bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leptin Increase During Dexamethasone and Its Association With Hunger and Fat in Pediatric Acute Lymphoblastic Leukemia
Authors: van Hulst Annelienke M , Verwaaijen Emma J , van den Berg Sjoerd A A , van Litsenburg Raphaële R L , Grootenhuis Martha A , Fiocco Marta , Neggers Sebastian J C M M , van den Heuvel-Eibrink Marry M , van den Akker Erica L T 
Published: October 2023

Abstract

Context
During treatment, children with acute lymphoblastic leukemia (ALL) receive high doses dexamethasone, which induce acute side effects.

Objective
To determine the influence of a 5-day dexamethasone course on changes in leptin, fat mass, BMI, hunger, sleep, and fatigue and to explore associations between these changes.

Methods
Pediatric ALL patients were included during maintenance treatment. Data were collected before (T1) and after (T2) a 5-day dexamethasone course (6 mg/m2/day). At both time points, BMI, fat mass (bioelectrical impedance analysis), and leptin were assessed, as well as parent-reported questionnaires regarding hunger, fatigue, and sleep problems. Changes between T1 and T2 were assessed using paired tests. Correlation coefficients were calculated to assess associations between these changes (Delta scores: T2-T1). Univariable regression models were estimated to study associations between covariates and elevated leptin.

Results
We included 105 children, with median age 5.4 years (range, 3.0-18.8). Leptin and fat mass, as well as hunger scores, fatigue, and sleep deteriorated after 5 days of dexamethasone (P &lt; .001), in contrast to BMI (P = .12). No correlations between delta leptin and delta fat mass, BMI, hunger, fatigue, or sleep were found. Elevated leptin on T1 was associated with older age (odds ratio [OR] 1.51; 95% CI, 1.28-1.77), higher fat mass (OR 1.19; 95% CI, 1.07-1.33), and earlier maintenance week (OR 0.96; 95% CI, 0.92-0.99).

Conclusion
Five days of high-dose dexamethasone treatment led to direct and significant changes in leptin, hunger scores, and fat mass. Since children with ALL are at increased risk for metabolic adverse events, understanding underlying mechanisms is important, and a dexamethasone-induced state of acute leptin resistance might play a role.
Association of Gestational Free and Total Triiodothyronine With Gestational Hypertension, Preeclampsia, Preterm Birth, and Birth Weight: An Individual Participant Data Meta-analysis
Authors: Derakhshan Arash , Männistö Tuija , Chen Liangmiao , Osinga Joris A J , Ashoor Ghalia , Lu Xuemian , Bliddal Sofie , Tao Fang-Biao , Brown Suzanne J , Vaidya Bijay , Hattersley Andrew T , Itoh Sachiko , Popova Polina V , Aminorroaya Ashraf , Kishi Reiko , Kianpour Maryam , Vasukova Elena A , López-Bermejo Abel , Oken Emily , Chatzi Leda , Vafeiadi Marina , Bramer Wichor M , Bassols Judit , Lertxundi Aitana , Fernández-Somoano Ana , Carrasco Paula , Auvinen Juha , Huang Kun , Feldt-Rasmussen Ulla , Grineva Elena N , Alexander Erik K , Pearce Elizabeth N , Chaker Layal , Walsh John P , Peeters Robin P , Guxens Mònica , Suvanto Eila , Nicolaides Kypros H , Korevaar Tim I M 
Published: October 2023

Abstract

Context
Triiodothyronine (T3) is the bioactive form of thyroid hormone. In contrast to thyroid-stimulating hormone and free thyroxine, we lack knowledge on the association of gestational T3 with adverse obstetric outcomes.

Objective
To investigate the associaiton of gestational free or total T3 (FT3 or TT3) with adverse obstetric outcomes.

Methods
We collected individual participant data from prospective cohort studies on gestational FT3 or TT3, adverse obstetric outcomes (preeclampsia, gestational hypertension, preterm birth and very preterm birth, small for gestational age [SGA], and large for gestational age [LGA]), and potential confounders. We used mixed-effects regression models adjusting for potential confounders.

Results
The final study population comprised 33 118 mother–child pairs of which 27 331 had data on FT3 and 16 164 on TT3. There was a U-shaped association of FT3 with preeclampsia (P = .0069) and a J-shaped association with the risk of gestational hypertension (P = .029). Higher TT3 was associated with a higher risk of gestational hypertension (OR per SD of TT3 1.20, 95% CI 1.08 to 1.33; P = .0007). A lower TT3 but not FT3 was associated with a higher risk of very preterm birth (OR 0.72, 95% CI 0.55 to 0.94; P = .018). TT3 but not FT3 was positively associated with birth weight (mean difference per 1 SD increase in TT3 12.8, 95% CI 6.5 to 19.1 g, P &lt; .0001) but there was no association with SGA or LGA.

Conclusion
This study provides new insights on the association of gestational FT3 and TT3 with major adverse pregnancy outcomes that form the basis for future studies required to elucidate the effects of thyroid function on pregnancy outcomes. Based on the current study, routine FT3 or TT3 measurements for the assessment of thyroid function during pregnancy do not seem to be of added value in the risk assessment for adverse outcomes.
Socioeconomic Disparities Affecting the Presentation and Outcomes in Pediatric Subdural Empyema Patients
Authors: Patel Nirali , Rock Mitchell , Dowlati Ehsan , Phan Tiffany , Sanchez Carlos E. , Myseros John S. , Oluigbo Chima , Syed Hasan R. , Donoho Daniel A. , Keating Robert F. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
Pediatric subdural empyemas (SDE) carry significant morbidity and mortality, and prompt diagnosis and treatment are essential to ensure optimal outcomes. Nonclinical factors affect presentation, time to diagnosis, and outcomes in several neurosurgical conditions and are potential causes of delay in presentation and treatment for patients with SDE. To evaluate whether socioeconomic status, race, and insurance status affect presentation, time to diagnosis, and outcomes for children with subdural empyema.

METHODS:
We conducted a retrospective cohort study with patients diagnosed with SDE between 2005 and 2020 at our institution. Information regarding demographics (age, sex, zip code, insurance status, race/ethnicity) and presentation (symptoms, number of prior visits, duration of symptoms) was collected. Outcome measures included mortality, postoperative complications, length of stay, and discharge disposition.

RESULTS:
42 patients were diagnosed with SDE with a mean age of 9.5 years. Most (85.7%) (n = 36) were male (P = .0004), and a majority, 28/42 (66.7%), were African American (P < .0001). There was no significant difference in socioeconomic status based on zip codes, although a significantly higher number of patients were on public insurance (P = .015). African American patients had a significantly longer duration of symptoms than their Caucasian counterparts (8.4 days vs 1.8 days P = .0316). In total, 41/42 underwent surgery for the SDE, most within 24 hours of initial neurosurgical evaluation. There were no significant differences in the average length of stay. The average length of antibiotic duration was 57.2 days and was similar for all patients. There were no significant differences in discharge disposition based on any of the factors identified with most of the patients (52.4%) being discharged to home. There was 1 mortality (2.4%).

CONCLUSION:
Although there were no differences in outcomes based on nonclinical factors, African American men on public insurance bear a disproportionately high burden of SDE. Further investigation into the causes of this is warranted.
Pretemporal Transcavernous Approach to Basilar Tip Aneurysms: Operative Technique and Surgical Nuances: 2-Dimensional Operative Video
Authors: Rai Hitesh Inder Singh , Kayssi Abdel Raouf , Krisht Ali 
Published: October 2023

Microsurgical clipping of basilar tip aneurysms is known to be more durable than endovascular therapy, especially in wide neck aneurysms.
1-3
We present a case example of a complex basilar tip aneurysm, which was deemed nonfavorable for endovascular therapy, treated using the pretemporal transcavernous approach
4
in a 60-year-old woman. The patient consented for the procedure and the publication of their images.

INDICATIONS: CORRIDORS AND LIMITS OF EXPOSURE:
This approach provides a 360° view of the anterior upper third of posterior fossa which can tackle any kind of complex basilar aneurysm. It combines the benefits of both pterional/orbitozygomatic and subtemporal approaches.

ANATOMIC ESSENTIALS: NEED FOR PREOPERATIVE PLANNING AND ASSESSMENT:
Computed tomography angiography revealed a low-lying basilar apex, so a full transcavernous approach was used. Electroencephalogram, somatosensory evoked potentials, and brainstem auditory evoked response are essential modalities to monitor during temporary clipping.

ESSENTIAL STEPS OF THE PROCEDURE:
Anterior clinoidectomy, dissection of cavernous sinus, and posterior clinoidectomy to expose the perforator-free zone of basilar artery proximal to the superior cerebellar artery are essential steps described in detail in the video. Analyzing the perforator anatomy around the aneurysm before putting a clip is utmost essential.

PITFALLS/AVOIDANCE OF COMPLICATIONS:
Clipping a basilar aneurysm using this approach requires a neurosurgeon to have a sound knowledge of the neuroanatomy as well as a skilled handset for performing clinoidectomy and cavernous sinus dissection to avoid neurovascular injury.

VARIANTS AND INDICATIONS FOR THEIR USE:
Pterional/orbitozygomatic (for high riding bifurcation), subtemporal (low riding bifurcation), and endovascular therapy (small aneurysm with narrow neck) are other options used for these aneurysms.
Anterior Petrosectomy With Intertentorial Approach
Authors: Starnoni Daniele , Peters David , Giammattei Lorenzo , Fava Arianna , Cadas Hugues , Schranz Sami , Sabatasso Sara , Messerer Mahmoud , Daniel Roy T. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
The extradural anterior petrosal approach (EAPA) can present a challenge because it deals with critical structures in a narrow, confined corridor. It is associated with several potential approach-related risks including temporal lobe and venous injuries. Tentorial peeling has the potential to largely eliminate these risks during the approach and may offer more options for tailoring the dural opening to the anatomic region that one wants to expose.

METHODS:
Anatomic dissections of five adult injected non–formalin-fixed cadaveric heads were performed. Anterior petrosectomy with intertentorial approach (APIA) through a tentorial peeling was completed. Step-by-step documentation of the cadaveric dissections and diagrammatic representations are presented along with an illustrative case.

RESULTS:
Tentorial peeling separates the tentorium into a temporal tentorial leaf and posterior fossa tentorial leaf, adding a fourth dural layer to the three classic ones described during a standard EAPA. This opens out the intertentorial space and offers more options for tailoring the dural incisions specific to the pathology being treated. This represents a unique possibility to address brainstem or skull base pathology along the mid- and upper clivus with the ability to keep the entire temporal lobe and basal temporal veins covered by the temporal tentorial leaf. The APIA was successfully used for the resection of a large clival chordoma in the illustrative case.

CONCLUSION:
APIA is an interesting modification to the classic EAPA to reduce the approach-related morbidity. The risk reduction achieved is by eliminating the exposure of the temporal lobe while maintaining the excellent access to the petroclival region. It also provides several options to tailor the durotomies based on the localization of the lesion.
Optimal Portfolio Choice with Unknown Benchmark Efficiency
Authors: Kan Raymond , Wang Xiaolu 
Published: October 2023

When a benchmark model is inefficient, including test assets in addition to the benchmark portfolios can improve the performance of the optimal portfolio. In reality, the efficiency of a benchmark model relative to the test assets is ex ante unknown; moreover, the optimal portfolio is constructed based on estimated parameters. Therefore, whether and how to include the test assets becomes a critical question faced by real world investors. For such a setting, we propose a combining portfolio strategy, optimally balancing the value of including test assets and the effect of estimation errors. The proposed combining strategy can work together with some existing estimation risk reduction strategies. In both empirical data sets and simulations, we show that our proposed combining strategy performs well. This paper was accepted by Agostino Capponi, finance. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2021.01767 .
Incentives from Career Concerns in a Contract Package: An Empirical Investigation
Authors: Yang Bicheng , Chan Tat , Owan Hideo , Tsuru Tsuyoshi 
Published: October 2023

This paper empirically studies the extent to which career concerns as part of a typical contract offer influence employees’ work performance in a Japanese auto dealership firm. Because career movements and base-wage adjustments rely on performance evaluation over time, we develop a dynamic structural model that allows concerns for future payoffs to impact an employee’s current work effort. A reform in personnel-management policies of the firm during the data period enables us not only to compare the performances across individuals, but also to compare within an individual the performance before and after the reform—this enhances the model identification. Our estimation results show that the added value from career movements on top of the monetary payoffs is more important than the monetary payoffs. Individuals respond to career movements and commissions differently, mainly due to varying cost of effort and different payoffs from career movements. Our counterfactual exercises suggest that, compared with the scenario when there is only monetary compensation, adding career movements in a contract package will greatly improve the firm’s gross profit. The firm can improve its net profit by making commission and promotion more performance-based. This paper was accepted by Matt Shum, marketing. Funding: Financial support from the Social Sciences and Humanities Research Council of Canada [Grant 20190410-01] is gratefully acknowledged. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.4956 .
The experience of physiotherapists navigating the portfolio route to completion of the roadmap to practice
Authors: Carus Catherine , Millington Paul , Edwards Lisa , Snaith Beverly 
Published: October 2023

Background: The education of first contact practitioners (FCPs) working in musculoskeletal practice in primary care is guided by an NHS England framework: the Roadmap to Practice. This includes a portfolio route to recognise the skills and capabilities of experienced physiotherapists. Aim: To review the portfolio route for evidencing the capabilities expected of the roadmap through the experience of practitioners. Method: An online survey and interviews were conducted of FCPs and supervisors from early-implementer sites. Results: While participants largely supported the need for assurance of their capabilities, their personal perceptions of completing the portfolio were strongly influenced by their career stage, clinical experience and length of time in their FCP role. Individuals often had limited planned time for portfolio development and competing clinical priorities. Conclusion: The portfolio route was acknowledged as a valuable way to evidence capability within practice. The volume of evidence required and the limited guidance given were overwhelming for many participants.
Food Insecurity and Health Outcomes of Children With Intellectual and Developmental Disabilities in the United States
Authors: Dhuliawala Samina , Payakachat Nalin , Painter Jacob T. , Swindle Taren , Li Chenghui 
Published: October 2023

AbstractWe aimed to (a) provide nationally representative estimates of food insecurity (FI) among children with intellectual and developmental disabilities (IDD), and (b) determine the association between FI and four health outcomes (overall health, problem behavior, activities of daily living, functional limitations) in 5,657 children with IDD compared to 1:1 propensity score matched children without IDD. Mixed-effects ordered logistic regression models were used. Children with IDD were more likely to experience FI than children without IDD (43.3% vs. 30.0%, p &lt; 0.001). FI and IDD were independently associated with worse scores on all four health outcomes. Having both FI and IDD further exacerbated the adverse impacts on these health outcomes. The association was stronger among children with moderate-to-severe FI than those with mild FI.
An experimental machine learning study investigating the decision-making process of students and qualified radiographers when interpreting radiographic images
Authors: Rainey Clare , Villikudathil Angelina T. , McConnell Jonathan , Hughes Ciara , Bond Raymond , McFadden Sonyia 
Published: October 2023

AI is becoming more prevalent in healthcare and is predicted to be further integrated into workflows to ease the pressure on an already stretched service. The National Health Service in the UK has prioritised AI and Digital health as part of its Long-Term Plan. Few studies have examined the human interaction with such systems in healthcare, despite reports of biases being present with the use of AI in other technologically advanced fields, such as finance and aviation. Understanding is needed of how certain user characteristics may impact how radiographers engage with AI systems in use in the clinical setting to mitigate against problems before they arise. The aim of this study is to determine correlations of skills, confidence in AI and perceived knowledge amongst student and qualified radiographers in the UK healthcare system. A machine learning based AI model was built to predict if the interpreter was either a student (n = 67) or a qualified radiographer (n = 39) in advance, using important variables from a feature selection technique named Boruta. A survey, which required the participant to interpret a series of plain radiographic examinations with and without AI assistance, was created on the Qualtrics survey platform and promoted via social media (Twitter/LinkedIn), therefore adopting convenience, snowball sampling This survey was open to all UK radiographers, including students and retired radiographers.Pearson’s correlation analysis revealed that males who were proficient in their profession were more likely than females to trust AI. Trust in AI was negatively correlated with age and with level of experience. A machine learning model was built, the best model predicted the image interpreter to be qualified radiographers with 0.93 area under curve and a prediction accuracy of 93%. Further testing in prospective validation cohorts using a larger sample size is required to determine the clinical utility of the proposed machine learning model.
Stent for life initiative in Portugal: Progress through years and Covid-19 impact
Authors: Pereira Ernesto , Calé Rita , Pereira Ângela Maria , Pereira Hélder , Martins Luís Dias 
Published: October 2023

BackgroundDuring Stent for Life Initiative in Portugal lifetime, positive changes in ST elevation myocardial infarction treatment were observed, by the increase of Primary Angioplasty numbers and improvements in patients’ behaviour towards myocardial infarction, with an increase in those who called 112 and the lower proportion attending non primary percutaneous coronary intervention centres. Despite public awareness campaigns and system educational programmes, patient and system delay did not change significantly over this period. The aim of this study was to address the public awareness campaign effectiveness on peoples’ behaviour facing STEMI, and how Covid-19 has affected STEMI treatment.MethodsData from 1381 STEMI patients were collected during a one-month period each year, from 2011 to 2016, and during one and a half month, matching first lockdown in Portugal 2020. Four groups were constituted: Group A (2011); Group B (2012&2013); Group C (2015&2016) and group D (2020).ResultsThe proportion of patients who called 112, increased significantly (35.2% Group A; 38.7% Group B; 44.0% Group C and 49.6% Group D, p = 0.005); significant reduction was observed in the proportion of patients who attended healthcare centres without PPCI (54.5% group A; 47.6% Group B; 43.2% Group C and 40.9% Group D, p = 0.016), but there were no differences on groups comparison. Total ischemic time, measured from symptoms onset to reperfusion increased progressively from group A [250.0 (178.0–430.0)] to D [296.0 (201.0–457.5.8)] p = 0.012, with statistically significant difference between group C and D (p = 0.034).ConclusionsDuring the term of SFL initiative in Portugal, patients resorted less to primary health centres and called more to 112. These results can be attributed the public awareness campaign. Nevertheless, patient and system delays did not significantly change over this period, mainly in late years of SFL, probably for low efficacy of campaigns and in 2020 due to Covid-19 pandemic.
Hospital-based violence prevention programmes in South Wales Emergency Departments: A process evaluation protocol
Authors: Van Godwin Jordan , Moore Graham , O’Reilly David , Hamilton Megan , Clift Niamh , Moore Simon C. 
Published: October 2023

BackgroundAddressing violence related harm is a global public health priority. While violence is primarily managed in the criminal justice system, healthcare supports and manages those injured by violence. Emergency Departments (EDs), the primary destination for those seriously injured, have emerged as a candidate location for violence prevention initiatives. There is limited evaluation of ED-based violence prevention, and a lack of guidance for the implementation and delivery of them. Nurse-led Violence Prevention Teams (VPTs) have been developed and implemented in two EDs in Wales, UK. This protocol describes methods used in the process evaluation of these VPTs.AimTo understand how VPTs function, how they were implemented, and mechanisms of impact, as well as the exploration of wider contextual factors influencing their function.MethodsAdopting a critical realist approach and informed by the Medical Research Council (MRC) guidance for process evaluations, the process evaluation will employ qualitative methods to collect and analyse data: a scoping review of evidence of effectiveness that considers the causal mechanisms underpinning violence; a documentary analysis to determine operational considerations concerning the development, implementation and delivery of the VPTs; a descriptive analysis of routine ED data to characterise the prevalence of violence-related attendances in each ED; interviews with professional stakeholders (N = 60) from the violence prevention ecologies in which the VPTs are embedded.DiscussionThis protocol outlines a process evaluation of a novel, nurse led violence prevention intervention. Findings will be used to inform policy makers’ decision making on whether and how VPTs should be used in practice in other EDs across the UK, and the extent that a single operational model should be adjusted to address the local characteristic of violence. To the authors knowledge, this is the first process evaluation of a UK-based, nurse led Emergency Department Violence Prevention Team.Trial registrationProtocol registrationISRCTN:15286575. Registered 13thMarch, 2023.