bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Serum Thyroxine and Atrial Fibrillation in Patients on Levothyroxine
Authors: Kravchenko Maria , Forbes Whitney , Graybill Sky 
Published: June 2024

ABSTRACT

Introduction
Excess thyroid hormone is a well-documented risk factor for the development of atrial fibrillation (AF). The purpose of the study is to assess incidence of AF in patients taking levothyroxine for hypothyroidism and correlate it with biochemical thyroid function.

Materials and Methods
This was a retrospective cohort study of patients aged 18 years and older who were treated with levothyroxine. Exclusion criteria were pre-existing diagnosis of AF and use of amiodarone in the prior year. Patients were followed 2012 through 2019 and stratified into 4 groups based on mean thyroid-stimulating hormone (TSH) value or mean fT4 value in 2012. Primary outcome was incidence of AF. Rates of AF between groups were assessed via Poisson regression with control of underlying confounders.

Results
Of 21,035 patients, 1091 (5.2%) developed AF during follow-up. Thyroid-stimulating hormone at baseline was not significantly associated with incident AF. Higher fT4 levels at baseline were associated with increased AF risk in age- and sex-adjusted analyses (hazard ratio 1.22; 95% CI, 1.03-1.44) for the highest quartile versus the lowest quartile of fT4.

Conclusions
In hypothyroid patients treated with levothyroxine, higher circulating fT4 levels are associated with increased risk of incident AF. There is no association of serum TSH with risk of AF. In patients at risk for AF, consideration should be given to avoiding fT4 levels in the highest quartile.
How Much Does Intravenous Fluid Cause Hematocrit to Drop? Improving Interpretation of Hematocrit Toward Better Post-Hemorrhage Care
Authors: Qureshi Nabeel , Bloom Matthew , Pevnick Joshua 
Published: June 2024

ABSTRACT

Introduction
Hemorrhage is assessed, at least in part, via hematocrit testing. To differentiate unexpected drops in hematocrit because of ongoing hemorrhage versus expected drops as a result of known hemorrhage and intravenous fluid administration, we model expected post-operative hematocrit values accounting for fluid balance and intraoperative estimated blood loss (EBL) among patients without substantial post-operative bleeding.

Materials and Methods
We reviewed patient-level data from the electronic health record of an academic medical center for all non-pregnant adults admitted for elective knee or hip arthroplasty from November 2013 to September 2022 who did not require blood products. We used linear regression to evaluate the association between post-operative hematocrit and predictor variables including pre-operative hematocrit, intraoperative net fluid intake, blood volume, time from surgery to lab testing, EBL, patient height, and patient weight.

Results
We included 6,648 cases. Mean (SD) estimated blood volume was 4,804 mL (1023), mean net fluid intake was 1,121 mL (792), and mean EBL was 144 mL (194). Each 100 mL of EBL and 1,000 mL net positive fluid intake was associated with a decrease of 0.52 units (95% CI, 0.51-0.53) and 2.4 units (2.2-2.7) in post-operative hematocrit. Pre-operative hematocrit was the strongest predictor of post-operative hematocrit. Each 1-unit increase in pre-operative hematocrit was associated with a 0.70-unit increase (95% CI, 0.67-0.73) in post-operative hematocrit. Our estimates were robust to sensitivity analyses, and all variables included in the model were statistically significant with P &lt;.005.

Conclusion
Patient-specific data, including fluid received since the time of initial hemorrhage, can aid in estimating expected post-hemorrhage hematocrit values, and thus in assessing for the ongoing hemorrhage.
The Human Developing Cerebral Cortex Is Characterized by an Elevated De Novo Expression of Long Noncoding RNAs in Excitatory Neurons
Authors: Morales-Vicente David A , Tahira Ana C , Woellner-Santos Daisy , Amaral Murilo S , Berzoti-Coelho Maria G , Verjovski-Almeida Sergio 
Published: June 2024

Abstract
The outstanding human cognitive capacities are computed in the cerebral cortex, a mammalian-specific brain region and the place of massive biological innovation. Long noncoding RNAs have emerged as gene regulatory elements with higher evolutionary turnover than mRNAs. The many long noncoding RNAs identified in neural tissues make them candidates for molecular sources of cerebral cortex evolution and disease. Here, we characterized the genomic and cellular shifts that occurred during the evolution of the long noncoding RNA repertoire expressed in the developing cerebral cortex and explored putative roles for these long noncoding RNAs in the evolution of the human brain. Using transcriptomics and comparative genomics, we comprehensively annotated the cortical transcriptomes of humans, rhesus macaques, mice, and chickens and classified human cortical long noncoding RNAs into evolutionary groups as a function of their predicted minimal ages. Long noncoding RNA evolutionary groups showed differences in expression levels, splicing efficiencies, transposable element contents, genomic distributions, and transcription factor binding to their promoters. Furthermore, older long noncoding RNAs showed preferential expression in germinative zones, outer radial glial cells, and cortical inhibitory (GABAergic) neurons. In comparison, younger long noncoding RNAs showed preferential expression in cortical excitatory (glutamatergic) neurons, were enriched in primate and human-specific gene co-expression modules, and were dysregulated in neurodevelopmental disorders. These results suggest different evolutionary routes for older and younger cortical long noncoding RNAs, highlighting old long noncoding RNAs as a possible source of molecular evolution of conserved developmental programs; conversely, we propose that the de novo expression of primate- and human-specific young long noncoding RNAs is a putative source of molecular evolution and dysfunction of cortical excitatory neurons, warranting further investigation.
Dose delay, dose reduction, and early treatment discontinuation in Black and White women receiving chemotherapy for nonmetastatic breast cancer
Authors: Forster Moriah , Deal Allison M , Page Annie , Vohra Sanah , Wardell Alexis C , Pak Joyce , Lund Jennifer L , Nyrop Kirsten A , Muss Hyman B 
Published: June 2024

Abstract

Background
To describe reasons for deviations from planned chemotherapy treatments in women with nonmetastatic breast cancer that contribute to less-than-planned receipt of chemotherapy.

Methods
Electronic medical records for patients receiving chemotherapy were reviewed for adverse events and treatment modifications. Log-binomial regression models were used to estimate relative risks (RRs) with 95% CIs to examine associations between chemotherapy modifications, patient characteristics, and treatment modalities.

Results
Delays in chemotherapy initiation (7%) were for surgical complications (58%), personal reasons (16%), and other (26%; port malfunction, infections, and obtaining extra imaging). Delays during chemotherapy (38%) were for infections (20%), neutropenia (13%), and personal reasons (13%). Dose reductions (38%) were for neuropathy (36%), unknown causes (9%), anemia (9%), and neutropenia (8%). Early treatment discontinuations (23%) were for neuropathy (29%). Patients receiving paclitaxel/nab-paclitaxel (RR 2.05; 95% CI, 1.47-2.87) and an anthracycline (RR 1.89; 95% CI, 1.39-2.57) reported more dose delays during chemotherapy. Black race (RR 1.46; 95% CI, 1.07-2.00), stage 3 (RR 1.79; 95% CI, 1.09-2.93), and paclitaxel/nab-paclitaxel receipt (RR 1.39; 95% CI, 1.02-1.90) increased the likelihood of dose reduction. Both Black race (RR 2.06; 95% CI, 1.35-3.15) and receipt of paclitaxel/nab-paclitaxel (RR 1.93; 95% CI, 1.19-3.13) increased the likelihood of early discontinuation. Patients receiving anthracyclines had higher rates of hospitalizations during chemotherapy (RR: 1.79; 95% CI, 1.11-2.89).

Conclusion
Toxicities are the most common reason for treatment modifications and need close monitoring in high-risk groups for timely intervention. Dose reductions and early treatment discontinuations occurred more for Black patients and need further study.
Visualizing Music with Video Game Technologies
Authors: Weinel Jonathan 
Published: June 2024

Abstract
Jonathan Weinel examines the use of video game engines for purposes other than gaming: specifically, how the software can be used for the purposes of visualizing music in scenarios such as audiovisual installations and concerts. The chapter outlines the early history of music visualization and music visualization’s relationship to multimodal perception and synesthesia, and then shows how video game engines can be used for the visualization of music in pedagogical contexts far removed from game development education. Weinel identifies a new paradigm emerging where older means of visualizing music are reinvigorated with the interactive possibilities and mechanics offered by video game engines.
Beyond Nerdcore
Authors: Lumumba-Kasongo Enongo 
Published: June 2024

Abstract
Using interviews with practitioners, while also drawing on personal experience, Enongo Lumumba-Kasongo explores the vibrant music subgenre of gamer-rap, focusing on the experiences of artists of color. As Lumumba-Kasongo uncovers, in the past decade, such artists had to navigate a path that risked either alienating non-Black audiences (due to the subgenre’s proximity to nerd/geek rap) or undermining their credibility in the wider world of hip-hop. As gamer-rap becomes more mainstream through lucrative deals with game studios and record labels, Lumumba-Kasongo sets out to bear witness to those artists who laid the foundation for this growth but have been largely ignored in academic scholarship and the nerd/geek rap scene.
Game Noir
Authors: Collins Jacob 
Published: June 2024

Abstract
Jazz soundtracks in film-noir-inspired detective video games are the focus of Jacob Collins’s chapter. The use of jazz in such games is leveraged by game developers to quickly convey framing information to players, a device adapted from the use of jazz in cinematic genres such as film noir and the later neonoir, but, as Collins notes, such tropes and clichés can be problematic. The chapter demonstrates how jazz is used to frame these games in the noir genre, but Collins also shows how the use of jazz in game noir can all too often reinforce and play to the racist and misogynistic stereotypes that came to be associated with the music through its representation in early film noir.
Taking a Pop at Ludonarratology
Authors: Ivănescu Andra 
Published: June 2024

Abstract
Andra Ivănescu’s chapter examines the relevance of narrative theories to an understanding of music in video games. Ivănescu acknowledges the debates and criticism surrounding the relationships between narrative and the fields of musicology and game studies, while arguing that narrative theories and narratological approaches can serve to enrich the field of ludomusicology. Concentrating on the use of popular music in games, Ivănescu shows that this use not only provides worthwhile ludic and musical experiences to players but also narrative experiences, and thus narrative, at least in the intersection between popular music and video games, is a productive field of inquiry for researchers.
Embeddedness and the psychological nature of default reason: On how particularists should address the flattening objection
Authors: Tsu Peter Shiu-Hwa 
Published: June 2024

Abstract
Particularism is widely conceived to endorse the view that moral reason is context-dependent. This being so, it is often accused of flattening the moral landscape—treating the feature of promise-keeping as constituting no more of a (moral) reason for action than the feature of wearing a yellow shoelace in advance of the considerations of the contexts. In reply, Dancy maintains that his particularism allows some features such as promise-keeping to have a reason status by default, ontologically speaking; it is just that their default reason status might get ‘switched off’ in some contexts. In this paper, I will argue that Dancy's ontological understanding of default reason wouldn't help the particularists address the flattening objection, due to a violation of what Tsu calls ‘the embedded thesis’, which is a general constraint on how moral reason behaves. However, once the nature of default reason is correctly understood as psychological, particularism will be enabled to deflate the flattening objection, or so I will argue.
Identifying oncology caregivers' pretreatment educational and emotional needs to inform future virtual reality educational interventions
Authors: Birkhoff Susan D. , Donovan Heidi , Lee Young Ji 
Published: June 2024

Abstract

Purpose:
To identify oncology caregivers' unmet educational needs for the development of a virtual reality experience.

Methods:
A qualitative descriptive methodology was used; data were collected via online surveys.

Results:
Eighteen participants said their educational experiences were overwhelming and emotionally exhausting. They suggested a need to deliver educational information through different modalities and provide more clinician-based resources and support.

Conclusion:
This study identified opportunities to complement traditional pretreatment education tailored to the caregivers' needs and experiences, such as specific procedural information and emotional management while being a caregiver. Creating virtual reality experiences exclusively for oncology caregivers is a novel nurse-led approach that is currently not in existence.
Nepali Translation, Validity and Reliability Study of the Cohen-Hoberman Inventory of Physical Symptoms for Utilization With Bhutanese Refugees
Authors: Walton Lori Maria , Hakim Renee , Schwartz Jennifer , Raigangar Veena , Zaaeed Najah , Neff-Futrell Sarah 
Published: June 2024

Background and Objectives:
Language-appropriate outcome measurements help to improve health equity. The purpose of this study was to translate and validate the Cohen-Hoberman Inventory of Physical Symptoms (CHIPS) in Nepali for Bhutanese refugee utilization.

Methods:
English-Nepali forward and back translations of CHIPS were completed by an official translator and evaluated by three content experts. A scaled rubric measured the following constructs: neurogenic stress response (NSR), somatic stress response (SSR), and visceral stress response (VSR). Data were analyzed using SPSS 26.0.

Results:
The Nepali version of CHIPS reported good content validity, strong internal consistency (Cronbach’s α = .94), and inter-rater reliability (ICC = 0.91). Kappa statistic reported 88% to 96% agreement. Constructs of NSR (0.91), SSR (0.94), and VSR (0.94) reported strong internal consistency.

Conclusions:
The Nepali translated version of CHIPS showed strong validity and reliability for utilization in the Bhutanese refugee population and improves health access to outcome measurements for a vulnerable population.
Update on Managing the Risks of Exposure to Lentiviral and Retroviral Vectors
Authors: Fujimoto Gary R. , Wooley Dawn P. , Byers Karen B. , Yang Otto O. , Behrman Amy J. , Winters Thomas H. , Hudson T. Warner 
Published: June 2024

Objective
This paper aims to review the risks associated with using lentiviral and retroviral vectors in research and clinical settings and to propose an update to an effective treatment plan.

Methods
Risks of exposure were evaluated based on vector design, safety features, viral tropism, transgene, and means and modes of transmission. These risks were weighed against the potential risks and benefits of current HIV medications.

Results
We recommend the following postexposure prophylactic treatment for significant lentiviral vector exposures: 1) dolutegravir 50 mg taken once a day for 7 days and 2) tenofovir disoproxil fumarate 300 mg taken once a day for 7 days (28 days of both medications for replication-competent vectors).

Conclusions
Because of the highly efficient delivery of transgenes by modern lentiviral and retroviral vectors, postexposure prophylaxis is indicated to prevent vector integration and oncogenic risks.
Safety and efficacy of intrawound vancomycin powder in the prevention of lumbar surgical site infection: a prospective, double-blind, randomized controlled study
Authors: Han Bo , Lu Hongyi , Pan Aixing , Guan Li , Cheng Fengqi , Zhao Mingzheng , Chu Shuilian , Hai Yong , Liu Yuzeng 
Published: June 2024

Background:
To evaluate the safety and efficacy of intrawound vancomycin powder in reducing surgical site infections (SSIs) after spine surgery.

Design:
A prospective, double-blind, randomized controlled study.

Participants:
Patients who underwent posterior lumbar interbody fusion (PLIF) surgery from May 2021 to September 2022.

Methods:
Patients who underwent PLIF surgery between May 2021 and September 2022 were included. Participants were randomized to the vancomycin treatment or control groups using block randomization (block size 4). Except for baseline and surgical data, the plasma levels of white blood cells, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), aspartate aminotransferase, alanine aminotransferase, and serum vancomycin concentration in the groups were analyzed on postoperative days (PODs) 1, 3, and 5. Vancomycin concentration was measured daily until the drainage tubes were removed. The primary outcomes were the 90-day vancomycin-related adverse reactions and SSI rates. Secondary outcomes were perioperative hematological parameters and vancomycin serum (drain) concentrations.

Results:
A total of 156 participants (78 each in each group) were analyzed by an independent researcher. The follow-up rate was 91%. All participants were followed up for at least 90 days. The 90-day SSI rate in the vancomycin group was 1.3% (1/78), comprising one case of superficial infection. The SSI rate in the control group was 10.3% (8/78), comprising seven cases of superficial infection and one case of deep infection. Compared with that in the control group, the SSI rate in the vancomycin group was decreased by 87.5%, with a statistically significant difference (RR=0.125, 95% CI=0.016–0.976). Additionally, the vancomycin group demonstrated a statistically significant decrease in serum ESR on POD 3 (P=0.039) and CRP on POD 5 (P=0.024) compared to the control group. The local plasma concentration of vancomycin remained elevated for at least 4 days postoperatively, while the serum concentration of vancomycin remained low. Vancomycin-associated adverse reactions were not observed.

Conclusion:
Intrawound application of vancomycin powder is a safe and effective procedure for reducing the risk of SSI during PLIF surgery.
Prognostic factors of extracorporeal shockwave therapy in the treatment of nonunion in long bones: a retrospective study
Authors: Wu Kuan-Ting , Cheng Jai-Hong , Jhan Shun-Wun , Chen Po-Cheng , Wang Ching-Jen , Chou Wen-Yi 
Published: June 2024

Background:
Nonunion of long bone fractures is a significant complication following surgical fixation, with an incidence ranging from 5 to 10%. Surgical intervention is the standard treatment for nonunions, but it may come with potential complications. Nonoperative approaches, such as Extracorporeal Shockwave Therapy (ESWT), have been advocated as alternatives.

Methods:
In the retrospective study conducted between January 2004 and January 2018, 91 patients who underwent ESWT for tibia or femur nonunions were included. Nonunion was defined based on radiographic criteria and clinical symptoms. The nonunion morphology was categorized as hypertrophic, oligotrophic, or atrophic. ESWT was administered using the OssaTron device in a single treatment session. Bony union was defined as the presence of a bridging callus over the fracture site with more than three-fourths of the circumference in both planes within the 12-month postoperative period.

Results:
The study included 91 patients, with an overall union rate of 62.6%. A higher healing rate was observed in trophic nonunion(69.9%) than in atrophic nonunion(33.3%). Multivariate analysis identified the number of surgeries, maximum fracture gap, and atrophic nonunion as independent factors influencing the risk of fracture nonunion after ESWT. The receiver operating characteristic curves were generated for these factors, providing more than one surgical intervention, and fracture gap greater than 3.94 mm as negative predictors of ESWT for long bone nonunions.

Conclusion:
The study’s primary findings suggest that ESWT is effective in achieving bony union for nonunions in long bones(62.6%). Despite the overall positive results, the study highlights that atrophic nonunions, larger fracture gaps of more than 3.94 mm, and multiple surgeries are associated with poorer outcomes.
The dynamics of drowning
Authors: Lareau Stephanie A. , Haines Carver , Sotelo Matthew , Davis Christopher A. 
Published: June 2024

Abstract:
Drowning is the process of respiratory impairment from immersion or submersion in a liquid. Worldwide, approximately 360,000 deaths annually can be attributed to drowning. Morbidity and mortality are a result of hypoxia, so the focus during resuscitation should be on airway management and optimizing oxygenation. This article describes several drowning scenarios and discusses appropriate response and treatment algorithms.
Vision-related quality of life, photoaversion, and optical rehabilitation in achromatopsia
Authors: Andersen Mette Kjøbæk Gundestrup , Jordana Joaquim Torner , Nielsen Hanne , Gundestrup Svend , Kessel Line 
Published: June 2024

SIGNIFICANCE
We report on photoaversion and patient-reported quality of life in Danish patients with achromatopsia and evaluate the best optical rehabilitation. Our results contribute to the evaluation of outcome measures in therapy trials and aid in providing the best optical rehabilitation for patients with this and clinically similar conditions.

PURPOSE
This study aimed to investigate the vision-related quality of life, the impact of photoaversion on daily living, and the best optical rehabilitation in a cohort of achromatopsia patients, including testing the hypothesis that red light-attenuating filters are generally preferred.

METHODS
Patients with genetically verified achromatopsia were recruited. Investigations included the 25-item Visual Function Questionnaire and supplementary questions regarding photoaversion and visual aids. Patients were evaluated by a low vision optometrist and given the choice between different light-attenuating filters. First, two specially designed red and gray filters both transmitting 6% light, and then a pre-defined broader selection of filters. Best-corrected visual acuity and contrast sensitivity were measured without filters and with the two trial filters.

RESULTS
Twenty-seven patients participated. Median 25-item Visual Function Questionnaire composite score was 73, with the lowest median score in the subscale near vision (58) and the highest in ocular pain (100). The majority of patients (88%) reported that light caused them discomfort, and 92% used aid(s) to reduce light. Ninety-six percent (26 of 27) preferred the gray filter to the red indoors; 74% (20 of 27) preferred the gray filter. Contrast sensitivity was significantly better with the gray filter compared with no filter (p=0.003) and the red filter (p=0.002).

CONCLUSIONS
Our cohort has a relatively high vision-related quality of life compared with other inherited retinal diseases, but photoaversion has a large impact on visual function. Despite what could be expected from a theoretical point of view, red filters are not generally preferred.