bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivery outcomes as a result of snoring as determined by standard sleep surveys
Authors: Robertson A , Makris A , Johnson P , Middleton S , Norman M , Sullivan C , Hennessy A 
Published: December 2021

Background Sleep-disordered breathing (SDB), is an umbrella term that encompasses obstructive sleep apnea (OSA), central sleep apnea (CSA) and hypoventilation. is common but studies in the pregnant population are limited. Data suggests relationships between OSA and preeclampsia, but the relationship between snoring and pregnancy outcomes is unknown. Methods A prospective study of 2224 singleton pregnancies was undertaken. Women were questioned using the Berlin Questionnaire (BQ- 2 or more categories where the score is positive.) and the Epworth Sleepiness Scale (ESS >10/24), the results compared with pregnancy outcomes with regard to hypertension in pregnancy. Results Women having symptoms raising the possibility of OSA defined by the BQ with a score >7 was 45.5%, and using ESS with a score >10, was 36%. The birth and neonatal outcomes for self-reported snoring and increased daytime sleepiness showed increased adverse outcomes notably increased caesarean section rates and low APGAR scores but not birth before 37 weeks of gestation. Conclusion Using questionnaires designed for the general population, the prevalence of possible undiagnosed OSA is high in the pregnant population. The increased adverse delivery and neonatal outcomes for self-reported snoring and increased daytime sleepiness with these tools indicated the need for further investigation of the links between snoring SDB and pregnancy outcomes.
Innovations in clinical documentation integrity practice: Continual adaptation in a data-intensive healthcare organisation
Authors: Pine Kathleen H , Landon Lee Anne , Bossen Claus , VanGelder ME 
Published: December 2021

Background Numbers of clinical documentation integrity specialists (CDIS) and CDI programs have increased rapidly. CDIS review patient records concurrently with patient admissions and visits to ensure that information is accurate, complete and non-ambiguous, and query clinicians when they see opportunities for improving data. The occupation was initially focused on improving data for reimbursement, but rapid changes to clinical coding requirements, technologies and payment systems led to a quickly evolving role for CDI programs and changes in CDIS practice. Objective This case study seeks to uncover the ongoing innovation and adaptation occurring in a CDI program by tracing the evolution of a single CDI program over time. Method We present a case study of the CDI program at the HonorHealth hospital system in Arizona. Results The HonorHealth CDI program holds a unique hybrid expertise and role within the healthcare organisation that allows it to rapidly adapt to support emergent demands both internal and external to the organisation, such as supporting accurate data collection for the COVID-19 pandemic. Conclusion CDIS are a vital component in present data-intensive resourcing efforts. The hybrid expertise of CDIS and capacity for adaption and relationship building has enabled the HonorHealth CDI program to adapt rapidly to meet a growing array of clinical documentation integrity needs, including emergent needs during the COVID-19 pandemic. Implications The HonorHealth case study can guide other CDI programs in adaptation of the CDI role and practices in response to changing organisational needs.
Nationalism and Siberian archeology of the 19th century
Authors: Ternov Nikolay , Mikhailov Dmitry 
Published: December 2021

The article provides a comparative characteristic of the nationally motivated ethnocultural concepts of the 19th century, based on the interpretation of Siberian peoples` history. Finnish nationalism was looking for the ancestral home of the Finns in Altai and tried to connect them with the Turkic-Mongol states of antiquity and the Middle Ages. Under the influence of the cultural and historical theories of regional experts, the Siberian national discourse itself began to form, which was especially clearly manifested in the example of the genesis of Altai nationalism. Russian great-power nationalism sought to make Slavic history more ancient and connected it with the prestigious Scythian culture. If we rely on the well-known periodization of the development of the national movement of M. Khrokh, then in the theory of the Finns` Altai origin, we can distinguish features characteristic of phase “B,” when the cultural capital of nationalism gradually turns into political. In turn, the historical research of the regional specialists illustrates the earliest stage in the emergence of the national movement, the period of nationalism not only without a nation but also without national intellectuals. The oblasts are forming the very national environment, which does not yet have the means for its own expression, but it obviously contains separatist potential. At the same time, both the Finnish and Siberian patriots, with their scientific research, solved the same ideological task—to include the objects of their research in the world cultural and historical context, to achieve recognition of their right to a place among European nations. However, Florinsky’s theory, performing the function of the official propaganda, is an example of the manifestation of state unifying nationalism, with imperial connotations characteristics of Russia.
Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case–control study)
Authors: Roble Abdurahman Kedir , Osman Mohamed Omar , Ibrahim Ahmed Mohamed , Wedajo Girma Tadesse , Abdi Usman Seid 
Published: December 2021

Objectives: A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020. Methods: A community-based unmatched case–control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3–5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval. Result: This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25–12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46–5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80–7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07–4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)) were identified as determinants of the short birth interval. Conclusion: Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.
Seeing no net loss: Making nature offset-able
Authors: Carver Louise 
Published: December 2021

Policies for biodiversity no net loss and net gain underwrite narratives for green growth through advancing reparative logics to ongoing habitat impacts. By enabling offsetting practices that risk accommodating rather than averting land change developments, net principles are said to resemble modes of ‘accumulation by environmental restoration’. Biodiversity net principles are frequently depicted visually as a diagram of the mitigation hierarchy for communicational ease and have proliferated over recent decades despite little evidence for their ecological effectiveness. This paper combines economic sociology, visual media analysis of the net diagram and political ecology to account for the stabilisation of net principles in policy frameworks. It highlights the upstream imaginative work that this visual tool and its wider assemblages perform to support offsetting and habitat banking practices on the ground. The paper positions the NNL diagram as a conceptual and ideational technology. It traces the practices through which biodiversity is rationalised by the Cartesian coordinates of an XY schematic, and en-framed as a measure of numerical value on a vertical scale. The effect is to engender coherence to the idea of netting out differences in aggregate sums of biodiversity unit value, making nature conceptually offset-able. I develop this account through a history of the diagram as well as the broader processes that have shaped the policy and its arrival in English planning frameworks. Observers increasingly question how biodiversity offsetting and no net loss/ net gain have become so popular when their empirical foundations are so weak. This paper proposes that within the wider assemblages of actors, one answer is located in the potency and mobility of conceptual technologies such as diagrams of no net loss or net gain of biodiversity and the logic of balance-sheet accounting that is imbricated within the visual design.
Prospective predictors of sustainment of multiple EBPs in a system-driven implementation context: Examining sustained delivery based on administrative claims
Authors: Lau Anna S. , Lind Teresa , Motamedi Mojdeh , Lui Joyce H. L. , Kuckertz Mary , Innes-Gomberg Debbie , Pesanti Keri , Brookman-Frazee Lauren 
Published: December 2021

Background System-driven scale-up of multiple evidence-based practices (EBPs) is an increasingly common method used in public mental health to improve care. However, there are little data on the long-term sustained delivery of EBPs within these efforts, and previous studies have relied on retrospective self-report within cross-sectional studies. This study identified prospective predictors of sustained EBP delivery at the EBP-, therapist-, and organizational-levels using survey and administrative claims data within a large-scale system-driven implementation effort. Methods 777 therapists and 162 program leaders delivering at least one of six EBPs of interest completed surveys assessing perceptions of EBPs and organizational context. These surveys were linked to administrative data to examine prospective predictors of therapists’ EBP delivery over 33 months. Results Five of the six EBPs implemented showed sustained delivery in the system, with volume varying by EBP. Although total EBP claim volume per therapist decreased over time, the volume ratio (ratio of EBP-specific claims to total EBP and non-EBP claims) stayed relatively stable. Multilevel models revealed that EBPs that required consultation, had unstructured content, higher therapist self-efficacy with the EBP, and more positive program leader perceptions of the EBP were associated with greater sustained volume and volume ratio of the EBP. Therapists who were trained in fewer EBPs, who were unlicensed, and who worked in agencies rated by program leaders as lower on organizational staff autonomy and stress showed greater sustained EBP volume and volume ratio. Finally, more direct service hours per week provided by therapist predicted greater sustained EBP volume, but lower volume ratio. Conclusions The results point to the importance of EBP, therapist, and organizational factors that may be targeted in implementation strategies to promote the sustainment of EBPs.
Endoscopic Removal of an Eroded LINX® Device Using a Mechanical Biliary Lithotriptor
Authors: Parker Brett C. , Dinary Fazel , Kumbhari Vivek , Louie Brian E. 
Published: December 2021

Background: Magnetic sphincter augmentation (MSA) via the surgical placement of a LINX® device (LINX® Reflux Management System, Torax Medical, Shoreview, MN, USA) is an increasingly performed minimally invasive outpatient anti-reflux procedure with a low erosion rate. The most common initial approach to eroded LINX® devices is endoscopic removal. Often endoscopy centers do not have specialized devices to cut through the newer, more durable LINX® systems. In this paper we describe a unique approach for removal of a LINX® with intraluminal erosion using a commonly stocked mechanical biliary lithotripsy device. Case description: A 63-year-old male with a history of GERD and symptomatic type III paraesophageal hernia (PEH) underwent a robotic PEH repair with magnetic sphincter augmentation (1.5T, 17 bead) at an outside hospital. He developed an acute recurrence of his PEH, and subsequent upper endoscopy and contrast esophagram four weeks postoperatively revealed a gastric erosion of the LINX device, which had migrated 6 cm onto the stomach. Attempted endoscopic LINX® removal using the OVESCO remove DC Cutter device was unsuccessful. Using principles of prior endoscopic bariatric lap band foreign body removal, the entire LINX® device was successfully removed with the described biliary lithotriptor technique. Conclusion: Using a common biliary mechanical lithotriptor device and a guidewire to transect the newer 1.5T LINX® Reflux Management System is a safe, effective and familiar technique for endoscopic removal of an eroded MSA device.
Sodium stibogluconate and CD47-SIRPα blockade overcome resistance of anti-CD20–opsonized B cells to neutrophil killing
Authors: van Rees Dieke J. , Brinkhaus Maximilian , Klein Bart , Verkuijlen Paul , Tool Anton T.J. , Schornagel Karin , Treffers Louise W. , van Houdt Michel , Kater Arnon P. , Vidarsson Gestur , Gennery Andrew R. , Kuijpers Taco W. , van Bruggen Robin , Matlung Hanke L. , van den Berg Timo K. 
Published: December 2021

AbstractAnti-CD20 antibodies such as rituximab are broadly used to treat B-cell malignancies. These antibodies can induce various effector functions, including immune cell-mediated antibody-dependent cellular cytotoxicity (ADCC). Neutrophils can induce ADCC toward solid cancer cells by trogoptosis, a cytotoxic mechanism known to be dependent on trogocytosis. However, neutrophils seem to be incapable of killing rituximab-opsonized B-cell lymphoma cells. Nevertheless, neutrophils do trogocytose rituximab-opsonized B-cell lymphoma cells, but this only reduces CD20 surface expression and is thought to render tumor cells therapeutically resistant to further rituximab-dependent destruction. Here, we demonstrate that resistance of B-cell lymphoma cells toward neutrophil killing can be overcome by a combination of CD47-SIRPα checkpoint blockade and sodium stibogluconate (SSG), an anti-leishmaniasis drug and documented inhibitor of the tyrosine phosphatase SHP-1. SSG enhanced neutrophil-mediated ADCC of solid tumor cells but enabled trogoptotic killing of B-cell lymphoma cells by turning trogocytosis from a mechanism that contributes to resistance into a cytotoxic anti-cancer mechanism. Tumor cell killing in the presence of SSG required both antibody opsonization of the target cells and disruption of CD47-SIRPα interactions. These results provide a more detailed understanding of the role of neutrophil trogocytosis in antibody-mediated destruction of B cells and clues on how to further optimize antibody therapy of B-cell malignancies.
Chronic lung allograft dysfunction phenotype and prognosis by machine learning CT analysis
Authors: McInnis Micheal C. , Ma Jin , Karur Gauri Rani , Houbois Christian , Levy Liran , Havlin Jan , Fuchs Eyal , Tikkanen Jussi , Chow Chung-Wai , Huszti Ella , Martinu Tereza 
Published: December 2021

BackgroundChronic lung allograft dysfunction (CLAD) is the principal cause of graft failure in lung transplant recipients and prognosis depends on CLAD phenotype. We used a machine learning computed tomography (CT) lung texture analysis tool at CLAD diagnosis for phenotyping and prognostication compared with radiologist scoring.MethodsThis retrospective study included all adult first double lung transplant patients (January 2010–December 2015) with CLAD (censored December 2019) and inspiratory CT near CLAD diagnosis. The machine learning tool quantified ground-glass opacity, reticulation, hyperlucent lung and pulmonary vessel volume (PVV). Two radiologists scored for ground-glass opacity, reticulation, consolidation, pleural effusion, air trapping and bronchiectasis. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of machine learning and radiologist for CLAD phenotype. Multivariable Cox proportional hazards regression analysis for allograft survival controlled for age, sex, native lung disease, cytomegalovirus serostatus and CLAD phenotype.Results88 patients were included (57 bronchiolitis obliterans syndrome (BOS), 20 restrictive allograft syndrome (RAS)/mixed and 11 unclassified/undefined) with CT a median 9.5 days from CLAD onset. Radiologist and machine learning parameters phenotyped RAS/mixed with PVV as the strongest indicator (area under the curve (AUC) 0.85). Machine learning hyperlucent lung phenotyped BOS using only inspiratory CT (AUC 0.76). Radiologist and machine learning parameters predicted graft failure in the multivariable analysis, best with PVV (hazard ratio 1.23, 95% CI 1.05–1.44; p=0.01).ConclusionsMachine learning discriminated between CLAD phenotypes on CT. Both radiologist and machine learning scoring were associated with graft failure, independent of CLAD phenotype. PVV, unique to machine learning, was the strongest in phenotyping and prognostication.
Impact of hepatopulmonary syndrome in liver transplantation candidates and the role of angiogenesis
Authors: Kawut Steven M. , Krowka Michael J. , Forde Kimberly A. , Al-Naamani Nadine , Krok Karen L. , Patel Mamta , Bartoli Carlo R. , Doyle Margaret , Moutchia Jude , Lin Grace , Oh Jae K. , Mottram Carl D. , Scanlon Paul D. , Fallon Michael B. 
Published: December 2021

BackgroundHepatopulmonary syndrome affects 10–30% of patients with cirrhosis and portal hypertension. We evaluated the serum angiogenic profile of hepatopulmonary syndrome and assessed the clinical impact of hepatopulmonary syndrome in patients evaluated for liver transplantation.MethodsThe Pulmonary Vascular Complications of Liver Disease 2 study was a multicentre, prospective cohort study of adults undergoing their first liver transplantation evaluation. Hepatopulmonary syndrome was defined as an alveolar–arterial oxygen gradient ≥15 mmHg (≥20 mmHg if age >64 years), positive contrast-enhanced transthoracic echocardiography and absence of lung disease.ResultsWe included 85 patients with hepatopulmonary syndrome and 146 patients without hepatopulmonary syndrome. Patients with hepatopulmonary syndrome had more complications of portal hypertension and slightly higher Model for End-Stage Liver Disease-Na score compared to those without hepatopulmonary syndrome (median (interquartile range) 15 (12–19)versus14 (10–17), p=0.006). Hepatopulmonary syndrome patients had significantly lower 6-min walk distance and worse functional class. Hepatopulmonary syndrome patients had higher circulating angiopoietin 2, Tie2, tenascin C, tyrosine protein kinase Kit (c-Kit), vascular cell adhesion molecule 1 and von Willebrand factor levels, and lower E-selectin levels. Patients with hepatopulmonary syndrome had an increased risk of death (hazard ratio 1.80, 95% CI 1.03–3.16, p=0.04), which persisted despite adjustment for covariates (hazard ratio 1.79, 95% CI 1.02–3.15, p=0.04). This association did not vary based on levels of oxygenation, reflecting the severity of hepatopulmonary syndrome.ConclusionHepatopulmonary syndrome was associated with a profile of abnormal systemic angiogenesis, worse exercise and functional capacity, and an overall increased risk of death.
Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study
Authors: FitzMaurice Thomas Simon , McCann Caroline , Nazareth Dilip S. , Walshaw Martin J. 
Published: December 2021

ObjectivesDynamic chest radiography (DCR) is a novel real-time digital fluoroscopic imaging system that produces clear, wide field-of-view diagnostic images of the thorax and diaphragm in motion, alongside novel metrics on moving structures within the thoracic cavity. We describe the use of DCR in the measurement of diaphragm motion in a pilot series of cases of suspected diaphragm dysfunction.MethodsWe studied 21 patients referred for assessment of diaphragm function due to suspicious clinical symptoms or imaging (breathlessness, orthopnoea, reduced exercise tolerance and/or an elevated hemidiaphragm on plain chest radiograph). All underwent DCR with voluntary sniff manoeuvres.ResultsParadoxical motion on sniffing was observed in 14 patients, and confirmed in six who also underwent fluoroscopy or ultrasound. In four patients, DCR showed reduced hemidiaphragm excursion, but no paradoxical motion; in three, normal bilateral diaphragm motion was demonstrated. DCR was quick to perform, and well tolerated in all cases and with no adverse events reported. DCR was achieved in ∼5 min per patient, with images available to view by the clinician immediately within the clinical setting.ConclusionDCR is a rapid, well-tolerated and straightforward chest radiography technique that warrants further investigation in the assessment of diaphragm dysfunction.
Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials
Authors: Kumar Jogender , Kumar Prawin , Goyal Jagdish Prasad , Thakur Chirag , Choudhary Puja , Meena Jitendra , Charan Jaykaran , Singh Kuldeep , Gupta Atul 
Published: December 2021

BackgroundThere is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesise the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.MethodsWe searched electronic databases (Medline, Embase and Web of Science) and a register (CENTRAL) for randomised controlled trials (RCTs) published until 30 September 2021. RCTs enrolling asthmatic children (1–18 years old) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits or hospitalisation). We used the Risk of Bias 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the level of certainty of the evidence.Results18 RCTs (1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (six studies with 445 participants; risk ratio (RR) 1.13, 95% CI 0.86–1.48; I2=0%) (moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials with 1132 participants; RR 0.84, 95% CI 0.65–1.09; I2=58%) (very low-certainty evidence). Vitamin D does not reduce the need for emergency visits (three studies with 361 participants; RR 0.97, 95% CI 0.89–1.07; I2=0%) and hospitalisation (RR: 1.38, 95% CI 0.52–3.66; I2=0%) (low-certainty evidence).ConclusionVery low- to moderate-certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.