bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elucidating measures of systemic racism to mitigate racial disparities in kidney transplantation
Authors: Wilson Elena M. , Chen Andy , Johnson Morgan , Perkins Jamilah A. , Purnell Tanjala S. 
Published: August 2021

Purpose of review
Given recent national attention to the role of racism in perpetuating racial inequities in society and health, this review provides a timely and relevant summary of key measures of systemic racism in kidney transplantation. More specifically, the review identifies current and promising interventions, whereas highlighting the need for more sustainable and impactful interventions.

Recent findings
Racial disparities persist in kidney transplantation. Black and Hispanic individuals are less likely to receive a kidney transplant than non-Hispanic Whites despite disproportionately higher rates of kidney failure. Studies demonstrate that socioeconomic factors do not fully explain existing racial disparities in transplantation. Systemic racism at all levels, individual, interpersonal, institutional, and structural, is at the core of racial disparities, and current interventions are insufficient in mitigating their effects. Thus, targeted and sustainable interventions must be implemented to mitigate systemic racism in kidney transplantation.

Summary
Systemic racism in all its forms continues to influence disparities at all stages of kidney transplantation. This paper highlights recent findings that shed light on how racism contributes to racial disparities in kidney transplantation. Using these findings to identify targets and strategies for mitigation, relevant interventions and policies that show promise are detailed.
Correction of Psycho-Emotional Status Using Neuromuscular Relaxation of the Face
Authors: Dubinskaya Anastasia D. , Yurova Olga V. , Fesyun Anatoliy D. , Kukshina Anastasia A. 
Published: August 2021

Abstract
This article is relevant, as most healthy women face the problem of increased facial muscle tone. The purpose of the study was to investigate current problems of the relationship between tonic activity of the facial muscles and psycho-emotional states. The study included a group of 151 women subjected to psychological testing. According to its results, they were randomized into five study groups depending on sex and age. The frequency and severity of psycho-emotional states and parameters of tonic activity of the facial muscles were studied. Currently accepted methods for the correction of psycho-emotional states based on the feedback mechanism were analyzed. The efficacy of myofascial facial massage as an instrument for psychological status correction was evaluated. The long-term effects of various massage techniques aimed at facial muscle relaxation on the psycho-emotional state were established. The most effective tools for muscle tone correction were proposed for psycho-emotional status correction.
Diagnostic Capability of a New Objective Method to Assess Meibomian Gland Visibility
Authors: García-Marqués José Vicente , García-Lázaro Santiago , Talens-Estarelles Cristian , Martínez-Albert Noelia , Cerviño Alejandro 
Published: August 2021

SIGNIFICANCE
The diagnosis of dry eye disease and meibomian gland dysfunction (MGD) is challenging. Measuring meibomian gland visibility may provide an additional objective method to diagnose MGD.

PURPOSE
This study aimed to evaluate the ability of new metrics to better diagnose MGD, based on measuring meibomian gland visibility.

METHODS
One hundred twelve healthy volunteers (age, 48.3 ± 27.5 years) were enrolled in this study. Ocular surface parameters were measured using the Oculus Keratograph 5M (Oculus GmbH, Wetzlar). Subjects were classified according to the presence or absence of MGD. New metrics based on the visibility of the meibomian glands were calculated and later compared between groups. The diagnostic ability of ocular surface parameters and gland visibility metrics was studied through receiver operating characteristic curves. Logistic regression was used to obtain the combined receiver operating characteristic curve of the metrics with the best diagnostic ability.

RESULTS
Statistically significant differences were found between groups for all ocular surface parameters and new gland visibility metrics, except for the first noninvasive keratograph breakup time and gland expressibility. New gland visibility metrics showed higher sensitivity and specificity than did current single metrics when their diagnostic ability was assessed without any combination. The diagnostic capability increased when gland visibility metrics were incorporated into the logistic regression analysis together with gland dropout percentage, tear meniscus height, dry eye symptoms, and lid margin abnormality score (P < .001). The combination of median pixel intensity of meibography gray values and the aforementioned ocular surface metrics achieved the highest area under the curve (0.99), along with excellent sensitivity (1.00) and specificity (0.93).

CONCLUSIONS
New meibomian gland visibility metrics are more powerful to diagnose MGD than current single metrics and can serve as a complementary tool for supporting the diagnosis of MGD.
Association between radicular low back pain and constipation: a retrospective cohort study using a real-world national database
Authors: Trager Robert James , Mok Shaffer R.S. , Schlick Kayla J. , Perez Jaime A. , Dusek Jeffery A. 
Published: August 2021

Abstract

Introduction:
Previous observational studies have reported an association between lumbosacral radiculopathy (LSR), a form of low back pain (LBP) with nerve root involvement, and constipation. However, it is unclear whether this association is due to confounding variables such as comorbidities and medications.

Objectives:
This study explores the possible association between LSR and constipation, with the hypothesis that adults with LSR have increased odds of developing constipation compared with those with nonradicular LBP.

Methods:
Adults aged 18 to 49 years with incident LSR and nonradicular LBP were identified from a national 70 million patient electronic health records network (TriNetX). Propensity score matching (PSM) was used to control for covariates and determine the odds ratio (OR) of constipation over a 1-year follow-up. Lumbar stenosis, cauda equina syndrome, and inflammatory bowel diseases were excluded.

Results:
After PSM, 503,062 patients were in each cohort. Before PSM, the likelihood of constipation was identical between cohorts (LSR 10.8% vs 10.9%; OR [confidence interval] = 0.99 [0.98-1.0], P = 0.251). This association was unchanged after PSM (LSR 10.8% vs 11.1%; OR [confidence interval] = 0.98 [0.97-0.99]; P = 0.003).

Conclusions:
The study hypothesis can be refuted given that the OR approximated the null in a large propensity-matched sample. Patients with LSR have equivalent odds of constipation compared with those with nonradicular LBP, suggesting that LSR is not a direct cause of constipation. The similar risk of constipation between cohorts could be explained by factors common to LBP in general, such as pain severity, physical inactivity, and constipating medications.
Examining the Relationship Between the Lean Management System and Quality Improvement Care Management Processes
Authors: Tierney Aaron A. , Shortell Stephen M. , Rundall Thomas G. , Blodgett Janet C. , Reponen Elina 
Published: August 2021

Background and Objectives:
The United States has an underperforming health care system on both cost and quality criteria in comparison with other developed countries. One approach to improving system performance on both cost and quality is to use the Lean Management System based on the Shingo principles originally developed by Toyota in Japan. Our objective was to examine the association between hospital use of the Lean Management System and evidence-based or recommended quality improvement care management processes.

Methods:
A cross-sectional analysis of data from 223 hospitals that responded to both the 2017 National Survey of Healthcare Organizations and Systems and the 2017 National Survey of Lean/Transformational Performance Improvement in Hospitals was conducted.

Results:
Controlling for hospital organizational and market characteristics, the number of years using Lean was positively associated with use of electronic health record–based decision support, use of quality-focused information management, use of evidence-based guidelines, and support for care transitions at the P < .05 level. The degree of education and training in Lean methods and processes was also positively associated (P < .05) with greater support for care transitions. The number of years using Lean was marginally associated with screening for clinical conditions at the P < .10 level. There was an unexpected negative association between education and training scores and screening for clinical conditions.

Conclusions:
Greater experience in using the Lean Management System is positively associated with several evidence-based and/or recommended quality improvement care management processes.
Anatomical Study of Ethmoidal Foramina and Optic Canal in Endoscopic Trans-Nasal Approach to Anterior Skull Base
Authors: Cheng Ye , Song Gang , Cao Jun , Bai Jie , Wang Xu , Zhang Lei , Tang Jie , Xiao Xinru 
Published: August 2021

Background:Surgery to anterior skull base is challenging since complex structures are involved. Injury of olfactory fila and optic nerve may result in postoperative complications. In our study, the authors aim to use computer topographic image to provide a comprehensive anatomical information of anterior skull base and set up a new classification of optic canal (OC) in ethmoid sinus by the degree of bony defect, so as to help surgeons in endoscopic transnasal approach to anterior skull base.Method:Computer topographic angiography images of 112 individuals were reviewed, the measurement was performed on coronal, sagittal, and axis planes after the multiplanar reformation. Nostril and mid-sagittal lines were used to locate the anterior, middle, and posterior part of ethmoidal foramina and orbital opening of OC. Further, the authors classified OC in ethmoidal sinus into 4 types by the degree of the bony defect.Result:Distance between nostril to anterior, middle, and posterior part of ethmoidal foramina and OC are 6.23 ± 0.21, 6.62 ± 0.26, 7.29 ± 0.25, and 7.76 ± 0.41 mm, respectively. Angle between line from nostril to ethmoidal foramina and horizontal plane are 47.50° ± 1.03°, 41.67° ± 1.33°, 37.20° ± 1.34°, respectively. For the 4 types of OC, the percentage is 15.6%, 11.6%, 31.3%, and 41.5%, respectively.Conclusions:Our findings provide anatomical information of ethmoidal foramina and OC during endoscopic transnasal approach to anterior skull base, on the basis of some fixed anatomical landmarks. So as to enhance the surgical safety of this procedure and aid in the choice of the appropriate endoscopic equipment for the procedure.
Reporting on Race and Racial Disparities in Breast Cancer
Authors: Loehrer Andrew P. , Cevallos Priscila C. , Jiménez Rafael T. , Wong Sandra L. 
Published: August 2021

Objective:
This study reviews the surgical literature on racial disparities in breast cancer mortality, specifically evaluating the inclusion, justification, and discussion of race and ethnicity as a driver of disparities.

Summary of Background Data:
The volume of research on racial disparities has increased over the past 2 decades, but we hypothesize that there is considerable variation in how race is contextualized, defined, and captured in the disparities literature, leading to its questionable validity and relevance as a covariate. Recent guidelines for reporting have been suggested, but not yet applied.

Methods:
A rubric was developed to evaluate the reporting of race and/or ethnicity. A systematic review (2010-2020) was performed to identify studies reporting on racial disparities in breast cancer surgery and mortality. We then evaluated these original articles based on key domains of race and/or ethnicity: justification for inclusion, formal definition, methodology used for classification, and type of racism contributing to disparity.

Results:
Of the 52 studies assessed, none provided a formal definition for race and/or ethnicity. A justification for the inclusion of race and/or ethnicity was provided in 71% of the studies. Although 81% of studies discussed at least 1 potential driver of observed racial disparities, only 1 study explicitly named racism as a driver of racial disparities.

Conclusions:
Significant improvement in the reporting on racial disparities in breast cancer surgical literature is warranted. A more rigorous framework should be applied by both researchers and publishers in reporting on race, racial health disparities, and racism.
High-risk Opioid Prescribing Associated with Postoperative New Persistent Opioid Use in Adolescents and Young Adults
Authors: Vargas Gracia M. , Gunaseelan Vidhya , Upp Lily , Deans Katherine J. , Minneci Peter C. , Gadepalli Samir K. , Englesbe Michael J. , Waljee Jennifer F. , Harbaugh Calista M. 
Published: August 2021

Objective:
In this study, we explored which postoperative opioid prescribing practices were associated with persistent opioid use among adolescents and young adults.

Background:
Approximately 5% of adolescents and young adults develop postoperative new persistent opioid use. The impact of physician prescribing practices on persistent use among young patients is unknown.

Methods:
We identified opioid-naïve patients aged 13 to 21 who underwent 1 of 13 procedures (2008–2016) and filled a perioperative opioid prescription using commercial insurance claims (Optum Deidentified Clinformatics Data Mart Database). Persistent use was defined as ≥ 1 opioid prescription fill 91 to 180 days after surgery. High-risk opioid prescribing included overlapping opioid prescriptions, co-prescribed benzodiazepines, high daily prescribed dosage, long-acting formulations, and multiple prescribers. Logistic regression modeled persistent use as a function of exposure to high-risk prescribing, adjusted for patient demographics, procedure, and comorbidities.

Results:
High-risk opioid prescribing practices increased from 34.9% to 43.5% over the study period; the largest increase was in co-prescribed benzodiazepines (24.1%–33.4%). High-risk opioid prescribing was associated with persistent use (aOR 1.235 [1.12,1.36]). Receipt of prescriptions from multiple opioid prescribers was individually associated with persistent use (aOR 1.288 [1.16,1.44]). The majority of opioid prescriptions to patients with persistent use beyond the postoperative period were from nonsurgical prescribers (79.6%).

Conclusions:
High-risk opioid prescribing practices, particularly receiving prescriptions from multiple prescribers across specialties, were associated with a significant increase in adolescent and young adult patients’ risk of persistent opioid use. Prescription drug monitoring programs may help identify young patients at risk of persistent opioid use.
The Trauma Dyad: The Role of Informal Caregivers for Older Adults After Traumatic Injury
Authors: Sokas Claire M. , Bollens-Lund Evan , Husain Mohammed , Ornstein Katherine A. , Kelly Masami T. , Sheu Christina , Kerr Emma , Jarman Molly , Salim Ali , Kelley Amy S. , Cooper Zara 
Published: August 2021

Objective:
To investigate the association between higher injury severity and increased informal caregiving received by injured older adults.

Summary of Background Data:
Injured older adults experience high rates of functional decline and disability after hospitalization. Little is known about the scope of caregiving received post-discharge, particularly from informal caregivers such as family.

Methods:
We used the National Health and Aging Trends Study 2011 to 2018 linked to Medicare claims to identify adults ≥65 with hospital admission for traumatic injury and a National Health and Aging Trends Study interview within 12 months pre- and post-trauma. Injury severity was assessed using the injury severity score (ISS, low 0–9; moderate 10–15; severe 16–75). Patients reported the types and hours of formal and informal help received and any unmet care needs. Multi variable logistic regression models examined the association between ISS and increase in informal caregiving hours after discharge.

Results:
We identified 430 trauma patients. Most were female (67.7%), non-Hispanic White (83.4%) and half were frail. The most common mechanism of injury was fall (80.8%) and median injury severity was low (ISS = 9). Those reporting receiving help with any activity increased post-trauma (49.0% to 72.4%, P < 0.01), and unmet needs nearly doubled (22.8% to 43.0%, P < 0.01). Patients had a median of 2 caregivers and most (75.6%) were informal, often family members. Median weekly hours of care received pre- versus post-injury increased from 8 to 14 (P < 0.01). ISS did not independently predict increase in caregiving hours; pre-trauma frailty predicted an increase in hours ≥8 per week.

Conclusions:
Injured older adults reported high baseline care needs which increased significantly after hospital discharge and were mostly met by informal caregivers. Injury was associated with increased need for assistance and unmet needs regardless of injury severity. These results can help set expectations for caregivers and facilitate post-acute care transitions.
Updates in treatment of depression in children and adolescents
Authors: Hazell Philip 
Published: August 2021

Purpose of review
To examine recent evidence that informs the treatment of depression in children and adolescents.

Recent findings
There are no new leads in the prevention and early intervention of depression in children and adolescents. For acute treatment of major depressive disorder, talking therapies are moving increasingly to internet-based platforms. Family therapy may have a slight edge over individual psychotherapy in the short-term. Patients with severe depression with endogenous features have a more robust response to pharmacotherapy than do patients with mild-to-moderate depression. Findings in relation to reward sensitivity and changes in brain-derived neurotrophic factor levels contradict research conducted in adults, suggesting developmental differences in the mechanisms underlying depression. Ketamine infusion could have a role for adolescents with treatment refractory depression. There was no new evidence concerning relapse prevention.

Summary
Most new findings have been concerned with moderators and mediators of treatment.
Director alignment at the nematic–isotropic interface: elastic anisotropy and active anchoring
Authors: Coelho Rodrigo C. V. , Araújo Nuno A. M. , Telo da Gama Margarida M. 
Published: August 2021

Activity in nematics drives interfacial flows that lead to preferential alignment that is tangential or planar for extensile systems (pushers) and perpendicular or homeotropic for contractile ones (pullers). This alignment is known as active anchoring and has been reported for a number of systems and described using active nematic hydrodynamic theories. The latter are based on the one-elastic constant approximation, i.e. they assume elastic isotropy of the underlying passive nematic. Real nematics, however, have different elastic constants, which lead to interfacial anchoring. In this paper, we consider elastic anisotropy in multiphase and multicomponent hydrodynamic models of active nematics and investigate the competition between the interfacial alignment driven by the elastic anisotropy of the passive nematic and the active anchoring. We start by considering systems with translational invariance to analyse the alignment at flat interfaces and, then, consider two-dimensional systems and active nematic droplets. We investigate the competition of the two types of anchoring over a wide range of the other parameters that characterize the system. The results of the simulations reveal that the active anchoring dominates except at very low activities, when the interfaces are static. In addition, we found that the elastic anisotropy does not affect the dynamics but changes the active length that becomes anisotropic.
This article is part of the theme issue ‘Progress in mesoscale methods for fluid dynamics simulation’.
A fast and efficient deep learning procedure for tracking droplet motion in dense microfluidic emulsions
Authors: Durve Mihir , Bonaccorso Fabio , Montessori Andrea , Lauricella Marco , Tiribocchi Adriano , Succi Sauro 
Published: August 2021

We present a deep learning-based object detection and object tracking algorithm to study droplet motion in dense microfluidic emulsions. The deep learning procedure is shown to correctly predict the droplets’ shape and track their motion at competitive rates as compared to standard clustering algorithms, even in the presence of significant deformations. The deep learning technique and tool developed in this work could be used for the general study of the dynamics of biological agents in fluid systems, such as moving cells and self-propelled microorganisms in complex biological flows.
This article is part of the theme issue ‘Progress in mesoscale methods for fluid dynamics simulation’.
Prelacteal Feeding and Associated Factors among Mothers of Infants Aged 6 to 12 Months in Chitwan District, Nepal: A Community Based Cross-sectional Study
Authors: Neupane Mani , Dhungana Govinda Prasad , Sharma Bimala , Paudel Dhirendra 
Published: August 2021

ABSTRACTBackgroundA Prelacteal feed is any food except mothers’ milk provided to a newborn before breastfeeding is established. Prelacteal feeding is a major barrier to exclusive breastfeeding and is associated with newborn infection. It is a prevalent practice in Nepal. This study aimed to investigate prelacteal feeding practice and associated factors among mothers of infants aged 6 to 12 months in Chitwan district, Nepal.MethodsA community-based cross-sectional study was conducted. 297 mothers of infants aged 6 to 12 months were selected using a systematic random sampling technique. Descriptive statistics, univariate and binomial logistic regression analysis were done to identify the factors associated with prelacteal feeding practice. Variable with a p-value <0.05 were identified as statistically significant factors.ResultThe prevalence of prelacteal feeding was 40.1% (95% CI: 34.5%-45.7%). Formula milk (n=109), animal milk (n=13), Plain water (n=6) were some of the types of prelacteal feed reported. Respondents in the 25-29 years age group were about 58.2% less likely to practice prelacteal feeding (adjusted odds ratio (AOR)=0.415, 95% confidence interval (CI):0.209-0.837) as compared to the respondents belonging to 35 years or more age group. Economic status was another factor associated with prelacteal feeding practice. Those mothers with poorer economic status were about 57.9 % (AOR= 0.421, CI: 0.179-0.992) less likely to practice prelacteal feeding than the mothers belonging to the richest. Similarly, mothers having poor knowledge on prelacteal feeding were found about three (AOR= 2.661, CI: 1.514-4.674) times more likely to have prelacteal feeding than those mothers who had good knowledge about prelacteal feeding. Home delivery and caesarean section in case of institutional delivery were two major reasons stated for providing prelacteal feeding.ConclusionPrelacteal feeding was commonly practiced in the Chitwan district, Nepal. Mother’s age, economic status, mothers’ knowledge of prelacteal feeding practices, and mode of delivery were factors associated with prelacteal feeding practices. Therefore, awareness and knowledge on the risk associated with prelacteal feeding, promotion of institutional delivery, timely initiation of breastfeeding, and avoidance of prelacteal feeding are important measures for preventing prelacteal feeding practices in Chitwan district, Nepal.