Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies
Authors: Tadic Marijana , Sala Carla , Carugo Stefano , Mancia Giuseppe , Grassi Guido , Cuspidi Cesare 
Published: May 2021

Aim:
Available evidence on systolic dysfunction in systemic hypertension, as assessed by left ventricular (LV) mechanics, is still based on single studies. Thus, we performed a systematic meta-analysis of two-dimensional speckle-tracking studies in order to provide an updated comprehensive information on this issue.

Methods:
The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English language articles published from the inception up to 31 December 2020. Studies were identified by using MeSH terms and crossing the following search items: ‘myocardial strain’, ‘left ventricular mechanics’, ‘speckle tracking echocardiography’, ‘systolic dysfunction’, ‘hypertensive heart disease’, ‘systemic hypertension’, ‘essential hypertension’.

Results:
Data from 4276 individuals (2089 normotensive controls and 2187 mostly uncomplicated hypertensive patients) were included. Left ventricular (LV) mass index, relative wall thickness, left atrial volume index and E/e’ ratio were significantly higher in hypertensive patients than in normotensive controls. LV ejection fraction did not differ in the two pooled groups (SMD −0.048 ± 0.054, 95% CI −0.20 to 0.10, P = 0.30), whereas LV global longitudinal strain (GLS) was significantly impaired in the hypertensive group (SMD: 1.07 ± 0. 15, 95% CI 0.77–1.36, P < 0.0001). Similar findings were obtained in a sub-analysis restricted to 15 studies in which mean age was similar in cases and controls (SMD 1.21 ± 0.23, 95% CI 0.76–1.67, P = 0.002).

Conclusion:
The present meta-analysis suggests that GLS assessment unmasks systolic dysfunction undetected by conventional ejection fraction in the uncomplicated hypertension setting and that this parameter should be incorporated into routine work-up aimed to identify hypertension-mediated cardiac damage.
Using the Delphi Method to Construct a Promotion Plan for Clinical Nurse Specialists
Authors: Zhao Han , Li Weihua , Gao Mingrong , Shi Lei 
Published: June 2021

Purpose
The aim of this study was to design a quantitative evaluation of the promotion plan for clinical nurse specialists in China.

Design
The evaluation indexes were selected and established by inquiring 22 experts and using the analytic hierarchy process. The promotion plan was sent to 22 specialized nurses. The reference value was established by comparing the results from predictions made by experts and the self-evaluation of specialized nurses.

Methods
This study used the Delphi method and mixed qualitative and quantitative methods, which not only determined the entry of the promotion plan but also calculated its weight, and obtained the baseline score through a small range of empirical studies.

Results
This promotion plan included basic promotion conditions, 5 primary indicators, 15 secondary indicators, and 61 tertiary indicators and was designed by experts who had a high degree of authority in this field. The self-evaluation results of 19 specialist nurses showed a reference value of 30 points per 3 years using the promotion plan. For clinical nursing managers, it is a management tool to evaluate specialist nurses, which can provide a basis for the promotion of specialist nurses.

Conclusions
The promotion plan for clinical nurse specialists in China formed by this research is quantifiable, scientific, and instructive.
Driving Pressure and Normalized Energy Transmission Calculations in Mechanically Ventilated Children Without Lung Disease and Pediatric Acute Respiratory Distress Syndrome*
Authors: Díaz Franco , González-Dambrauskas Sebastián , Cristiani Federico , Casanova Daniel R. , Cruces Pablo 
Published: May 2021

OBJECTIVES:
To compare the new tools to evaluate the energy dissipated to the lung parenchyma in mechanically ventilated children with and without lung injury. We compared their discrimination capability between both groups when indexed by ideal body weight and driving pressure.

DESIGN:
Post hoc analysis of individual patient data from two previously published studies describing pulmonary mechanics.

SETTING:
Two academic hospitals in Latin-America.

PATIENTS:
Mechanically ventilated patients younger than 15 years old were included. We analyzed two groups, 30 children under general anesthesia (ANESTH group) and 38 children with pediatric acute respiratory distress syndrome.

INTERVENTIONS:
Respiratory mechanics were measured after intubation in all patients.

MEASUREMENTS AND MAIN RESULTS:
Mechanical power and derived variables of the equation of motion (dynamic power, driving power, and mechanical energy) were computed and then indexed by ideal body weight. Driving pressure was higher in pediatric acute respiratory distress syndrome group compared with ANESTH group. Receiver operator curve analysis showed that driving pressure had the best discrimination capability compared with all derived variables of the equation of motion indexed by ideal body weight. The same results were observed when the subgroup of patients weighs less than 15 kg. There was no difference in unindexed mechanical power between groups.

CONCLUSIONS:
Driving pressure is the variable that better discriminates pediatric acute respiratory distress syndrome from nonpediatric acute respiratory distress syndrome in children than the calculations derived from the equation of motion, even when indexed by ideal body weight. Unindexed mechanical power was useless to differentiate against both groups. Future studies should determine the threshold for variables of the energy dissipated by the lungs and their association with clinical outcomes.
Blindness Secondary to Orbital Giant Cell Granuloma Mass-Effect in Noonan Syndrome With Return of Vision Following Surgical Decompression
Authors: Anderson Spencer R. , Mancho Salim N. 
Published: May 2021

AbstractNoonan syndrome is a rare, autosomal dominant disorder encompassing multiple congenital defects, as well as association with solid tumor and lesion development. The authors present a 26-year-old female with known Noonan syndrome and ongoing complaint of worsening unilateral vision, progressing to vision loss due to lesion mass effect. Decompressive surgery was performed, restoring patient's vision to baseline immediately postoperative. The lesion was confirmed to be giant cell granuloma. In this paper we discuss the unique presentation of vision loss due to orbital giant cell granuloma in Noonan syndrome with postoperative return of vision; the importance of a multi-disciplinary team evaluation, thorough preoperative clinical and image-based work up, intraoperative findings, postoperative outcome, and complexity of definitive management.
Unicoronal Craniosynostosis: Is There a Lateral Difference in Retinal Morphology?
Authors: Kalmar Christopher L. , Carlson Anna R. , Zapatero Zachary D. , Kosyk Mychajlo S. , Aleman Tomas S. , Bartlett Scott P. , Liu Grant T. , Avery Robert A. , Taylor Jesse A. , Swanson Jordan W. 
Published: May 2021

Background:
Craniosynostosis is the premature fusion of cranial sutures in pediatric patients, which may lead to elevated intracranial pressure due to cerebro-cephalic disproportion between a growing brain and constricted skull. It is unknown whether this increased pressure is distributed equally throughout the cranial vault, or whether certain areas of the brain experience greater pressure at these regions of premature osseous fusion.

Methods:
Optical coherence tomography (OCT) is a noninvasive modality for detecting elevated intracranial pressure. Optical coherence tomography was utilized to measure the peripapillary retinal nerve fiber layer (RNFL) thickness in patients undergoing surgical correction of craniosynostosis. Retinal nerve fiber layer in the eye ipsilateral to the unicoronal suture fusion was compared to the RNFL in the eye contralateral to the unicoronal suture fusion.

Results:
During the study interval, 21 patients met inclusion criteria. Median age at operative intervention was 8.0 months, and 28.6% patients presented with left-sided unicoronal craniosynostosis, whereas 71.4% of patients presented with right-sided unicoronal craniosynostosis. Rather than universal increase on the affected side of coronal suture fusion, retinal nerve fiber layer thickness parameters showed a rotation phenomenon, such that the patterns of elevation had a 45° circumferential rotation in the direction of intorsion.

Conclusions:
The explanation for these results remains elusive, but they likely indicate either intracranial changes transmitted differentially to the peripapillary retina, or differing retinal morphology, between the ipsilateral and contralateral eyes in unicoronal craniosynostosis.
A spatial model of COVID-19 transmission in England and Wales: early spread, peak timing and the impact of seasonality
Authors: Danon Leon , Brooks-Pollock Ellen , Bailey Mick , Keeling Matt 
Published: May 2021

An outbreak of a novel coronavirus was first reported in China on 31 December 2019. As of 9 February 2020, cases have been reported in 25 countries, including probable human-to-human transmission in England. We adapted an existing national-scale metapopulation model to capture the spread of COVID-19 in England and Wales. We used 2011 census data to inform population sizes and movements, together with parameter estimates from the outbreak in China. We predict that the epidemic will peak 126 to 147 days (approx. 4 months) after the start of person-to-person transmission in the absence of controls. Assuming biological parameters remain unchanged and transmission persists from February, we expect the peak to occur in June. Starting location and model stochasticity have a minimal impact on peak timing. However, realistic parameter uncertainty leads to peak time estimates ranging from 78 to 241 days following sustained transmission. Seasonal changes in transmission rate can substantially impact the timing and size of the epidemic. We provide initial estimates of the epidemic potential of COVID-19. These results can be refined with more precise parameters. Seasonal changes in transmission could shift the timing of the peak into winter, with important implications for healthcare capacity planning.
This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK.
Optimizing time-limited non-pharmaceutical interventions for COVID-19 outbreak control
Authors: Morgan Alex L. K. , Woolhouse Mark E. J. , Medley Graham F. , van Bunnik Bram A. D. 
Published: May 2021

Retrospective analyses of the non-pharmaceutical interventions (NPIs) used to combat the ongoing COVID-19 outbreak have highlighted the potential of optimizing interventions. These optimal interventions allow policymakers to manage NPIs to minimize the epidemiological and human health impacts of both COVID-19 and the intervention itself. Here, we use a susceptible–infectious–recovered (SIR) mathematical model to explore the feasibility of optimizing the duration, magnitude and trigger point of five different NPI scenarios to minimize the peak prevalence or the attack rate of a simulated UK COVID-19 outbreak. An optimal parameter space to minimize the peak prevalence or the attack rate was identified for each intervention scenario, with each scenario differing with regard to how reductions to transmission were modelled. However, we show that these optimal interventions are fragile, sensitive to epidemiological uncertainty and prone to implementation error. We highlight the use of robust, but suboptimal interventions as an alternative, with these interventions capable of mitigating the peak prevalence or the attack rate over a broader, more achievable parameter space, but being less efficacious than theoretically optimal interventions. This work provides an illustrative example of the concept of intervention optimization across a range of different NPI strategies.This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.
Emerging SARS-CoV-2 variants of concern evade humoral immune responses from infection and vaccination
Authors: Caniels Tom G. , Bontjer Ilja , van der Straten Karlijn , Poniman Meliawati , Burger Judith A. , Appelman Brent , Lavell Ayesha H.A. , Oomen Melissa , Godeke Gert-Jan , Valle Coralie , Mögling Ramona , van Willigen Hugo D.G. , Wynberg Elke , Schinkel Michiel , van Vught Lonneke A. , Guerra Denise , Snitselaar Jonne L. , Chaturbhuj Devidas N. , Martin Isabel Cuella ,   Amsterdam UMC COVID-19 S3/HCW study group, Moore John P. , de Jong Menno D. , Reusken Chantal , Sikkens Jonne J. , Bomers Marije K. , de Bree Godelieve J. , van Gils Marit J. , Eggink Dirk , Sanders Rogier W. 
Published: June 2021

AbstractEmerging SARS-CoV-2 variants pose a threat to human immunity induced by natural infection and vaccination. We assessed the recognition of three variants of concern (B.1.1.7, B.1.351 and P.1) in cohorts of COVID-19 patients ranging in disease severity (n = 69) and recipients of the Pfizer/BioNTech vaccine (n = 50). Spike binding and neutralization against all three VOC was substantially reduced in the majority of samples, with the largest 4-7-fold reduction in neutralization being observed against B.1.351. While hospitalized COVID-19 patients and vaccinees maintained sufficient neutralizing titers against all three VOC, 39% of non-hospitalized patients did not neutralize B.1.351. Moreover, monoclonal neutralizing antibodies (NAbs) show sharp reductions in their binding kinetics and neutralizing potential to B.1.351 and P.1, but not to B.1.1.7. These data have implications for the degree to which pre-existing immunity can protect against subsequent infection with VOC and informs policy makers of susceptibility to globally circulating SARS-CoV-2 VOC.
Prevalence of Returnable Genetic Results Based on Recognizable Phenotypes among Children with Autism Spectrum Disorder
Authors: Bishop Somer L. , Thurm Audrey , Robinson Elise , Sanders Stephan J 
Published: June 2021

AbstractThe importance of extensive genetic testing of autism spectrum disorder (ASD) cases has been demonstrated repeatedly in research settings but such testing in clinical settings remains sporadic. Determining which individuals should be prioritized for expensive tests remains a challenge. Several guidelines have been released relating to clinical genetic evaluations and testing in the context of ASD and these guidelines may be informed by the results of genetic testing in large research cohorts. The current study summarizes findings from over 2,000 individuals with ASD who received genetic testing, including microarray and exome testing, through the Simons Simplex Consortium. A returnable genetic result is identified in 10% of cases, however, this yield increases based on four readily accessible phenotypes: female sex and the presence of intellectual disability, seizures or delayed walking. Combinations of these factors increase return rate further, with some combinations yielding a return rate over 50%. In conclusion, these four phenotypes provide a simple approach to prioritize genetic testing in a clinical setting and inform future clinical guidelines. Providing a systematic approach to decisions about who to test removes barriers for, and therefore decrease disparities in, reimbursable genetic testing for individuals diagnosed with ASD.