bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Adaptive Mode Adjustment for Multimode Household Surveys
Authors: Brick J Michael , Kennedy Courtney , Cervantes-Flores Ismael , Mercer Andrew W 
Published: July 2021

Abstract
Multimode data collection has emerged as a common approach for conducting household surveys in the United States. A number of different data collection schemes have been investigated, with an emphasis on collecting as many respondents by the Web prior to going to paper data collection to reduce costs. Despite this, little research has been conducted on the approaches to weighting data from multimode surveys. The typical approach assumes that all respondents should be treated the same regardless of mode even though it is well known that the response patterns by mode vary substantially. We examine an adaptive mode adjustment to address these differences and propose an imbalance measure to help determine the adjustment factor using ideas from responsive design. We then compare the effects of the alternative weighting method in two recent sequential mixed-mode surveys and show it appears to reduce bias while only slightly increasing variances of the estimates.
Evolution-Based Protein Engineering for Antifungal Peptide Improvement
Authors: Gu Jing , Isozumi Noriyoshi , Yuan Shouli , Jin Ling , Gao Bin , Ohki Shinya , Zhu Shunyi 
Published: July 2021

Abstract
Antimicrobial peptides (AMPs) have been considered as the alternatives to antibiotics because of their less susceptibility to microbial resistance. However, compared with conventional antibiotics they show relatively low activity and the consequent high cost and nonspecific cytotoxicity, hindering their clinical application. What’s more, engineering of AMPs is a great challenge due to the inherent complexity in their sequence, structure, and function relationships. Here, we report an evolution-based strategy for improving the antifungal activity of a nematode-sourced defensin (Cremycin-5). This strategy utilizes a sequence-activity comparison between Cremycin-5 and its functionally diverged paralogs to identify sites associated with antifungal activity for screening of enhanceable activity-modulating sites for subsequent saturation mutagenesis. Using this strategy, we identified a site (Glu-15) whose mutations with nearly all other types of amino acids resulted in a universally enhanced activity against multiple fungal species, which is thereby defined as a Universally Enhanceable Activity-Modulating Site (UEAMS). Especially, Glu15Lys even exhibited &gt;9-fold increased fungicidal potency against several clinical isolates of Candida albicans through inhibiting cytokinesis. This mutant showed high thermal and serum stability and quicker killing kinetics than clotrimazole without detectable hemolysis. Molecular dynamic simulations suggest that the mutations at the UEAMS likely limit the conformational flexibility of a distant functional residue via allostery, enabling a better peptide–fungus interaction. Further sequence, structural, and mutational analyses of the Cremycin-5 ortholog uncover an epistatic interaction between the UEAMS and another site that may constrain its evolution. Our work lights one new road to success of engineering AMP drug leads.
Are all dietary fibers equal for patients with inflammatory bowel disease? A systematic review of randomized controlled trials
Authors: Peters Vera , Dijkstra Gerard , Campmans-Kuijpers Marjo J E 
Published: July 2021

Abstract

Context
Conflicting practice-based dietary recommendations are sometimes given to patients with inflammatory bowel disease (IBD); whereas intake of fiber should increase during remission, it should be avoided during relapse. Moreover, European countries set daily requirements of total fiber and do not specify any types.

Objective
This systematic review appraised data from randomized clinical trials (RCTs) of the types of fibers beneficial for patients in the treatment of IBD to guide dietary fiber advice.

Data Sources
The PubMED database was searched following PRISMA guidelines.

Data Extraction
RCTs evaluating the effects of any type of fiber on clinical and physiological outcomes in patients with IBD were assessed. Quality assessment of the selected full-text articles was conducted using the Cochrane Risk of Bias Tool.

Data Analysis
Eight studies were included reporting on 5 types of fibers. In 2 RCTs, germinated barley foodstuff (GBF) was shown to lower pro-inflammatory cytokines and clinical disease activity scores. Fructo-oligosaccharides (FOS) were demonstrated to lower IBD Questionnaire scores (lower well-being), in contrast to inulin, which decreased disease activity scores. An RCT could not find lower remission rates in the psyllium treatment group, while another RCT reported that administration led to less symptoms in patients. In RCTs, no concrete evidence was found that wheat bran improves disease course.

Conclusions
Although the evidence is sparse, GBF and inulin seem propitious and merit further exploration. Evidence on wheat bran and psyllium is still too limited. Adequately powered long-term human RCTs with objective outcomes are needed to improve dietary advice on types of fiber in IBD.
Understanding the predictive value and methods of risk assessment based on coronary computed tomographic angiography in populations with coronary artery disease: a review
Authors: Li Yiming , Jia Kaiyu , Jia Yuheng , Yang Yong , Yao Yijun , Chen Mao , Peng Yong 
Published: July 2021

Abstract
Risk assessment in coronary artery disease plays an essential role in the early identification of high-risk patients. However, conventional invasive imaging procedures all require long intraprocedural times and high costs. The rapid development of coronary computed tomographic angiography (CCTA) and related image processing technology has facilitated the formulation of noninvasive approaches to perform comprehensive evaluations. Evidence has shown that CCTA has outstanding performance in identifying the degree of stenosis, plaque features, and functional reserve. Moreover, advancements in radiomics and machine learning allow more comprehensive interpretations of CCTA images. This paper reviews conventional as well as novel diagnostic and risk assessment tools based on CCTA.
A Qualitative Exploration of Challenges Experienced by Online MSN Nurse Educator Students
Authors: Scott Melissa D. 
Published: July 2021

Abstract
Institutions of higher learning offer flexible online master of science in nursing education (MSN NE) programs to increase the number of available nursing faculty. Such programs are a viable option to degree completion; however, online programs create challenges that impact student success. This qualitative pilot study describes challenges experienced by seven enrolled or recently graduated MSN NE students. Technology, scheduling, group behaviors, faculty, curricula, and personal barriers emerged as themes. The results underscore the need to create an effective community of inquiry that fosters an environment online to promote student success.
A Comparison of Collaborative Testing and Alternative Test-Taking Methods on Content Retention in Baccalaureate Nursing Students
Authors: Witt Amy J. , Gerdin Bethany J. , De Haan Julie A. , Bergman Lauren K. 
Published: July 2021

Abstract
Nursing faculty look for ways to promote the retention of content so that students can build on that content and apply it to nursing practice. A study was designed to determine differences in content retention between testing collaboratively, which involves students taking an exam collectively within a small group, using an individual notecard, and including written rationale for test answers during collaborative testing. Students who tested collaboratively had significantly higher long-term content retention than students who tested with the other methods.
Skeletal Maturity Using Knee X-rays: Understanding the Resilience of 7 Radiographic Parameters to Rotational Position
Authors: Castillo Tafur Julio C. , Benedick Alexander , Knapik Derrick M. , Janes Jessica L. , Delozier Sarah J. , Liu Raymond W. 
Published: July 2021

Background:
Recently, a skeletal maturity system using knee radiographs, named the modified Roche-Wainer-Thissen (RWT) system, has been developed using 7 discrete radiographic parameters. While the system has been shown to significantly outperform the Greulich and Pyle atlas, the effect of rotational variation of the knee radiograph on skeletal maturity determinations has not been studied.

Methods:
Normal knee computed tomography scans of 12 male children ages 10 to 16 years and 8 female children ages 8 to 14 years were obtained retrospectively, converted into 3-dimensional reconstructions, and then used to simulate knee radiographs in 5 different rotational positions. Images were graded using the modified RWT system, and 1-way repeated measures analysis of variance was used to compare skeletal age in the patella centered view versus the other positions. We next retrospectively found 85 pediatric patients with both bilateral standing anteroposterior hip to ankles and separate knee radiograph within 6 months of each other. The skeletal maturity values from the 2 different radiographs were compared in 39 males between the ages of 10 and 16 years and 46 females between 8 and 14 years of age using paired t test and Wilcoxon-signed rank test.

Results:
On the computed tomography scan-based images, there was no statistically significant effect of rotational position on the modified RWT score using repeat measures analysis of variance (P=0.210). Only the width ratio of the tibial epiphysis and metaphysis and the width ratio of the fibular epiphysis and metaphysis were statistically different between rotational positions (P<0.05). Comparing clinical full length versus knee radiographs, we found a small difference of 0.069 years which trended towards a statistically significant difference (P=0.009).

Conclusions:
This retrospective study supports the resilience of the RWT model to rotational variation, reassuring clinicians that bone age estimation can be performed in a slightly rotated knee x-ray within a reasonable margin of error. These results can minimize the number of radiographs needed to assess skeletal maturity limiting radiation exposure and expedite clinical flow.

Level of Evidence:
Level-III—diagnostic study.
Examination of Adult Spinal Deformity Patients Undergoing Surgery with Implanted Spinal Cord Stimulators and Intrathecal Pumps
Authors: Daniels Alan H. , Durand Wesley M. , Steinbaum Alyssa J. , Lafage Renaud , Hamilton D. Kojo , Passias Peter G. , Kim Han Jo , Protopsaltis Themistocles , Lafage Virginie , Smith Justin S. , Shaffrey Christopher , Gupta Munish , Klineberg Eric O. , Schwab Frank , Gum Jeffrey L. , Mundis Gregory , Eastlack Robert , Kebaish Khaled , Soroceanu Alex , Hostin Richard A. , Burton Doug , Bess Shay , Ames Christopher , Hart Robert A. 
Published: July 2021

Study Design.
Retrospective cohort study of a prospectively collected multi-center database of adult spinal deformity (ASD) patients.

Objective.
We hypothesized that patients undergoing ASD surgery with and without previous spinal cord stimulators (SCS)/ intrathecal medication pumps (ITP) would exhibit increased complication rates but comparable improvement in health-related quality of life.

Summary of Background Data.
ASD patients sometimes seek pain management with SCS or ITP before spinal deformity correction. Few studies have examined outcomes in this patient population.

Methods.
Patients undergoing ASD surgery and eligible for 2-year follow-up were included. Preoperative radiographs were reviewed for the presence of SCS/ITP. Outcomes included complications, Oswestry Disability Index (ODI), Short Form-36 Mental Component Score, and SRS-22r. Propensity score matching was utilized.

Results.
In total, of 1034 eligible ASD patients, a propensity score-matched cohort of 60 patients (30 with SCS/ITP, 30 controls) was developed. SCS/ITP were removed intraoperatively in most patients (56.7%, n = 17). The overall complication rate was 80.0% versus 76.7% for SCS/ITP versus control (P > 0.2), with similarly nonsignificant differences for intraoperative and infection complications (all P > 0.2). ODI was significantly higher among patients with SCS/ITP at baseline (59.2 vs. 47.6, P = 0.0057) and at 2-year follow-up (44.4 vs. 27.7, P = 0.0295). The magnitude of improvement, however, did not significantly differ (P = 0.45). Similar results were observed for SRS-22r pain domain. Satisfaction did not differ between groups at either baseline or follow-up (P > 0.2). No significant difference was observed in the proportion of patients with SCS/ITP versus control reaching minimal clinically important difference in ODI (47.6% vs. 60.9%, P = 0.38). Narcotic usage was more common among patients with SCS/ITP at both baseline and follow-up (P < 0.05).

Conclusion.
ASD patients undergoing surgery with SCS/ITP exhibited worse preoperative and postoperative ODI and SRS-22r pain domain; however, the mean improvement in outcome scores was not significantly different from patients without stimulators or pumps. No significant differences in complications were observed between patients with versus without SCS/ITP.

Level of Evidence: 3
Risk factors for gastric cancer: a large-scale, population-based case-control study
Authors: Zhang Rui , Li He , Li Ni , Shi Ju-Fang , Li Jiang , Chen Hong-Da , Yu Yi-Wen , Qin Chao , Ren Jian-Song , Chen Wan-Qing , He Jie 
Published: July 2021

Abstract

Background:
Early detection of gastric cancer (GC) has been the topic of major efforts in China. This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk population of GC.

Methods:
Based on the cancer screening cohort of the National Cancer Screening Program in Urban China, GC patients diagnosed by endoscopy and pathological examinations constituted the case group, and controls were 1:3 matched by sex and age (±5 years) individually. The variables were selected by univariable analysis of factors such as body mass index (BMI), dietary habits, lifestyle, stomach disease history, and family history of GC; and multivariable logistic regression was used to analyze the influencing factors of GC and to calculate the odds ratio (OR) of related factors and its 95% confidence interval (CI).

Results:
A total of 215 GC cases and 645 matched healthy controls were included in the final analysis, with a median age of 61 years for the case and control groups. Overall analysis showed that high educational level (above primary school) (OR = 0.362, 95% CI = 0.219–0.599, P < 0.001), overweight/obesity (BMI ≥24 kg/m2; OR = 0.489, 95% CI = 0.329–0.726, P < 0.001), cigarette smoking (OR = 3.069, 95% CI = 1.700–5.540, P < 0.001), alcohol consumption (OR = 1.661, 95% CI = 1.028–2.683, P = 0.038), history of stomach disease (OR = 6.917, 95% CI = 4.594–10.416, P < 0.001), and family history of GC in first-degree relatives (OR = 4.291, 95% CI = 1.661–11.084, P = 0.003) were significantly correlated with the occurrence of GC. Subgroup analyses by age and gender indicated that GC risk was still increased in the presence of a history of stomach disease. A history of chronic gastritis, gastric ulcer, or gastric polyposis was positively associated with GC, with adjusted ORs of 4.155 (95% CI = 2.711–6.368), 1.839 (95% CI = 1.028–3.288), and 2.752 (95% CI = 1.197–6.326).

Conclusions:
Subjects who smoke, drink, with history of stomach disease and family history of GC in first-degree relatives are the high-risk populations for GC. Therefore, attention should be paid to these subjects for GC screening.
Concurrent Nab-paclitaxel and Radiotherapy
Authors: Arscott William T. , Nead Kevin T. , Bear Adham , Venigalla Sriram , Shabason Jacob , Lukens John N. , Plastaras John P. , Wojcieszynski Andrzej , Metz James , O’Hara Mark , Reiss Kim A. , Teitelbaum Ursina , Loaiza-Bonilla Arturo , Drebin Jeffrey , Lee Major K. , Shroff Stuti G. , Ben-Josef Edgar 
Published: July 2021

Purpose:
This study evaluates the toxicity and tumor response with concurrent nab-paclitaxel chemoradiotherapy (CRT) compared with standard (5-fluorouracil or gemcitabine) CRT.

Materials and Methods:
Fifty patients with borderline resectable or unresectable pancreatic adenocarcinoma from 2014 to 2017 were divided into 2 groups: concurrent nab-paclitaxel (100 to 125 mg/m2 weekly) CRT (median: 2.1 Gy fraction size and 52.5 Gy total) or standard CRT (median: 1.8 Gy fraction size, 54.5 Gy total). The primary endpoint was toxicity, and secondary endpoints were local failure and conversion to resectability. Comparisons were made using rank-sum or Fisher exact test and multivariable competing risk regression for the cumulative incidence of local failure.

Results:
There were 28 patients in the nab-paclitaxel CRT group and 22 in the standard CRT group; 88% had the unresectable disease. The median follow-up was 18 months. The median duration of chemotherapy before concurrent CRT was 1.9 and 2.3 months in the nab-paclitaxel and standard CRT groups (P=0.337), and radiotherapy dose was 52.5 Gy (range, 52.5 to 59.4 Gy) and 54.5 Gy (range, 45.0 to 59.4 Gy), respectively. There were no statistically significant grade ≥2 toxicities. The nab-paclitaxel CRT group experienced a nonstatistically significant lower incidence of local failure (hazard ratio=0.91, 95% confidence interval: 0.27-3.03, P=0.536). More patients in the nab-paclitaxel CRT group proceeded to surgery (9/28 compared with 3/22 in the standard CRT, P=0.186); of which 6 (25%) in the nab-paclitaxel CRT and 2 (10%) in the standard CRT groups were initially unresectable.

Conclusions:
Nab-paclitaxel CRT had similar toxicity compared with standard CRT in the treatment of borderline resectable or unresectable pancreatic cancer. Its use was associated with an arithmetically lower cumulative incidence of local failure and an arithmetically higher conversion to resectability, both of which were not statistically significant.
Bipolar Depression: A Historical Perspective of the Current Concept, with a Focus on Future Research
Authors: Martino Diego J. , Valerio Marina P. 
Published: July 2021

Abstract
The aim of this narrative review is to trace the origin of the concept of bipolar depression and to expose some of its limitations. Bipolar depression is a broad clinical construct including experiences ranging from traditional melancholic and psychotic episodes ascribed to “manic-depressive insanity,” to another heterogeneous group of depressive episodes originally described in the context of binary models of unipolar depression (e.g., psychogenic depression, neurotic depression). None of the available empirical evidence suggests, however, that these subsets of “bipolar” depression are equivalent in terms of clinical course, disability, family aggregation, and response to treatment, among other relevant diagnostic validators. Therefore, the validity of the current concept of bipolar depression should be a matter of concern. Here, we discuss some of the potential limitations that this broad construct might entail in terms of pathophysiological, clinical, and therapeutic aspects. Finally, we propose a clinical research program for bipolar depression in order to delimit diagnostic entities based on empirical data, with subsequent validation by laboratory or neuroimaging biomarkers. This process will then aid in the development of more specific treatments.
Empathy During Patient-Provider Interactions for Women With Chronic Pelvic Pain: A Qualitative Study
Authors: Kays Pamela 
Published: July 2021

Background:
Despite 25 years of evidence emphasizing problematic health care experiences for women with chronic pelvic pain and the benefits of clinical empathy and patient-centered care, negative patient-provider interactions for women with chronic pelvic pain persist.

Purpose:
The purpose of the current study was to investigate the lived experiences of patient-provider interactions from the perspective of women with chronic pelvic pain.

Subjects:
Thirteen women aged 18 to 65 years who had chronic pelvic pain for a minimum of 6 months and who had pursued medical consultation/care were included.

Materials/Methods:
This phenomenological qualitative study used semi-structured, in-depth interviews. A topic guide was used for interview questions and consisted of 5 semi-structured questions with probes, as necessary. Each participant was interviewed face-to-face and one-on-one, and interviews were audio-recorded. Qualitative data analysis software was used to manually code and analyze the data through thematic nodes using an open and inductive approach and constant comparison to facilitate interpretive phenomenological analysis.

Results:
Participants described negative patient-provider interactions during their health care encounters through patterns of health care provider behaviors and traits with a particular lack of empathy.

Conclusions:
These findings highlight the need for improved integration of research into health care provider education to develop empathetic patient-provider interactions. Provider effort to help may be a major component missing in negative patient-provider interactions for this population. Cultivating positive patient-provider interactions can advance best practices and ultimately result in the best care for women with chronic pelvic pain.
Coronavirus disease 2019 respiratory failure: what is the best supportive care for patients who require ICU admission?
Authors: Sweeney Daniel A. , Malhotra Atul 
Published: July 2021

Purpose of review
Currently, there is no cure for SARS-CoV-2 infection, yet hospital mortality rates for COVID-19 have improved over the course of the pandemic and may be due in part to improved supportive care in the ICU. This review highlights the evidence for and against various ICU supportive therapies for the treatment of critically ill patients with COVID-19.

Recent findings
Early in the pandemic, there was great interest in novel ICU supportive care, both for the benefit of the patient, and the safety of clinicians. With a few exceptions (e.g. prone ventilation of nonintubated patients), clinicians abandoned most of these approaches (e.g. early intubation, avoidance of high flow or noninvasive ventilation). Standard critical care measures, especially for the treatment of severe viral respiratory infection including acute respiratory distress syndrome (ARDS) were applied to patients with COVID-19 with apparent success.

Summary
In general, the COVID-19 pandemic reaffirmed the benefits of standard supportive care for respiratory failure and in particular, recent advances in ARDS treatment. Prone ventilation of nonintubated patients, an approach that was adopted early in the pandemic, is associated with improvement in oxygenation, but its impact on clinical outcome remains unclear. Otherwise, prone mechanical ventilation and avoidance of excessive tidal volumes, conservative fluid management, antibiotic stewardship and early evaluation for extracorporeal membrane oxygenation (ECMO) -- basic tenants of severe respiratory infections and ARDS care -- remain at the core of management of patients with severe COVID-19.