bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations in head tilt during the acquisition of cone beam computed tomography scans and their effects on effective radiation dose
Authors: Mancini Arthur X M , Carmozini Gabriela A , Inácio Thiago M , Réa Marcela T , Viccari Cassiana , Brasil Danieli M , Oliveira-Santos Christiano 
Published: August 2024

Abstract

Objectives
This study evaluated the impact of variations in anteroposterior and lateral tilts of patients head on radiation-weighted doses to organs/tissues and effective doses using 3 different cone beam computed tomography (CBCT) machines.

Methods
An anthropomorphic phantom was used to estimate radiation doses in 3 CBCT machines (OP300, Eagle X 3D, and Eagle Edge). Thermoluminescent dosimeters were placed in regions corresponding to pre-stablished organ/tissues. CBCT examinations from the posterior mandible and anterior maxilla regions were acquired, with 3 different anteroposterior angulations (0°, 30°, and 45°), and from the posterior mandible in 3 different lateral angulations (0°, 20° to the left, and 20° to the right side). Radiation-weighted doses for each organ/tissue and effective doses were calculated for each machine and angulation.

Results
For the posterior mandible acquisitions, anteroposterior angulations of the head at 30° and 45° yielded a reduction in effective doses in all 3 devices. A 20° tilt to the right side resulted in lower doses than to the left [same side as the field of view (FOV)]. For the anterior maxilla, increased anteroposterior angulation was associated with reduction in effective dose in 2 devices.

Conclusions
Effective doses are lower when small FOV CBCT exams of the posterior mandible and anterior maxilla are acquired with increased anteroposterior head angulation at 30° and 45°. For FOV in the posterior mandible, a 20° lateral tilt towards the side opposite to the FOV also yields lower effective doses. The main contribution to these dose reductions is the decrease in dose to salivary glands.
Cardiac sarcoidosis manifesting with atrioventricular block and intracardiac masses: case report and literature review
Authors: Newman Noah , Garcia Mariana , Ayele Frehiywot , Gandiga Prateek , Bhatt Kunal 
Published: August 2024

Abstract

Background
Cardiac sarcoidosis (CS) typically manifests with atrioventricular block (AVB), ventricular arrhythmias, or heart failure. Intracardiac masses due to CS are rare, and there is both a paucity of evidence and guidelines of how manage them.

Case summary
We describe a 45-year-old woman who presented with palpitations and dyspnoea on exertion found to have second-degree AVB. Further work-up noted two right atrial masses that, following excision and pathology, were identified as CS. Within several months of immunosuppressive treatment, imaging and device reports demonstrated mass resolution without arrhythmia recurrence.

Discussion
Intracardiac masses are a rare manifestation of CS. Immunosuppressive therapy remains the mainstay of treatment, with consideration of mass resection for diagnostic purposes.
Associations Between Attachment and Depressive Symptoms Among Older Adults Living With Early-Stage Cognitive Impairment and Their Adult Children
Authors: Monin Joan K , Shah Maya , Chang Wei , Feeney Brooke C , Birditt Kira , Gaugler Joseph E , Vranceanu Ana Maria , Marottoli Richard 
Published: August 2024

Abstract

Objectives
This study examined the extent to which multiple relationship-specific attachment schemas (general, parent-child, and romantic) are interrelated and relate to depressive symptoms among older adults living with early-stage dementia and their adult children, a context likely to activate the attachment system.

Methods
The study consisted of 150 early-stage cognitively impaired parents and one child. Both self-reported general, parent-child, and romantic attachment anxiety as well as avoidance and depressive symptoms. Parents’ cognitive and functional impairment were assessed.

Results
Most attachment variables were interrelated for individuals, except that the child’s parent-child-specific avoidance was not associated with their general or romantic avoidance. The parent’s worse functional, but not cognitive, impairment was associated with the child’s greater parent-child-specific attachment anxiety. Using Actor Partner Interdependence Models, general attachment anxiety was associated with greater depressive symptoms (actor effects). When both dyad members were high in general avoidance, depressive symptoms were greatest (actor × partner effect). A parent had the greatest depressive symptoms when they were avoidantly attached to their child (role × actor effect) and their child was high in anxiety and low in avoidance toward them (role × partner effects). A child had the greatest depressive symptoms when they were low in avoidance toward the parent (role × actor effect) and the parent was low in anxiety and high in avoidance toward the child (role × partner effects). Romantic anxiety was associated with greater depressive symptoms (actor effects).

Discussion
Psychosocial interventions that incorporate attachment theory as a framework may benefit parent-child dyads coping with dementia.
Environmental factors and management practices associated with beef cattle carcass quality in the mid-west of Brazil
Authors: Amaral Thaís B , Le Cornec Alain P , Rosa Guilherme J M 
Published: August 2024

Abstract
The “Precoce MS” program, established by the Brazilian government in Mato Grosso do Sul in 2017, aims to encourage beef producers to harvest animals at younger ages to enhance carcass quality. About 40% of the beef produced in the state now comes from this program, which offers tax refunds ranging from 49% to 67% based on carcass classification and production system. Despite the program success, with participants delivering younger animals (with a maximum of 4 incisors), there remains significant variability in carcass quality. This paper investigates management practices and environmental factors affecting farm performance regarding carcass quality. Data from all animals harvested between the beginning of 2017 and the end of 2018 were analyzed, totaling 1,107 million animals from 1,470 farms. Farm performance was assessed based on the percentage of animals achieving grades “AAA” and “AA.” Each batch of harvested cattle from each farm was categorized into two groups: high farm performance (HFP, with more than 50% of animals classified as “AAA” or “AA”) and low farm performance (LFP, with less than 50% classified as such). A predictive logistic model was developed to forecast farm performance (FP) using 14 continuous and 15 discrete pre-selected variables. The most effective model, obtained through backward stepwise variable selection, had an R2 of 0.18, accuracy of 71.5%, and AUC of 0.715. Key predictors included animal category, production system type, carcass weight, individual identification, traceability system, presence of a feed plant, location, and the Normalized Difference Vegetation Index (NDVI) from the 12-mo average before harvest. Developing predictive models of carcass quality by integrating data from commercial farms with other sources of information (animal, production system, and environment) can improve our understanding of production systems, optimize resource allocation, and advance sustainable animal production. Additionally, they offer valuable insights for designing and implementing better sectorial, social, and environmental policies by public administrations, not only in Brazil but also in other tropical and subtropical regions worldwide.
Assessing Soybean Cultivar Resistance to Target Spot Using a Detached Leaf Assay
Authors: Wolf Rachael , Holland Robert , Rojas J. Alejandro , Fernandes Samuel , Fernandes Igor , Rupe John C. 
Published: August 2024

Target spot (TS), caused by the fungus Corynespora cassiicola, is a foliar disease of increasing importance to soybean in the United States. Identifying cultivar resistance to TS is challenging. The objective of this research was to determine the reactions of a diverse collection of soybean genotypes to TS using a detached leaf inoculation method. A detached unifoliate leaf of each soybean genotype was placed in a Petri dish on moist filter paper, wounded at three locations, inoculated with 10 μl of a 105-conidial suspension of C. cassiicola, and incubated at room temperature (23°C). The percent leaf area with TS symptoms (TSS) was measured digitally at 7, 10, 14, and 17 days after inoculation (DAI), and the area under the disease progress curve (AUDPC) was calculated. Thirty-seven soybean genotypes and three soybean cultivars were evaluated in three replicated trials. At 17 DAI, TSS ranged from 2 to 84%. Significant differences occurred between soybean genotypes at each rating time in each trial. Across the three trials, the reaction of most soybean genotypes ranged from resistant to susceptible. These soybean genotypes were evaluated in the field with natural inoculum at two locations in 2022. TS developed late but differed significantly between genotypes, averaging from 0.35 to 3.35% TSS. Field results were not significantly correlated to the detached leaf results. The detached leaf assay is another tool for screening soybean genotypes for resistance to TS but needs field validation. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Hymenoptera venom allergy in children and adolescents
Authors: Norelli Francesca , Gueli Valentina , Bonadonna Patrizia 
Published: August 2024

Purpose of review
This review will identify and summarize the published existing data pertaining specifically to Hymenoptera venom allergy in children and adolescents, highlighting the major studies currently available on venom immunotherapy (VIT) and its prognosis in children.

Recent findings
The current review covers the incidence and prevalence of Hymenoptera venom allergy (HVA) in children, factors influencing occurrence and severity of reactions (age, sex, comorbidities, etc.), indications to perform diagnostic tests and start VIT in children, different existing VIT protocols and their safety and efficacy.

Summary
Hymenoptera venom allergy is the second most common cause of anaphylaxis in children and it considerably affects quality of life. Cutaneous reactions are the most prevalent clinical presentation in children who usually have a more favourable prognosis than adult patients. However, studies on HVA in children and adolescents are still limited. Currently VIT is the only treatment able to modify the natural history of HVA in adults as well as in children, and to protect patients from systemic reactions after subsequent stings.
Ocular surface disorders: office procedures for the allergist/clinical immunologist
Authors: Norris Matthew Ryan , Katelaris Constance , Rosario Nelson , Delgado Luis , Leonardi Andrea , Bielory Leonard 
Published: August 2024

Purpose of review
Ocular surface disorders (OSDs) are a prevalent and often debilitating condition encountered in clinical practice, particularly by allergists and clinical immunologists.

Recent findings
A comprehensive guide to office procedures for evaluating and managing OSDs, with a specific focus on ocular allergies, would assist in the evaluation process that begins with an initial patient assessment utilizing standardized forms to systematically gather detailed medical history, symptomatology, and environmental exposure data. This structured approach ensures a thorough understanding of the patient's condition and facilitates targeted interventions. In addition to allergy testing, the assessment of the tear film is essential for a comprehensive evaluation of OSDs. The Schirmer test is employed to quantify tear production, providing objective data on tear film adequacy and guiding interventions for tear film deficiencies.

Summary
This multifaceted diagnostic approach ensures that all contributing factors to OSDs are identified and appropriately managed. By integrating these office procedures, allergists and clinical immunologists can enhance their diagnostic accuracy and therapeutic efficacy, ultimately improving patient outcomes. This manuscript provides a practical resource, outlining some of the methodologies and clinical applications of each procedure, and highlighting their role in the holistic management of OSDs in allergic patients.
The Concept of Treatment-Refractory Addiction: Implications for Addiction Treatment Systems and Research
Authors: Nunes Edward V. , McLellan A. Thomas 
Published: August 2024

Abstract
The concept of treatment-refractory addiction, proposed by Eric Strain in this edition of the Journal, has the potential to invigorate the field of addiction treatment and research by focusing on a phenomenon that is familiar to any clinician treating patients with substance use disorders, namely, the patient who does not experience sufficient improvement from standard treatments. An analogy is drawn to the concept of treatment-resistant depression and the STAR*D study, which demonstrated an algorithmic approach to treatment, where if the first antidepressant medication tried did not result in remission from depression, subsequent trials of medications or cognitive behavioral therapy doubled the proportion of patients achieving remission. Recognizing treatment-refractory addiction challenges our field to develop analogous, stepwise, algorithmic approaches to treatment of substance use disorders, moving away from siloed treatment programs toward integrated treatment systems where alternative treatments are available, offering the kind of personalized, tailored forms of care used in the treatment of most other chronic illnesses. Like in STAR*D, research could focus on samples of patients who have not benefitted from initial trials of standard addiction treatments, addressing the key clinical question of what to do next when previous treatments fail.
Deep and Superficial Debridement Techniques in Lower Extremity Split-thickness Skin Grafting
Authors: Rohrich Rachel N. , Li Karen R. , Lava Christian X. , Alahmadi Sami , Stanton Henry L. , Kim Victoria H. , Spoer Daisy L. , Evans Karen K. , Steinberg John S. , Attinger Christopher E. 
Published: August 2024

Background:
Patients with nonhealing lower extremity (LE) wounds often require a split-thickness skin graft (STSG) for closure. Nonviable tissue must be debrided before STSG inset. Our study aimed to compare differences in debridement depth on STSG outcomes.

Methods:
Chronic, atraumatic LE wounds receiving STSG from December 2014 to December 2022 at a single institution were reviewed. Demographics, wound characteristics, operative details, and outcomes were collected. Superficially debrided wounds were compared with wounds receiving deep debridement (DD), defined by debriding to the level of white tissue underlying the granulation tissue. Subanalysis was performed on wounds that had a negative and positive postdebridement culture. Primary outcome was graft failure.

Results:
Overall, 244 wounds in 168 patients were identified. In total, 158 (64.8%) wounds were superficially debrided and 86 (35.3%) received DD. The cohort had a median Charlson Comorbidity Index of 4 [interquartile range (IQR): 3]. Diabetes (56.6%) and peripheral artery disease (36.9%) were prevalent. The only statically significant demographic difference between groups was congestive heart failure (SD: 14.9% versus DD: 3.0%, P = 0.017). Wound size, depth, and all microbiology results were similar between groups. Postoperatively, the DD group demonstrated significantly less graft failure (10.5% versus 22.2%, P = 0.023). In a multivariate regression, DD was independently associated with lower odds of graft failure (OR: 0.0; CI, 0.0–0.8; P = 0.034). Sub-analysis of graft failure supported this finding in culture-positive wounds (DD: 7.6% versus DD: 22.1%, P = 0.018) but not in culture-negative wounds (13.6% versus 22.2%, P = 0.507).

Conclusions:
The DD technique demonstrates improved outcomes in chronic, culture-positive LE wounds receiving STSG.
Research Letter: Retrograde Amnesia and Posttraumatic Amnesia in Service Members and Veterans With Remote History of TBI
Authors: Lippa Sara M. , Gillow Kelly C. , Hungerford Lars D. , Bailie Jason M. , French Louis M. , Brickell Tracey A. , Lange Rael T. 
Published: August 2024

Objective:
The recently updated American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury (mTBI) removed retrograde amnesia (RA) as a main criterion for mTBI, recommending it be included as a substitute criterion only when posttraumatic amnesia (PTA) cannot be reliably assessed. This study aimed to investigate the evidence base for this recommendation.

Setting:
Military treatment facility.

Participants:
A total of 752 US military service members/veterans (mean age = 36.1 years, SD = 9.4 years) with a history of TBI prospectively enrolled in the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence 15-Year Longitudinal TBI study who sustained a total of 1015 TBIs with substantiated RA and PTA. Most participants were male (93.6%), not of Hispanic Origin (84.7%), and White (84.5%). Evaluations were conducted on average 7.6 years (SD = 6.9 years) after injury.

Design:
Case series.

Main Measures:
Presence and duration of RA and PTA; and ratio of PTA and RA (PTA:RA).

Results:
There were no TBIs where RA was present but PTA was absent. Within the 1015 TBIs, 896 (88.3%) involved both RA and PTA, 65 (6.4%) involved PTA only, and 54 (5.3%) did not involve RA or PTA. For the 635 TBI events with substantiated recorded minutes of RA and PTA both >0, the mean ratio of PTA:RA was 31:1. In only one instance was the ratio of PTA:RA <1.

Conclusion:
There were no TBIs where RA was present without PTA. RA tended to be much shorter than PTA. Findings support the American Congress of Rehabilitation Medicine’s decision to remove RA as a main criterion for mTBI.
Relationship Between Retinal Oxygen Saturation and the Severity of Visual Field Damage in Glaucoma
Authors: Mahmoudinezhad Golnoush , Moghimi Sasan , Micheletti Eleonora , Du Kelvin H. , Adelpour Mohsen , Latif Kareem , Walker Evan , Salcedo Matthew , Rubio Veronica , Weinreb Robert N. 
Published: August 2024

Précis:
Increased oxygen saturation (StO2) was significantly associated with the severity of visual field (VF) damage in patients with glaucoma.

Objective:
To investigate the association between retinal StO2 percentage and the severity of VF loss in glaucoma.

Methods:
A total of 198 eyes from 131 patients with glaucoma were included in this cross-sectional study. Participants underwent imaging using ocular oximetry (Zilia) and 24-2 Swedish Interactive Threshold Algorithm standard VF (Carl Zeiss-Meditec). StO2 (%) was measured at 2 locations of the peripapillary optic nerve head (superotemporal, and inferotemporal). Measurements were reported as the mean of at least 5 measurements in each location. Associations between the severity of VF loss, reported as mean deviation, and StO2 (%) were calculated.

Results:
A total of 198 eyes of 131 patients (mean (95% CI) age, 71.1 (68.9,73.3) years, 68 females (51.9%), and 63 males (48.1%) were analyzed. In univariable analysis, higher StO2 −0.06 (−0.12, 0.00) was associated with severity in all hemifields (P = 0.047). Multivariate regression analysis showed that each 1% increase in StO2 was associated with −0.06 (−0.12, -0.00) dB loss in mean deviation in all hemifields (P = 0.043). In multivariate regression analysis in the superior hemifields, higher StO2 −0.07 (−0.16, 0.01) tended to be associated with superior hemifield severity (P = 0.09).

Conclusions:
Retinal oximetry enabled the continuous quantitative measurement of retinal StO2. Increased StO2 was significantly associated with the severity of VF damage in patients with glaucoma.
Development of an Acute Stroke Care Seeking Framework
Authors: Smith Fiona S. , Whisenant Meagan , Johnson Constance M. , Burnett Jason , Savitz Sean I. , Beauchamp Jennifer E. S. 
Published: August 2024

ABSTRACT

BACKGROUND: A multitude of variables influence an individual's decision to seek care in emergency situations. By recognizing these variables and their impact on the timeline of an individual seeking care for a stroke, nurses have an opportunity to positively affect the outcomes of stroke within the community. The purpose of this narrative review was to develop a research framework describing the variables involved in care seeking during an acute stroke. METHODS: Using a theory synthesis methodology that included variable identification and the establishment of relationships between variables based on existing literature, a framework describing variables relevant to acute stroke care seeking behavior was developed. RESULTS: Fourteen recently published studies reported significant variables related to seeking emergency medical care during the hyperacute phase of a stroke. Eight variables were identified and characterized as either promoters or distractors. Promoters led an individual to seek acute stroke care earlier, such as perceived symptom severity, stroke knowledge, and the presence of others. Distractors led an individual to delay seeking acute stroke care and resulted in later hospital arrival times, such as a lack of social network or resources, comorbid conditions, and incongruity with the local health system. CONCLUSION: Although individual decision making is exceedingly complex and varies by individual and situation, the developed acute stroke care seeking framework may provide a basis on which to develop stroke awareness programs and interventions targeted at individuals at risk for delayed acute stroke care.
Fluid Management in Critically Ill Children: Single-Center Retrospective Comparison of Trauma and Postoperative Patients, 2020–2022*
Authors: Wu Yeu Sanz , Gennell Tania , Porigow Chloe , Fan Weijia , Rubsam Jeanne , Dorrello Nicolino Valerio , Stylianos Steven , Duron Vincent P. 
Published: August 2024

OBJECTIVE:
Injury and surgery both represent well-defined starting points of a predictable inflammatory response, but the consequent response to IV fluids has not been studied. We aimed to review and compare our single-center fluid management strategies in these two populations.

DESIGN:
Retrospective cohort study from January 2020 to July 2022. The primary outcome was total IV fluid volume administered. Net fluid balances and select clinical outcomes were also evaluated.

SETTING:
Single tertiary academic center and level 1 pediatric trauma center in New York.

PATIENTS:
A dataset of critically ill trauma and surgical patients aged 0–18 years who were admitted to the PICU, 2020–2022. Trauma patients had at least moderate traumatic injuries (Injury Severity Score ≥ 9) and surgical patients had at least a 1-hour operation time.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We identified 25 trauma and 115 surgical patients. During the first 5 days of hospitalization, we did not identify an association between grouping and total IV fluids administered and fluid balance in the prehospital, emergency department, and operating room (p = 0.90 and p = 0.79), even when adjusted for weight (p = 0.96). Time trend graphs of net fluid balance and IV fluid administered illustrated analogous fluid requirement and response with the transition from net positive to net negative fluid balance between 48 and 72 hours. There was an association between total IV fluid and ventilator requirement (p = 0.003).

CONCLUSIONS:
Critically ill pediatric trauma and postoperative patients seem to have similar fluid management and balance after injury or surgery. In our opinion, these two critically ill populations could be combined in large prospective studies on optimal fluid therapy in critically ill children.