bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risks of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder treated with long-acting injectable or oral antipsychotics: A population-based retrospective cohort study in Taiwan
Authors: Tang Chao-Hsiun , Shen Shih-Pei , Huang Min-Wei , Qiu Hong , Watanabe Sayuri , Goh Choo Hua , Liu Yanfang 
Published: December 2021

AbstractBackgroundLong-acting injectable (LAI) antipsychotics improve medication adherence in patients with schizophrenia and extend the duration of therapeutic drug levels but with administration of an increased dose. Real-world mortality data in patients prescribed LAIs are lacking. We conducted a population-based cohort study to estimate and compare the incidence rates of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder exposed to LAIs and oral antipsychotics.MethodsPatients with a diagnosis of schizophrenia/schizoaffective disorder between January 1, 2015 and November 30, 2019 were enrolled from the Taiwan National Health Insurance Research Database and linked to Death Registry records. Eligible patients were new antipsychotic users. Relative risks of death for each antipsychotic compared with oral paliperidone were evaluated using a Cox proportional hazard model adjusted for age, sex, Charlson Comorbidity Index, index year, bipolar or major depressive or other mood disorders, mental disorders due to drug use, and baseline hospitalization frequency.ResultsThere were 228,791.08 person-years of follow-up (mean 2.48 years). The incidence rates of all-cause death in users of LAI paliperidone administered monthly (PP1M) and every 3 months (PP3M) were 7.40/1,000 person-years (95% confidence interval 5.94–9.11) and 9.93 (5.88–15.79), respectively. The incidences of completed suicide were 2.03/1,000 person-years (1.32–2.99) and 3.10 (1.14–6.88), respectively. No significant associations were observed between PP1M and PP3M compared to oral paliperidone in incidences of all-cause death or for completed suicide.DiscussionNo increased risk of all-cause death or completed suicide was observed in users of antipsychotic LAIs, including PP1M and PP3M.
Robotic-Assisted vs Nonrobotic-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Cost-Utility Analysis
Authors: Garcia Diogo , Akinduro Oluwaseun O. , De Biase Gaetano , Sousa-Pinto Bernardo , Jerreld Daniel J. , Dholakia Ruchita , Borah Bijan , Nottmeier Eric , Deen H. Gordon , Fox W. Christopher , Bydon Mohamad , Chen Selby , Quinones-Hinojosa Alfredo , Abode-Iyamah Kingsley 
Published: December 2021

BACKGROUND:
Management of degenerative disease of the spine has evolved to favor minimally invasive techniques, including nonrobotic-assisted and robotic-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Value-based spending is being increasingly implemented to control rising costs in the US healthcare system. With an aging population, it is fundamental to understand which procedure(s) may be most cost-effective.

OBJECTIVE:
To compare robotic and nonrobotic MIS-TLIF through a cost-utility analysis.

METHODS:
We considered direct medical costs related to surgical intervention and to the hospital stay, as well as 1-yr utilities. We estimated costs by assessing all cases involving adults undergoing robotic surgery at a single institution and an equal number of patients undergoing nonrobotic surgery, matched by demographic and clinical characteristics. We adopted a willingness to pay of $50 000/quality-adjusted life year (QALY). Uncertainty was addressed by deterministic and probabilistic sensitivity analyses.

RESULTS:
Costs were estimated based on a total of 76 patients, including 38 undergoing robot-assisted and 38 matched patients undergoing nonrobot MIS-TLIF. Using point estimates, robotic surgery was projected to cost $21 546.80 and to be associated with 0.68 QALY, and nonrobotic surgery was projected to cost $22 398.98 and to be associated with 0.67 QALY. Robotic surgery was found to be more cost-effective strategy, with cost-effectiveness being sensitive operating room/materials and room costs. Probabilistic sensitivity analysis identified robotic surgery as cost-effective in 63% of simulations.

CONCLUSION:
Our results suggest that at a willingness to pay of $50 000/QALY, robotic-assisted MIS-TLIF was cost-effective in 63% of simulations. Cost-effectiveness depends on operating room and room (admission) costs, with potentially different results under distinct neurosurgical practices.
Hybrid Therapy (Surgery and Radiosurgery) for the Treatment of Renal Cell Carcinoma Spinal Metastases
Authors: Hussain Ibrahim , Goldberg Jacob L. , Carnevale Joseph A. , Hanz Samuel Z. , Reiner Anne S. , Schmitt Adam , Higginson Daniel S. , Yamada Yoshiya , Laufer Ilya , Bilsky Mark H. , Barzilai Ori 
Published: December 2021

BACKGROUND:
The management of spinal metastatic renal cell carcinoma (mRCC) is controversial regarding extent of resection and radiation dosing.

OBJECTIVE:
To determine outcomes in patients treated with hybrid therapy (separation surgery plus adjuvant stereotactic body radiation therapy [SBRT]) for mRCC.

METHODS:
A retrospective study of a prospectively collected cohort of patients undergoing hybrid therapy for mRCC between 2003 and 2017 was performed. SBRT was delivered as high-dose single-fraction, high-dose hypofractionated, or low-dose hypofractionated. Extent of disease, clinical and operative outcomes, and complications data were collected, and associations with overall survival (OS) and progression-free survival were determined.

RESULTS:
Ninety patients with mRCC with high-grade epidural spinal cord compression (ESCC grades 2 and 3) were treated. Metastases were widespread, oligometastatic, and solitary in 56%, 33%, and 11% of patients, respectively. SBRT delivered was high-dose single-fraction, high-dose hypofractionated, and low-dose hypofractionated in 24%, 56%, and 20% of patients, respectively. The 1-yr cumulative incidence of major complications was 3.4% (95% confidence interval [CI]: 0.0%-7.2%). The median follow-up was 14.2 mo for the entire cohort and 38.3 mo for survivors. The 1-yr cumulative incidence of progression was 4.6% (95% CI: 0.2%-9.0%), which translates to a local control rate of 95.4% (95% CI: 91.0%-99.8%) 1 yr after surgery. The median OS for the cohort was 14.8 mo.

CONCLUSION:
These data support the use of hybrid therapy as a safe and effective strategy for the treatment of renal cell spine metastases.
What gives a stroke publication impact? Assessing traditional and alternative metrics of scientific impact for papers published in the journal Stroke
Authors: Wong Li Siang , Drozdowska Bogna A , Doherty Daniel , Quinn Terence J 
Published: December 2021

Background: The ‘impact’ of a scientific paper is a measure of influence in its field. In recent years, traditional, citation-based measures of impact have been complemented by Altmetrics, which quantify outputs including social media footprint. As authors and research institutions seek to increase their visibility both within and beyond the academic community, it is important to identify and compare the determinants of traditional and alternative metrics. We explored this using Stroke – a leading journal in its field. Methods: We described the impact of original research papers published in Stroke (2015-2016) using citation count and Altmetric Attention Score (Altmetrics). Using these two metrics as our outcomes, we assessed univariable and multivariable associations with 21 plausibly relevant publication features. We set the significance threshold at p<0.01. Results: Across 911 papers published in Stroke, there was an average citation count of 21.60 (±17.40) and Altmetric score of 17.99 (±47.37). The two impact measures were weakly correlated (r=0.15, p<0.001). Citations were independently associated with five publication features at a significance level of p<0.01: Time Since Publication (beta=0.87), Number of Authors (beta=0.22), Publication Type (beta=6.76), Number of Previous Publications (beta=0.01) and Editorial (beta=9.45). For Altmetrics, we observed a trend for independent associations with: Time Since Publication (beta=-0.25, p=0.02), Number of References (beta=0.32, p=0.02) and Country of Affiliation (beta=8.59, p=0.01). Our models explained 21% and 3% of variance in citations and Altmetrics, respectively. Conclusion: Papers published in Stroke have impact. Certain aspects of content and format may contribute to impact, but these differ for traditional measures and Altmetrics, and explain only a very modest proportion of variance in the latter. Citation counts and Altmetrics seem to represent different constructs and, therefore, should be used in conjunction to allow a more comprehensive assessment of publication impact.
Biological performance of a bioabsorbable Poly (L-Lactic Acid) produced in polymerization unit: in vivo studies
Authors: Xavier Mariana , Farez Nayla , Salvatierra Paola Luciana , Jardini Andre Luiz , Kharmandayan Paulo , Feldman Sara 
Published: December 2021

Background: The biomaterials engineering goal is to manufacture a biocompatible scaffold that adequately supports or improves tissue regeneration after implantation of the biomaterial in the injured area. Many requirements are demanded for a biomaterial, such as biocompatibility, elasticity, degradation time, and a very important factor is its cost of importation or synthesis, making its application inaccessible to some countries. Studies about biomaterials market show that Polylactic acid (PLLA) is one of the most used polymers, but expensive to produce. It becomes important to prove the biocompatibility of the new PLLA and to find strategies to produce biocompatible biopolymers at an acceptable production cost. Methods: In this work, the polylactic acid biomaterial was synthesized by ring-opening polymerization. The polymer was submitted to initial in vivo biocompatibility studies in 12 New Zealand female rabbits, assigned to two groups: (1) Lesion and PLLA group (n = 6), (2) Lesion No PLLA group (n = 6). Each group was divided into two subgroups at six and nine months post-surgical time. Before euthanasia clinical and biochemical studies were performed and after that tomographic (CT), histological (Hematoxylin and Eosin and Masson's trichrome) and histomorphometric analyses were performed to evaluate the injury site and prove biocompatibility. The final cost of this polymer was analyzed. Results: The statistical studies of hemogram and hepatocyte enzymes, showed that there were no significant differences between the groups for any of the times studied, in any of the variables considered and the results of CT and histology showed that there was an important process of neoregeneration. The cost analysis showed the biopolymer synthesis is between R$3,06 - R$5,49 cheaper than the import cost. Conclusions: It was possible to synthesize the PLLA biopolymer by cyclic ring opening, which proved to be biocompatible, potential osteoregenerative and cheaper than other imported biopolymers.
Gastronot: a pilot project for promoting healthy eating habits using mixed-method study design
Authors: Respati Titik , Fitriyana Susan , Romadhona Nurul , Ibnusantosa Ganang , Frederrico Rio , Yulianto Fajar Awalia , Shandriasti Aughya , Nugroho Eko 
Published: December 2021

Background: Eating habits are formed from childhood and develop into adulthood. Unhealthy eating habits will persist into adulthood and can lead to various diseases. Healthy eating and behaviour should be taught using engaging tools. The study aims to pilot nutrition education using the game-based learning approach, implementing a specially designed learning board game entitled "Gastronot". Methods: A mixed-method study was used in two stages. The first stage was an FGD with 14 informants and in-depth interviews with six informants to develop the game. The second stage was the game's development, and a pre and post-test were conducted on 88 children to evaluate the game—the study was conducted from August 2019 to July 2020. Results: Results showed almost half the children (49%) never heard about Balanced Nutrition Diet Pyramid. There was a significant difference between respondents' knowledge before and after playing the game with a p-value of 0.021. The game was able to engage participants in the active learning process. Conclusions: We concluded that the game-based learning utilizing the Gastronot board game demonstrated good results as a method for teaching primary school students about food and healthy eating habits.
Genomic evidence for the parallel regression of melatonin synthesis and signaling pathways in placental mammals
Authors: Emerling Christopher A. , Springer Mark S. , Gatesy John , Jones Zachary , Hamilton Deana , Xia-Zhu David , Collin Matt , Delsuc Frédéric 
Published: December 2021

Background: The study of regressive evolution has yielded a wealth of examples where the underlying genes bear molecular signatures of trait degradation, such as pseudogenization or deletion. Typically, it appears that such disrupted genes are limited to the function of the regressed trait, whereas pleiotropic genes tend to be maintained by natural selection to support their myriad purposes. One such set of pleiotropic genes is involved in the synthesis (AANAT, ASMT) and signaling (MTNR1A, MTNR1B) of melatonin, a hormone secreted by the vertebrate pineal gland. Melatonin provides a signal of environmental darkness, thereby influencing the circadian and circannual rhythmicity of numerous physiological traits. Therefore, the complete loss of a pineal gland and the underlying melatonin pathway genes seems likely to be maladaptive, unless compensated by extrapineal sources of melatonin. Methods: We examined AANAT, ASMT, MTNR1A and MTNR1B in 123 vertebrate species, including pineal-less placental mammals and crocodylians. We searched for inactivating mutations and modelled selective pressures (dN/dS) to test whether the genes remain functionally intact. Results: We report that crocodylians retain intact melatonin genes and express AANAT and ASMT in their eyes, whereas all four genes have been repeatedly inactivated in the pineal-less xenarthrans, pangolins, sirenians, and whales. Furthermore, colugos have lost these genes, and several lineages of subterranean mammals have partial melatonin pathway dysfunction. These results are supported by the presence of shared inactivating mutations across clades and analyses of selection pressure based on the ratio of non-synonymous to synonymous substitutions (dN/dS), suggesting extended periods of relaxed selection on these genes. Conclusions: The losses of melatonin synthesis and signaling date to tens of millions of years ago in several lineages of placental mammals, raising questions about the evolutionary resilience of pleiotropic genes, and the causes and consequences of losing melatonin pathways in these species.
Crew Assignment with Duty Time Limits for Transport Services: Tight Multicommodity Models
Authors: Balakrishnan Anantaram , Mirchandani Prakash , Lin Sifeng 
Published: December 2021

Modeling Crew Assignments for Urban Transport Services Using Differentiated Flows Public transit agencies need to judiciously deploy their limited crew members to operate numerous daily scheduled services, while meeting duty and working time regulations for each crew member. Since crew costs account for a large portion of the organizations’ operating expenses, minimizing the total crew and transfer costs is very important. But, with hundreds of daily trips and millions of possible crew itineraries, optimizing trip-to-crew assignment decisions is challenging. In “Crew Assignment with Duty Time Limits for Transport Services: Tight Multicommodity Models,” Balakrishnan, Mirchandani, and Lin propose a novel integer optimization model that represents itineraries as multicommodity flows, differentiated by first trip and depot, to capture the duty time limits and incorporate additional requirements such as selecting equitable schedules. The authors show that this compact model can be tighter than previous formulations, further strengthen the model, and propose a restricted optimization approach combined with an optimality test to generate near-optimal solutions quickly. Extensive computational tests using well-known and real-life problem instances show that the proposed model and solution approach can be very effective in practice.
Near-surface atmospheric turbulence profile measuring technology based
on an airship-mounted laser communication system
Authors: Wang Tong , Zhao Xin , Song Yansong , Wang Junyao , Luan Yusheng , Li Yang , Chang Shuai 
Published: December 2021

Atmospheric turbulence is an important factor affecting the transmission performance of
free-space optical communications (FSOC), especially in the
near-surface where the atmospheric turbulence characteristics are
complex and variable. In this paper, we study the real-time
measurement technique of a near-surface atmospheric turbulence profile
of an airship-borne laser communication system based on the principle
of light intensity scintillation. Aiming at the influence of an
avalanche photon diode detector system noise and environmental factors
such as background light and platform vibration on the measurement
results, a noise-canceling scintillation index calculation method,
combined with a wavelet threshold denoising method, is proposed to
improve the accuracy of atmospheric turbulence profile measurements.
We build a communication distance of a 12 km airship-borne laser
communication experiment and carry out a real-time measurement of
turbulence profile under 1 km near the ground without affecting the
laser communication rate of 2.5 Gbps data transmission. The
experimental results show that the atmospheric turbulence profile
measured in real time follows the same trend as the theoretical
simulation curve of the Hufnagel–Valley model, and the jitter of the
measured values after denoising is significantly smaller than that of
the measured values without denoising. The research results provide
technical guidance and data support to promote the development of
space laser communication and adaptive optics.
Long durations from symptom onset to diagnosis and from diagnosis to treatment in obsessive-compulsive disorder: A retrospective self-report study
Authors: Ziegler Sina , Bednasch Klara , Baldofski Sabrina , Rummel-Kluge Christine 
Published: December 2021

Background
Although obsessive-compulsive disorder (OCD) is one of the most common mental disorders, it takes up to 17 years for patients with OCD to receive adequate therapy. According to existing outdated literature, this study aimed to investigate the current duration between symptom onset and diagnosis and between diagnosis and the beginning of therapy separately.

Methods
In a cross-sectional study, N = 100 patients diagnosed with OCD undergoing treatment in a psychiatric outpatient department were assessed, using self-report questionnaires on sociodemographic and clinical variables. Based on self-reported information, the durations between age at symptom onset and age at diagnosis, and between age at diagnosis and beginning of therapy were calculated. To investigate associated factors, two subgroups of patients, one with a short duration between symptom onset and diagnosis < 7 years, and another with a long duration between symptom onset and diagnosis ≥ 7 years, respectively, were compared.

Results and conclusion
Patients reported first symptoms of OCD at a mean age of 18.72 years. The mean duration between age at symptom onset and age at diagnosis was 12.78 years and the mean duration between age at diagnosis and the beginning of therapy was 1.45 years. Subgroup comparison indicated that patients with a short duration between symptom onset and diagnosis were significantly younger than patients with a long duration. However, patients with a short duration between symptom onset and diagnosis were at an older age when they reported first symptoms of OCD. Further, they showed less severe symptoms of OCD, higher functioning levels, and less self-stigmatization than patients with a long duration. It can be concluded that the duration until patients with OCD are diagnosed correctly and receive adequate treatment is still very long. Therefore, the duration between symptom onset and diagnosis should be shortened. Further, the duration between diagnosis and the beginning of therapy could be a good additional approach to reduce the overall duration of untreated disorder.
Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound
Authors: Yoon Jimin , Choi Yangsean , Jang Jinhee , Shin Na-Young , Ahn Kook-Jin , Kim Bum-soo 
Published: December 2021

Purpose
To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC).

Methods
This was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student’s t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs.

Results
A total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751–0.897), followed by CM HU (0.762; 95% CI, 0.679–0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941.

Conclusion
Compared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC.