bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizing Pelvic Floor Muscle Function and Morphometry in Survivors of Gynecological Cancer Who Have Dyspareunia: A Comparative Cross-Sectional Study
Authors: Cyr Marie-Pierre , Dumoulin Chantale , Bessette Paul , Pina Annick , Gotlieb Walter H , Lapointe-Milot Korine , Morin Mélanie 
Published: January 2021

Abstract

Objective
More than one-half of gynecological cancer survivors are affected by pain during sexual intercourse, also known as dyspareunia. Oncological treatments may result in pelvic floor muscle (PFM) alterations, which are suspected to play a key role in dyspareunia. However, to our knowledge, no study has investigated PFM function and morphometry in this population. The aim of the study was to characterize and compare PFM function and morphometry between gynecological cancer survivors with dyspareunia and asymptomatic women.

Methods
Twenty-four gynecological cancer survivors with dyspareunia and 32 women with a history of total hysterectomy but without pelvic pain (asymptomatic women) participated in this comparative cross-sectional study. PFM passive forces (tone), flexibility, stiffness, maximal strength, coordination, and endurance were assessed with an intra-vaginal dynamometric speculum. Bladder neck position, levator plate angle, anorectal angle, and levator hiatal dimensions were measured at rest and on maximal contraction with 3D/4D transperineal ultrasound imaging.

Results
Compared with asymptomatic women, gynecological cancer survivors showed heightened PFM tone, lower flexibility, higher stiffness, and lower coordination and endurance. At rest, they had a smaller anorectal angle and smaller levator hiatal dimensions, indicating heightened PFM tone. They also presented fewer changes from rest to maximal contraction for anorectal angle and levator hiatal dimensions, suggesting an elevated tone or altered contractile properties.

Conclusions
Gynecological cancer survivors with dyspareunia present with altered PFM function and morphometry. This research therefore provides a better understanding of the underlying mechanisms of dyspareunia in cancer survivors.

Impact
Our study confirms alterations in PFM function and morphometry in gynecological cancer survivors with dyspareunia. These findings support the rationale for developing and assessing the efficacy of physical therapy targeting PFM alterations in this population.
Folklore
Authors: Michalopoulos Stelios , Xue Melanie Meng 
Published: January 2021

Abstract
Folklore is the collection of traditional beliefs, customs, and stories of a community passed through the generations by word of mouth. We introduce to economics a unique catalog of oral traditions spanning approximately 1,000 societies. After validating the catalog’s content by showing that the groups’ motifs reflect known geographic and social attributes, we present two sets of applications. First, we illustrate how to fill in the gaps and expand upon a group’s ethnographic record, focusing on political complexity, high gods, and trade. Second, we discuss how machine learning and human classification methods can help shed light on cultural traits, using gender roles, attitudes toward risk, and trust as examples. Societies with tales portraying men as dominant and women as submissive tend to relegate their women to subordinate positions in their communities, both historically and today. More risk-averse and less entrepreneurial people grew up listening to stories wherein competitions and challenges are more likely to be harmful than beneficial. Communities with low tolerance toward antisocial behavior, captured by the prevalence of tricksters being punished, are more trusting and prosperous today. These patterns hold across groups, countries, and second-generation immigrants. Overall, the results highlight the significance of folklore in cultural economics, calling for additional applications.
Health outcomes of continuous positive airway pressure versus mandibular advancement device for the treatment of severe obstructive sleep apnea: an individual participant data meta-analysis
Authors: Trzepizur Wojciech , Cistulli Peter A , Glos Martin , Vielle Bruno , Sutherland Kate , Wijkstra Peter J , Hoekema Aarnoud , Gagnadoux Frédéric 
Published: January 2021

Abstract

Study Objectives
The impact of therapy with continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) has not been directly compared in patients with severe obstructive sleep apnea (OSA). The purpose of this individual participant data meta-analysis was to compare the treatment effects of CPAP and titratable MAD on sleepiness, quality of life, sleep-disordered breathing severity, and sleep structure in patients with severe OSA.

Methods
Randomized controlled trials (RCTs) that included severe OSA patients were identified in order to compare the impact of the two treatments. Individual data from severe OSA patients were extracted from the databases and pooled for analysis.

Results
Of the seven studies identified, three crossover RCT and one parallel-group RCT corresponding to 151 patients and 249 observations (125 in the CPAP treatment arm and 124 in the MAD treatment arm) were included in the analysis. Titratable MAD had a similar impact to CPAP on major patient-centered outcomes (sleepiness and quality of life). CPAP was more effective in reducing AHI and ODI. However, the two treatments had a similar impact on sleep structure with an increase of N3 and REM sleep. Finally, treatment adherence and preference were largely in favor of MAD.

Conclusion
This meta-analysis suggests that MAD represents an effective alternative treatment in severe OSA patients intolerant to CPAP or who prefer alternate therapy.
Molecular resolution of a behavioral paradox: sleep and arousal are regulated by distinct acetylcholine receptors in different neuronal types in Drosophila
Authors: Dai Xihuimin , Zhou Enxing , Yang Wei , Mao Renbo , Zhang Wenxia , Rao Yi 
Published: January 2021

Abstract
Sleep and arousal are both important for animals. The neurotransmitter acetylcholine (ACh) has long been found to promote both sleep and arousal in mammals, an apparent paradox which has also been found to exist in flies, causing much confusion in understanding sleep and arousal. Here, we have systematically studied all 13 ACh receptors (AChRs) in Drosophila to understand mechanisms underlying ACh function in sleep and arousal. We found that exogenous stimuli-induced arousal was decreased in nAChRα3 mutants, whereas sleep was decreased in nAChRα2 and nAChRβ2 mutants. nAChRα3 functions in dopaminergic neurons to promote exogenous stimuli-induced arousal, whereas nAChRα2 and β2 function in octopaminergic neurons to promote sleep. Our studies have revealed that a single transmitter can promote endogenous sleep and exogenous stimuli-induced arousal through distinct receptors in different types of downstream neurons.
Comparison of two live-animal ultrasound systems for genetic evaluation of carcass traits in Angus cattle
Authors: Duff C J , van der Werf J H J , Parnell P F , Clark S A 
Published: January 2021

Abstract
The improvement of carcass traits is an important breeding objective in beef cattle breeding programs. The most common way of selecting for improvement in carcass traits is via indirect selection using ultrasound scanning of selection candidates which are submitted to genetic evaluation programs. Two systems used to analyze ultrasound images to predict carcass traits are the Pie Medical Esaote Aquila (PIE) and Central Ultrasound Processing (CUP). This study compared the ability of the two systems to predict carcass traits for genetic evaluation in Australian Angus cattle. Genetic and phenotypic parameters were estimated using data from 1,648 Angus steers which were ultrasound scanned twice with both systems, first at feedlot entry and then following 100 d in the feedlot. The traits interpreted from ultrasound scanning included eye muscle area (EMA), rib fat (RIB) rump fat (RUMP), and intramuscular fat (IMF). Abattoir carcass data were collected on all steers following the full feedlot feeding period of 285 d. For all ultrasound scan traits, CUP resulted in higher phenotypic and genetic variances compared to the PIE. For IMF, CUP had higher heritability at feedlot intake (0.51 for CUP compared to 0.37 for PIE) and after 100 d feeding (0.54 for CUP compared to 0.45 PIE). CUP predicted IMF also tended to have stronger correlations with the breeding objective traits of carcass IMF and marbling traits, both genetically (ranging from 0.59 to 0.75 for CUP compared to 0.45–0.63 for PIE) and phenotypically (ranging from 0.27 to 0.43 for CUP compared to 0.19–0.28 for PIE). Ultrasound scan EMA was the only group of traits in which the heritabilities were higher for PIE (0.52 for PIE compared to 0.40 for CUP at feedlot intake and 0.46 for PIE compared to 0.43 for CUP at 100 d of feeding), however with similar relationships to the breeding objective carcass EMA observed. For subcutaneous fat traits of ultrasound RIB and RUMP, the heritabilites and genetic correlations to the related carcass traits were similar, with the exception being the higher heritability observed for CUP predicted RUMP at feedlot intake at 0.52 compared to 0.38 for PIE. The results from this study indicates that the CUP system, compared to PIE, provides an advantage for genetic evaluation of carcass traits in Angus cattle, particularly for the IMF and associated marbling traits.
Spring phenology is affected by fall non-structural carbohydrate concentration and winter sugar redistribution in three Mediterranean nut tree species
Authors: Amico Roxas Adele , Orozco Jessica , Guzmán-Delgado Paula , Zwieniecki Maciej A 
Published: January 2021

Abstract
Deciduous trees mostly rely on non-structural carbohydrates (NSC—soluble carbohydrates and starch) stored prior to dormancy to sustain both spring bloom and the initial phase of spring growth prior to the transition of leaves from sink to source. Winter management of NSC, their loss due to respiration, reallocation patterns and remobilization during spring, seems to be key to a timely and synchronous bloom. To assess tree dependence on NSC during dormancy, we tested whether the interruption of local branch NSC accumulation prior to dormancy by defoliation and the interruption of NSC translocation by phloem girdling influence spring phenology in three major deciduous Mediterranean nut crop species: Prunus dulcis (Mill.) D.A Webb, a hybrid between Pistacia integerrima (J. L. Stewart ex Brandis) and P. atlantica Desf. (referred to as P. integerrima), and Juglans regia L. Defoliation treatments had different effects on NSC concentration in different species depending on the time of application. However, despite the significant initial impact (increase or decrease of NSC concentration), with time this impact diminished resulting in overall similar concentrations between control and defoliated branches suggesting the presence of NSC reallocation during dormancy. Phloem girdling in P. dulcis and P. integerrima resulted in reduced export activity and greater NSC concentrations, while in J. regia girdling resulted in lower NSC concentrations, indicating that this species requires a net import of NSC during dormancy. Bud break was distinctly delayed by both defoliation and phloem girdling in all the three species, providing evidence of the significant roles that fall NSC accumulation and winter NSC management play in priming trees for spring growth resumption.
L’acquisition du statut d’entreprenant-commerçant en droit OHADA
Authors: Tamkam Silatchom Guy Armel 
Published: January 2021

Abstract
Les conditions d’acquisition de la qualité d’entreprenant-commerçant présentent des particularités au moment de l’entrée dans le cadre de l’entreprenant. Ainsi, contrairement au statut du commerçant qui est ouvert tant aux personnes physiques, qu’aux personnes morales, le statut d’entreprenant est exclusivement réservé aux personnes physiques et la déclaration au RRCM est simplifiée. Mais, au moment de l’exercice de l’activité commerciale, les conditions se rapprochent de celles du commerçant. Cet état de chose fait que les frontières des deux statuts sont poreuses et l’on pourra s’interroger sur l’opportunité de leur distinction.
Mindfulness-Based Interventions to Reduce Burnout and Stress in Physicians: A Systematic Review and Meta-Analysis
Authors: Fendel Johannes C. , Bürkle Johannes J. , Göritz Anja S. 
Published: January 2021

Purpose
To perform a systematic review and meta-analysis of studies evaluating the effectiveness of mindfulness-based interventions (MBIs) in reducing burnout and stress among physicians.

Method
The authors searched records in MEDLINE, Embase, PsycINFO, PSYNDEX, Web of Science, CINAHL, and CENTRAL from database inception to August 8, 2019, using combinations of terms for mindfulness, interventions, and physicians. Eligible studies were randomized controlled trials (RCTs) and nonrandomized trials (NRTs), including controlled and noncontrolled before-after studies, all assessing burnout and stress among physicians preintervention and postintervention via validated instruments. Two reviewers independently screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. The authors used random-effects modeling to calculate pooled effect sizes and conducted prespecified subgroup and sensitivity analyses to explore potential moderators.

Results
Of 6,831 identified records, 25 studies (with 925 physicians) were ultimately included. MBIs were associated with significant small reductions in burnout in between-group analyses (5 comparisons: standardized mean difference [SMD] = −0.26; 95% confidence interval [CI] = −0.50, −0.03) and pre–post analyses (21 comparisons: SMD = −0.26; 95% CI = −0.37, −0.15), and with a significant medium reduction in stress in between-group analyses (4 comparisons: SMD = −0.55; 95% CI = −0.95, −0.14) and a significant small reduction in stress in pre–post analyses (17 comparisons: SMD = −0.41; 95% CI = −0.61, −0.20). Versions of established MBIs showed higher effectiveness in reducing stress than other forms of MBIs or a mindfulness app. Reductions were maintained over an average follow-up of 5.3 months. The risk of bias was moderate with RCTs and high with NRTs. The overall quality of evidence was low to very low.

Conclusions
MBIs can be effective in reducing physicians’ burnout and stress. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials providing long-term follow-up data.
Clinical Risk Factors and Perioperative Hematological Characteristics of Early Postoperative Symptomatic Deep Vein Thrombosis in Posterior Lumbar Spinal Surgery
Authors: Zhang Hengyan , Weng Huiling , Yu Keyi , Qiu Guixing 
Published: January 2021

Study Design.
A retrospective analysis (2015–2019) of data collected from patients who underwent posterior lumbar spinal surgery.

Objective.
This study aims to identify the incidence, perioperative hematological characteristics, potential prognostic indicators, and risk factors of deep venous thrombosis (DVT) in the lower limbs after posterior lumbar spinal surgery. Eliminating risk factors or taking measures against patients at risk may reduce the incidence of DVT.

Summary of Background Data.
Deep venous thromboses have been extensively studied in other reconstructive surgeries. Present literatures provide limited evidence for determining the prognostic and risk factors for this complication after spinal surgery.

Methods.
Patients who underwent posterior lumbar spinal surgery with internal fixation in the Spine Surgery Center of Peking Union Medical College Hospital (PUMCH) were evaluated. The patient demographics, the number of operative segments, the hematological and biochemical parameters on baseline and postoperative day 1, and the presence of DVTs were obtained from all patients. The diagnosis of DVT was established by venous ultrasound when symptomatic. A multivariate logistic regression test was subsequently performed to determine the prognostic indicators and risk factors for DVT.

Results.
A total of 2053 patients who received lumbar spine procedures were qualified and included. Patients were followed up for 12 weeks. Early symptomatic DVT occurred in 58 individuals (2.39%; 95% confidence interval [CI], 0.4–0.7%). Advanced age, higher preoperative serum D-dimer level, and lower serum potassium level were recognized as independent risk factors for symptomatic DVT.

Conclusion.
Multiple independent risk factors were identified for early symptomatic DVT after posterior lumbar spine surgery. Postoperative prophylactic anti-coagulation treatment might be warranted for patients with high D-dimer or low potassium levels before the procedure.

Level of Evidence: 4
Does Selective Posterior Correction and Fusion Surgery Influence Cervical Sagittal Alignment in Patient with Lenke Type 5 Adolescent Idiopathic Scoliosis?—A 5-year Follow-up Retrospective Cohort Study
Authors: Okubo Toshiki , Yagi Mitsuru , Suzuki Satoshi , Nori Satoshi , Tsuji Osahiko , Nagoshi Narihito , Okada Eijiro , Fujita Nobuyuki , Nakamura Masaya , Matsumoto Morio , Watanabe Kota 
Published: January 2021

Study Design.
A retrospective comparative study.

Objective.
The aim of this study was to examine the changes in cervical sagittal alignment (CSA) following surgical correction in a patient with Lenke type 5 adolescent idiopathic scoliosis (AIS) and evaluate any possible factors influencing postoperative CSA.

Summary of Background Data.
Few studies have assessed the association between CSA and thoracic or lumbar sagittal alignment in AIS patients with major thoracolumbar/lumbar curve who underwent posterior correction and fusion surgery.

Methods.
Sixty-six patients with Lenke type 5 AIS (two males and 64 females, the mean age at surgery of 16.2 years) were included in this study. They were followed up for minimum 5 years after surgery. Multiple linear regression analysis was used to evaluate possible factors influencing the postoperative CSA. To determine the influence of upper end vertebra (UEV) level on postoperative CSA, the subjects were divided into two groups according to UEV level of ≥T9 or ≤T10. The outcome variables were compared between the two groups and analyzed for changes in various spinal sagittal profiles using radiographic outcomes.

Results.
Multiple linear regression analysis revealed that preoperative T10-L2 kyphosis and LL were significantly correlated with postoperative C2–7 lordosis. However, CSA did not significantly change at 5 years after surgery. Sub-analysis of the cohort revealed that in the UEV ≥T9 group, the mean thoracic kyphosis significantly increased from 20.3° ± 10.6° to 24.0° ± 8.9° and the mean C2–7 lordosis also significantly increased from −12.5° ± 8.3° to −4.3° ± 10.3° at 5-year postoperatively. SRS-22 outcomes were comparable between the groups.

Conclusion.
We indicated that the CSA was not influenced by surgical correction in most Lenke type 5 AIS patients. However, in a patient whose UEV was located at T9 or higher levels, CSA was influenced through the changes in thoracic kyphosis following posterior correction surgery.

Level of Evidence: 4
Association of Medicare and Medicaid Insurance Status with Increased Spine Surgery Utilization Rates
Authors: Benton Joshua A. , Weiss Brandon T. , Mowrey Wenzhu B. , Yassari Neeky , Wang Benjamin , Ramos Rafael De La Garza , Gelfand Yaroslav , Castro-Rivas Erida , Puthenpura Vidya , Yassari Reza , Yanamadala Vijay 
Published: January 2021

Study Design.
Retrospective single-institution study.

Objective.
The aim of this study was to determine the relationship between patients’ insurance status and the likelihood for them to be recommended various spine interventions upon evaluation in our neurosurgical clinics.

Summary of Background Data.
Socioeconomically disadvantaged populations have worse outcomes after spine surgery. No studies have looked at the differential rates of recommendation for surgery for patients presenting to spine surgeons based on socioeconomic status.

Methods.
We studied patients initially seeking spine care from spine-fellowship trained neurosurgeons at our institution from July 1, 2018 to June 30, 2019. Multivariable logistic regression was used to assess the association between insurance status and the recommended patient treatment.

Results.
Overall, 663 consecutive outpatients met inclusion criteria. Univariate analysis revealed a statistically significant association between insurance status and treatment recommendations for surgery (P < 0.001). Multivariate logistic regression demonstrated that compared with private insurance, Medicare (odds ratio [OR] 3.54, 95% confidence interval [CI] 1.21–7.53, P = 0.001) and Medicaid patients (OR 2.46, 95% CI 1.21–5.17, P = 0.014) were more likely to be recommended for surgery. Uninsured patients did not receive recommendations for surgery at significantly different rates than patients with private insurance.

Conclusion.
Medicare and Medicaid patients are more likely to be recommended for spine surgery when initially seeking spine care from a neurosurgeon. These findings may stem from a number of factors, including differential severity of the patient's condition at presentation, disparities in access to care, and differences in shared decision making between surgeons and patients.

Level of Evidence: 3