bluuebunny/crossref_metadata_2025_split huggingface dataset:
High rates of anticoagulant rodenticide exposure in California Barred Owls are associated with the wildland–urban interface
Authors: Hofstadter Daniel F , Kryshak Nicholas F , Gabriel Mourad W , Wood Connor M , Wengert Greta M , Dotters Brian P , Roberts Kevin N , Fountain Emily D , Kelly Kevin G , Keane John J , Whitmore Sheila A , Berigan William J , Peery M Zachariah 
Published: June 2021

Abstract
Pesticide use is pervasive and the exposure of non-target wildlife has been well documented over the past half-century. Among pesticides, anticoagulant rodenticides (AR) have emerged as a particularly important threat in forests of the western United States, with exposure and mortality reported for several species of conservation concern. To further quantify this threat, we collected specimens of Barred Owls (Strix varia) and Barred Owl x Spotted Owl hybrids from the Klamath and Cascade Mountains and Sierra Nevada in California, USA to use as indicator species for environmental contamination with AR and to infer exposure of closely related and ecologically similar Northern and California Spotted Owls (S. occidentalis caurina, and S. o. occidentalis, respectively). We tested 115 Barred Owl and 12 Barred Owl x Spotted Owl hybrid livers for 8 AR compounds and found high rates of exposure (62%) across our study area, and greater than previous studies in the Pacific Northwest. In addition, we sampled 7 ovaries from 7 females and 100% tested positive for AR. Female Barred Owls were more likely than males to be exposed (78% and 50%, respectively). Unlike previous studies, we found no clear link between illegal cannabis cultivation and AR exposure. However, Barred Owls sampled in proximity to the wildland–urban interface (WUI) were more likely to be exposed to AR. Though the exact source (e.g., cannabis cultivation or application around human dwellings) and location are unknown, the association of AR exposure with the WUI was supported from GPS data from Barred Owls, Northern and California Spotted Owls, and hybrids using the WUI for foraging. The high rate of AR exposure in Barred Owls and hybrids provides mounting evidence of an additional stressor that ARs may pose to Spotted Owls—including the first evidence for California Spotted Owls—and fauna native to western forest ecosystems.
Creditor Control of Corporate Acquisitions
Authors: Becher David A , Griffin Thomas P , Nini Greg 
Published: June 2021

Abstract
We examine the impact of creditor control rights on corporate acquisitions. Nearly 75$\%$ of loan agreements include restrictions that limit borrower acquisition decisions throughout the life of the contract. Following a financial covenant violation, creditors use their bargaining power to tighten these restrictions and limit acquisition activity, particularly deals expected to earn negative announcement returns. Firms that do announce an acquisition after violating a financial covenant earn 1.8$\%$ higher stock returns, on average, and do not pursue less risky deals. We conclude that creditors use contractual rights and the renegotiation process to limit value-destroying acquisitions driven by managerial agency problems.
Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders?
Authors: Sagaspe Patricia , Micoulaud-Franchi Jean-Arthur , Bioulac Stéphanie , Taillard Jacques , Guichard Kelly , Bonhomme Emilien , Dauvilliers Yves , Bastien Célyne H , Philip Pierre 
Published: June 2021

Abstract

Study Objectives
To determine whether the feeling of having slept or not during the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleep-related traffic near misses and accidents in patients with sleep disorders.

Methods
This study was conducted in patients hospitalized in a French sleep center to perform a 4 × 40 min MWT. Relationship between mean sleep latency on the MWT, feeling of having slept or not during MWT trials and sleep-related near misses and accidents reported during the past year was analyzed.

Results
One hundred and ninety-two patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome were included. One hundred and sixty-five patients presented no or one misjudgment of feeling of having slept during MWT trials while 27 presented more than two misjudgments. Almost half of the latter (48.1%) reported a sleepiness-related traffic near miss or accident in the past year versus only one third (27.9%) for the former (p &lt; 0.05). Multivariate logistic regression showed that patients with more than two misjudgments had a 2.52-fold (95% CI, 1.07–5.95, p &lt; 0.05) increase in the risk of reporting a sleepiness-related near miss/accident.

Conclusions
Misjudgment in self-perceived sleep during the MWT is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents in the past year in patients suffering from sleep disorders. Asking about the perception of the occurrence of sleep during the MWT could be used to improve driving risk assessment in addition to sleep latencies.
Maintaining constants amongst variable factors: the challenge of equitable accounting in the property context
Authors: Chung Benny , Yeon Thomas 
Published: June 2021

Abstract
Cheung Lai Mui v Cheung Wai Shing and Ors is a recent Hong Kong Court of Final Appeal judgment which concerns a family feud over the ownership of properties. In this article, we will focus on the part of the judgment which concerns the issue of equitable accounting. Although this judgment did not break new legal ground, we believe that it has several important implications which warrant attention. We will first unpack and explain the judgment and supplement the discussions with the relevant legal principles and concepts. We will then discuss the judgment’s implications for cases involving equitable accounting and where courts are given the option to exercise wide, flexible discretionary powers.
Comparative Analysis of Cortical Auditory Evoked Potential in Cochlear Implant Users
Authors: Távora-Vieira Dayse , Mandruzzato Giacomo , Polak Marek , Truong Belinda , Stutley Alex 
Published: June 2021

Objectives:
The primary goal of the study was to investigate electrical cortical auditory evoked potentials (eCAEPs) at maximum comfortable level (MCL) and 50% MCL on three cochlear implant (CI) electrodes and compare them with the acoustic CAEP (aCAEPs), in terms of the amplitude and latency of the P1–N1–P2 complex. This was achieved by comparing the eCAEP obtained with the method described and stimulating single electrodes, via the fitting software spanning the cochlear array and the aCAEP obtained using the HEARLab system at four speech tokens.

Design:
Twenty MED-EL (MED-EL Medical Electronics, Innsbruck, Austria) CI adult users were tested. CAEP recording with HEARLab System was performed with speech tokens /m/, /g/, /t/, and /s/ in free field, presented at 55 dB SPL. eCAEPs were recorded with an Evoked Potential device triggered from the MAX Programming Interface (MED-EL Medical Devices) with 70 msec electrical burst at 0.9 Hz at the apical (1), middle (6), and basal (10 or 11) CI electrode at their MCL and 50% MCL.

Results:
CAEP responses were recorded in 100% of the test subjects for the speech token /t/, 95% for the speech tokens /g/ and /s/, and 90% for the speech token /m/. For eCAEP recordings, in all subjects, it was possible to identify N1 and P2 peaks when stimulating the apical and middle electrodes. This incidence of detection decreased to an 85% chance of stimulation at 50% MCL on the same electrodes. A P1 peak was less evident for all electrodes. There was an overall increase in latency for stimulation at 50% MCL compared with MCL. There was a significant difference in the amplitude of adjacent peaks (P1–N1 and N1–P2) for 50% MCL compared with MCL. The mean of the maximum cross-correlation values were in the range of 0.63 to 0.68 for the four speech tokens. The distribution of the calculated time shift, where the maximum of the cross-correlation was found, was distributed between the speech tokens. The speech token /g/ had the highest number of valid cross-correlations, while the speech token /s/ had the lowest number.

Conclusions:
This study successfully compared aCAEP and eCAEP in CI users. Both acoustic and electrical P1–N1–P2 recordings obtained were clear and reliable, with good correlation. Latency increased with decreasing stimulation level, while amplitude decreased. eCAEP is potentially a better option to verify speech detection at the cortical level because it (1) uses direct stimulation and therefore creates less interference and delay of the sound processor and (2) creates more flexibility with the recording setup and stimulation setting. As such, eCAEP is an alternative method for CI optimization.
Coronavirus disease 2019: update on coronavirus disease 2019 outcomes and vaccine efficacy in patients with immune-mediated inflammatory disease
Authors: Sparks Jeffrey A. , Wallace Zachary S. , Robinson Philip C. 
Published: June 2021

Purpose of review
Although the literature to date on COVID-19 outcomes in those with immune-mediated inflammatory disease has been largely reassuring there remain many unanswered questions. These include the impact of specific medications on outcomes and the antibody response after COVID-19 vaccination.

Recent findings
We summarized the current literature related to COVID-19 outcomes in immune-mediated inflammatory diseases in rheumatology, gastroenterology, dermatology, and neurology. Overall, we found either no difference or modest differences in risk for severe COVID-19 for people with immune-mediated diseases compared with the general population. When considering disease-specific factors, glucocorticoid use and underlying immune-mediated disease activity were generally associated with worse outcomes. Specific medications varied in associations: tumor necrosis factor inhibitors generally had lower odds for severe COVID-19 outcomes, whereas rituximab use generally had higher odds for severe outcomes. We also detailed the recent reports of antibody response to COVID-19 vaccination in people with immune-mediated inflammatory diseases.

Summary
Investigations of immune-mediated inflammatory diseases across several organ systems have offered important insight into the COVID-19 disease course. Overall, these studies have provided reassurance to patients and clinicians while also identifying groups who may be at higher risk for poor outcomes.
Are Orthopaedic Trauma Surgeons Adequately Compensated for Longer Procedures? An Analysis of Relative Value Units and Operative Times From the American College of Surgeons National Surgical Quality Improvement Program Database
Authors: Simcox Trevor , Becker Jacob , Kreinces Jason , Islam Shahidul , Grossman Mark , Gould Jason 
Published: June 2021

Background:
The physician work relative value unit (wRVU) scale is the primary determinant of compensation. Operative time, technical skill, effort, and surgical complexity contribute to wRVU allocation. The aim of this study was to identify the relationship between these factors and reimbursement for trauma procedures.

Methods:
The National Surgical Quality Improvement Program database was queried for orthopaedic trauma procedures from 2016 to 2018. Physician wRVU data were obtained from the 2020 Centers for Medicare & Medicaid Services fee schedule. The primary outcome measured was mean wRVU per minute of operative time (wRVU/min). Wilcoxon rank sum test and quantile regression were used to determine the association between wRVU, operative time, complication rate, upper or lower extremity procedure, and wRVU/min.

Results:
Sixty-three current procedural terminology codes or 107,171 cases were queried. Median wRVU/min was significantly lower for longest 50% of procedures (0.119 vs. 0.160, P < 0.001) and higher for the top 50% with regard to complication rate (0.161 vs. 0.124, P < 0.001). Upper extremity procedures were reimbursed less than lower extremity (0.110 vs. 0.145, P < 0.001). Quintile regression showed that adjusted for complication rate, median wRVU/min decreased by 0.0005 (95% confidence interval: 0.0007–0.0003, R1 = 0.27, P < 0.001) for every additional minute of operative time.

Conclusions:
The 2020 wRVU scale does not allocate sufficient wRVUs to orthopaedic trauma procedures with longer mean operative time or to procedures performed on the upper extremity. There is a negative correlation between operative time and hourly reimbursement, equating to a decrease of $64.96/h per hour of operation.
New imaging modalities to distinguish rare uterine mesenchymal cancers from benign uterine lesions
Authors: Causa Andrieu Pamela , Woo Sungmin , Kim Tae-Hyung , Kertowidjojo Elizabeth , Hodgson Anjelica , Sun Simon 
Published: June 2021

Purpose of review
Uterine sarcomas are rare and are often challenging to differentiate on imaging from benign mimics, such as leiomyoma. As functional MRI techniques have improved and new adjuncts, such as machine learning and texture analysis, are now being investigated, it is helpful to be aware of the current literature on imaging features that may sometimes allow for preoperative distinction.

Recent findings
MRI, with both conventional and functional imaging, is the modality of choice for evaluating uterine mesenchymal tumors, especially in differentiating uterine leiomyosarcoma from leiomyoma through validated diagnostic algorithms. MRI is sometimes helpful in differentiating high-grade stromal sarcoma from low-grade stromal sarcoma or differentiating endometrial stromal sarcoma from endometrial carcinoma. However, imaging remains nonspecific for evaluating rarer neoplasms, such as uterine tumor resembling ovarian sex cord tumor or perivascular epithelioid cell tumor, primarily because of the small number and power of relevant studies.

Summary
Through advances in MRI techniques and novel investigational imaging adjuncts, such as machine learning and texture analysis, imaging differentiation of malignant from benign uterine mesenchymal tumors has improved and could help reduce morbidity relating to misdiagnosis or diagnostic delays.
Nurses' Educational Needs Assessment for Hemodynamic Monitoring in Intensive Care Units
Authors: Jeshvaghani Tahereh Arabi , Mofrad Malahat Nikravan , Farahani Ziba Borzabadi , Nasiri Malihe 
Published: June 2021

Introduction:
Hemodynamic monitoring is widely accepted as a cornerstone of intensive care units (ICUs). So, the main objective of this study was to evaluate the educational needs assessment of nurses for hemodynamic monitoring in ICUs.

Methods:
The present descriptive–analytical study was conducted to evaluate the educational needs assessment of ICU nurses in terms of the hemodynamic monitoring. The research sample included 100 ICU nurses selected from the hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran. For data collection, researcher-made observational checklist and researcher-made questionnaire of clinical reasoning skills were used to assess the educational needs for hemodynamic monitoring.

Results:
The findings from the clinical practice checklists on hemodynamic monitoring revealed that nurses' practice was moderate in all 10 cases of monitoring with a mean of 79.30% (SD = 15.32%). Moreover, the nurses included were given a 9-item questionnaire regarding clinical reasoning skills. Accordingly, the results of this questionnaire indicated that nurses' clinical reasoning skills were at a poor level with a mean of 52.56% (SD = 8.71%).

Discussion:
The findings suggested that the development of continuing education programs in the area of clinical reasoning skills for hemodynamic monitoring should be more emphasized on. Also, nurses need to learn how to examine the patient carefully, find nursing diagnoses, set goals of care, and plan nursing interventions for their patients. They should also be able to assess how they affected the patient after performing the interventions. Furthermore, attention should be paid on improving practical skills for hemodynamic monitoring.
Effects of deprivation and age on staging of breast, colon, rectum and prostate cancer in Umbria region, Italy: a multilevel approach
Authors: Vercelli Marina , Lillini Roberto , Brunori Valerio , Bianconi Fortunato , Stracci Fabrizio 
Published: June 2021

Background
Early diagnosis of breast, colon, rectum and prostate cancers improves health outcomes. Low socioeconomic status (SES) is related to advanced stages at diagnosis; inequalities could explain differences in outcomes by age. The influence of SES, age and residence area on staging was explored in the Umbrian population.

Methods
2001–2010 cases were geo-coded by census tract of residence. Stage distribution or Gleason score were analyzed by multilevel multinomial logistic regression with age and SES as the fixed effects and census tract as the random-effect.

Results
For breast and colorectal cancers, the screening age class was advantaged. For breast, age effect was modulated by deprivation and census tract. In the elderly, the richest were advantaged, the poorest disadvantaged; issues emerged for the young. For colon, age effect is modulated by census tract in early stages and deprivation in late stages. The elderly were disadvantaged; the young and the deprived had more stages IV. About rectum, age effect was modulated by deprivation in the late stages. The elderly were disadvantaged; the young and the deprived presented more stages IV. For prostate, age effect was modulated by deprivation and census tract. The intermediate age class was advantaged, the elderly disadvantaged.

Conclusion
Age was not always the determinant of a delayed staging when SES was considered. For breast and colorectal cancers, issues of delayed diagnosis emerged in the young. If the care center was near the residence, the census tract modified the stage at diagnosis. These results are useful to reduce SES barriers by specific programs adapted to the age of the patient and area of residence.
Feasibility of wearable activity trackers in cystectomy patients to monitor for postoperative complications
Authors: Slade Austen D. , Cardinal James R. , Martin Christopher R. , Presson Angela P. , Allen Chelsea D. , Lowrance William T. , Dechet Christopher B. , O’Neil Brock B. 
Published: June 2021

Abstract

Background:
To determine the feasibility of using wearables in patients undergoing radical cystectomy to monitor postoperative heart rate and activity and attempt to correlate these factors to complications and readmissions.

Materials and methods:
We conducted a prospective study of 20 patients undergoing radical cystectomy for bladder cancer between June 2017 and March 2018. Each patient was provided with a Garmin Vívofit heart rate (HR) activity tracker and instructed to wear it on their wrist for 30 days postoperatively. Heart rate, steps, and sleep data were collected during this time. Patients were called at 10-day intervals and surveyed for complications and device compliance. Univariable mixed effects logistic regression models were used to compare daily activity tracker measures with occurrence of an adverse event. Odds ratios, 95% confidence intervals, and p-values were reported.

Results:
Median age was 65 (interquartile range 61–74) years. Patients had usable data for a median of 59.3% (interquartile range 25–71.7%) of the time. Five patients experienced a postoperative event (1 readmission for sepsis from urinary tract source, 1 inpatient rapid response called for tachycardic event, 3 unscheduled visits related to dehydration), where event data was recorded over a total of 17 days. Higher step count was associated with reduced odds of an adverse event (odds ratio 0.31, 95% confidence interval 0.10–0.98 per 1000 steps, p = 0.047).

Conclusions:
Postoperative activity and heart rate monitoring in cystectomy patients is feasible though current wearables are not well suited for this task.
Scrotal base distance: A new key genital measurement in males with hypospadias and cryptorchidism
Authors: Abbas Tariq O. , Ali Mansour 
Published: June 2021

Abstract

Background:
Anogenital distance (AGD) in both humans and animals is a known reflection of fetal endocrine effect on genital virilization and the related abnormalities, including cryptorchidism and hypospadias. However, we introduce here and investigate scrotal base distance (SBD) as a sensitive genital anthropometric biomarker in human infants with cryptorchidism and hypospadias, which are considered early manifestations of testicular dysgenesis syndrome. We aim to assess SBD in patients with cryptorchidism or hypospadias against healthy subjects.

Material and methods:
Patients with hypospadias (n = 61, age 17.4 ± 6.3 months) or cryptorchidism (n = 51, age 11.4 ± 4.8 months) were enrolled for assessment of SBD, AGD, and penile length; and compared with a cohort of 102 full-term healthy boys for standard ritual circumcision by measuring age-specific standard deviation scores.

Results:
Patients having hypospadias had lower mean SBD, AGD, and penile length standard deviation scores than the control group (p < 0.01). These values in patients with cryptorchidism were longer than mean values in boys with hypospadias (p < 0.01) and shorter than mean values in the control group.

Conclusions:
We showed that SBD, AGD, and penile length were lower in patients with cryptorchidism or hypospadias compared to normative data measured from a control group of healthy boys for ritual circumcision. These results enforce the use of SBD as an objective anthropometric measurement and a viable biomarker to assess the effects of fetal endocrine imbalance on male external genitalia development.
Permission to prescribe: do cardiologists need permission to prescribe diabetes medications that afford cardiovascular benefit?
Authors: Sharma Abhinav , Aziz Haya , Verma Subodh , Abramson Beth L. , Choi Richard , Chua Grace L. , Connelly Kim A. , Honos George , Mancini G.B. John , Ramer Sarah A. , Swiggum Elizabeth , Teoh Hwee , Zieroth Shelley , Leiter Lawrence A. 
Published: June 2021

Purpose of review
Antihyperglycemic therapies including sodium glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have been demonstrated to confer significant cardiovascular benefit and reduce future events in patients with type 2 diabetes mellitus (T2DM). However, despite positive data from cardiovascular outcome trials, these therapies remain underutilized in a large proportion of patients who have clinical indications and meet coverage guidelines for their initiation. One of the causes of the observed gap between scientific evidence and clinical cardiology practice is therapeutic hesitancy (otherwise known as therapeutic inertia). The purpose of this review is to discuss the contributors to therapeutic hesitancy in the implementation of these evidence-based therapies and, more importantly, provide pragmatic solutions to address these barriers.

Recent findings
Recent studies have demonstrated that clinicians may not initiate cardiovascular protective therapies due to a reluctance to overstep perceived interdisciplinary boundaries, concerns about causing harm due to medication side effects, and a sense of unfamiliarity with the optimal choice of therapy amidst a rapidly evolving landscape of T2DM therapies.

Summary
Herein, we describe a multifaceted approach aimed at creating a ‘permission to prescribe’ culture, developing integrated multidisciplinary models of care, enhancing trainees’ experiences in cardiovascular disease prevention, and utilizing technology to motivate change. Taken together, these interventions should increase the implementation of evidence-based therapies and improve the quality of life and cardiovascular outcomes of individuals with T2DM.