bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 2 diabetes impairs annulus fibrosus fiber deformation and rotation under disc compression in the University of California Davis type 2 diabetes mellitus (UCD-T2DM) rat model
Authors: Rosenberg James L , Schaible Eric , Bostrom Alan , Lazar Ann A , Graham James L , Stanhope Kimber L , Ritchie Robert O , Alliston Tamara N , Lotz Jeffrey C , Havel Peter J , Acevedo Claire , Fields Aaron J 
Published: November 2023

Abstract
Understanding the biomechanical behavior of the intervertebral disc is crucial for studying disease mechanisms and developing tissue engineering strategies for managing disc degeneration. We used synchrotron small-angle X-ray scattering to investigate how changes to collagen behavior contribute to alterations in the disc’s ability to resist compression. Coccygeal motion segments from 6-month-old lean Sprague-Dawley rats ( n=7) and diabetic obese University of California Davis type 2 diabetes mellitus (UCD-T2DM) rats ( n=6, diabetic for 68±7 days) were compressed during simultaneous synchrotron scanning to measure collagen strain at the nanoscale (beamline 7.3.3 of the Advanced Light Source). After compression, the annulus fibrosus was assayed for nonenzymatic cross-links. In discs from lean rats, resistance to compression involved two main energy-dissipation mechanisms at the nanoscale: (1) rotation of the two groups of collagen fibrils forming the annulus fibrosus and (2) straightening (uncrimping) and stretching of the collagen fibrils. In discs from diabetic rats, both mechanisms were significantly impaired. Specifically, diabetes reduced fibril rotation by 31% and reduced collagen fibril strain by 30% (compared to lean discs). The stiffening of collagen fibrils in the discs from diabetic rats was consistent with a 31% higher concentration of nonenzymatic cross-links and with evidence of earlier onset plastic deformations such as fibril sliding and fibril–matrix delamination. These findings suggest that fibril reorientation, stretching, and straightening are key deformation mechanisms that facilitate whole-disc compression, and that type 2 diabetes impairs these efficient and low-energy elastic deformation mechanisms, thereby altering whole-disc behavior and inducing the earlier onset of plastic deformation.
The Best Chance for Democratic Success: The Role of Well-Organized Actors and External Support
Authors: Yerkes Sarah E 
Published: November 2023

Abstract
Popular Politics and the Path to Durable Democracy makes a compelling case for the importance of well-organized and lengthy popular mobilization movements in contributing to lasting democracy. Through a mixed-methods approach, Mohammad Ali Kadivar draws a correlation between length of a mobilization and electoral democracy. However, his analysis is incomplete, and he fails to account for several important factors, most particularly the role of external actors in supporting (or harming) a democratic transition. And he fails to explain the large variance in his findings—why some of the most well-consolidated democracies lasting a half a century also have some of the shortest periods of mobilization, while some of the most repressive countries had lengthy mobilization periods leading up to their failed transitions.
X-ray scatter in projection radiography
Authors: Ylimaula Satu , Räsänen Lasse , Hurskainen Miia , Peuna Arttu , Julkunen Petro , Nieminen Miika Tapio , Hanni Matti 
Published: November 2023

Abstract
Projection radiography is the most common radiological modality, and radiation safety of it concerns both radiation workers and the public. We measured and generated a series of scattered radiation maps for projection radiography and estimated effective doses of the supporting person during exposure. Measured adult patient protocols included chest posterior–anterior, chest lateral, pelvis anterior–posterior (AP), abdomen AP and bedside chest AP. Maps concretise spatial distribution and the scattered radiation dose rates in different imaging protocols. Highest and lowest rates were measured in abdomen AP and bedside chest AP protocols, respectively. The effective dose of supporting person in abdomen AP examination at distance of 0.5 m was 300 nSv and in bedside supine chest AP examination at distance of 0.7 m was 0.5 nSv. The estimated annual effective dose of emergency unit radiographer was 0.11 mSv. The obtained effective dose values are small compared to annual dose limits of radiation workers and the public.
Rotational Changes Following Use of Direct Vertebral Rotation in Adolescent Idiopathic Scoliosis
Authors: Kim Hong Jin , Chang Dong-Gune , Lenke Lawrence G. , Pizones Javier , Castelein René , Trobisch Per D. , Watanabe Kota , Yang Jae Hyuk , Suh Seung Woo , Suk Se-Il 
Published: November 2023

Study Design.
A retrospective cohort study.

Objective.
To evaluate long-term rotational changes in the vertebrae of patients with adolescent idiopathic scoliosis (AIS) who underwent direct vertebral rotation (DVR).

Summary of Background Data.
DVR using thoracic pedicle screws, a rotational corrective maneuver used in the surgical treatment of AIS, was introduced in 2004. Although DVR is considered to be the main axial corrective maneuver, the long-term rotational changes of vertebrae following this treatment are not well understood.

Materials and Methods.
A total of 135 vertebrae that underwent DVR using thoracic pedicle screws with a minimum five-year follow-up were retrospectively assessed for the vertebral rotation angle. The vertebral rotation of the apical vertebra (AV) and distal end vertebra (EV) was evaluated using the Nash-Moe scale, the rotational angle to the sacrum (RAsac), and the Aaro and Dahlborn method. The Student ttest (paired means) was used for continuous variables, and the χ2 test was used for categorical variables, as appropriate. A comparison of two and three groups used a one-way repeated measures analysis of variance, and the post hoc analysis used the Bonferroni test.

Results.
The mean Nash-Moe scale of distal EV showed statistically significant differences between preoperative and postoperative values (P=0.034) and no statistically significant difference between postoperative and last follow-up values (P=1.000). The last follow-up RAsac of AV did not differ significantly from the preoperative RAsac of AV (P=0.515). The last follow-up RAsac of distal EV was significantly lower than the preoperative RAsac of distal EV (P=0.001). The Pearson correlation analysis showed that the last follow-up RAsac of distal EV was correlated with the Cobb angle of the main curve (r=0.459, P=0.004), loss of correction (r=0.541, P=0.001), and lowest instrumented vertebra tilt angle (r=0.504, P=0.001)

Conclusions.
The rotation regression phenomenon in AV and rotation maintenance in distal EV were observed after DVR over an average 10-year follow-up. These findings suggest that the DVR in the surgical treatment of AIS has a positive long-term effect on the stabilization of distal EV from the point of view of axial rotation.

Level of Evidence.
4.
Does Reinforcement Learning Improve Outcomes for Critically Ill Patients? A Systematic Review and Level-of-Readiness Assessment
Authors: Otten Martijn , Jagesar Ameet R. , Dam Tariq A. , Biesheuvel Laurens A. , den Hengst Floris , Ziesemer Kirsten A. , Thoral Patrick J. , de Grooth Harm-Jan , Girbes Armand R.J. , François-Lavet Vincent , Hoogendoorn Mark , Elbers Paul W.G. 
Published: November 2023

OBJECTIVE:Reinforcement learning (RL) is a machine learning technique uniquely effective at sequential decision-making, which makes it potentially relevant to ICU treatment challenges. We set out to systematically review, assess level-of-readiness and meta-analyze the effect of RL on outcomes for critically ill patients.DATA SOURCES:A systematic search was performed in PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, Elsevier/SCOPUS and the Institute of Electrical and Electronics Engineers Xplore Digital Library from inception to March 25, 2022, with subsequent citation tracking.DATA EXTRACTION:Journal articles that used an RL technique in an ICU population and reported on patient health-related outcomes were included for full analysis. Conference papers were included for level-of-readiness assessment only. Descriptive statistics, characteristics of the models, outcome compared with clinician’s policy and level-of-readiness were collected. RL-health risk of bias and applicability assessment was performed.DATA SYNTHESIS:A total of 1,033 articles were screened, of which 18 journal articles and 18 conference papers, were included. Thirty of those were prototyping or modeling articles and six were validation articles. All articles reported RL algorithms to outperform clinical decision-making by ICU professionals, but only in retrospective data. The modeling techniques for the state-space, action-space, reward function, RL model training, and evaluation varied widely. The risk of bias was high in all articles, mainly due to the evaluation procedure.CONCLUSION:In this first systematic review on the application of RL in intensive care medicine we found no studies that demonstrated improved patient outcomes from RL-based technologies. All studies reported that RL-agent policies outperformed clinician policies, but such assessments were all based on retrospective off-policy evaluation.
Finding our Voice: Evaluation of Goal Setting Using the Habits of Preceptors Rubric in Terms of Focus, “SMARTness,” and Impact
Authors: Wolken Maura J. , Larson Suzanne , Raney Erin C. , Pogge Elizabeth K. , Afolabi Titilola M. , Storjohann Tara , Fairman Kathleen A. , Davis Lindsay E. 
Published: November 2023

Introduction:
Effective leadership propels teams from effectiveness to greatness and is accomplished when everyone achieves and contributes their full potential, or “voice.” The Clinician Educators Program Teaching and Learning Curriculum fosters preceptor development using the Habits of Preceptors Rubric (HOP-R) to guide participants in finding their precepting “voice.” After the HOP-R self-assessment, participants select a habit of focus (HOF) and craft a SMART (specific/measurable/achievable/relevant/time-bound) goal. This report describes a pilot rubric, SMART-EP (emotional intelligence(EI)/professionalism), exploring goal “SMARTness” alongside change (impact) in participants' perceived precepting capabilities.

Methods:
HOP-R self-ratings (2018–2020) and HOF/SMART goals (2019–2020) were retrospectively reviewed by two raters. Perceived preceptor capabilities were measured by analyzing the change in self-assessed habit level ratings between the first/fourth-quarter surveys. SMART goals were categorized by HOF and inclusion of SMART-EP components. Participants were guided in the inclusion of SMART, but not -EP, components.

Results:
In aggregate, 120 participants completed HOP-R surveys (2018–2020). Within-subject changes across all 11 habits were significant (P < .001). For the SMART-EP rubric analysis (2019–2020), 71 participants had an average “SMARTness” score of 3.92 (of 5) with corresponding interrater reliability of 0.91. Goals included 2.77 (of 4) EI traits and 1.72 (of 3) professionalism components.

Discussion:
The SMART-EP rubric provided insights into preceptor development opportunities among participants. Beyond SMART components, participants often included elements of EI and professionalism. Ratings confirm and support the consistency of the HOP-R as a tool to assess precepting habits.
Treatment decision based on unilateral index from nonadrenocorticotropic hormone-stimulated and adrenocorticotropic hormone-stimulated adrenal vein sampling in primary aldosteronism
Authors: Zhang Xizi , Shu Xiaoyu , Wu Feifei , Yang Jun , Cheng Qingfeng , Du Zhipeng , Song Ying , Yang Yi , Hu Jinbo , Wang Yue , Li Qifu , Yang Shumin ,   the Chongqing Primary Aldosteronism Study (CONPASS) Group†
Published: November 2023

Objective:
Adrenal venous sampling (AVS) is recommended for identifying the subtype of primary aldosteronism before making a surgical treatment decision, but failed cannulation of one adrenal vein is common. To evaluate whether using results of one adrenal vein during AVS could accurately predict unilateral primary aldosteronism.

Methods:
A retrospective study was conducted in primary aldosteronism patients receiving bilaterally or unilaterally successful AVS. The aldosterone–cortisol ratio from the adrenal vein divided by the aldosterone–cortisol ratio from the inferior vena cava (IVC) was calculated as the AV/IVC index.

Results:
The study examined 455 patients with primary aldosteronism, including 347 patients with unilateral primary aldosteronism. Among them, 250 and 125 patients received non- adrenocorticotropic hormone (ACTH) and ACTH-stimulated AVS, respectively, and 80 patients received both forms of AVS. Under non-ACTH-stimulated AVS, AUC of the AV/IVC index to diagnose ipsilateral and contralateral primary aldosteronism were 0.778 and 0.924, respectively. The specificity was 100% for both, with sensitivities of 5 and 26%, respectively, when using cutoffs of 17.05 to diagnose ipsilateral primary aldosteronism and 0.15 to diagnose contralateral primary aldosteronism. When using cutoffs of 3.60 and 0.70, the specificity decreased, but if combined with CT results (ipsilateral or contralateral adrenal nodules larger than 10 mm), the specificity could be maintained at 99%, with sensitivities of 33 and 45%, respectively. Under ACTH-stimulated AVS, the AV/IVC index showed similar accuracy to diagnose ipsilateral and contralateral primary aldosteronism.

Conclusion:
The unilateral AV/IVC index can be used to diagnose unilateral primary aldosteronism during AVS. Combining CT results can increase the accuracy further.
Decreased toll-like receptor 4 and CD11b/CD18 expression on peripheral monocytes of hypertensive patients correlates with a lesser extent of endothelial damage: a preliminary study
Authors: Budzyń Magdalena , Gryszczyńska Bogna , Begier-Krasińska Beata , Kaja Elżbieta , Mikołajczak Przemysław , Kujawski Radosław , Grupińska Joanna , Iskra Maria , Tykarski Andrzej , Kaczmarek Mariusz 
Published: November 2023

Background:
Low-grade chronic inflammation is recognized to contribute to the physiopathology of arterial hypertension. Therefore, this study aimed to assess the pro-inflammatory phenotype of peripheral monocytes of hypertensive patients by analyzing Toll-like receptor 4 (TLR4) and CD11b/CD18 surface expression. In the second part, the influence of phenotypic alterations of monocytes on the endothelial status reflected by circulating endothelial cells (CECs) was evaluated.

Patients:
The study included 60 patients with arterial hypertension, who were divided into two subgroups based on the disease severity according to the applicable criteria. The mild hypertension and resistant hypertension groups included 30 patients each. The control group consisted of 33 normotensive volunteers matched for age and sex.

Results:
Both in the entire group of patients and individual subgroups, reduced surface expression of TLR4 and CD11b/CD18 was found compared to normotensive volunteers. A reduced percentage of monocytes with the CD14+TLR4+ immunophenotype was correlated with a lower MFI level of CD18 and CD11b in the entire group of patients and after division only in the mild hypertension group. Reduced surface expression of TLR4 in hypertensive patients correlated with a lower number of CECs. This relationship was not observed in the resistant hypertension group; instead, an independent effect of reduced CD11b/CD18 expression on the reduction of CEC number was demonstrated.

Conclusion:
Our preliminary study showed for the first time that hypertension of varying severity is accompanied by phenotypic changes in monocytes, manifested by reduced surface expression of both TLR4 and CD11b/CD18. These phenotypic changes were associated with a reduced degree of endothelial injury. Our study opens a new, unexplored area of research on the protective features of peripheral monocytes in hypertension.
RDT-FSDet: Few-shot Object Detection for Rapid Antigen Test
Authors: Duan Yaofei , Wang Rongsheng , Tan Tao , Jin Xiaoyan , Lam Chan-Tong , Im Sio-Kei 
Published: November 2023

Abstract

Objective:
Manual verification of rapid diagnostic test (RDT) results is a time-consuming task; therefore, it is essential to introduce an object detection model into RDT result recognition to reduce the time involved. To address these problems, a detector that can rapidly adapt to different RDT results in various regions is important.

Methods:
We employed the few-shot object detection strategy and trained the Faster R-CNN detector with the mainland data set as the base class, followed by fine-tuning with the few-shot approach on the Macau RDT result data set. Moreover, we introduced 2 novel data augmentation methods, namely the “light simulation mask method” and “synthetic positive samples” for an unbalanced data set, to increase the sample size and balance the data set of the RDT detection task.

Result:
Compared with LightR-YOLOv5, RDT-few-shot detector (FSDet) achieved an mean average precision of 91.18 and a recall of 93.59 on the Macau RDT data set, demonstrating that this model can rapidly adapt to RDT results in different regions. The inference time of RDT-FSDet for each RDT result was 0.14 seconds, which can save ~90% of the detection time compared with manual screening.

Conclusion:
In addition to its application in the context of the coronavirus disease 2019 pandemic, this model can also be used as a general small-sample detection model. RDT-FSDet can be applied to the detection tasks of other small data sets, such as managing and analyzing detection results in other or future epidemics.
The association of C-reactive protein with major depressive symptoms in nonmetastatic renal cell carcinoma
Authors: Nicaise Edouard , Schmeusser Benjamin N. , Biermann Henry , Ali Adil , Ambadi Sriram , Patil Dattatraya H. , Armas-Phan Manuel , Vashi Khushali , Palacios Arnold R. , Midenberg Eric , Petrinec Benjamin , Nazha Bassel , Bilen Mehmet A. , Ogan Kenneth , Master Viraj A. 
Published: November 2023

Abstract

Introduction and Objective:
Patients with kidney cancer experience higher rates of depression compared with other cancer subtypes. Inflammation has been shown to contribute to depression associated with malignancy. Here, we assess the association between preoperative C-reactive protein (CRP) and major depression, as screened by the eight-item Patient Health Questionnaire (PHQ-8) depression scale, in patients undergoing nephrectomy for nonmetastatic renal cell carcinoma (RCC).

Methods:
Retrospective review of prospectively administered PHQ-8 surveys in patients who underwent nephrectomy for nonmetastatic RCC was conducted. Patients with available PHQ-8 within 180 days before and after surgery were included. The association of major depressive symptoms on preoperative PHQ-8 and clinical improvement on postoperative survey with patient/tumor characteristics and CRP levels was determined by the generalized chi-square test for categorical variables and analysis of variance for continuous variables. Multivariable logistic regression was used to analyze variables associated with major depression on PHQ-8 and postoperative survey improvement.

Results:
Two hundred forty-five patients were analyzed. Most were male (66%). Median age and body mass index were 65 and 28.9 kg/m2, respectively. 64.5% of patients were White, and 29.0% were Black. 30.2% had an elevated CRP (≥10 mg/L). 45 (18.4%) patients screened positive for major depressive symptoms on PHQ-8 (≥10 points). Patients with elevated CRP were more likely to have positive preoperative depression screening (odds ratio [OR] 2.66, 95% CI 1.08–6.52, P = .033) but had higher probability of demonstrating meaningful change on PHQ-8 after nephrectomy (OR 3.50, 95% CI 1.04–11.85, P = .044).

Conclusion:
In nonmetastatic RCC, patients with elevated preoperative CRP had higher scoring for major depressive symptoms on PHQ-8 and were more likely to demonstrate clinical improvement in depressive symptomatology after nephrectomy.
Survivorship representation at IPOS World Congress: abstract review and analysis
Authors: Gitonga Isaiah , Thornton Clifton P. , Schulte Fiona , Jefford Michael , Luigjes-Huizer Yvonne , Ruble Kathy 
Published: November 2023

Abstract

Background:
Advancements in cancer treatments have enabled more people worldwide to survive cancer, but many experience lasting impacts. The International Psycho-Oncology Society (IPOS) is a global professional organization which hosts an annual World Congress. This study reviewed survivorship content from the World Congress meetings to understand areas of focus, apparent strengths and weaknesses, and global representation.

Methods:
Peer-reviewed abstracts presented in 2017, 2018, 2019, and 2021 were reviewed. Abstracts were identified by searching for “survivor.” Identified abstracts were read in full to extract content of interest (population of interest, cancer type, number of participants, study design, study topic, first author/country, and international collaboration). Coding was defined a priori. Data were extracted using REDCap. Inter-rater reliability checks were performed.

Results:
A total of 1813 abstracts were identified and reviewed. The proportion of survivorship-focused abstracts ranged from 13.2%–20.7% annually. Breast cancer dominated survivorship work. The most frequently addressed topics included distress/anxiety/depression (36.6%), quality of life (28.6%), and health behaviors (15.5%). Nearly three-quarters (73%) of abstracts focused on adult populations, and there was apparent international collaboration in 12%–20%. Authorships and abstracts were primarily from high-income countries (91%). Most studies were observational (44%); few were randomized controlled trials (4%).

Conclusions:
This study found overrepresentation of authorship from some countries. Many topics, patient populations, and countries were not highly represented. IPOS might consider efforts to remedy this imbalance with the ultimate goal of improving psychosocial care for those affected by cancer, globally.