bluuebunny/crossref_metadata_2025_split huggingface dataset:
ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure
Authors: Oczkowski Simon , Ergan Begüm , Bos Lieuwe , Chatwin Michelle , Ferrer Miguel , Gregoretti Cesare , Heunks Leo , Frat Jean-Pierre , Longhini Federico , Nava Stefano , Navalesi Paolo , Ozsancak Uğurlu Aylin , Pisani Lara , Renda Teresa , Thille Arnaud W. , Winck João Carlos , Windisch Wolfram , Tonia Thomy , Boyd Jeanette , Sotgiu Giovanni , Scala Raffaele 
Published: October 2021

BackgroundHigh-flow nasal cannula (HFNC) has become a frequently used noninvasive form of respiratory support in acute settings; however, evidence supporting its use has only recently emerged. These guidelines provide evidence-based recommendations for the use of HFNC alongside other noninvasive forms of respiratory support in adults with acute respiratory failure (ARF).Materials and methodologyThe European Respiratory Society task force panel included expert clinicians and methodologists in pulmonology and intensive care medicine. The task force used the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methods to summarise evidence and develop clinical recommendations for the use of HFNC alongside conventional oxygen therapy (COT) and noninvasive ventilation (NIV) for the management of adults in acute settings with ARF.ResultsThe task force developed eight conditional recommendations, suggesting the use of 1) HFNC over COT in hypoxaemic ARF; 2) HFNC over NIV in hypoxaemic ARF; 3) HFNC over COT during breaks from NIV; 4) either HFNC or COT in post-operative patients at low risk of pulmonary complications; 5) either HFNC or NIV in post-operative patients at high risk of pulmonary complications; 6) HFNC over COT in nonsurgical patients at low risk of extubation failure; 7) NIV over HFNC for patients at high risk of extubation failure unless there are relative or absolute contraindications to NIV; and 8) trialling NIV prior to use of HFNC in patients with COPD and hypercapnic ARF.ConclusionsHFNC is a valuable intervention in adults with ARF. These conditional recommendations can assist clinicians in choosing the most appropriate form of noninvasive respiratory support to provide to patients in different acute settings.
Scan-based competing death risk model for re-evaluating lung cancer computed tomography screening eligibility
Authors: Schreuder Anton , Jacobs Colin , Lessmann Nikolas , Broeders Mireille J.M. , Silva Mario , Išgum Ivana , de Jong Pim A. , van den Heuvel Michel M. , Sverzellati Nicola , Prokop Mathias , Pastorino Ugo , Schaefer-Prokop Cornelia M. , van Ginneken Bram 
Published: October 2021

BackgroundA baseline computed tomography (CT) scan for lung cancer (LC) screening may reveal information indicating that certain LC screening participants can be screened less, and instead require dedicated early cardiac and respiratory clinical input. We aimed to develop and validate competing death (CD) risk models using CT information to identify participants with a low LC risk and a high CD risk.MethodsParticipant demographics and quantitative CT measures of LC, cardiovascular disease and chronic obstructive pulmonary disease were considered for deriving a logistic regression model for predicting 5-year CD risk using a sample from the National Lung Screening Trial (n=15 000). Multicentric Italian Lung Detection data were used to perform external validation (n=2287).ResultsOur final CD model outperformed an external pre-scan model (CD Risk Assessment Tool) in both the derivation (area under the curve (AUC) 0.744 (95% CI 0.727–0.761) and 0.677 (95% CI 0.658–0.695), respectively) and validation cohorts (AUC 0.744 (95% CI 0.652–0.835) and 0.725 (95% CI 0.633–0.816), respectively). By also taking LC incidence risk into consideration, we suggested a risk threshold where a subgroup (6258/23 096 (27%)) was identified with a number needed to screen to detect one LC of 216 (versus 23 in the remainder of the cohort) and ratio of 5.41 CDs per LC case (versus 0.88). The respective values in the validation cohort subgroup (774/2287 (34%)) were 129 (versus 29) and 1.67 (versus 0.43).ConclusionsEvaluating both LC and CD risks post-scan may improve the efficiency of LC screening and facilitate the initiation of multidisciplinary trajectories among certain participants.
Computed tomography-based radiomics decodes prognostic and molecular differences in interstitial lung disease related to systemic sclerosis
Authors: Schniering Janine , Maciukiewicz Malgorzata , Gabrys Hubert S. , Brunner Matthias , Blüthgen Christian , Meier Chantal , Braga-Lagache Sophie , Uldry Anne-Christine , Heller Manfred , Guckenberger Matthias , Fretheim Håvard , Nakas Christos T. , Hoffmann-Vold Anna-Maria , Distler Oliver , Frauenfelder Thomas , Tanadini-Lang Stephanie , Maurer Britta 
Published: October 2021

BackgroundRadiomic features calculated from routine medical images show great potential for personalised medicine in cancer. Patients with systemic sclerosis (SSc), a rare, multiorgan autoimmune disorder, have a similarly poor prognosis due to interstitial lung disease (ILD). Here, our objectives were to explore computed tomography (CT)-based high-dimensional image analysis (“radiomics”) for disease characterisation, risk stratification and relaying information on lung pathophysiology in SSc-ILD.MethodsWe investigated two independent, prospectively followed SSc-ILD cohorts (Zurich, derivation cohort, n=90; Oslo, validation cohort, n=66). For every subject, we defined 1355 robust radiomic features from standard-of-care CT images. We performed unsupervised clustering to identify and characterise imaging-based patient clusters. A clinically applicable prognostic quantitative radiomic risk score (qRISSc) for progression-free survival (PFS) was derived from radiomic profiles using supervised analysis. The biological basis of qRISSc was assessed in a cross-species approach by correlation with lung proteomic, histological and gene expression data derived from mice with bleomycin-induced lung fibrosis.ResultsRadiomic profiling identified two clinically and prognostically distinct SSc-ILD patient clusters. To evaluate the clinical applicability, we derived and externally validated a binary, quantitative radiomic risk score (qRISSc) composed of 26 features that accurately predicted PFS and significantly improved upon clinical risk stratification parameters in multivariable Cox regression analyses in the pooled cohorts. A high qRISSc score, which identifies patients at risk for progression, was reverse translatable from human to experimental ILD and correlated with fibrotic pathway activation.ConclusionsRadiomics-based risk stratification using routine CT images provides complementary phenotypic, clinical and prognostic information significantly impacting clinical decision making in SSc-ILD.
Clinical value of bronchodilator response for diagnosing asthma in steroid-naïve adults
Authors: Tuomisto Leena E. , Ilmarinen Pinja , Lehtimäki Lauri , Niemelä Onni , Tommola Minna , Kankaanranta Hannu 
Published: October 2021

Spirometry and testing for bronchodilator response have been recommended to detect asthma, and a bronchodilator response (BDR) of ≥12% and ≥200 mL has been suggested to confirm asthma. However, the clinical value of bronchodilation tests in newly diagnosed steroid-naïve adult patients with asthma remains unknown.We evaluated the sensitivity of BDR in forced expiratory volume in 1 s (FEV1) as a diagnostic test for asthma in a real-life cohort of participants in the Seinäjoki Adult Asthma Study. In the diagnostic phase, 369 spirometry tests with bronchodilation were performed for 219 steroid-naïve patients. The fulfilment of each test threshold was assessed. According to the algorithm of the National Institute for Health and Care Excellence, we divided the patients into obstructive (FEV1/forced vital capacity (FVC) <0.70) and non-obstructive (FEV1/FVC ≥0.70) groups.Of the overall cohort, 35.6% fulfilled ΔFEV1 ≥12% and ≥200 mL for the initial FEV1, 18.3% fulfilled ΔFEV1 ≥15% and ≥400 mL for the initial FEV1, and 36.1% fulfilled ΔFEV1 ≥9% of predicted FEV1at least once. One-third (31%) of these steroid-naïve patients was obstructive (pre-bronchodilator FEV1/FVC <0.7). Of the obstructive patients, 55.9%, 26.5% and 48.5%, respectively, met the same thresholds. In multivariate logistic regression analysis, different thresholds recognised different kinds of asthma patients.In steroid-naïve adult patients, the current BDR threshold (ΔFEV1 ≥12% and ≥200 mL) has low diagnostic sensitivity (36%) for asthma. In obstructive patients, sensitivity is somewhat higher (56%) but far from optimal. If the first spirometry test with bronchodilation is not diagnostic but asthma is suspected, spirometry should be repeated, and other lung function tests should be used to confirm the diagnosis.
The moderating effect of gender on the relationships between obesity, well-being, and stress perception in Korean adolescents
Authors: Su-Jung Nam , Jong-Ho Park 
Published: October 2021

Abstract
Background
Children and adolescents with obesity are more likely to become adults with obesity. Therefore, obesity prevention in adolescence is essential for eliminating complications associated with obesity, which can affect health throughout the lifespan. This study examined the influences of adolescents’ obesity based on BMI and that of obesity based on adolescents’ perception of their well-being and stress, as well as the moderating effect of gender on these influences.

Methods
Data were analyzed for 61,861 adolescents aged 12–18, who participated in the 2019 Korean Adolescent Health Behavior Survey, an online self-administered questionnaire. Adolescents’ obesity based on perception was based on their self-rating as underweight, healthy weight, or obese. Chi-squared tests were used to determine whether well-being and stress perception were related to obesity based on BMI and obesity based on perception, and a general linear model was used to examine the main and interaction effects of obesity based on BMI, obesity based on perception, and gender on well-being and stress perception.

Results
Obesity based on BMI and obesity based on perception coincided in 58.7% of the sample. However, the degree of obesity was overestimated and underestimated by 19.2 and 24.3% of the sample, respectively. Obesity based on BMI and obesity based on perception varied by gender, age, economic status, and academic achievement. The main effect of obesity based on BMI was not statistically significant on both well-being and stress perception, and only the main effect of obesity based on perception was statistically significant on stress perception. The interaction between obesity based on perception and gender was significant for well-being and stress perception. Herein, males scored higher on well-being and lower on stress perception. However, the association patterns were similar for males and females, with significant differences between underweight, healthy weight, and overweight/obese; however, for only females, there was no difference in well-being scores between underweight and those who perceived themselves as having a healthy weight.

Conclusion
The well-being and stress perception are influenced by obesity based on perception rather than obesity based on BMI, and this influence varies according to gender in adolescents.
Biomechanical analysis of reduction technique for lumbar spondylolisthesis: anterior lever versus posterior lever reduction method
Authors: Lin Yu-Tsung , Su Kuo-Chih , Chen Kun-Hui , Pan Chien-Chou , Shih Cheng-Min , Lee Cheng-Hung 
Published: October 2021

Abstract
Background
Reduction of lumbar spondylolisthesis during spinal fusion surgery is important for improving the fusion rate and restoring the sagittal alignment. Despite the variety of reduction methods, the fundamental mechanics of lumbar spondylolisthesis reduction remain unclear. This study aimed to investigate the biomechanical behavior while performing spondylolisthesis reduction with the anterior and posterior lever reduction method.

Methods
We developed an L4–L5 spondylolisthesis model using sawbones. Two spine surgeons performed the simulated reduction with a customized Cobb elevator. The following data were collected: the torque and angular motion of Cobb, displacement of vertebral bodies, change of lordotic angle between L4 and L5, total axial force and torque applied on the model, and force received by adjacent disc.

Results
Less torque value (116 N-cm vs. 155 N-cm) and greater angular motion (53o vs. 38o) of Cobb elevator were observed in anterior lever reduction. Moreover, the total axial force received by the entire model was greater in the posterior lever method than that in the anterior lever method (40.8 N vs. 16.38 N). Besides, the displacement of both vertebral bodies was greater in the anterior lever method.

Conclusions
The anterior lever reduction is a more effort-saving method than the posterior lever reduction method. The existing evidence supports the biomechanical advantage of the anterior reduction method, which might be one of the contributing factors to successfully treating high-grade lumbar spondylolisthesis with short-segment instrumentation.
Prevalence and location of endplate fracture and subsidence after oblique lumbar interbody fusion for adult spinal deformity
Authors: Inoue Gen , Saito Wataru , Miyagi Masayuki , Imura Takayuki , Shirasawa Eiki , Ikeda Shinsuke , Mimura Yusuke , Kuroda Akiyoshi , Yokozeki Yuji , Inoue Sho , Akazawa Tsutomu , Nakazawa Toshiyuki , Uchida Kentaro , Takaso Masashi 
Published: October 2021

Abstract
Background
Recently, Oblique lumbar interbody fusion (OLIF) is commonly indicated to correct the sagittal and coronal alignment in adult spinal deformity (ASD). Endplate fracture during surgery is a major complication of OLIF, but the detailed location of fracture in vertebral endplate in ASD has not yet been determined. We sought to determine the incidence and location of endplate fracture and subsidence of the OLIF cage in ASD surgery, and its association with fusion status and alignment.

Methods
We analyzed 75 levels in 27 patients were analyzed using multiplanar CT to detect the endplate fracture immediately after surgery and subsidence at 1 year postoperatively. The prevalence was compared between anterior and posterior, approach and non-approach sides, and concave and convex side. Their association with fusion status, local and global alignment, and complication was also investigated.

Results
Endplate fracture was observed in 64 levels (85.3%) in all 27 patients, and the incidence was significantly higher in the posterior area compared with the anterior area (85.3 vs. 68.0%, p=0.02) of affected vertebra in the sagittal plane. In the coronal plane, there was no significant difference in incidence between left (approach) and right (non-approach) sides (77.3 and 81.3%, respectively), or concave and convex sides (69.4 and 79.6%) of wedged vertebra. By contrast, cage subsidence at 1 year postoperatively was noted in 14/75 levels (18.7%), but was not associated with endplate fracture. Fusion status, local and global alignment, and complications were not associated with endplate fracture or subsidence.

Conclusion
Endplate fracture during OLIF procedure in ASD cases is barely avoidable, possibly induced by the corrective maneuver with ideal rod counter and cantilever force, but is less associated with subsequent cage subsidence, fusion status, and sustainment of corrected alignment in long fusion surgery performed even for elderly patients.
Effects of the Mental Health and Welfare Law revision on schizophrenia patients in Korea: an interrupted time series analysis
Authors: Heo Jongho , Yoon Nan-He , Shin Soyoun , Yu Soo-Young , Lee Manwoo 
Published: October 2021

Abstract
Background
High rates of involuntary hospitalization and long lengths of stay have been problematic in Korea. To address these problems, the Mental Health and Welfare Law was revised in 2016, mainly to protect patient rights by managing involuntary admissions. The aim of this study was to evaluate the impact of the revised Mental Health and Welfare Law on deinstitutionalization by using routinely collected data from hospital admissions and continuity of mental health service use after hospital discharge as proxy measures of deinstitutionalization.

Methods
We used monthly-aggregated claims-based data with a principal or secondary diagnosis of schizophrenia from 2012 to 2019, collected by the National Health Insurance Service. Outcome variables included rates of first admission; discharges; re-admissions within 7, 30, and 90 days; outpatient visits after discharge within 7 and 30 days; and continuity of visits, at least once a month for 6 months after discharge. Using interrupted time series analysis, we estimated the change in levels and trends of the rates after revision, controlling for baseline level and trend.

Results
There was no significant change in first admission and discharge rates after the revision. Immediately after the revision, however, the rates of re-admission within 7 and 30 days dropped significantly, by 2.24% and 1.99%, respectively. The slopes of the re-admission rate decreased significantly, by 0.10% and 0.14%, respectively. The slopes of the re-admission rate within 90 days decreased (0.001%). The rates of outpatient visits within 7 and 30 days increased by 1.98% and 2.72%, respectively. The rate of continuous care showed an immediate 4.0% increase.

Conclusions
The revision had slight but significant effects on deinstitutionalization, especially decreasing short-term re-admission and increasing immediate outpatient service utilization.
Proposal of standardization of every step of angiographic procedure in bleeding patients from pelvic trauma
Authors: Renzulli Matteo , Ierardi Anna Maria , Brandi Nicolò , Battisti Sofia , Giampalma Emanuela , Marasco Giovanni , Spinelli Daniele , Principi Tiziana , Catena Fausto , Khan Mansoor , Di Saverio Salomone , Carrafiello Giampaolo , Golfieri Rita 
Published: October 2021

AbstractTrauma accounts for a third of the deaths in Western countries, exceeded only by cardiovascular disease and cancer. The high risk of massive bleeding, which depends not only on the type of fractures, but also on the severity of any associated parenchymal injuries, makes pelvic fractures one of the most life-threatening skeletal injuries, with a high mortality rate. Therefore, pelvic trauma represents an important condition to correctly and early recognize, manage, and treat. For this reason, a multidisciplinary approach involving trauma surgeons, orthopedic surgeons, emergency room physicians and interventional radiologists is needed to promptly manage the resuscitation of pelvic trauma patients and ensure the best outcomes, both in terms of time and costs. Over the years, the role of interventional radiology in the management of patient bleeding due to pelvic trauma has been increasing. However, the current guidelines on the management of these patients do not adequately reflect or address the varied nature of injuries faced by the interventional radiologist. In fact, in the therapeutic algorithm of these patients, after the word “ANGIO”, there are no reports on the different possibilities that an interventional radiologist has to face during the procedure. Furthermore, variations exist in the techniques and materials for performing angioembolization in bleeding patients with pelvic trauma. Due to these differences, the outcomes differ among different published series. This article has the aim to review the recent literature on optimal imaging assessment and management of pelvic trauma, defining the role of the interventional radiologist within the multidisciplinary team, suggesting the introduction of common and unequivocal terminology in every step of the angiographic procedure. Moreover, according to these suggestions, the present paper tries to expand the previously drafted algorithm exploring the role of the interventional radiologist in pelvic trauma, especially given the multidisciplinary setting.
Governance of food and nutrition security in Eswatini: an analysis of government policies and reports
Authors: Phungwayo Thobile , Kushitor Sandra Boatemaa , Koornhof Liesbet 
Published: October 2021

Abstract
Background
Governance of food and nutrition security is vital in achieving sustainable development goals. Yet, the role of governance in shaping and preventing malnutrition risk is complex and poorly understood. This paper examined the governance of food and nutrition security in Eswatini.

Methods
Policy documents, annual reports, and minutes of board meetings from five government ministries were the documents that were used for this study. The data analysis focused on the strength of nutrition governance, actors involved in policymaking, nutrition-specific and sensitive-programs, and multisectoral coordination of programs.

Results
The findings show that Eswatini has medium strength, nutrition governance. The nutrition-specific programs included: micronutrient supplementation and deworming programs, breastfeeding campaigns, and treatment of acute malnutrition. The nutrition-sensitive initiatives included programs on school nutrition, sanitation and hygiene, agriculture production, and healthcare. However, multisectoral coordination was ineffective, as collaborative efforts are not structured, during implementation.

Conclusion
This study examined the governance of food and nutrition security in Eswatini using documents from government ministries. Diverse actors were involved in policy formation and implementation. The strength of nutrition governance was medium and multisectoral coordination was usually ad-hoc. The multiple actors involved in nutrition governance in Eswatini need to intentionally plan to improve multisectoral coordination to achieve higher impact.