bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Cervical Assessment Using 2-Dimentional Transvaginal Shear Wave Elastography in Nonpregnant and Pregnant Women
Authors: Zhang Man , Townsel Courtney D. , Akers Lindsay B. , Kiros Leah , Treadwell Marjorie C. , Maturen Katherine E. 
Published: May 2021

Abstract
This study evaluated the technical feasibility of 2-dimensional transvaginal shear wave elastography to quantify cervical stiffness in nonpregnant and pregnant women and established normal values in each group. With institutional review board approval, we performed a prospective study with an age-matched historical control design. Sixteen premenopausal nonpregnant women without cervical pathology and 17 low-risk pregnant women (gestational age 17–33 weeks) were enrolled. Cervical shear wave speeds were measured on a SuperSonic Aixplorer machine. The mean shear wave speeds of anterior cervix were 4.96 ± 1.96 m/s in nonpregnant women and 1.92 ± 0.31 m/s in pregnant women. No significant stiffness difference was found between the anterior and posterior cervix (P = 0.15). The upper cervix was stiffer than the lower cervix in the pregnant women (P = 0.00012). Transvaginal shear wave elastography reveals that cervix at a midterm gestation is significantly softer than nonpregnant cervix (P < 0.0001) and suggests a spatial stiffness gradient along the length of the cervix, consistent with histopathology and limited elastography literature. Our results indicate the potential of transvaginal shear wave elastography to provide objective and quantitative estimates of cervical stiffness, especially during pregnancy.
Efficacy of Shear Wave Elastography in the Differentiation of Acute and Subacute Deep Venous Thrombosis
Authors: Durmaz Fatma , Gultekin Mehmet Ali 
Published: May 2021

Abstract
It is important to know the age of clot formation to determine an appropriate treatment for deep vein thrombosis (DVT). The present study aims to differentiate between acute and subacute DVT using the shear wave elastography (SWE) technique. Patients with complaints no longer than 4 weeks and who were found to have early-stage (acute-subacute) thrombus on ultrasound (US) between January 2020 and May 2020 were included in the study. All of the patients underwent SWE using a Philips Healthcare EPIQ 5 Ultrasound System Inc. device with a high-resolution linear US probe (eL18-4, 22–2 MHz). Included in the study were 50 patients, including 23 with acute DVT and 27 with subacute DVT. Of the patients, 22 were women and 28 were men, and the mean age was 46.32 ± 11.33 years (range: 24–74 years). The mean SWE value was 2.63± 0.16 (2.39–2.96) in patients with acute DVT and 3.34± 0.31 (2.65–3.88) in patients with subacute DVT. The findings were statistically significant in the comparison of the 2 groups using an independent samples t test (P < 0.001). In the receiver operating characteristic analysis, the area under the curve was found to be 97.6%. When the cutoff value was taken as 2.85 according to the area under the curve, sensitivity was found to be 96.3%, and specificity was 91.3%. Thrombus stage plays a critical role in treatment decisions in DVT in the lower extremities. The present study reveals that the shear wave US elastography technique can be used to discriminate between acute and subacute DVT.
Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound
Authors: Routzong Megan R. , Abramowitch Steven D. , Chang Cecilia , Goldberg Roger P. , Rostaminia Ghazaleh 
Published: May 2021

Abstract
We used dynamic pelvic floor ultrasound to investigate the relationship between obstructed defecation symptom (ODS) severity and the degree of rectal hypermobility/folding. In this retrospective study, women who presented with ODS from October 2017 to January 2019 and underwent an interview, pelvic examination, and pelvic floor ultrasound were recruited. Patients were diagnosed with abdominal constipation, dyssynergia, or pelvic constipation. Pelvic constipation patients were categorized based on their reported frequency of incomplete emptying of stool (<50% or ≥50% of bowel movements) representing mild and severe ODS, respectively. Using dynamic ultrasound, rectal hypermobility was quantified via rectovaginal septum length at rest and Valsalva and its compression ratio, where shorter lengths and larger compression ratios are indicative of increased rectal hypermobility. One hundred twenty-one patients (41 with abdominal constipation, 7 with dyssynergia, and 73 with pelvic constipation) were included. Compression ratios were higher in women with severe versus mild ODS (17.36 ± 16.89 vs 36.38 ± 25.82, P = 0.0039). The risk of having severe symptoms was 4 times greater (odds ratio = 4.2, 95% confidence interval = 1.4 to 12.6, P = 0.01) among those with a high compression ratio (≥20%) after controlling for age, body mass index, and levator plate descent angle. Incomplete emptying was weakly, positively, linearly correlated with rectal hypermobility/folding (r = −0.2724, −0.3767 to 0.3922, and P = 0.0197, 0.0010, 0.0006, respectively). Women with more severe ODS experienced more rectal hypermobility/folding as measured via dynamic ultrasound—a cheaper, effective alternative to magnetic resonance defecography for evaluation of obstructed defecation.
Interobserver Agreement Between Primary Sonographers and Secondary Overreaders for Screening and Surveillance Liver Ultrasounds Using Ultrasound Liver Imaging Reporting and Data System
Authors: Dawkins Adrian , Nelson Leslie W. , Gulati Vaibhav , Stepp Angela , Chapelin Fanny , Khurana Aman 
Published: May 2021

Abstract
The authors aim to identify if primary sonographers and secondary reviewers, both radiologists and sonographers, are likely to assign the same Ultrasound Liver Imaging Reporting and Data System (US LI-RADS) scores for liver surveillance ultrasounds. Institutional review board approval was obtained. Sonographers were familiarized with US LI-RADS via radiologist-led lectures. Three sonographers prospectively scored 170 screening examinations using US LI-RADS recommendations. Scans were retrospectively rescored by a fourth sonographer and a radiologist, both of whom were blinded to the original scores. Results were analyzed with weighted and nonweighted Cohen kappa statistical analysis methods. There was near-perfect agreement between primary and secondary sonographers and primary sonographer and radiologist (kappa of 0.87 and 0.92, respectively) for US LI-RADS category (cat) scores. However, only substantial and moderate agreements were noted for visualization (vis) scores between primary and secondary sonographers and primary sonographer and radiologist (weighted kappa of 0.73 and 0.48, respectively). There was vis score disagreement between the primary sonographer and radiologist in 60 (35.3%) cases. In 35 (20%) cases, the radiologist assigned a lower/more conservative vis score. There was vis score disagreement between the primary and secondary reviewing sonographers in 30 (17.6%) cases. In 12 (7%) cases, the secondary sonographer assigned a more conservative vis score. Although a good degree of concordance was noted between the groups, radiologists will need to generate their own US LI-RADS scoring to accurately reflect their impression and appropriately steer management.
Ultrasound Studies of COVID-19–Positive Patients and Patient Under Investigation
Authors: Gawande Rakhee S. , Vadvala Harshna V. , Shan Alan , Sheth Sheila 
Published: May 2021

Abstract
This retrospective study shares our departmental experience of screening of ultrasound (US) requests, triaging of studies, and abbreviated US protocols implemented during the COVID-19 pandemic. For US studies requested in April and May 2020, the following data were collected: type of study, indication, COVID-19 status (positive or patient under investigation [PUI]), decision to perform study, US findings, and location of patient. A total of 196 US studies in 150 patients were included. The median age of patients was 60 years (female: 46.7% [70/150]). At the time of study request, 83 patients (55.3%) were COVID-19–positive and 67 (44.7%) were PUI, of which 8 (11.9%) tested positive after waiting for test result. The most frequently requested study was venous extremity Doppler (51%), followed by right upper quadrant (20.4%), renal (11.7%), and liver duplex (6.6%). After radiologist screening and triage of US requests, 156 studies were performed (79.6%), 15 were postponed until COVID test result (7.6%), and 40 were not performed after discussion with ordering provider (20.4%). Notably, 40.1% of studies performed on COVID-19–positive patients yielded pathological findings, most frequently deep venous thrombosis (18.1%), medical renal disease (7.6%), and gall bladder sludge (5.7%). Abbreviated US protocols were used in 29.4% of studies. In conclusion, US study screening and triage played an important role to optimize care of COVID-19 patients and PUIs.
Use of Simulation to Visualize Healthcare Worker Exposure to Aerosol in the Operating Room
Authors: Frauenfelder Claire , Hall Andrew , Walsh Bill , Ross Alasdair , Broughton Emma , Hynds Robert E. , Nandi Reema , O'Callaghan Christopher , Butler Colin R. 
Published: May 2021

Summary Statement
Simulation resources offer an opportunity to highlight aerosol dispersion within the operating room environment. We demonstrate our methodology with a supporting video that can offer operating room teams support in their practical understanding of aerosol exposure and the importance of personal protective equipment.
Circulating Donor Lung-specific Exosome Profiles Enable Noninvasive Monitoring of Acute Rejection in a Rodent Orthotopic Lung Transplantation Model
Authors: Habertheuer Andreas , Ram Chirag , Schmierer Maggie , Chatterjee Shampa , Hu Robert , Freas Andrew , Zielinski Patrick , Rogers Wade , Silvestro Eva M. , McGrane Michael , Moore Jonni S. , Korutla Laxminarayana , Siddiqui Sarmad , Xin Yi , Rizi Rahim , Qin Tao Jian , Kreisel Daniel , Naji Ali , Ochiya Takahiro , Vallabhajosyula Prashanth 
Published: May 2021

Background.
There is a critical need for development of biomarkers to noninvasively monitor for lung transplant rejection. We investigated the potential of circulating donor lung-specific exosome profiles for time-sensitive diagnosis of acute rejection in a rat orthotopic lung transplant model.

Methods.
Left lungs from Wistar transgenic rats expressing human CD63-GFP, an exosome marker, were transplanted into fully MHC-mismatched Lewis recipients or syngeneic controls. Recipient blood was collected between 4 h and 10 d after transplantation, and plasma was processed for exosome isolation by size exclusion column chromatography and ultracentrifugation. Circulating donor exosomes were profiled using antihuman CD63 antibody quantum dot on the nanoparticle detector and via GFP trigger on the nanoparticle flow cytometer.

Results.
In syngeneic controls, steady-state levels of circulating donor exosomes were detected at all posttransplant time points. Allogeneic grafts lost perfusion by day 8, consistent with acute rejection. Levels of circulating donor exosomes peaked on day 1, decreased significantly by day 2, and then reached baseline levels by day 3. Notably, decrease in peripheral donor exosome levels occurred before grafts had histological evidence of acute rejection.

Conclusions.
Circulating donor lung-specific exosome profiles enable an early detection of acute rejection before histologic manifestation of injury to the pulmonary allograft. As acute rejection episodes are a major risk factor for the development of chronic lung allograft dysfunction, this biomarker may provide a novel noninvasive diagnostic platform that can translate into earlier therapeutic intervention for lung transplant patients.
Early childhood trauma, substance use and complex concurrent disorders among adolescents
Authors: Cabanis Maurice , Outadi Ava , Choi Fiona 
Published: May 2021

Purpose of review
To highlight the interdependence between early childhood trauma, substance use and complex concurrent disorders among adolescents and discuss the delayed response and gaps in the healthcare system.

Recent findings
High-risk behavior such as suicidality, self-harm and hazardous substance use including overdose and the use of psychotropic substances for self-medication of mental health challenges is a growing concern. These symptoms are often related to early childhood trauma, substance use and complex concurrent disorders. Most countries do not have a youth mental healthcare system, there are no specific guidelines and only few programs addressing high-risk substance use are in place.

Summary
In addition to the significance of traumatic experience for high-risk substance use and addiction, most parts of the system of care ignore the trauma aspect in treatment of substance use and focus on abstinence. There are hardly any early intervention programs, broader prevention strategies or evidence-based or target-group-oriented treatment offers.
Digging the channels of inheritance: On how to distinguish between cultural and biological inheritance
Authors: Kronfeldner Maria 
Published: May 2021

Theories of cultural evolution rest on the assumption that cultural inheritance is distinct from biological inheritance. Cultural and biological inheritance are two separate so-called channels of inheritance, two sub-systems of the sum total of developmental resources travelling in distinct ways between individual agents. This paper asks:what justifies this assumption?In reply, a philosophical account is offered that points at three related but distinct criteria that (taken together) make the distinction between cultural and biological inheritance not only precise but also justify it as real, i.e. as ontologically adequate. These three criteria are (i) the autonomy of cultural change, (ii) the near-decomposability of culture and (iii) differences in temporal order between cultural and biological inheritance.This article is part of the theme issue ‘Foundations of cultural evolution’.
Culture, humanities, evolution: the complexity of meaning-making over time
Authors: Leerssen Joep 
Published: May 2021

This article outlines how the historical human sciences see ‘culture’ and its dynamic developments over time and over generations. The operations of human culture are systemically self-reflexive and, as a result, exhibit a complexity that sets them apart, as a semiotic system, from mere communicative information transfer. Peculiar to this complexity is the two-way interaction between the ‘etic’ substance of the cultural exchanges and their ‘emic’ function. Cultural signals require parallel etic/emic processing at stacked levels of complexity. As a result of this complexity, the homeostasis and autopoiesis of human culture, including its dynamics and development over time, cannot be explained fully in terms of responses to the physical environment. How, this article ponders by way of conclusion, can an evolutionary approach be reconciled with these characteristics of human culture, or the notion of culture be applied to evolutionary modelling?This article is part of the theme issue ‘Foundations of cultural evolution’.
Modelling cultural systems and selective filters
Authors: Jansson Fredrik , Aguilar Elliot , Acerbi Alberto , Enquist Magnus 
Published: May 2021

A specific goal of the field of cultural evolution is to understand how processes of transmission and selection at the individual level lead to population-wide patterns of cultural diversity and change. Models of cultural evolution have typically assumed that traits are independent of one another and essentially exchangeable. But culture has a structure: traits bear relationships to one another that affect the transmission and selection process itself. Here, we introduce a modelling framework to explore the effect of interdependencies on the process of learning. Through simulations, we find that introducing a simple structure changes the cultural dynamics. Based on a basic filtering mechanism for parsing trait relationships, more elaborate cultural filters emerge. In a mostly incompatible cultural domain of traits, these filters organize culture into mostly (but not fully) consistent and stable systems. Incompatible domains produce small homogeneous cultures, while more compatibility increases size, diversity and group divergence. When individuals copy based on a trait’s features (here, its compatibility relationships), they produce more homogeneous cultures than when they copy based on the agent carrying the cultural trait. We discuss the implications of considering cultural systems and filters in the dynamics of cultural change.This article is part of the theme issue ‘Foundations of cultural evolution’.
The cultural evolution and ecology of institutions
Authors: Currie Thomas E. , Campenni Marco , Flitton Adam , Njagi Tim , Ontiri Enoch , Perret Cedric , Walker Lindsay 
Published: May 2021

Human societies are structured by what we refer to as ‘institutions’, which are socially created and culturally inherited proscriptions on behaviour that define roles and set expectations about social interactions. The study of institutions in several social science fields has provided many important insights that have not been fully appreciated in the evolutionary human sciences. However, such research has often lacked a shared understanding of general processes of change that shape institutional diversity across space and time. We argue that evolutionary theory can provide a useful framework for synthesizing information from different disciplines to address issues such as how and why institutions change over time, how institutional rules co-evolve with other culturally inherited traits, and the role that ecological factors might play in shaping institutional diversity. We argue that we can gain important insights by applying cultural evolutionary thinking to the study of institutions, but that we also need to expand and adapt our approaches to better handle the ways that institutions work, and how they might change over time. In this paper, we illustrate our approach by describing macro-scale empirical comparative analyses that demonstrate how evolutionary theory can be used to generate and test hypotheses about the processes that have shaped some of the major patterns we see in institutional diversity over time and across the world today. We then go on to discuss how we might usefully develop micro-scale models of institutional change by adapting concepts from game theory and agent-based modelling. We end by considering current challenges and areas for future research, and the potential implications for other areas of study and real-world applications.This article is part of the theme issue ‘Foundations of cultural evolution’.
The evolution of social learning as phenotypic cue integration
Authors: Kuijper Bram , Leimar Olof , Hammerstein Peter , McNamara John M. , Dall Sasha R. X. 
Published: May 2021

Most analyses of the origins of cultural evolution focus on when and where social learning prevails over individual learning, overlooking the fact that there are other developmental inputs that influence phenotypic fit to the selective environment. This raises the question of how the presence of other cue ‘channels’ affects the scope for social learning. Here, we present a model that considers the simultaneous evolution of (i) multiple forms of social learning (involving vertical or horizontal learning based on either prestige or conformity biases) within the broader context of other evolving inputs on phenotype determination, including (ii) heritable epigenetic factors, (iii) individual learning, (iv) environmental and cascading maternal effects, (v) conservative bet-hedging, and (vi) genetic cues. In fluctuating environments that are autocorrelated (and hence predictable), we find that social learning from members of the same generation (horizontal social learning) explains the large majority of phenotypic variation, whereas other cues are much less important. Moreover, social learning based on prestige biases typically prevails in positively autocorrelated environments, whereas conformity biases prevail in negatively autocorrelated environments. Only when environments are unpredictable or horizontal social learning is characterized by an intrinsically low information content, other cues such as conservative bet-hedging or vertical prestige biases prevail.
This article is part of the theme issue ‘Foundations of cultural evolution’.
Not by transmission alone: the role of invention in cultural evolution
Authors: Perry Susan , Carter Alecia , Smolla Marco , Akçay Erol , Nöbel Sabine , Foster Jacob G. , Healy Susan D. 
Published: May 2021

Innovation—the combination of invention and social learning—can empower species to invade new niches via cultural adaptation. Social learning has typically been regarded as the fundamental driver for the emergence of traditions and thus culture. Consequently, invention has been relatively understudied outside the human lineage—despite being the source of new traditions. This neglect leaves basic questions unanswered: what factors promote the creation of new ideas and practices? What affects their spread or loss? We critically review the existing literature, focusing on four levels of investigation: traits (what sorts of behaviours are easiest to invent?), individuals (what factors make some individuals more likely to be inventors?), ecological contexts (what aspects of the environment make invention or transmission more likely?), and populations (what features of relationships and societies promote the rise and spread of new inventions?). We aim to inspire new research by highlighting theoretical and empirical gaps in the study of innovation, focusing primarily on inventions in non-humans. Understanding the role of invention and innovation in the history of life requires a well-developed theoretical framework (which embraces cognitive processes) and a taxonomically broad, cross-species dataset that explicitly investigates inventions and their transmission. We outline such an agenda here.This article is part of the theme issue ‘Foundations of cultural evolution’.
Beyond social learning
Authors: Singh Manvir , Acerbi Alberto , Caldwell Christine A. , Danchin Étienne , Isabel Guillaume , Molleman Lucas , Scott-Phillips Thom , Tamariz Monica , van den Berg Pieter , van Leeuwen Edwin J. C. , Derex Maxime 
Published: May 2021

Cultural evolution requires the social transmission of information. For this reason, scholars have emphasized social learning when explaining how and why culture evolves. Yet cultural evolution results from many mechanisms operating in concert. Here, we argue that the emphasis on social learning has distracted scholars from appreciating both the full range of mechanisms contributing to cultural evolution and how interactions among those mechanisms and other factors affect the output of cultural evolution. We examine understudied mechanisms and other factors and call for a more inclusive programme of investigation that probes multiple levels of the organization, spanning the neural, cognitive-behavioural and populational levels. To guide our discussion, we focus on factors involved in three core topics of cultural evolution: the emergence of culture, the emergence of cumulative cultural evolution and the design of cultural traits. Studying mechanisms across levels can add explanatory power while revealing gaps and misconceptions in our knowledge.
This article is part of the theme issue ‘Foundations of cultural evolution’.