bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Intrathecal Medication Delivery With the IRRAflow Catheter: Pearls and Early Experience
Authors: Garavaglia Jeffrey , Hardigan Trevor , Turner Ryan , Monachello Gracie , Khan Muhammad Babar , Hodge Johnie O. , Brandmeir Nicholas J. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
Intrathecal (IT) medications are routinely introduced through catheterization of the intraventricular space or subarachnoid space. There has been sporadic use of IT medications delivered directly to the ventricle either by intermittent injection through an external ventricular drain (EVD) or by an Ommaya reservoir with a ventricular catheter. IT medication delivery through EVD has many drawbacks, including the necessary opening of a sterile system, delivery of medication in a bolus form, and requirements to clamp the EVD after medication delivery. Despite these setbacks, IT medications delivered through EVD have been used across a wide range of applications, including antibiotic delivery treatment of vasospasm with nicardipine and delivery of tissue plasminogen activator.

METHODS:
We used a newly developed active fluid exchange device to treat various severe conditions involved in the cerebral ventricles. Here, we present our treatment protocols and advice on the techniques related to successful active fluid exchange therapy.

RESULTS:
Seventy patients have been treated with our system with various conditions, including subarachnoid hemorrhage, intraventricular hemorrhage, ventriculitis, and cerebral abscess. Total complication rate was 14% with only 1 catheter occlusion and low rates of hemorrhage, infection, and spinal fluid leak.

CONCLUSION:
Current continuous IT medication dosages and protocols are based on reports and consensus statements evaluating intermittent instillation of medication boluses. The pharmacokinetics of continuous dosing and the therapeutic and safety profiles of the medications need to be studied in a prospective manner to evaluate the true optimal dosing standards. Furthermore, the ability to deliver continuous, sterile medications directly through an IT route will open new avenues of pharmacotherapy that were previously closed. This report serves as a basic guide for the safe and effective use of the IRRAflow active fluid exchange catheter to deliver IT medications.
Netrin 1 directs vascular patterning and maturity in the developing kidney
Authors: Honeycutt Samuel E. , N'Guetta Pierre-Emmanuel Y. , Hardesty Deanna M. , Xiong Yubin , Cooper Shamus L. , Stevenson Matthew J. , O'Brien Lori L. 
Published: October 2023

ABSTRACT
The intricate vascular system of the kidneys supports body fluid and organ homeostasis. However, little is known about how vascular architecture is established during kidney development. More specifically, how signals from the kidney influence vessel maturity and patterning remains poorly understood. Netrin 1 (Ntn1) is a secreted ligand that is crucial for vessel and neuronal guidance. Here, we demonstrate that Ntn1 is expressed by Foxd1+ stromal progenitors in the developing mouse kidney and conditional deletion (Foxd1GC/+;Ntn1fl/fl) results in hypoplastic kidneys with extended nephrogenesis. Wholemount 3D analyses additionally revealed the loss of a predictable vascular pattern in Foxd1GC/+;Ntn1fl/fl kidneys. As vascular patterning has been linked to vessel maturity, we investigated arterialization. Quantification of the CD31+ endothelium at E15.5 revealed no differences in metrics such as the number of branches or branch points, whereas the arterial vascular smooth muscle metrics were significantly reduced at both E15.5 and P0. In support of our observed phenotypes, whole kidney RNA-seq revealed disruptions to genes and programs associated with stromal cells, vasculature and differentiating nephrons. Together, our findings highlight the significance of Ntn1 to proper vascularization and kidney development.
A study to assess the efficacy of print and digital health communication media tools (HCMT) in rural and urban communities.
Authors: Kanchan Sushim , Gaidhane Abhay 
Published: October 2023

Background: Existing studies have described the potential of either digital or print media for health information in one discipline. Both media are excellent tools for disseminating information, promoting social awareness, and offering in-depth healthcare information thereby being considered as leading health communication media tools. Hence, this study aims to assess and compare the effectiveness of print and digital media in various aspects of health communication in rural and urban populations. Methodology: A cross-sectional population survey will be conducted in rural and urban areas, using a semi-structured, pre-tested questionnaire, which includes socio-demographic variables, media usage patterns, perception, and health behavior change from health information via both media. The study population size will include 342 individuals in the age group of 21 to 60 with minimum qualification of matriculation. Study implications: Our research will help to understand which media are more effective at reaching different populations and can help choose appropriate communication channels for health promotion efforts, develop more effective interventions, and identify potential disparities in access to health information and resources.
Operationalizing competency-based assessment: Contextualizing for cultural and gender divides
Authors: Ahmed Samar , Shersad Fouzia , Ziganshina Arina , Shadan Mariam , Elmardi Abdelmoneim , El Tayeb Yousif 
Published: October 2023

Following current trends, educational institutions often decide to use a competency framework as an overarching structure in their assessment system. Despite the presence of a common understanding of how different examinations can contribute to the decision on attaining a particular competency, a detailed mapping of the data points appears to be a challenging area that remains to be explored. Faced with the newly emerged task of introducing the assessment of the attainment of UAE medical students against the EmiratesMEDs competency framework, Dubai Medical College for Girls (DMCG) attempted to operationalise the designed concept in the assessment system considering the cultural and gender divide. We believe that health professionals who attempt to implement contextualized competency-based assessment could benefit from being acquainted with our experience.  The article offers a step-by-step guide on contextualized competency assessment operationalization, describing building the team, working with consultants and faculty development, estimating institutional assessment capacity, mapping and operationalizing the maps by using both human recourses and the software. We also offer the readers the list of enabling factors and introduce the scope of limitations in the process of developing the competency-based assessment system. We believe that following the present guide can allow educators to operationalize competency-based assessment in any context with respect to local culture and traditions.
Friend or Foe? Teaming Between Artificial Intelligence and Workers with Variation in Experience
Authors: Wang Weiguang , Gao Guodong (Gordon) , Agarwal Ritu 
Published: October 2023

As artificial intelligence (AI) applications become more pervasive, it is critical to understand how knowledge workers with different levels and types of experience can team with AI for productivity gains. We focus on the influence of two major types of human work experience (narrow experience based on the specific task volume and broad experience based on seniority) on the human-AI team dynamics. We developed an AI solution for medical chart coding in a publicly traded company and conducted a field study among the knowledge workers. Based on a detailed analysis performed at the medical chart level, we find evidence that AI benefits workers with greater task-based experience, but senior workers gain less from AI than their junior colleagues. Further investigation reveals that the relatively lower productivity lift from AI is not a result of seniority per se but lower trust in AI, likely triggered by the senior workers’ broader job responsibilities. This study provides new empirical insights into the differential roles of worker experience in the collaborative dynamics between AI and knowledge workers, which have important societal and business implications. This paper was accepted by Kartik Hosanagar, information systems. Funding: This work was supported by Inovalon [Sponsor of the Health Insights AI Laboratory]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2021.00588 .
Vedolizumab-Associated Hypereosinophilia and Hepatoxicity
Authors: De Marco Davide , Bessissow Talat , Marcus Victoria , Benmassaoud Amine 
Published: October 2023

ABSTRACT
Vedolizumab, which is approved for the treatment of ulcerative colitis, has been associated with drug-induced liver injury because of an unclear mechanism. We describe the case of a 29-year-old man who presented with abnormal liver enzymes and peripheral hypereosinophilia after vedolizumab initiation. A complete workup for causes of hepatitis and hypereosinophilia was negative, and liver biopsy showed signs compatible with drug-induced liver injury. After the withdrawal of vedolizumab, the patient's eosinophil count and liver enzymes normalized. As vedolizumab becomes more prominent, it is important to understand the potential side-effect profile of vedolizumab.
Comparative Evaluation of the Long-Term Filtration Performance of Recycled Materials in Highway Drainage Systems
Authors: Bayin Sariahmetoglu Aysegul , Hatipoglu Mustafa , Dayioglu Asli Y. 
Published: October 2023

ABSTRACT
Highway drainage systems are designed to remove surface water and groundwater without deteriorating the road structure; hence, their durability is crucial to sustain the performance of highways. Filtration performance of a drainage system consisting of aggregate and geotextiles is one key parameter that needs to be carefully assessed so that clogging of the system does not result in failure. Substituting the natural aggregate in drainage systems with recycled materials would result in preservation of natural resources and employment of stockpiled recycled material, creating a mutually beneficial solution. In this study, the long-term filtration performance of three different recycled materials from different industries (i.e., two steel slag, recycled asphalt pavement, recycled concrete aggregate) has been investigated when used as filter material in drainage systems. Furthermore, two natural aggregate materials as control soils were used to compare the performance of recycled materials. A nonwoven geotextile with a low apparent opening size that represents the least favorable scenario in terms of clogging was selected as the filtration media. Long-term filtration experiments were carried out in the modified gradient ratio test setup and the hydraulic gradient ratio (GR) along with the permeability ratio (KR) were determined under different hydraulic gradients to evaluate the clogging performance. The results indicate that even under the most undesirable conditions, recycled materials exhibit a satisfactory filtration performance compared with natural aggregates, and they can be employed as aggregate material in highway drainage systems.
Leaching Characteristics of Heavy Metals from Asphalt Mixture with Basic Oxygen Furnace Slag as Aggregate
Authors: Fan Yansong , Chen Meizhu , Yang Tianyuan , Li Naiqiang , Yao Xinyu 
Published: October 2023

Abstract
Basic oxygen furnace (BOF) slag, which has good mechanical properties, can be recycled as pavement materials. However, BOF slag contains several kinds of heavy metals. Batch leaching tests are usually conducted to investigate the leaching characteristics of asphalt mixture with BOF slag, which has a few limitations. In this article, the leaching characteristics of heavy metals were investigated through the column leaching test device self-designed in the laboratory. The factors that influence the leaching of heavy metals were evaluated. The experimental results indicate that high-basicity BOF slag that has high content of free calcium oxide (f-CaO) can effectively inhibit the leaching of heavy metals from asphalt mixture. Copper and nickel have no leaching risk in neutral and weakly acidic conditions. However, zinc and lead in asphalt mixture with medium-basicity BOF slag have a risk of causing environmental implication in long-term leaching process. Moreover, covering of asphalt inhibits the leaching of f-CaO and hinders the contact between heavy metals and the leachant at the same time. The conclusions of this article provide a theoretical basis for the green application of BOF slag as an asphalt pavement material.
Extracellular ATP Neurotransmission and Nicotine Sex-Specifically Modulate Habenular Neuronal Activity in Adolescence
Authors: Chen Yen-Chu , Rindner Daniel Jun , Fowler James P. , Lallai Valeria , Mogul Allison , Demuro Angelo , Lur Gyorgy , Fowler Christie D. 
Published: October 2023

The recent increase in the use of nicotine products by teenagers has revealed an urgent need to better understand the impact of nicotine on the adolescent brain. Here, we sought to examine the actions of extracellular ATP as a neurotransmitter and to investigate whether ATP and nicotinic signaling interact during adolescence. With the GRABATP(G-protein-coupled receptor activation-based ATP sensor), we first demonstrated that nicotine induces extracellular ATP release in the medial habenula, a brain region involved in nicotine aversion and withdrawal. Using patch-clamp electrophysiology, we then demonstrated that activation of the ATP receptors P2X or P2Y1increases the neuronal firing of cholinergic neurons. Surprisingly, contrasting interactive effects were observed with nicotine exposure. For the P2X receptor, activation had no observable effect on acute nicotine-mediated activity, but during abstinence after 10 d of nicotine exposure, coexposure to nicotine and the P2X agonist potentiated neuronal activity in female, but not male, neurons. For P2Y1signaling, a potentiated effect of the agonist and nicotine was observed with acute exposure, but not following extended nicotine exposure. These data reveal a complex interactive effect between nicotinic and ATP signaling in the adolescent brain and provide mechanistic insights into extracellular ATP signaling with sex-specific alterations of neuronal responses based on prior drug exposure.SIGNIFICANCE STATEMENTIn these studies, it was discovered that nicotine induces extracellular ATP release in the medial habenula and subsequent activation of the ATP purinergic receptors increases habenular cholinergic neuronal firing in the adolescent brain. Interestingly, following extended nicotine exposure, nicotine was found to alter the interplay between purinergic and nicotinic signaling in a sex-specific manner. Together, these studies provide a novel understanding for the role of extracellular ATP in mediating habenular activity and reveal how nicotine exposure during adolescence alters these signaling mechanisms, which has important implications given the high incidence of e-cigarette/vape use by youth.
Increasing Exclusive Nursery Care of Late Preterm and Low Birth Weight Infants
Authors: Gupta Basuray Rakhi , Cacioppo Carrie , Inuzuka Vanessa , Cooper Keri , Hardy Charles , Perry Michael F. 
Published: October 2023

BACKGROUND AND OBJECTIVE
Late preterm (LPT) and low birth weight (LBW) infants are populations at increased risk for NICU admission, partly due to feeding-related conditions. This study was aimed to increase the percentage of LPT and LBW infants receiving exclusive nursery care using quality improvement methodologies.

METHODS
A multidisciplinary team implemented interventions at a single academic center. Included infants were 35 to 36 weeks gestational age and term infants with birth weights &lt;2500 g admitted from the delivery room to the nursery. Drivers of change included feeding protocol, knowledge, and care standardization. We used statistical process control charts to track data over time. The primary outcome was the percentage of infants receiving exclusive nursery care. Secondary outcomes included rates of hypoglycemia, phototherapy, and average weight loss. Balancing measures were exclusive breast milk feeding rates and length of stay.

RESULTS
Included infants totaled 1336. The percentage of LPT and LBW infants receiving exclusive nursery care increased from 83.9% to 88.8% with special cause variation starting 1 month into the postintervention period. Reduction in neonatal hypoglycemia, 51.7% to 45.1%, coincided. Among infants receiving exclusive nursery care, phototherapy, weight loss, exclusive breast milk feeding, and length of stay had no special cause variation.

CONCLUSIONS
Interventions involving a nursery feeding protocol, knowledge, and standardization of care for LPT and LBW infants were associated with increased exclusive nursery care (4.9%) and reduced rates of neonatal hypoglycemia (6.6%) without adverse effects. This quality initiative allowed for the preservation of the mother-infant dyad using high-value care.
Effect of matrix self-healing on the bond-slip behavior of micro steel fibers in ultra-high-performance concrete
Authors: Al-Obaidi Salam , He Shan , Schlangen Erik , Ferrara Liberato 
Published: October 2023

AbstractThis study investigates the bond-slip behavior of micro steel fibers embedded into an Ultra-High-Performance Concrete (UHPC) matrix as affected by the self-healing of the same matrix in different exposure conditions. The UHPC matrix contains a crystalline admixture as a promoter of the autogenous self-healing specially added to enhance the durability in the cracked state. For the aforesaid purpose, some samples were partially pre-damaged with controlled preload (fiber pre-slip at different levels) and subjected to one-month exposure in 3.5% NaCl aqueous solution and in tap water to study the fiber corrosion, if any, and the effects of self-healing; after that, they were subjected to a pull-out test, to be compared with the behavior of analogous non-pre-slipped samples undergoing the same curing history. Moreover, some samples were cured in the chloride solution, intended to simulate a marine environment, to study the effect of marine curing on the pull-out behavior of steel fiber. The steel fiber corrosion and self-healing products attached to the surface of the steel fiber were analyzed via Scanning Electron Microscopy (SEM), and Energy -Dispersive Spectroscopy (EDS). The results indicate that the newly healed particles formed on the highly damaged fiber-matrix interface significantly enhance the friction phase of the bond-slip behavior and result in a significant residual capacity compared to non-pre-slipped specimens. On the other hand, the self-healing effect in specimens subjected to low damage pre-slip contributed more to the chemical adhesion region of the bond-slip behavior. Owning to the dense microstructure of the matrix, curing in 3.5% NaCl aqueous solution was not found to significantly affect the pull-out resistance as compared to the samples cured in tap water.
Examining Excess Mortality Among Critical Workers in Minnesota During 2020–2021: An Occupational Analysis
Authors: Karnik Harshada , Wrigley-Field Elizabeth , Levin Zachary , Chen Yea-Hung , Zabel Erik W. , Ramirez Marizen , Leider Jonathon P. 
Published: October 2023

Objectives. To understand the occupational risk associated with COVID-19 among civilian critical workers (aged 16–65 years) in Minnesota. Methods. We estimated excess mortality in 2020 to 2021 for critical occupations in different racial groups and vaccine rollout phases using death certificates and occupational employment rates for 2017 to 2021. Results. Excess mortality during the COVID-19 pandemic was higher for workers in critical occupations than for noncritical workers. Some critical occupations, such as transportation and logistics, construction, and food service, experienced higher excess mortality than did other critical occupations, such as health care, K–12 school staff, and agriculture. In almost all occupations investigated, workers of color experienced higher excess mortality than did White workers. Excess mortality in 2021 was greater than in 2020 across groups: occupations, vaccine eligibility tiers, and race/ethnicity. Conclusions. Although workers in critical occupations experienced greater excess mortality than did others, excess mortality among critical workers varied substantially by occupation and race. Public Health Implications. Analysis of mortality across occupations can be used to identify vulnerable populations, prioritize protective interventions for them, and develop targeted worker safety protocols to promote equitable health outcomes. (Am J Public Health. 2023;113(11):1219–1222. https://doi.org/10.2105/AJPH.2023.307395 )
The American Association of Latino Orthopaedic Surgeons
Authors: Escalera Cristian , Rodarte Patricia , Navarro Ronald A. , Bolanos Alberto A. , Buerba Rafael A. , Payares-Lizano Monica , Santos Erick M. , Gonzalez Mark H. , Jimenez Ramon 
Published: October 2023

Abstract:
The mission of the American Association of Latino Orthopaedic Surgeons (AALOS) is to provide collegiality, advancement, education, and social justice for Latino orthopaedic surgeons and the minority populations they represent. We strive to enhance diversity within the field of orthopaedic surgery by increasing the visibility of AALOS, highlighting its core focus, and emphasizing its mission. The purposes of this article are to discuss the need for this organization and highlight its history and future goals. As AALOS recently celebrated its 15-year anniversary, we are excited to continue advancing the field of orthopaedic surgery and improving our patients’ care.
Effects of laser power on the microstructure, mechanical properties and corrosion resistance of welded joints in dissimilar laser welding of 05Cr17Ni4Cu4Nb stainless steel and HR-2 stainless steel
Authors: Liu Hangtian , Zhao Jian , Han Ke , Xu Feifan , Liu Haikun , Li Fangzhou 
Published: October 2023

Abstract

The dissimilar 05Cr17Ni4Cu4Nb stainless steel and HR-2 stainless steel were welded without groove and wire filling by laser deep fusion welding. The weld metals (WM) microstructure characteristics of different laser power and its mechanical properties and Crep on the corrosion resistance of welded joints resistance were investigated in detail. The dissimilar the WM illustrated ferritic-austenitic mode of solidification with different welding processes. The weld joints have fine grain size and excellent mechanical properties with lower laser powers. The test specimens of mechanical properties failed at the HR-2 side with massive dimples distributing on the fracture surfaces, indicating typical ductile fracture characteristics of weld joints. The EDS results of the WM show that the white granular carbides are mainly NbC and M(Cr, Fe)23C6 precipitated phases in the WM. The results of electrochemical testing of welded joints show that the best corrosion resistance of welded joints is achieved with higher Crep in the WM.