bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tied-array beam localization of radio transients and pulsars
Authors: Bezuidenhout M C , Clark C J , Breton R P , Stappers B W , Barr E D , Caleb M , Chen W , Jankowski F , Kramer M , Rajwade K , Surnis M 
Published: March 2023

Abstract
Multi-element interferometers such as MeerKAT, which observe with high time resolution and have a wide field of view, provide an ideal opportunity to perform real-time, untargeted transient and pulsar searches. However, because of data storage limitations, it is not always feasible to store the baseband data required to image the field of a discovered transient or pulsar. This limits the ability of surveys to effectively localize their discoveries and may restrict opportunities for follow-up science, especially of one-off events like some fast radio bursts. Here, we present a novel maximum-likelihood estimation approach to localizing transients and pulsars detected in multiple MeerKAT tied-array beams at once, which we call tied-array beam localization, as well as a Python implementation of the method named SeeKAT. We provide real-world examples of SeeKAT’s use as well as a Monte Carlo analysis to show that it is capable of localizing single pulses detected in beamformed MeerKAT data to (sub)arcsec precision.
Non-viral gene coating modified IOL delivering PDGFR-α shRNA interferes with the fibrogenic process to prevent posterior capsular opacification
Authors: Wang Jiahao , Hu Yulin , Han Yuemei , Fang Qiuna , Chen Zhirong , Wang Yajia , Zhao Peiyi , Wang Hui , Lin Quankui 
Published: March 2023

AbstractPosterior capsule opacification (PCO), the most common complication after cataract surgery, is caused by the proliferation, migration and epithelial–mesenchymal transition (EMT) of residual lens epithelial cells in the capsule bag. Although the surface modification and drug loading of intraocular lens (IOLs) have been effective in preventing PCO to some extent, the intraocular safety of anti-proliferative drug application is still a major limitation in clinical application. In this study, we used non-viral gene delivery systems in combination with layer-by-layer (LBL) self-assembly technology, and the modified IOL could effectively prevent the development of PCO by interfering with the EMT process mediated by the platelet-derived growth factor receptor-α (PDGFR-α). Herein, the gene fragments were wrapped by electrostatic conjugation using polyethyleneimine-graft-poly(ethylene glycol) to form gene complexes. Gene complexes were characterized by dynamic light scattering, transmission electron microscopy (TEM) and agarose gel electrophoresis, and evaluated for storage and serum stability. The layer assembly behavior of the IOL surface, changes in optical properties and the release behavior of the gene complexes were characterized using quartz crystal microbalance, UV–vis, contact angle and TEM. In vitro experiments showed that the IOL coating has good bio-compatibility and can achieve the corresponding transfection effect, and the released gene complexes exhibited excellent cell internalization and lysosomal escape behaviors, as well as effective inhibition of PDGFR-α expression and its mediated EMT process. The early PCO prevention effect and bio-compatibility evaluation of the modified IOL in vivo were evaluated by implantation into animal eyes. This study provides a new strategy for the development of surface modifications of small nucleic acid drugs and non-toxic EMT interference therapies for PCO.
COVID-19 stay-at-home restrictions increase the alignment in sleep and light exposure between school days and weekends in university students
Authors: Rice Alicia , Sather Olivia , Wright Kenneth P , Vetter Céline , Martin Melanie A , de la Iglesia Horacio O 
Published: March 2023

Abstract
Younger adults have a biological disposition to sleep and wake at later times that conflict with early morning obligations like work and school; this conflict leads to inadequate sleep duration and a difference in sleep timing between school days and weekends. The COVID-19 pandemic forced universities and workplaces to shut down in person attendance and implement remote learning and meetings that decreased/removed commute times and gave students more flexibility with their sleep timing. To determine the impact of remote learning on the daily sleep–wake cycle we conducted a natural experiment using wrist actimetry monitors to compare activity patterns and light exposure in three cohorts of students: pre-shutdown in-person learning (2019), during-shutdown remote learning (2020), and post-shutdown in-person learning (2021). Our results show that during-shutdown the difference between school day and weekend sleep onset, duration, and midsleep timing was diminished. For instance, midsleep during school days pre-shutdown occurred 50 min later on weekends (5:14 ± 12 min) than school days (4:24 ± 14 min) but it did not differ under COVID restrictions. Additionally, we found that while the interindividual variance in sleep parameters increased under COVID restrictions the intraindividual variance did not change, indicating that the schedule flexibility did not cause more irregular sleep patterns. In line with our sleep timing results, school day vs. weekend differences in the timing of light exposure present pre- and post-shutdown were absent under COVID restrictions. Our results provide further evidence that increased freedom in class scheduling allows university students to better and consistently align sleep behavior between school days and weekends.
Revisiting the Mesenchymal “Stem vs. Stromal” Cell Dichotomy and Its Implications for Development of Improved Potency Metrics
Authors: Phinney Donald G , Hwa Lee Ryang , Boregowda Siddaraju V 
Published: March 2023

Abstract
Mesenchymal stem/stromal cell (MSC)-based therapies have been evaluated in over 1500 human clinical trials for a diverse array of disease indication, but outcomes remain unpredictable due to knowledge gaps in the quality attributes that confer therapeutic potency onto cells and their mode of action in vivo. Based on accumulated evidence from pre-clinical models, MSCs exert therapeutic effects by repressing inflammatory and immune-mediated response via paracrine action following reprogramming by the host injury microenvironment, and by polarization of tissue resident macrophages following phagocytosis to an alternatively activated (M2) state. An important tenet of this existing paradigm is that well-established stem/progenitor functions of MSCs are independent of paracrine function and dispensable for their anti-inflammatory and immune suppressive functions. Herein, we review evidence that stem/progenitor and paracrine functions of MSCs are mechanistically linked and organized hierarchically and describe how this link may be exploited to develop metrics that predict MSC potency across a spectrum of activities and regenerative medicine applications.
Satisfaction, Stress, and Turnover: Comparing U.S. Intensivist Physicians Before and During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic
Authors: Barshied Claire B. , Russell Cortessa 
Published: March 2023

OBJECTIVES:
To evaluate changes in work satisfaction, work-life balance (WLB) satisfaction, stress, and turnover intention among U.S. critical care physicians during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic of 2021–2022 compared with prepandemic levels in 2016.

DESIGN:
A cross-sectional electronic survey.

SETTING:
Critical care practices in the United States.

SUBJECTS:
U.S. physician members of the Society for Critical Care Medicine.

MEASUREMENTS AND MAIN RESULTS:
A total of 1,148 intensivists completed online surveys administered in two waves: in 2016 (693 respondents) and in the late 2021 to early 2022 (455 respondents). They reported demographic and practice characteristics, self-perceived levels of satisfaction, stress, health, and intention to leave their current job. U.S.-based critical care physicians in 2022 report significantly lower levels of job satisfaction compared with 2016. Frequency of work stress and turnover intention also increased, whereas WLB satisfaction has remained the same. Nearly two-thirds of intensivists wish they could work fewer hours, and this discontentment is correlated with decreased satisfaction, increased stress, and increased turnover, particularly in pandemic respondents. More than 25% of physicians rated their mental health as poor or fair, and 20% rated their physical health as poor or fair; these self-ratings correlated with decreased satisfaction and increased stress and turnover intention.

CONCLUSIONS:
The SARS-CoV-2 pandemic has further burdened an already-strained critical care workforce. During the pandemic, job satisfaction fell, work stress became more frequent, and turnover intention increased for critical care physicians. They also have consistently low rates of WLB satisfaction. Work hours matter the most for physician satisfaction, stress, and turnover intention, and the desire to work fewer hours is negatively related to all outcomes. Many critical care physicians reported poor mental and physical health during the pandemic, which is strongly and negatively related to all outcomes. These results emphasize the importance of prioritizing the working preferences and the self-care of intensivist physicians.
Population-based Long-term Outcomes for Squamous Cell Carcinoma of the Nasal Cavity
Authors: Hamilton Sarah Nicole , Liu Jason , Holmes Connor , DeVries Kimberly , Olson Robert , Tran Eric , Berthelet Eric , Wu Jonn , Chau Nicole , Chan Matthew , Thamboo Andrew 
Published: March 2023

Background:
This study evaluates population-based outcomes of patients with squamous cell carcinoma (SCC) of the nasal cavity treated in British Columbia.

Methods:
A retrospective review of nasal cavity SCC treated from 1984 to 2014 was performed (n = 159). Locoregional recurrence (LRR) and overall survival (OS) were evaluated.

Results:
The 3-year OS was 74.2% for radiation alone, 75.8% for surgery alone, and 78.4% for surgery and radiation (P = 0.16). The 3-year LRR was 28.4% for radiation alone, 28.2% for surgery alone, and 22.6% for surgery and radiation (P = 0.21). On multivariable analysis, surgery and postoperative radiation relative to surgery alone was associated with a lower risk of LRR (hazard ratio: 0.36, P = 0.03). Poor Eastern Cooperative Oncology Group status, node-positive, orbital invasion, smoking, and advanced age were associated with worse OS (all P <0.05).

Conclusion:
In this population-based analysis, multimodality treatment with surgery and adjuvant radiation were associated with improved locoregional control for SCC of the nasal cavity.
ACR–ARS Practice Parameter on Informed Consent Radiation Oncology
Authors: Hurwitz Mark D. , Chundury Anupama , Goodman Chelain R. , Jones Joshua , Lo Simon S. , Saeed Hina , Small William , Schechter Naomi R. 
Published: March 2023

Objectives:
Consent is a communication process between the patient and a health care provider, in which both parties have the opportunity to ask questions and exchange information relevant to the patient’s diagnosis and treatment. The process of informed consent is designed to protect a patient’s autonomy in their medical decision-making in the context of an asymmetric relationship with the health care system. A proper consent process assures a patient’s individual autonomy, reduces the opportunity for abusive conduct or conflicts of interest, and raises trust levels among participants. This document was developed as an educational tool to facilitate these goals.

Methods:
This practice parameter was produced according to the process described under the heading “The Process for Developing ACR Practice Parameters and Technical Standards” on the ACR website (https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters—Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS. Committee members were charged with reviewing the prior version of the informed consent practice parameter published in 2017 and recommending additions, modifications, or deletions. The committee met through remote access and subsequently through an online exchange to facilitate the development of the revised document. Focus was given on identifying new considerations and challenges with informed consent given the evolution of the practice of radiation oncology in part driven by the COVID-19 pandemic and other external factors.

Results:
A review of the practice parameter published in 2017 confirmed the ongoing relevance of recommendations made at that time. In addition, the evolution of the practice of radiation oncology since the publication of the prior document resulted in the need for new topics to be addressed. These topics include remote consent either through telehealth or telephone and with the patient or their health care proxy.

Conclusions:
Informed consent is an essential process in the care of radiation oncology patients. This practice parameter serves as an educational tool designed to assist practitioners in optimizing this process for the benefit of all involved parties.
Predictive value of liver fibrosis scores in cardiovascular diseases among hypertensive population
Authors: Xiong Shengjun , Yin Shizhang , Deng Wanshu , Zhao Yuanhui , Li Wenhang , Wang Pengbo , Li Zhao , Yang Hongmei , Zhou Ying , Yu Shasha , Guo Xiaofan , Sun Yingxian 
Published: March 2023

Purpose:
To explore the predictive value of liver fibrosis scores [fibrosis-4, AST/platelet ratio index, BAAT score (BMI Age ALT TG), and BARD score (BMI AST/ALT Ratio Diabetes)] for the risk of cardiovascular disease (CVD) in a hypertensive population.

Methods:
A total of 4164 hypertensive participants without history of CVD were enrolled in the follow-up. Four liver fibrosis scores (LFSs) were used, including the fibrosis-4 (FIB-4), APRI, BAAT score, and BARD score. The endpoint was CVD incidence which was defined as stroke or coronary heart disease (CHD) during the follow-up period. Cox regression analyses were used to calculate hazard ratios between LFSs and CVD. Kaplan–Meier curve was used to show the probability of CVD in different levels of LFSs. Restricted cubic spline further explored whether the relationship between LFSs and CVD was linear. Finally, we assessed the discriminatory ability of each LFS for CVD was assessed using C-statistics, net reclassification index (NRI), and integrated discrimination improvement (IDI).

Results:
During a median follow-up time of 4.66 years, 282 hypertensive participants had CVD. Kaplan–Meier curve showed that four LFSs were associated with CVD and high levels of LFSs significantly increase the probability of CVD in hypertensive population. In the multivariate Cox regression analysis, the adjusted hazard ratios for four LFSs were 3.13 in FIB-4, 1.66 in APRI, 1.47 in BAAT score, and 1.36 in BARD score. Moreover, after adding LFSs to original risk prediction model, we find that all four new models have higher C-statistics of CVD than the traditional model. Furthermore, the results of both NRI and IDI were positive, indicating that LFSs enhanced the effect on the prediction of CVD.

Conclusions:
Our study showed that LFSs were associated with CVD in hypertensive populations in northeastern China. Furthermore, it suggested that LFSs could be a new tool for identifying patients at high risk of primary CVD in a hypertensive population.
Intersectionality of Systemic Disadvantage on Mortality and Care Following TBI
Authors: Starosta Amy J. , Mata-Greve Felicia , Humbert Andrew , Zheng Zihan , Prado Maria G. , Au Margaret A. , Mollis Brenda , Stephens Kari A. , Hoffman Jeanne M. 
Published: March 2023

Background:
People of color (POC), especially those who also hold social identities associated with disadvantage (non–English-speaking, female, older, lower socioeconomic level), continue to be underserved in the health system, which can result in poorer care and worsened health outcomes. Most disparity research in traumatic brain injury (TBI) focuses on the impact of single factors, which misses the compounding effect of belonging to multiple historically marginalized groups.

Objective:
To examine the intersectional impact of multiple social identities vulnerable to systemic disadvantage following TBI on mortality, opioid usage during acute hospitalization, and discharge location.

Methods:
Retrospective observational design utilizing electronic health records merged with local trauma registry data. Patient groups were defined by race and ethnicity (POC or non-Hispanic White), age, sex, type of insurance, and primary language (English-speaking vs non–English-speaking). Latent class analysis (LCA) was performed to identify clusters of systemic disadvantage. Outcome measures were then assessed across latent classes and tested for differences.

Results:
Over an 8-year period, 10 809 admissions with TBI occurred (37% POC). LCA identified a 4-class model. Groups with more systemic disadvantage had higher rates of mortality. Classes with older populations had lower rates of opioid administration and were less likely to discharge to inpatient rehabilitation following acute care. Sensitivity analyses examining additional indicators of TBI severity demonstrated that the younger group with more systemic disadvantage had more severe TBI. Controlling for more indicators of TBI severity changed statistical significance in mortality for younger groups.

Conclusion:
Results demonstrate significant health inequities in the mortality and access to inpatient rehabilitation following TBI along with higher rates of severe injury in younger patients with more social disadvantages. While many inequities may be related to systemic racism, our findings suggested an additive, deleterious effect for patients who belonged to multiple historically disadvantaged groups. Further research is needed to understand the role of systemic disadvantage for individuals with TBI within the healthcare system.
Nurse practitioners and the Fulbright Scholar Program: My experience in India
Authors: Roberts Lisa R. 
Published: March 2023

ABSTRACT
The Fulbright Scholar Program offers numerous awards, presenting nurse practitioners with opportunities to interact with colleagues around the world. As increasing acceptance of the nurse practitioner role is gaining acceptance and being defined in various countries across the world, with expanding role definitions, this represents a trailblazing opportunity to influence global representation. The recent completion of a Fulbright award experience in India is provided as an exemplar of the Fulbright opportunity. Nurse practitioner program development and continuing education are key to enhancing patient care and access to care among patients who need it most. To be a part of the effort to prepare nurse practitioners everywhere expands the reach beyond that of an individual nurse practitioner. We can learn from each other, share strategies for implementation across settings, and together address barriers to practice.
Mechanical Power Is Associated With Mortality in Pediatric Acute Respiratory Distress Syndrome
Authors: Percy Andrew G. , Mai Mark V. , Bhalla Anoopindar K. , Yehya Nadir 
Published: March 2023

Objectives:
Mechanical power (MP) transferred from the ventilator to the lungs has been proposed as a summary variable that may impact mortality in children with acute respiratory distress syndrome (ARDS). To date, no study has shown an association between higher MP and mortality in children with ARDS.

Design:
Secondary analysis of a prospective observational study.

Setting:
Single-center, tertiary, academic PICU.

Patients:
Five hundred forty-six intubated children with ARDS enrolled between January 2013 and December 2019 receiving pressure-controlled ventilation.

Interventions:
None.

Measurements and Main Results:
Higher MP was associated with increased mortality (adjusted hazard ratio [HR] 1.34 per 1 sd increase, 95% CI 1.08–1.65; p = 0.007). When assessing the contribution of individual components of MP, only positive end-expiratory pressure (PEEP) was associated with mortality (HR 1.32; p = 0.007), whereas tidal volume, respiratory rate, and driving pressure (ΔP = [peak inspiratory pressure (PIP)–PEEP]) were not. Finally, we tested whether there remained an association when specific terms were removed from the MP equation by calculating MP from static strain (remove ΔP), MP from dynamic strain (remove PEEP), and mechanical energy (remove respiratory rate). MP from static strain (HR 1.44; p < 0.001), MP from dynamic strain (HR 1.25; p = 0.042), and mechanical energy (HR 1.29; p = 0.009) were all associated with mortality. MP was associated with ventilator-free days only when using MP normalized to predicted body weight, but not when using measured weight.

Conclusions:
Higher MP was associated with mortality in pediatric ARDS, and PEEP appears to be the component most consistently driving this association. As higher PEEP is used in sicker patients, the association between MP and mortality may reflect a marker of illness severity rather than MP itself being causal for mortality. However, our results support future trials testing different levels of PEEP in children with ARDS as a potential means to improve outcome.
Long-Term Outcomes After External Maxillary Distraction Surgery in Patients With Down Syndrome
Authors: Arnold Sydney H. , Figueroa Alvaro A. , Wiegmann Aaron L. , Lee Jugyeong , Padala Soumya , Hamati Fadi , Hansdorfer Marek A. , Tragos Christina 
Published: March 2023

Background:
Patients with Down syndrome have severe facial deformities that can precipitate functional consequences and social stigmatization. Craniofacial surgical intervention can play a role in improving these symptoms and patient quality of life. The objective of this study was to investigate the long-term outcomes of distraction osteogenesis and orthognathic surgical intervention in patients with Down syndrome.

Materials and Methods:
Charts of 3 patients with Down syndrome who were treated with external maxillary distraction osteogenesis were retrospectively reviewed. The patients’ caregivers were prospectively interviewed between 10 and 15 years after surgery to determine surgical stability, long-term function, and quality of life status.

Results:
All patients and their caregivers reported excellent results with improvements in function and quality of life. Facial skeletal changes have been stable over time. The cephalometric analysis demonstrated significant maxillary advancement in all 3 patients and mandibular changes to correct mandibular prognathism and asymmetry in the patient who underwent finishing orthognathic surgery.

Conclusions:
External maxillary distraction osteogenesis and orthognathic surgery may be considered in select patients with Down syndrome as part of their multidisciplinary health care. These interventions can result in long-term improvements in patient function and quality of life.