bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute copper deficiency myelopathy after single-anastomosis gastric bypass
Authors: Taylor Georgia , Jeyarajan Eshwarshanker 
Published: December 2023

Abstract
Bariatric surgery is a well-established treatment for morbid obesity, combining both restrictive and malabsorptive mechanisms to achieve weight loss. Macro and micronutrient deficiencies are some of the most common complications of these operations, which in rare occasions can be unexpected, severe, and difficult to manage. We present a case of severe copper deficiency related myelopathy in a patient post single anastomosis gastric bypass, requiring parenteral copper replacement and eventual reversal. She presented with ascending lower limb paraesthesia and weakness, with copper levels on admission of 4 μmol/l, and ceruloplasmin 94 mg/l. She continued to have progressive neuropathy and visual deterioration, despite IV and enteral replacement, and eventually underwent reversal of her bypass, with normalization in her copper levels and incomplete improvement in symptoms. Copper deficiency myelopathy is a rare and severe complication of bariatric surgery. Early identification is key, as neurological symptoms are often not reversible.
Hedgehog Inhibitors Beyond Clinical Complete Response in Basal Cell Carcinoma: Should I Stop or Should I Go?
Authors: Alfieri Salvatore , Romanò Rebecca , Marceglia Sara , De Giorgi Vincenzo , Peris Ketty , Sollena Pietro , Piccerillo Alfredo , Moro Ruggero , Gualdi Giulio , Ascierto Paolo Antonio , Palla Marco , Paone Miriam , Eibenschutz Laura , Spagnolo Francesco , Queirolo Paola , Filippini Daria Maria , Cavalieri Stefano , Resteghini Carlo , Bergamini Cristiana , Manocchio Antonello , Licitra Lisa , Bossi Paolo 
Published: December 2023

Abstract

Introduction
In advanced basal cell carcinoma (BCC), the issue of whether Hedgehog inhibitors (HHIs) should be stopped or not after clinical complete response (cCR) achievement remains an unmet clinical need.

Materials and Methods
We conducted a retrospective, multicenter study across 7 Italian dermato-oncology units including patients with BCC who continued vismodegib after cCR between 2012 and 2019. We assessed the relationship between the duration of vismodegib intake (days to cCR [DTCR], days to stop after cCR [DTS], total treatment days [TTD]), and disease-free survival (DFS). Reasons to stop vismodegib were (R1) toxicity and (R2) disease recurrence. The relationship between DTCR, DTS, TTD, and DFS in the whole population and in R1 subgroup was assessed by Pearson’s correlation coefficient (P &lt; .05) and Bayesian statistics (BF10).

Results
Sixty-eight BCC patients with a median (m) age of 75.5 years (39-100) were included. Most patients were male (N = 43, 63%), without Gorlin syndrome (N = 56, 82%) and with head and neck area as primary site (N = 51, 75%). After cCR, out of 68 patients, 90% (N = 61/68) discontinued vismodegib: 82% (N = 50/61) due to toxicity (R1), and 18% (N = 11/61) due to recurrence (R2). Conversely, 10% (N = 7/68) continued vismodegib until last follow-up. In the whole population (N = 68), cCR was achieved with a mDTCR of 180.50 days. DFS showed a significant correlation with DTS (P &lt; .01, BF10 = 39.2) and TTD (P &lt; .01, BF10 = 35566), while it was not correlated to DTCR (BF10 &lt; 0.1). The analysis of R1 subgroup (N = 50) confirmed these results. DFS correlated with DTS in all recurrent patients (N = 38, r = 0.44, P &lt; .01) and in the recurrent patients who stopped vismodegib for toxicity (N = 26, r = 0.665, P &lt; .01). DFS was longer when vismodegib was maintained for &gt;2 months after cCR (mDFS &gt; 2 months, N = 54 vs. ≤ 2 months, N = 14: 470 vs. 175 d, P &lt; .01).

Conclusions
Our retrospective results suggest that HHIs should be continued after cCR to improve DFS in BCC.
Statistical mechanics approach to the holographic renormalization group: Bethe lattice Ising model and p-adic AdS/CFT
Authors: Okunishi Kouichi , Takayanagi Tadashi 
Published: December 2023

Abstract
The Bethe lattice Ising model—a classical model of statistical mechanics for the phase transition—provides a novel and intuitive understanding of the prototypical relationship between tensor networks and the anti-de Sitter (AdS)/conformal field theory (CFT) correspondence. After analytically formulating a holographic renormalization group for the Bethe lattice model, we demonstrate the underlying mechanism and the exact scaling dimensions for the power-law decay of boundary-spin correlations by introducing the relation between the lattice network and an effective Poincaré metric on a unit disk. We compare the Bethe lattice model in the high-temperature region with a scalar field in AdS2, and then discuss its more direct connection to the p-adic AdS/CFT. In addition, we find that the phase transition in the interior induces a crossover behavior of boundary-spin correlations, depending on the depth of the corresponding correlation path.
Annual gamma-ray background dose rates in dwellings of rural Tumkur
Authors: Udagani Chikkappa 
Published: December 2023

Abstract
The exposure to high levels of ionising radiation can cause severe health risks including cancer. The monitoring of background radiation is a primary task of nuclear scientists and researchers in the present day. The aim of the present work is to measure effective annual dose rate due to gamma-ray background radiation in dwellings of selected villages around Tumkur. It is very important to monitor background radiation in dwellings to safeguard from the harmful effects of gamma-ray background radiation. The dose rates in dwellings were measured using a German-made portable gamma dosemeter, Gamma-Scout. The measured annual dose rates were in the range of 1.103—2.824 mSv/y. From this survey, it was observed that the average annual dose rate for dwellings under study area with concrete ceiling and tiles floor are comparatively higher than the dwellings with griddle ceiling and stone floor.
An innovative approach for estimating energy absorption buildup factors (EABF) with HVL and TVL
Authors: Nagaraja Narayanappa , Manjunatha Holaly C , Sridhar Krishnachari Nagarathnamma , Sowmya Nagarajan , Seenappa Lakshmaiah , Munirathnam Rajachari , Soundar Renu 
Published: December 2023

Abstract
The current study proposes an empirical formula for absorption buildup factors as a function of target thickness. The present formula produces absorption buildup factors of compounds and mixtures with simple inputs of linear attenuation coefficient (μ), tenth value layer (TVL) and half value layer (HVL) of interacting target for the atomic number region 29 &lt; Z &lt; 92 for the energies 0.2 MeV &lt; E &lt; 1.5 MeV. This method is used to compute the energy absorption buildup factors using HVL and TVL.
Sustained polyphasic sleep restriction abolishes human growth hormone release
Authors: Rosenblum Yevgenia , Weber Frederik D , Rak Michael , Zavecz Zsófia , Kunath Nicolas , Breitenstein Barbara , Rasch Björn , Zeising Marcel , Uhr Manfred , Steiger Axel , Dresler Martin 
Published: December 2023

Abstract

Study Objectives
Voluntary sleep restriction is a common phenomenon in industrialized societies aiming to increase time spent awake and thus productivity. We explored how restricting sleep to a radically polyphasic schedule affects neural, cognitive, and endocrine characteristics.

Methods
Ten young healthy participants were restricted to one 20-minute nap opportunity at the end of every 4 hours (i.e. six sleep episodes per 24 hours) without any extended core sleep window, which resulted in a cumulative sleep amount of just 2 hours per day (i.e. ~20 minutes per bout).

Results
All but one participant terminated this schedule during the first month. The remaining participant (a 25-year-old male) succeeded in adhering to a polyphasic schedule for five out of the eight planned weeks. Cognitive and psychiatric measures showed modest changes during polyphasic as compared to monophasic sleep, while in-blood cortisol or melatonin release patterns and amounts were apparently unaltered. In contrast, growth hormone release was almost entirely abolished (&gt;95% decrease), with the residual release showing a considerably changed polyphasic secretional pattern.

Conclusions
Even though the study was initiated by volunteers with exceptional intrinsic motivation and commitment, none of them could tolerate the intended 8 weeks of the polyphasic schedule. Considering the decreased vigilance, abolished growth hormone release, and neurophysiological sleep changes observed, it is doubtful that radically polyphasic sleep schedules can subserve the different functions of sleep to a sufficient degree.
Reconstructing the phylodynamic history and geographic spread of the CRF01_AE-predominant HIV-1 epidemic in the Philippines from PR/RT sequences sampled from 2008 to 2018
Authors: Polotan Francisco Gerardo M , Salazar Carl Raymund P , Morito Hannah Leah E , Abulencia Miguel Francisco B , Pantoni Roslind Anne R , Mercado Edelwisa S , Hué Stéphane , Ditangco Rossana A 
Published: December 2023

Abstract
The Philippines has had a rapidly growing human immunodeficiency virus (HIV) epidemic with a shift in the prevalent subtype from B to CRF01_AE. However, the phylodynamic history of CRF01_AE in the Philippines has yet to be reconstructed. We conducted a descriptive retrospective study reconstructing the history of HIV-1 CRF01_AE transmissions in the Philippines through molecular epidemiology. Partial polymerase sequences (n = 1144) collected between 2008 and 2018 from three island groups were collated from the Research Institute for Tropical Medicine drug resistance genotyping database. Estimation of the time to the most recent common ancestor (tMRCA), effective reproductive number (Re), effective viral population size (Ne), relative migration rates, and geographic spread of CRF01_AE was performed with BEAST. Re and Ne were compared between CRF01_AE and B. Most CRF01_AE sequences formed a single clade with a tMRCA of June 1996 [95 per cent highest posterior density (HPD): December 1991, October 1999]. An increasing CRF01_AE Ne was observed from the tMRCA to 2013. The CRF01_AE Re reached peaks of 2.46 [95 per cent HPD: 1.76, 3.27] in 2007 and 2.52 [95 per cent HPD: 1.83, 3.34] in 2015. A decrease of CRF01_AE Re occurred in the intervening years of 2007 to 2011, reaching as low as 1.43 [95 per cent HPD: 1.06, 1.90] in 2011, followed by a rebound. The CRF01_AE epidemic most likely started in Luzon and then spread to the other island groups of the country. Both CRF01_AE and Subtype B exhibited similar patterns of Re fluctuation over time. These results characterize the subtype-specific phylodynamic history of the largest CRF01_AE cluster in the Philippines, which contextualizes and may inform past, present, and future public health measures toward controlling the HIV epidemic in the Philippines.
Survey of Phytophthora Diversity Reveals P. abietivora as a Potential Phytophthora Root Rot Pathogen in Québec Christmas Tree Plantations
Authors: Charron Guillaume , Yergeau Julie , Van der Heyden Hervé , Bilodeau Guillaume J. , Beaulieu Carole , Tanguay Philippe 
Published: December 2023

Christmas trees are an economically and culturally important ornamental plant in North America. Many microorganisms are pathogens of firs cultivated as Christmas trees. Among those, Phytophthora causes millions of dollars in damage to plantations annually. In Canada, it is unknown which species are responsible for Phytophthora root rot (PRR) of cultivated Abies species. Between 2019 and 2021, soil and root samples were collected from 40 Christmas tree plantations in Québec province. We used soil baiting and direct isolation from unidentified root fragments to assess the diversity of culturable Phytophthora spp. The obtained isolates were identified using a multilocus sequencing and phylogenetic approach. A total of 44 isolates were identified, including eight P. chlamydospora, eight P. abietivora, seven P. gonapodyides, three P. gregata, six P. megasperma, and two P. kelmanii isolates, plus 10 isolates belonging to a previously unknown taxon that is phylogenetically close to P. chlamydospora and P. gonapodyides. Among the known species, P. abietivora was the most prevalent isolated species associated with trees showing aboveground PRR-like symptoms. Pathogenicity trials confirmed the pathogenicity potential of P. abietivora on both Fraser fir and balsam fir seedlings. Our study provides a first snapshot of the Phytophthora diversity in Québec’s Christmas tree productions and describes multiple potential first associations between Phytophthora species and Abies balsamea and A. fraseri. [Formula: see text] Copyright © 2024 His Majesty the King in Right of Canada, as represented by the Minister of Natural Resources Canada. This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Missed Opportunities: Substance Use Hotline Operator Uncertainty of State Buprenorphine Prescribing via Telemedicine
Authors: Haley Danielle F. , Agoos Eleanor R. , Yarbrough Courtney R. , Suen Leslie W. , Beletsky Leo 
Published: December 2023

Objectives
We examined substance use hotline operator certainty of each US state and Washington, DC's endorsement of buprenorphine (initiation and continuation) prescribing via telemedicine.

Methods
Between March and May 2021, we called hotlines in 50 US states and Washington, DC, requesting information on whether practitioners in that state could initiate or continue buprenorphine treatment for opioid use disorder (OUD) via telephone or video conference. We compared operator responses to state implementation of buprenorphine telemedicine initiation. This study was designated as not human subjects research by the Boston University Institutional Review Board.

Results
We spoke with operators in 47 states and Washington, DC. Operators could not be reached in Alaska, California, and Montana. Most operators were uncertain (don't know, probably yes, probably no) whether the state permitted buprenorphine initiation (81%, n = 39) or continuation (83%, n = 40) via telemedicine. Practitioners could initiate buprenorphine prescribing via telemedicine in 7 states (100%) where operators were certain practitioners could initiate buprenorphine, 1 state (100%) where the operator was certain practitioners could not, and 6 states (86%) where operators indicated practitioners probably could not.

Conclusions
Most US states and Washington, DC, expanded the role of telemedicine in OUD treatment. However, most operators expressed uncertainty and sometimes communicated inaccurate information regarding whether practitioners could initiate buprenorphine treatment via telemedicine. There is an urgent need for policy mandates institutionalizing the role of telemedicine, and of buprenorphine specifically, in OUD treatment and for resources to train and support substance use hotline operators in this evolving policy environment.
Improving Arterial Puncture Success in Neonatal Patients Using Transillumination
Authors: Rhoads Sarah C. , Purdy Andrea , Fox Emily , Anspaugh Hannah 
Published: December 2023

Background:
Arterial punctures are a common procedure used to obtain blood samples for lab tests that guide treatment of neonatal patients. These punctures can be painful and have associated risks, emphasizing the importance of keeping attempts to a minimum.

Purpose:
The purpose of this quality improvement initiative was to determine whether using transillumination to visualize arteries before and while obtaining a blood sample would improve outcomes in neonatal patients.

Methods:
Quantitative data were collected pre- and postimplementation of education for the use of a transillumination device for arterial punctures on neonates in a level III neonatal intensive care unit (NICU). Outcomes followed included the success rate, average time to obtain a blood sample, and the average number of sticks to obtain a blood sample. Data were collected on 47 blood draw attempts in the control group (preimplementation) and 19 blood draw attempts in the experimental group (postimplementation).

Results:
A statistical analysis concluded that the use of the studied transillumination device does positively affect the incidence of successful blood draws, particularly for the novice NICU nurse. In addition, the average number of sticks to obtain a blood sample significantly decreased in the experimental group. Finally, the average time to obtain a blood sample using the device was not impacted in this study.

Implications for Practice and Research:
Use of a transillumination device does appear to result in improved outcomes for arterial punctures in neonatal patients. More research is needed to confirm these findings due to the small sample size of the study.
Estimated National Cost of Pelvic Organ Prolapse Surgery in the United States
Authors: St Martin Brad , Markowitz Melissa A. , Myers Evan R. , Lundsberg Lisbet S. , Ringel Nancy 
Published: December 2023

OBJECTIVE:
To estimate the national cost of pelvic organ prolapse (POP) surgery in the United States.

METHODS:
In this cross-sectional, population-based study, we used the 2016–2018 Healthcare Cost and Utilization Project National Inpatient Samples and National Ambulatory Surgery Samples to identify patients undergoing POP surgery using International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes, ICD-10 procedural codes, and Current Procedural Terminology codes. Cost-to-charge ratios and weighted estimates were used to calculate nationwide costs. Descriptive analysis was used to identify the sociodemographic, clinical, and surgical characteristics of the population undergoing POP surgery.

RESULTS:
Between 2016 and 2018, there were 140,762 POP surgical cases annually with an annual national cost estimated at $1.523 billion per year. The median cost per procedure increased slightly from $8,837 in 2016 to $8,958 in 2018. Overall, 82.5% of the total surgeries and 78% of the total national costs associated with POP surgery came from the ambulatory setting over this time period. Of these surgeries, 44.7% included an apical repair, and 42.3% included a concomitant hysterectomy. The average age of the population was 62 years, and 20% of the total population receiving prolapse surgery were younger than age 50 years.

CONCLUSION:
The annual national cost associated with surgical correction of POP is substantial, and the majority of cases occur in an ambulatory setting. These findings will contribute to enhancing cost-effectiveness analyses and decision-making processes for both health care professionals and policymakers as the national population continues to age.
Long-term safety of biologic and targeted synthetic disease modifying drugs in rheumatology
Authors: Barth Kaia , Gill Harsimrat , Singh Namrata 
Published: December 2023

Purpose of review
The landscape for treatment of rheumatic diseases is ever evolving, with several new drugs recently approved across diseases and more in the pipeline. This timely review aims to highlight the latest literature on long-term safety profiles of salient established and emerging biologic (b) and targeted synthetic (ts) disease modifying antirheumatic drugs (DMARDs).

Recent findings
The risk of infection remains elevated with the use of most b and tsDMARDs, with specifically risk of hepatitis B reactivation with rituximab and zoster infection with JAK inhibitors (JAKi). The results of the ORAL surveillance trial led to new black box warnings for JAKi and evoked critical risk-benefit discussions surrounding JAKi and DMARDs overall.

Summary
Such well conducted trials are needed to gather long term comparative safety data of DMARDs. In the interim, real world observational studies also have a role to play in our understanding of long-term drug safety, provided that detailed attention is paid to minimize biases inherent in observational studies.
Application of Cardiovascular Physiology to the Critically Ill Patient
Authors: Bronicki Ronald A. , Tume Sebastian , Gomez Hernando , Dezfulian Cameron , Penny Daniel J. , Pinsky Michael R. , Burkhoff Daniel 
Published: December 2023

OBJECTIVES:To use the ventricular pressure–volume relationship and time-varying elastance model to provide a foundation for understanding cardiovascular physiology and pathophysiology, interpreting advanced hemodynamic monitoring, and for illustrating the physiologic basis and hemodynamic effects of therapeutic interventions. We will build on this foundation by using a cardiovascular simulator to illustrate the application of these principles in the care of patients with severe sepsis, cardiogenic shock, and acute mechanical circulatory support.DATA SOURCES:Publications relevant to the discussion of the time-varying elastance model, cardiogenic shock, and sepsis were retrieved from MEDLINE. Supporting evidence was also retrieved from MEDLINE when indicated.STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS:Data from relevant publications were reviewed and applied as indicated.CONCLUSIONS:The ventricular pressure–volume relationship and time-varying elastance model provide a foundation for understanding cardiovascular physiology and pathophysiology. We have built on this foundation by using a cardiovascular simulator to illustrate the application of these important principles and have demonstrated how complex pathophysiologic abnormalities alter clinical parameters used by the clinician at the bedside.
Stress and Infant Media Exposure During COVID-19: A Study Among Latino Families
Authors: Zanzoul Sarah , Strickland Pamela Ohman , Mendelsohn Alan L. , Malke Keanaan , Bator Alicja , Hemler Jennifer , Jimenez Manuel E. 
Published: December 2023

Abstract:Objective:The COVID-19 pandemic disproportionately harmed Latino families; however, its effects on their stress and media routines remain understudied. We examined economic and parenting stress patterns during the COVID-19 pandemic and estimated associations between these forms of stress and nonadherence to American Academy of Pediatrics (AAP) infant media exposure recommendations among Latino families. We also explored how nonadherence with AAP recommendations varied with COVID-19 cases.Methods:We analyzed baseline data from an ongoing clinical trial recruiting low-income Latino parent-infant dyads. Nonadherence with AAP media exposure recommendations (ScreenQ) and economic and parent stress were measured using parent reports. Additional variables included epidemiological data on COVID-19 cases. Linear models examined associations between the pandemic and both stress variables as well as between stress and ScreenQ. Using locally weighted scatterplot smoothing curve fitting, the rise and fall of NJ COVID-19 cases were overlayed with ScreenQ scores over time to visualize and explore trends.Results:All parents identified as Latino (62.6% unemployed, 91.5% limited English proficiency). Mean infant age was 8.2 months. Parent stress increased over time during the COVID-19 pandemic (r = 0.13,p= 0.0369). After covariate adjustment, economic and parent stress were associated with increased nonadherence with AAP recommendations (standardized beta = 0.16, 95% confidence interval [CI], 0.03–0.29; standardized beta = 0.18, 95% CI, 0.04–0.31, respectively). Nonadherence to media exposure recommendations seemed to track with rises in the number of COVID-19 cases with a lag of 7 days.Conclusion:Parent and economic stress were associated with nonadherence to infant media exposure recommendations among Latino families. These findings highlight the need for practitioners to support families from under-resourced communities and to promote healthy media routines.