bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement in paediatric CT use and justification: a single-centre experience
Authors: Tiidermann Mariliis , Pihlakas Triin , Saaring Juhan , Märs Janelle , Aasmäe Jaanika , Langemets Kristiina , Lintrop Mare , Kool Pille , Ilves Pilvi 
Published: August 2024

Abstract

Objectives
To analyse changes in the use of paediatric (≤16 years) CT over the past decade and to evaluate the appropriateness of CT examinations at a tertiary teaching hospital.

Methods
Data from 290 paediatric CTs were prospectively collected in 2022 and compared with data from 2017 (358 cases) and 2012 (538 cases). The justification of CTs was evaluated with regard to medical imaging referral guidelines and appropriateness rates were calculated.

Results
Paediatric CTs decreased 39.4% over the 10 years, contrasting with a 27.6% increase in overall CTs. Paediatric CTs as the share of overall CTs dropped from 2.5% in 2012 to 1.1% in 2022 (P &lt; .0001), with a concurrent rise in paediatric MRIs (P &lt; .0001). Notable reductions in CT use occurred for head trauma (P = .0003), chronic headache (P &lt; .0001), epilepsy (P = .037), hydrocephalus (P = .0078), chest tumour (P = .0005), and whole-body tumour (P = .0041). The overall appropriateness of CTs improved from 73.1% in 2017 to 79.0% in 2022 (P = .0049). In 15.4% of the cases, no radiological examination was deemed necessary, and in 8.7% of the cases, another modality was more appropriate. Appropriateness rates were the highest for the head and neck angiography (100%) and the chest (96%) and the lowest for the neck (66%) and the head (67%).

Conclusions
Justification of CT scans can be improved by regular educational interventions, increasing MRI accessibility, and evaluating the appropriateness of the requested CT before the examination. Interventions for a more effective implementation of referral guidelines are needed.

Advances in knowledge
The focus for improvement should be CTs for head and cervical spine trauma, accounting for the majority of inappropriate requests in the paediatric population.
Implementation of community-based rehabilitation in Colombia in mental health: barriers, facilitators, and purposes
Authors: Agudelo-Hernández Felipe , Giraldo-Álvarez Ana Belén , Marulanda-López Eduardo 
Published: August 2024

Abstract
Mental health holds a crucial position within global public health agendas, particularly in the context of developing and implementing community-based approaches. Despite this, there remains a scarcity of evidence regarding the methodologies and anticipated outcomes associated with community-based rehabilitation (CBR) in low- and middle-income countries. This study aims to address this gap by identifying the barriers and facilitators. Through a qualitative approach involving focus groups conducted within a CBR training programme in Colombia, thematic analysis was employed to discern, analyze, and present patterns within the data. The findings, drawn from the participation of 208 individuals including clinical and administrative mental health professionals, as well as community leaders, underscored recurring themes such as the necessity for alliances across various sectors with a shared mental health goal, the importance of contextual considerations in programme development, the need for increased economic resources allocated to mental health, and the significance of empowering community autonomy. Ultimately, the study highlights the imperative of fostering equitable dialogue between communities and decision-makers to facilitate the effective transition of CBR from theory to implementation.
GABA system in the prefrontal cortex involved in psychostimulant addiction
Authors: Shi Wenjing , Li Minyu , Zhang Ting , Yang Chunlong , Zhao Dongdong , Bai Jie 
Published: August 2024

Abstract
Drug addiction is a chronic and relapse brain disorder. Psychostimulants such as cocaine and amphetamine are highly addictive drugs. Abuse drugs target various brain areas in the nervous system. Recent studies have shown that the prefrontal cortex (PFC) plays a key role in regulating addictive behaviors. The PFC is made up of excitatory glutamatergic cells and gamma-aminobutyric acid (GABAergic) interneurons. Recently, studies showed that GABA level was related with psychostimulant addiction. In this review, we will introduce the role and mechanism of GABA and γ-aminobutyric acid receptors (GABARs) of the PFC in regulating drug addiction, especially in psychostimulant addiction.
Wages and Inflation in the Euro Area
Authors: Michail Nektarios A , Louca Kyriaki G 
Published: August 2024

Abstract
We investigate the relationship between the four main inflation components (services, NEIG, energy, and food) and wages in the euro area. Using a panel vector autoregressive (PVAR) model for the 2002q1–2021q4 period, we find that wages positively respond to shocks in services inflation, energy inflation and GDP growth, with the first being the largest. In addition, services inflation is affected by all other inflation categories. The results are in line with the inflation path since 2022, following the food and energy price surges. Implications for policy include a feedback loop between wages and services inflation that lasts at least a year, with a possible reinforcement effect stemming from inflation expectations. Similar to US evidence, we also find that the unemployment rate does not affect wage developments in a Phillips curve setup. (JEL codes: J30, E24, E31)
Viability of Chlamydia trachomatis in Different Anatomical Sites—a Systematic Review and Meta-analysis
Authors: Wong Arthur , Lima Nicole , Applegate Tanya L , Guy Rebecca , Huston Wilhelmina M , Hocking Jane S , Boettiger David 
Published: August 2024

Abstract

Background
Modern assays for the detection of Chlamydia trachomatis (CT) rely on nucleic acid amplification testing (NAAT) of DNA or ribosomal RNA. However, it is also known that both viable (“living”) and non-viable (“dead”) CT can be detected by NAAT. Multiple laboratory techniques to measure CT viability have emerged.

Methods
We searched PubMed, EMBASE, Scopus, and Dimensions as well as conference abstracts for entries between January 2000 and May 2023. We included any studies that measured CT viability among NAAT-positive samples. Viability assays include enhanced cell culture, direct fluorescent antibody (DFA), messenger RNA (mRNA) detection via digital droplet polymerase chain reaction (PCR, ddPCR), viability PCR (V-PCR), and real-time PCR measuring RNA-to-DNA ratio (RDR) (eg, InSignia®). A meta-analysis was performed on the proportions of non-viable CT by anatomical site.

Results
We screened 31 342 records and included 16 studies in the analysis. The pooled proportions of non-viable CT by site were: 33% (95% confidence interval [CI]: 19%–47%) in rectal swabs (8 studies), 17% (95% CI: 7%–27%) in cervical swabs (6 studies), 15% (95% CI: 6%–25%) in vaginal swabs (6 studies), and 11% (95% CI: 9%–17%) in urine/urethral swabs (2 studies).

Conclusions
All included studies found that a proportion of NAAT-detected CT is non-viable. The findings have far-reaching implications for screening programs and studies evaluating new STI tests and antimicrobial regimens.
Slack K+ channels confer protection against myocardial ischaemia/reperfusion injury
Authors: Roslan Anna , Paulus Katharina , Yang Jiaqi , Matt Lucas , Bischof Helmut , Längst Natalie , Schanz Sophia , Luczak Annika , Cruz Santos Melanie , Burgstaller Sandra , Skrabak David , Bork Nadja I , Malli Roland , Schmidtko Achim , Gawaz Meinrad , Nikolaev Viacheslav O , Ruth Peter , Ehinger Rebekka , Lukowski Robert 
Published: August 2024

Abstract

Aims
Na+-activated Slack potassium (K+) channels are increasingly recognized as regulators of neuronal activity, yet little is known about their role in the cardiovascular system. Slack activity increases when intracellular Na+ concentration ([Na+]i) reaches pathophysiological levels. Elevated [Na+]i is a major determinant of the ischaemia and reperfusion (I/R)-induced myocardial injury; thus, we hypothesized that Slack plays a role under these conditions.

Methods and results
K+ currents in cardiomyocytes (CMs) obtained from wildtype but not from global Slack knockout mice were sensitive to electrical inactivation of voltage-sensitive Na+ channels. Live-cell imaging demonstrated that K+ fluxes across the sarcolemma rely on Slack, while the depolarized resting membrane potential in Slack-deficient CMs led to excessive cytosolic Ca2+ accumulation and finally to hypoxia/reoxygenation-induced cell death. Cardiac damage in an in vivo model of I/R was exacerbated in global and CM-specific conditional Slack mutants and largely insensitive to mechanical conditioning manoeuvres. Finally, the protection conferred by mitochondrial ATP-sensitive K+ (mitoKATP) channels required functional Slack in CMs.

Conclusion
Collectively, our study provides evidence for Slack's crucial involvement in the ion homeostasis of no or low O2-stressed CMs. Thereby, Slack activity opposes the I/R-induced fatal Ca2+-uptake to CMs supporting the cardioprotective signaling attributed to mitoKATP function.
Double coronary artery occlusion presenting as inferior ST segment elevation myocardial infarction and Wellens syndrome type A: a case report
Authors: Marchi Enrico , Muraca Iacopo , Cesarini Daniel , Pennesi Matteo , Valenti Renato 
Published: August 2024

Abstract

Background
ST elevation myocardial infarctions are usually a consequence of the occlusion of a single coronary artery, but in 2.5% of the cases, two or more culprit lesions are found. Simultaneous coronary artery occlusion is a potentially life-threatening condition that leads to cardiogenic shock or ventricular arrhythmias.

Case summary
We presented the case of a 74-year-old man presenting with chest pain and ST segment elevation (STE) in inferior leads and evidence of alternating STE in anterior leads in a pattern like Wellens syndrome type A in subsequent electrocardiogram (ECGs). Emergency coronary angiography (CA) revealed thrombotic occlusion of the proximal right coronary artery (RCA) and sub-occlusion of mid left anterior descending artery (LAD). During the CA, he became haemodynamically unstable requiring intravenous inotropes and vasopressors, and he underwent primary percutaneous coronary intervention of both RCA and LAD culprit lesions. His subsequent hospital stay was uneventful, and he was discharged 5 days later.

Discussion
ST elevation myocardial infarction with more than one culprit coronary artery is a rare but at high risk of haemodynamic decompensation. The causes of occlusion of multiple coronary arteries may be several: coronary embolism, coronary ectasia, simultaneous plaque disruption, coronary vasospasm, hypercoagulability states, smoking, and illicit drug abuse. The presumed mechanism behind the presented case may be a combination of release of pro-thrombotic cytokines due to the thrombotic occlusion of the first coronary and low output state secondary to myocardial dysfunction leading to impaired flow in a severe stenotic coronary artery with subsequent thrombosis.
An magnetic resonance imaging–pathology correlation case report of cardiac sarcoidosis mimicking arrhythmogenic biventricular cardiomyopathy
Authors: Kim B Michelle , Bois Melanie C , Del-Carpio Munoz Freddy , Rosenbaum Andrew N , Chang Ian C 
Published: August 2024

Abstract

Background
Cardiac sarcoidosis (CS) is a granulomatous disease that can manifest as conduction defects, ventricular arrhythmias, and heart failure. The diagnosis of CS is inherently difficult due to variable presentations; as such, endomyocardial biopsy is often required but lacks sensitivity due to patchy myocardial involvement. Moreover, the diagnostic criteria of CS and arrhythmogenic cardiomyopathy overlap, particularly in right-side dominant or biventricular presentations, which further complicates an already challenging differential diagnosis.

Case summary
A 53-year-old man with no prior chronic medical conditions presented with ventricular tachycardia (VT) and heart failure with reduced ejection fraction. He was found to have biventricular cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance imaging, resulting in an initial diagnosis of arrhythmogenic cardiomyopathy. Implantable cardioverter-defibrillator was placed, but he was readmitted for recurrent VT 2 months later. Despite an aggressive VT therapy (combination of antiarrhythmic drugs, epicardial and endocardial ablation, and stellate ganglion block), he continued with refractory VT and developed cardiogenic shock. Extra-corporeal membrane oxygenation was initiated as a bridge to heart transplantation. Pathology of the explanted heart revealed the underlying disease to be CS.

Discussion
Cardiac sarcoidosis can mimic arrhythmogenic biventricular cardiomyopathy and may be difficult to distinguish by the proposed diagnostic criteria. High clinical suspicion and thorough investigation are necessary for an earlier diagnosis and initiation of treatment.
Beyond the ordinary: TNF-alpha inhibitor as a rescue therapy in relapsing Hughes–Stovin syndrome with intracardiac thrombosis—a case report and literature review
Authors: Chadli Sarra , Maamar Mouna , Khibri Hajar , Tazi Mezalek Zoubida , Harmouche Hicham 
Published: August 2024

Abstract

Background
Hughes–Stovin syndrome (HSS) is a rare vasculitis characterized by the association of thrombophlebitis with pulmonary artery aneurysms (PAAs). Because it is rarely reported, there are currently no established diagnostic criteria or standardized treatment guidelines for HSS. While conventional immunosuppressants are generally effective as first-line treatment, relapsing and refractory cases urge the need to investigate alternative therapies, such as TNF-alpha inhibitors. However, with only five cases published in the literature, knowledge of their efficacy in HSS is very limited.

Case summary
A 28-year-old man, with no past medical history, presented with haemoptysis, chest pain, and dyspnoea on exertion. Physical examination found bilateral leg swelling, with no associated lesions. CT angiography showed multiple bilateral PAA, proximal pulmonary artery thrombosis (PAT), and deep venous thrombosis (DVT) in the superior mesenteric vein and spleno-mesaraic confluence. Echocardiography was performed, identifying right intracardiac thrombosis (ICT). Initial management included high-dose corticosteroids and monthly cyclophosphamide cycles, followed by maintenance treatment with oral azathioprine. Eighteen months later, the patient presented with haemoptysis revealing a relapse of ICT and two new PAA. Infliximab was initiated, allowing complete and sustained remission after one year of follow-up.

Discussion
We report the challenging case of an HSS patient presenting with multiple PAA, proximal PAT, right ICT, and extended abdominal DVT. The positive response of our patient to infliximab, following a relapse under conventional immunosuppressants, supports the efficacy of TNF-alpha inhibitors as second-line treatment in relapsing/refractory HSS.
Atherosclerosis quantification and cardiovascular risk: the ISCHEMIA trial
Authors: Nurmohamed Nick S , Min James K , Anthopolos Rebecca , Reynolds Harmony R , Earls James P , Crabtree Tami , Mancini G B John , Leipsic Jonathon , Budoff Matthew J , Hague Cameron J , O'Brien Sean M , Stone Gregg W , Berger Jeffrey S , Donnino Robert , Sidhu Mandeep S , Newman Jonathan D , Boden William E , Chaitman Bernard R , Stone Peter H , Bangalore Sripal , Spertus John A , Mark Daniel B , Shaw Leslee J , Hochman Judith S , Maron David J 
Published: August 2024

Abstract

Background and Aims
The aim of this study was to determine the prognostic value of coronary computed tomography angiography (CCTA)–derived atherosclerotic plaque analysis in ISCHEMIA.

Methods
Atherosclerosis imaging quantitative computed tomography (AI-QCT) was performed on all available baseline CCTAs to quantify plaque volume, composition, and distribution. Multivariable Cox regression was used to examine the association between baseline risk factors (age, sex, smoking, diabetes, hypertension, ejection fraction, prior coronary disease, estimated glomerular filtration rate, and statin use), number of diseased vessels, atherosclerotic plaque characteristics determined by AI-QCT, and a composite primary outcome of cardiovascular death or myocardial infarction over a median follow-up of 3.3 (interquartile range 2.2–4.4) years. The predictive value of plaque quantification over risk factors was compared in an area under the curve (AUC) analysis.

Results
Analysable CCTA data were available from 3711 participants (mean age 64 years, 21% female, 79% multivessel coronary artery disease). Amongst the AI-QCT variables, total plaque volume was most strongly associated with the primary outcome (adjusted hazard ratio 1.56, 95% confidence interval 1.25–1.97 per interquartile range increase [559 mm3]; P = .001). The addition of AI-QCT plaque quantification and characterization to baseline risk factors improved the model’s predictive value for the primary outcome at 6 months (AUC 0.688 vs. 0.637; P = .006), at 2 years (AUC 0.660 vs. 0.617; P = .003), and at 4 years of follow-up (AUC 0.654 vs. 0.608; P = .002). The findings were similar for the other reported outcomes.

Conclusions
In ISCHEMIA, total plaque volume was associated with cardiovascular death or myocardial infarction. In this highly diseased, high-risk population, enhanced assessment of atherosclerotic burden using AI-QCT-derived measures of plaque volume and composition modestly improved event prediction.
Experimental study on the rupture behaviours of orthogonal faults: Effects of stress state and rupture initiation location
Authors: Xu Ran , Wang Zhengyan , Xu Ying , Dong Peng , Xia Kaiwen 
Published: August 2024

SUMMARY
Fault rupture dynamics is expected to be significantly affected by the geometry of fault system, especially for orthogonal faults. However, the rupture behaviours of orthogonal faults, especially the coseismic interactions, are far from fully understood. Here, we present experimental results from a series of laboratory earthquakes to elucidate the effect of the stress state and initiation location on the rupture behaviours of orthogonal faults. Our results reveal a phase diagram of rupture behaviours of orthogonal faults, which is collectively controlled by stress state and rupture initiation location. For events initiating from the main fault, the rupture cannot jump to the branch, which may be due to the clamping effect or the inhibited shear stress accumulation on the branch. On the contrary, events initiating from the branch can persistently trigger ruptures of the main fault. This difference highlights the directional effect associated with the rupture of orthogonal faults. Further, the rupture length of triggered ruptures on the main fault is controlled by the stress state of the fault system. With the increase of the ratio between the shear stress and normal stress, the rupture length of the main fault increases. Our results reproduce the rupture behaviours of orthogonal faults, which may provide insights into the rupture characteristics of natural earthquakes.
Perceptions of prior authorization burden and solutions
Authors: Sahni Nikhil R , Istvan Brooke , Stafford Celia , Cutler David 
Published: August 2024

Abstract
The prior authorization (PA) process consumes time and money on the part of patients, providers, and payers. While some research shows substantial possible savings in the PA process, identifying what different groups can do is not as well known. Thus, organizations have struggled to capture this opportunity. To understand different perspectives on PA burden and receptivity to possible changes in the PA process, we surveyed 1005 patients, 1010 provider employees, and 115 private payer employees. Patients reported the longest perceived wait times but indicated the highest perceived approval rates and lowest perceived burden. The relatively low burden for patients is because most do not have to engage in PA directly. Provider respondents reported spending time equivalent of more than 100 000 full-time registered nurses per year on prior authorization. Artificial intelligence (AI) represents a possible solution: 65% of private payer respondents reported that their organizations planned to incorporate AI into the process in the next 3 to 5 years. Intended adoption by provider respondents is much smaller (11%). Private payer respondents cited cybersecurity concerns and a lack of technical infrastructure as barriers; provider respondents cited lack of budget and limited trust in the technology.
The future of UN peace operations: pragmatism, pluralism or statism?
Authors: Paris Roland 
Published: August 2024

Abstract
Although United Nations peace missions have played an important conflict management role for decades, a backlash against the post-Cold War model of ‘liberal peacebuilding’ and other recent developments have called their future into doubt. Some observers contend that a ‘pragmatic turn’ is now underway—a shift away from ambitious plans to transform war-torn societies into liberal democracies and towards more modest and realistic goals. Whether ‘pragmatism’ offers a viable alternative framework for peacebuilding, however, is less clear. This article challenges key assumptions of the pragmatic approach to peacebuilding, including the notion that UN missions can be ‘agnostic’ about the governance arrangements of societies that host these operations, as some proponents of pragmatism recommend. Historical case-studies show that such assumptions are integral features of collective conflict management systems, including UN peace missions. Moreover, a close examination of the pragmatist approach reveals that it, too, is based on such assumptions—namely, that building peace requires the promotion of pluralist societies and states. Pluralist peacebuilding, the article concludes, could offer a compelling foundation for future UN missions in an era of rising statist–authoritarianism, but developing this approach will first require discarding pragmatism's pretence of ideological agnosticism.
Residual and past varinaccuracy measures
Authors: Sharma Akash , Kundu Chanchal 
Published: August 2024

Abstract
Analysing the information measures’ dispersion index has garnered increasing attention. In this regard, variability of entropy has been explored for residual and past lifetimes. In a recent paper, Balakrishnan et al. (2023, Commun. Stat. Theory Methods, 53, 5574–5592) have studied the variability of the Kerridge inaccuracy measure. The dynamic measures of varinaccuracy, namely residual varinaccuracy and past varinaccuracy, have been introduced in this article. A detailed course of theoretical results has been investigated with examples. Further, some applications of the residual varinaccuracy have been added to show the functionality of the defined measure.