bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of aortic valve calcium quantification thresholds measured by computed tomography in Asian patients with calcific aortic stenosis
Authors: Guzzetti Ezequiel , Oh Jin Kyung , Shen Mylène , Dweck Marc R , Poh Kian Keong , Abbas Amr E , Mando Ramy , Pressman Gregg S , Brito Daniel , Tastet Lionel , Pawade Tania , Falconi Mariano Luis , de Arenaza Diego Perez , Kong William , Tay Edgar , Pibarot Philippe , Song Jae-Kwan , Clavel Marie-Annick 
Published: May 2021

Abstract

Aims
Sex-specific thresholds of aortic valve calcification (AVC) have been proposed and validated in Caucasians. Thus, we aimed to validate their accuracy in Asians.

Methods and results
Patients with calcific aortic stenosis (AS) from seven international centres were included. Exclusion criteria were ≥moderate aortic/mitral regurgitation and bicuspid valve. Optimal AVC and AVC-density sex-specific thresholds for severe AS were obtained in concordant grading and normal flow patients (CG/NF). We included 1263 patients [728 (57%) Asians, 573 (45%) women, 837 (66%) with CG/NF]. Mean gradient was 48 (26–64) mmHg and peak aortic velocity 4.5 (3.4–5.1) m/s. Optimal AVC thresholds were: 2145 Agatston Units (AU) in men and 1301 AU in women for Asians; and 1885 AU in men and 1129 AU in women for Caucasians. Overall, accuracy (% correctly classified) was high and comparable either using optimal or guidelines’ thresholds (2000 AU in men, 1200 AU in women). However, accuracy was lower in Asian women vs. Caucasian women (76–78% vs. 94–95%; P &lt; 0.001). Accuracy of AVC-density (476 AU/cm2 in men and 292 AU/cm2 in women) was comparable to absolute AVC in Caucasians (91% vs. 91%, respectively, P = 0.74), but higher than absolute AVC in Asians (87% vs. 81%, P &lt; 0.001). There was no interaction between AVC/AVC-density and ethnicity (all P &gt; 0.41) with regards to AS haemodynamic severity.

Conclusion
AVC thresholds defining severe AS are comparable in Asian and Caucasian populations, and similar to those proposed in the guidelines. However, accuracy of AVC to identify severe AS in Asians (especially women) is sub-optimal. Therefore, the use of AVC-density is preferable in Asians.
Use of quality assessment tools within systematic reviews in orthodontics during the last decade: looking for a threshold?
Authors: Mikelis Filippos , Koletsi Despina 
Published: May 2021

SummaryObjectiveTo record the prevalence and extent of use of quality assessment/ risk of bias tools in orthodontic systematic reviews and to identify whether systematic reviews authors stipulated a threshold during the evaluation process of the primary studies included in systematic reviews, published across the previous decade and until now. Associations with publication characteristics including the journal of publication, year, the inclusion of a meta-analysis, design of primary studies and others, were sought.Materials and MethodsElectronic search within 6 orthodontic journals and the Cochrane Database of Systematic Reviews was conducted to identify relevant systematic reviews from 1 January 2010 and 31 December 2020. The outcomes of interest pertained to the use, type and extent of quality appraisal/ risk of bias tools utilized as a standard process within the systematic reviews, and also whether a threshold had been stipulated by the systematic reviews authors. Predictor variables included journal, year of publication, geographic region, number of authors, involvement of a methodologist, type of systematic reviews, inclusion of meta-analysis, type/design of primary studies.ResultsA total of 262 systematic reviews were eligible for inclusion, with 41 quality appraisal/ risk of bias sets of tools being described either jointly or in isolation. One-third of the systematic reviews of the present sample (88/262; 33.6%) included a threshold, while this was mostly represented by the stipulation of sensitivity analyses in this respect (64/88; 72.8%). Journal of publication (non-Cochrane systematic reviews versus Cochrane systematic reviews: adjusted odds ratio, OR: 0.04, 95%CI: 0.01, 0.16; P &lt; 0.001) and inclusion of a meta-analysis (adjusted OR: 8.76; 95%CI: 4.18, 18.37; P &lt; 0.001), were identified as significant predictors for preplanning of thresholds.Conclusions and implicationsQuality assessment tools for primary studies are largely used and varied in orthodontic systematic reviews, while a threshold-level has been stipulated in only one third. Additional efforts should be endorsed by the scientific community, to embrace more straightforward adoption of the most rigorous reporting guidelines in this respect.
Evidence of a double anaerobic threshold in healthy subjects
Authors: Rovai Sara , Magini Alessandra , Cittar Marco , Masè Marco , Carriere Cosimo , Contini Mauro , Vignati Carlo , Sinagra Gianfranco , Agostoni Piergiuseppe 
Published: May 2021

Abstract

Aims
The anaerobic threshold (AT) is an important cardiopulmonary exercise test (CPET) parameter both in healthy and in patients. It is normally determined with three approaches: V-slope method, ventilatory equivalent method, and end-tidal method. The finding of different AT values with these methods is only anecdotic. We defined the presence of a double threshold (DT) when a ΔVO2 &gt; 15 mL/min was observed between the V-slope method (met AT) and the other two methods (vent AT). The aim was to identify whether there is a DT in healthy subjects.

Methods and results
We retrospectively analysed 476 healthy subjects who performed CPET in our laboratory between 2009 and 2018. We identified 51 subjects with a DT (11% of cases). Cardiopulmonary exercise test data at rest and during the exercise were not different in subjects with DT compared to those without. Met AT always preceded vent AT. Compared to subjects without DT, those with DT showed at met AT lower carbon dioxide output (VCO2), end-tidal carbon dioxide tension (PetCO2) and respiratory exchange ratio (RER), and higher ventilatory equivalent for carbon dioxide (VE/VCO2). Compared to met AT, vent AT showed a higher oxygen uptake (VO2), VCO2, ventilation, respiratory rate, RER, work rate, and PetCO2 but a lower VE/VCO2 and end-tidal oxygen tension. Finally, subjects with DT showed a higher VO2 increase during the isocapnic buffering period.

Conclusion
Double threshold was present in healthy subjects. The presence of DT does not influence peak exercise performance, but it is associated with a delayed before acidosis-induced hyperventilation.
New genomic resources and comparative analyses reveal differences in floral gene expression in selfing and outcrossingCollinsiasister species
Authors: Frazee Lauren J , Rifkin Joanna , Maheepala Dinusha C , Grant Alannie-Grace , Wright Stephen , Kalisz Susan , Litt Amy , Spigler Rachel 
Published: May 2021

AbstractThe evolutionary transition from outcross- to self-fertilization is one of the most common in angiosperms and is often associated with a parallel shift in floral morphological and developmental traits, such as reduced flower size and pollen to ovule ratios, known as the “selfing syndrome.” How these convergent phenotypes arise, the extent to which they are shaped by selection, and the nature of their underlying genetic basis are unsettled questions in evolutionary biology. The genus Collinsia (Plantaginaceae) includes seven independent transitions from outcrossing or mixed mating to high selfing rates accompanied by selfing syndrome traits. Accordingly, Collinsia represents an ideal system for investigating this parallelism, but requires genomic resource development. We present a high quality de novo genome assembly for the highly selfing species Collinsia rattanii. To begin addressing the basis of selfing syndrome developmental shifts, we evaluate and contrast patterns of gene expression from floral transcriptomes across three stages of bud development for C. rattanii and its outcrossing sister species Collinsia linearis. Relative to C. linearis, total gene expression is less variable among individuals and bud stages in C. rattanii. In addition, there is a common pattern among differentially expressed genes: lower expression levels that are more constant across bud development in C. rattanii relative to C. linearis. Transcriptional regulation of enzymes involved in pollen formation specifically in early bud development may influence floral traits that distinguish selfing and outcrossing Collinsia species through pleiotropic functions. Future work will include additional Collinsia outcrossing-selfing species pairs to identify genomic signatures of parallel evolution.
Investigating Older Adults’ Willingness to Invest Time to Acquire Technology Skills Using a Discounting Approach
Authors: Sharit Joseph , Moxley Jerad H , Czaja Sara J 
Published: May 2021

Abstract

Background and Objectives
Delay discounting is a common behavioral phenomenon that can influence decision making. A person with a higher discounting rate (DR) will have a stronger preference for smaller, more immediate rewards over larger, delayed rewards than will a person with a lower DR. This study used a novel approach to investigate, among a diverse sample of older adults, discounting of the time people were willing to invest to acquire technology skills across various technologies.

Research Design and Methods
One hundred and eighty-seven male and female adults 65–92 years of age participated in the study and were given presentations on 5 different technologies spanning domains that included transportation, leisure, health, and new learning. A measure of discounting was computed based on participants’ assessments of how much additional time they would be willing to spend to acquire increased skill levels on each of the technologies and their ratings of importance of attaining those skill levels. Measures of participants’ perceived value of the technologies, technology readiness, and self-assessed cognitive abilities were also collected.

Results
The findings indicated a significant and robust effect of lower DRs with increasing age. Higher perceived value of the technologies and higher levels of positive technology readiness predicted willingness to invest more time to learn the technologies, whereas self-assessments of cognitive abilities predicted the levels of technology skills that participants desired on the 5 technologies.

Discussion and Implications
Our findings demonstrate that for realistic decision-making scenarios related to the acquisition of technology skills, DRs decrease with increasing age, even within an older adult cohort, and that discounting is related to the perceived value of the technology. The findings also have important implications for the design and marketing of technology products for older consumers.
Efficient extended-search space full-waveform inversion with unknown source signatures
Authors: Aghamiry H S , Mamfoumbi-Ozoumet F W , Gholami A , Operto S 
Published: May 2021

SUMMARY
Full waveform inversion (FWI) requires an accurate estimation of source signatures. Due to the coupling between the source signatures and the subsurface model, small errors in the former can translate into large errors in the latter. When direct methods are used to solve the forward problem, classical frequency-domain FWI efficiently processes multiple sources for source signature and wavefield estimations once a single lower–upper (LU) decomposition of the wave-equation operator has been performed. However, this efficient FWI formulation is based on the exact solution of the wave equation and hence is highly sensitive to the inaccuracy of the velocity model due to the cycle skipping pathology. Recent extended-space FWI variants tackle this sensitivity issue through a relaxation of the wave equation combined with data assimilation, allowing the wavefields to closely match the data from the first inversion iteration. Then, the subsurface parameters are updated by minimizing the wave-equation violations. When the wavefields and the source signatures are jointly estimated with this approach, the extended wave equation operator becomes source dependent, hence making direct methods and, to a lesser extent, block iterative methods ineffective. In this paper, we propose a simple method to bypass this issue and estimate source signatures efficiently during extended FWI. The proposed method replaces each source with a blended source during each data-assimilated wavefield reconstruction to make the extended wave equation operator source independent. Besides computational efficiency, the additional degrees of freedom introduced by spatially distributing the sources allows for a better signature estimation at the physical location when the velocity model is rough. We implement the source signature estimation with a variable projection method in the recently proposed iteratively refined wavefield reconstruction inversion (IR-WRI) method. Numerical tests on the Marmousi II and 2004 BP salt synthetic models confirm the efficiency and the robustness against velocity model errors of the new method compared to the case where source signatures are known.
Estimation of micro-earthquake source locations based on full adjoint P and S wavefield imaging
Authors: Duan Chenglong , Lumley David , Zhu Hejun 
Published: May 2021

SUMMARY
Locating micro-earthquakes with high resolution and accuracy is a challenge for traveltime inversion, which has uncertainty on the order of a Fresnel zone (many wavelengths). We develop a wave-equation imaging method to increase resolution and reduce location errors to less than a wavelength, but requires very densely deployed receiver arrays with wide aperture and considerable computational cost. Instead of using acoustic data or direct P wave arrivals only, we use elastic multicomponent data and present a new method that uses the full P and S adjoint wavefields to image the microseismic source locations. We separate the P and S waves from the data, and extrapolate the P and S wavefields of each receiver subarray by solving the P and S adjoint wave equations in parallel. We formulate three source imaging conditions by multiplying over subarrays the adjoint P wavefield (IP), S wavefield (IS) and cross-correlated P and S wavefields (IPS). We perform numerical experiments on the highly realistic SEG SEAM4D reservoir model using surface acquisition array geometries. Results for 2-D and 3-D microseismic source estimations show clean images without noisy artefacts at shallow depths. In particular, IPS provides the highest resolution source location image, while IP is limited by the P wavelength and IS is influenced by small coda artefacts. The major-axis alignment and resolution of the source location image are determined by the hypocentral location with respect to the receiver array and illumination-angle coverage, respectively. We discuss the impacts of S-wave attenuation and frequency bandwidth on the source location images. Noise tests indicate that the imaging results are relatively insensitive to ambient noise, as is observed for the surface monitoring data. Using smoothed velocity models, the imaging results are similar to the results using the true realistically heterogeneous velocity model. The 90 per cent confidence ellipse of the source location due to Gaussian-distributed velocity errors shows a larger depth error as the source becomes deeper, while the horizontal error does not change as much.
Transmitral resection of left ventricular lipoma by right mini-thoracotomy using a rolled up flexible ruler
Authors: Kim Yun Seok , Kim Jin Young , Shin Hyeong Chan 
Published: May 2021

AbstractLeft ventricular lipoma is a rare intracardiac tumour that is usually resected through sternotomy to effectively explore the left ventricular cavity. We introduce a simple technique to expose the left ventricular cavity and resect the intraventricular lipoma using a rolled up flexible ruler through right mini-thoracotomy. Imaging studies and gross and microscopic photography of intraventricular lipoma are presented in this report.
Cost of Illness Due to Severe Enteric Fever in India
Authors: Kumar Dilesh , Sharma Atul , Rana Saroj Kumar , Prinja Shankar , Ramanujam Karthikeyan , Karthikeyan Arun S , Raju Reshma , Njarekkattuvalappil Swathi Krishna , Premkumar Prasanna S , Chauhan Akashdeep Singh , Mohan Venkata Raghava , Ebenezer Sheena Evelyn , Thomas Mathew Santosh , Gupta Madhu , Singh Ashita , Jinka Dasaratha Ramaiah , Thankaraj Shajin , Koshy Roshine Mary , Dhas Sankhro Christina , Kapil Arti , Shastri Jayanthi , Saigal Karnika , Perumal Sulochana Putli Bai , Nagaraj Savitha , Anandan Shalini , Thomas Maria , Ray Pallab , John Jacob , Kang Gagandeep 
Published: May 2021

Abstract

Background
Lack of robust data on economic burden due to enteric fever in India has made decision making on typhoid vaccination a challenge. Surveillance for Enteric Fever network was established to address gaps in typhoid disease and economic burden.

Methods
Patients hospitalized with blood culture-confirmed enteric fever and nontraumatic ileal perforation were identified at 14 hospitals. These sites represent urban referral hospitals (tier 3) and smaller hospitals in urban slums, remote rural, and tribal settings (tier 2). Cost of illness and productivity loss data from onset to 28 days after discharge from hospital were collected using a structured questionnaire. The direct and indirect costs of an illness episode were analyzed by type of setting.

Results
In total, 274 patients from tier 2 surveillance, 891 patients from tier 3 surveillance, and 110 ileal perforation patients provided the cost of illness data. The mean direct cost of severe enteric fever was US$119.1 (95% confidence interval [CI], US$85.8–152.4) in tier 2 and US$405.7 (95% CI, 366.9–444.4) in tier 3; 16.9% of patients in tier 3 experienced catastrophic expenditure.

Conclusions
The cost of treating enteric fever is considerable and likely to increase with emerging antimicrobial resistance. Equitable preventive strategies are urgently needed.
Assessment of adherence to pneumonia guidelines and its determinants in an ambulatory care clinic in Ghana: findings and implications for the future
Authors: Sefah Israel Abebrese , Essah Darius Obeng , Kurdi Amanj , Sneddon Jacqueline , Alalbila Thelma Mpoku , Kordorwu Hope , Godman Brian 
Published: May 2021

Abstract

Background
Adherence to local standard guidelines is seen as a pragmatic way to measure and improve the quality of future prescribing in ambulatory care to reduce morbidity, mortality and healthcare costs.

Objectives
To evaluate adherence to the Ghana Standard Treatment Guidelines (STGs) for the empirical antibiotic treatment of ambulatory care patients with community-acquired pneumonia (CAP) in a region in Ghana and factors associated with it.

Methods
A cross-sectional survey was conducted using a checklist to collect data from the hospital electronic database, which included sociodemographic details, payment type and clinical information of all ambulatory patients attending Keta Municipal Hospital, diagnosed and managed for CAP from September 2018 to January 2019. Prescriptions were assessed for adherence to the Ghana STG based on choice of antibiotics. A χ2 test and multiple logistic regression were subsequently conducted.

Results
A total of 1929 patient records with diagnosis of CAP within the study period at the ambulatory clinic were identified. The overall rate of adherence to the Ghana STG was 32.50% (n = 627). From the patient records collected, 62.50% were female, 41.84% were children (0–12 years), and 97.15% had a valid national health insurance status. Adherence was associated with the duration of antibiotic prescribing, number of additional antibiotics prescribed and some patients’ clinical characteristics.

Conclusions
The rate of adherence to Ghana STG among the study population was low. Efforts must be made to train and encourage prescribers to follow empirical guidelines to reduce inappropriate selection of antibiotics in the ambulatory care settings.
Management of Pediatric Pavement Burns
Authors: Saquib Syed , Carroll Joseph , Flores Carmen , Chestovich Paul 
Published: May 2021

Abstract
Pavement burns are common in a dry high heat climate. This study reviews the etiology, management, and outcome pavement burns in children. All patients age &lt;18 who sustained contact burns from hot pavement from January 1, 2014 to December 31, 2019 were reviewed for mechanism, medical history, treatment course, and outcome. The high ambient temperature on each date and zip code of each injury were extracted from Weather Underground (www.wunderground.com). In this study, 45 patients met criteria and were reviewed 27 patients (60%) were male. Average age was 3.29 years (SD 0.69), made up two discrete age groups: age 3 years and under (n = 40, 89%) and older patients 14 years of age and up (n = 5, 11%). Thirty-eight patients (84%) had no known medical history. All had second-degree burns and one patient (2%) also had third-degree burns. Mean TBSA was 2.5% (SD 1.4%, range 0.75%–5.5%). Burn etiology included 31 patients (69%) who were walking barefoot on pavement, six (13%) who fell onto pavement, one (2%) seizure, and other/unknown etiology for the remaining seven patients (16%). Thirty patients (67%) had injuries on the plantar aspect of the bilateral feet, two (4%) to bilateral palms of hands, four (9%) to other parts of upper extremities, and 10 (22%) to other parts of lower extremities. Thirty-four patients (76%) were managed without any hospitalization. Those that were hospitalized had an average length of stay of 2.72 days (range 1–9 days). All burns were managed nonoperatively with topical therapy alone. Thirty-four patients (76%) were managed initially with silver sulfadiazene alone and six (13%) with bacitracin alone. Aquacel dressing was utilized in 10 patients at a follow-up visit (22%). Three patients (6.7%) were treated with collagenase enzyme therapy at some point in their care. One patient developed a superficial infection requiring oral antibiotic therapy. There were no mortalities in this group. High ambient temperature on date and location of each injury was 102.1°F (SD 5.4°F, range 89–111°F). Of the 30 patients that continued to follow up in clinic the average time to the burn being 95% healed was 10.50 days (SD 8.97 days, range 2–40 days). Pavement burns in children are partial thickness and are safely managed with topical therapy alone with good outcomes. Patients age 3 and under are at high risk.
Don’t Downplay “Play”: Reasons Why Health Systems Should Protect Childhood Play
Authors: Nielsen Lasse 
Published: May 2021

AbstractMuch research has studied the importance of play for children’s development. However, questions of its political importance and our public institutions’ duties to protect it have been largely neglected. This article argues that childhood play is politically important due to having both intrinsic and instrumental value, and it suggests that the duty to protect the capability for play in childhood falls especially on the public health system. If this argument succeeds, it follows that we have stronger duties toward our children than we currently believe.