bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dimension-wise Sequential Update for Learning a Multidimensional Environment in Humans
Authors: Higashi Hiroshi 
Published: February 2023

Abstract
When confronted with multidimensional environment problems, humans may need to jointly update multiple state–action–outcome associations across various dimensions. Computational modeling of human behavior and neural activities suggests that such updates are implemented based upon Bayesian update principle. However, it is unclear whether humans perform these updates individually or sequentially. If the update occurs sequentially, the order in which the associations are updated matters and can influence the updated results. To address this question, we tested a few computational models with different update orders using both human behavior and EEG data. Our results indicated that a model undertaking dimension-wise sequential updates was the best fit to human behavior. In this model, ordering the dimensions was decided using entropy, which indexed the uncertainty of associations. Simultaneously collected EEG data revealed evoked potentials that were correlated to the proposed timing of this model. These findings provide new insights into the temporal processes underlying Bayesian update in multidimensional environments.
Effects of prior acclimation on the survival, feed intake and salinity preference of a freshwater-adapted euryhaline crab
Authors: Yu Fan , Huang Cheng , Wang Xu , Ge Jiachun , Li Zhongqiu 
Published: February 2023

Abstract
In estuarine systems, salinity changes by freshwater inflows and tides affect the survival and behaviour of euryhaline species. Juvenile Chinese mitten crabs, Eriocheir sinensis, are considered to live in fresh water during their complex life history, whilst some are found in coastal wetlands. To understand how juveniles disperse in estuarine residence, we investigated their survival, feed intake and salinity preference after acclimating in three different water situations (i.e., fresh water, salt water and alternation between fresh water and salt water). We supposed that behavioural alternation and salinity preference would play an essential role in their acclimation. Results showed no significant difference in survival and feed intake amongst the three groups of juveniles () in acclimation trials. However, the feed intake of crabs in each group was declining after changing water every three days. In the salinity preference experiment, crabs from fresh water preferred 0 and 12, whereas those from salinity and alternation treatments showed no preference. The salinity preference seemed to be modified by prior acclimation as well, and juvenile crabs could therefore survive and disperse in the different salinities. Our study helps to explain the complex distribution of juveniles in estuaries and provides arguments for the feasibility of Chinese mitten crabs being reared in low salinity waters.
Understanding Head CT Scan Usage Amongst Adolescent Blunt Trauma Patients Treated at a Level 1 Adult Trauma Center
Authors: Parker Laurel A. , Villamor Laurie L. , Groszman Lilly , Xiang Laurel , Koganti Deepika , Smith Randi , Sola Richard 
Published: February 2023

Background Guidelines developed by the Pediatric Emergency Care Applied Research Network (PECARN) exist to reserve the use of head CT for pediatric patients with a high risk of head injury. However, CTs are still being overutilized especially at adult trauma centers. The aim of our study was to review our use of head CTs in adolescent blunt trauma patients. Materials and Methods Patients aged 11-18 who underwent head CT scans from 2016 to 2019 at our urban level 1 adult trauma center were included. Data was collected via electronic medical record and analyzed through retrospective chart review. Results Of the 285 patients requiring a head CT, 205 had a negative head CT (NHCT) and 80 patients had a positive head CT (PHCT). There was no difference in age, gender, race, and trauma mechanism between the groups. The PHCT group was found to be with a statistically significant higher likelihood of the Glasgow Coma Scale (GCS) < 15 (65% vs 23%; P < .01), abnormal head exam (70% vs 25%; P < .01), and loss of consciousness (85% vs 54%; P < .01) compared to the NHCT group. There were 44 patients who had low risk of head injury, based on the PECARN guidelines, and received a head CT. None of the patients had a positive head CT. Conclusion Our study suggests that reinforcement of the PECARN guidelines should occur for ordering head CTs in adolescent blunt trauma patients. Future prospective studies are needed to validate the use of PECARN head CT guidelines in this patient population.
Gastrointestinal Bleeding in the Setting of Juvenile Polyposis Syndrome Due to SMAD4 Mutation
Authors: Smith Paula Marincola , Tan Marcus C. 
Published: February 2023

A 27-year-old female presented at 13 weeks’ gestation with epigastric pain and anemia requiring blood and iron transfusions but no family history of gastrointestinal malignancy. Upper endoscopy revealed a giant circumferential polyp and associated hyperplastic-appearing polyps in the proximal stomach. Biopsies revealed hyperplasia with lamina propria eosinophils. She was supported with intermittent transfusions until labor was induced at 34 weeks’ gestation. Total gastrectomy was performed at seven weeks post-partum. Final pathology revealed multiple hamartomatous polyps without malignancy. Her anemia resolved postoperatively. Genetic testing revealed mutation of the SMAD4 gene and Juvenile Polyposis Syndrome. JPS is caused by germline mutations in the SMAD4 or BMPR1A genes and is characterized by hamartomatous polyps in the gastrointestinal tract. While most polyps are benign, malignant transformation can occur. One should have low threshold to send patients for genetic screening when multiple polyps are found in a young patient, even without family history.
Thoracoscopic treatment of primary spontaneous pneumothorax without a drainage tube in male patients
Authors: Fu Honghao , Jin Defeng , Wei Yutao 
Published: February 2023

Objective To propose a treatment approach for primary spontaneous pneumothorax (PSP) in male patients with a smaller incision and less pain. Methods We retrospectively studied 29 patients with PSP who underwent areola-port video-assisted thoracoscopic surgery (VATS) and 21 patients who underwent single-port VATS. The areola-port VATS technique was performed as follows. First, an arc incision was made along the lower edge of the areola, and a 5-mm-diameter thoracoscope was placed. The bullae were completely removed, and the absence of air leaks and other bullae was confirmed. A drainage tube was placed in the chest with negative pressure and then quickly pulled out, and the reserved suture line was knotted. Results All patients were male, and their mean age was 19.07 ± 2.43 years. The mean intraoperative hemorrhage volume and postoperative pain score were significantly lower in the areola-port than single-port group. The mean operative time and mean postoperative hospital stay were also shorter in the areola-port group, but without statistical significance. The incidence of complications and the 1-year postoperative recurrence rate were 0% in both groups. Conclusion Our method is clinically feasible and inexpensive, has a traceless effect, and is especially suitable for adolescents.
Surgical treatment of renal cell carcinoma with tumor thrombosis of the inferior vena cava and the right heart: How we do it
Authors: Komarov Roman N , Rapoport Leonid M , Belov Yuri V , Germagenova Ekaterina K , Chernyavskii Stanislav V , Ismailbaev Alisher M , Tlisov Boris M , Zhong Baojun , Zavaruev Artem V , Tsarichenko Dmitry G , Korolev Dmitry O 
Published: February 2023

Objective: Renal cell carcinoma with inferior vena cava thrombosis is a rare disease with a poor prognosis without surgical treatment. We report our 11-year experience in the surgical treatment of renal cell carcinoma with extension of the inferior vena cava. Methods: We conducted a retrospective analysis of patients undergoing surgical treatment for renal cell carcinoma with invasion of the inferior vena cava in two hospitals from May 2010 to March 2021. To assess the spread of the tumor process invasion, we used the Neves and Zincke classification. Results: A total of 25 people underwent surgical treatment. Sixteen patients were men, nine were women. Thirteen patients underwent cardiopulmonary bypass (CBP) surgery. The following postoperative complications were recorded: two cases of disseminate intravascular coagulation (DIC), two cases of acute myocardial infarction (MI) and one case of coma of unknown reason, Takotsubo syndrome and postoperative wound dehiscence. Three patients deceased (16.7%) of DIC syndrome and AMI. After discharge, one of the patients had a recurrence of tumor thrombosis 9 months after surgery, and another patient had the same 16 months later, presumably due to the neoplastic tissue in the adrenal gland on the contralateral side. Conclusion: We believe that this problem should be dealt with by an experienced surgeon with a multidisciplinary team in the clinic. The use of CPB provides benefits and reduces blood loss.
Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults
Authors: Glover Crystal M. , Stewart Christopher C. , Yu Lei , Wilson Robert S. , Lamar Melissa , Bennett David A. , Boyle Patricia A. 
Published: February 2023

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04 years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86–30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = −0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.
A Multiphase Mixed Methods Study on the Integration of a Population Health Approach in Sexual Health Programs and Services in Ontario Public Health Units
Authors: Frost Linda , Valaitis Ruta , Jack Susan M. , Butt Michelle , Akhtar-Danesh Noori 
Published: February 2023

Purpose This study investigated the extent of and factors influencing implementation of a population health approach within sexual health programming in public health. Method This sequential multi-phase mixed methods study combined findings from a quantitative survey assessing the extent that a population health approach was implemented in sexual health programs in Ontario public health units and qualitative interviews with sexual health managers and/or supervisors. Interviews explored factors influencing implementation and were analyzed using directed content analysis. Results Staff from fifteen of 34 public health units completed surveys and ten interviews were completed with sexual health managers/supervisors. From the 8 Population Health Key Elements Template, 6 elements were moderately implemented and 2 had low implementation. Qualitative findings focused on enablers and barriers to implementing a population health approach in sexual health programs and services and explained most of the quantitative results. However, some of the quantitative findings were not explained by qualitative data (e.g., low implementation of using the principles of social justice). Conclusion Qualitative findings revealed factors influencing the implementation of a population health approach. A lack of resources available to health units, differing priorities between health units and community stakeholders, and access to evidence around population-level interventions influenced implementation.
The Application of Mataraman Javanese Manners in Patient Care
Authors: Arrini Masayu Nisya , Putri Pertiwi Ariani Arista , Noviana Uki 
Published: February 2023

Background: Nurses should have a treatment philosophy, which is behavior providing a sense of comfort and hospitality. Such behavior is reflected in Mataraman Javanese people’s attitude as determined by Javanese ancestors in social rules known as tata krama (manners). This study aimed to depict Mataraman Javanese manner implementation in nursing practice. Method: It is a descriptive qualitative study. Data were collected from December 2019 to January 2020 through a semi-structured interview with 10 participants. Participants were Mataraman Javanese nurses working in an inpatient unit of a public referral hospital in Yogyakarta, Indonesia. Data were analyzed using content analysis method. Results: Results revealed participants’ knowledge and experiences concerning the concepts and types of Mataraman Javanese manners, the implementation of these manners, and their effect on nursing practices. Conclusion: Nurses need to comprehend and implement Mataraman Javanese manners when caring for their patients.
Feasibility and Acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) Intervention for Caregivers of Children with Craniofacial Conditions
Authors: Fladeboe Kaitlyn M. , Stock Nicola Marie , Heike Carrie L. , Evans Kelly N. , Junkins Courtney , Stueckle Laura , O’Daffer Alison , Rosenberg Abby R. , Yi-Frazier Joyce P. 
Published: February 2023

Objectives Few evidence-based psychosocial programs exist within craniofacial care. This study (a) assessed feasibility and acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) intervention among caregivers of children with craniofacial conditions and (b) described barriers and facilitators of caregiver resilience to inform program adaptation. Design In this single-arm cohort study, participants completed a baseline demographic questionnaire, the PRISM-P program, and an exit interview. Participants Eligible individuals were English-speaking legal guardians of a child <12-years-old with a craniofacial condition. Intervention PRISM-P included 4 modules (stress-management, goal-setting, cognitive-restructuring, meaning-making) delivered in 2 one-on-one phone or videoconference sessions 1–2 weeks apart. Main Outcome Measures Feasibility was defined as >70% program completion among enrolled participants; acceptability was defined as >70% willingness to recommend PRISM-P. Intervention feedback and caregiver-perceived barriers and facilitators of resilience were summarized qualitatively. Results Twenty caregivers were approached and 12 (60%) enrolled. The majority were mothers (67%) of a child <1-year-old diagnosed with a cleft lip and/or palate (83%) or craniofacial microsomia (17%). Of these, 8 (67%) completed PRISM-P and 7 (58%) completed interviews; 4 (33%) were lost-to-follow-up before PRISM-P and 1 (8%) before the interview. Feedback was highly positive, with 100% willing to recommend PRISM-P. Perceived barriers to resilience included uncertainty about their child's health; facilitators included social support, parental identity, knowledge, and control. Conclusions PRISM-P was acceptable among caregivers of children with craniofacial conditions but not feasible based on program completion rates. Barriers and facilitators of resilience support the appropriateness of PRISM-P for this population and inform adaptation.
Effect of Pre-Meal Metformin With or Without an Acute Exercise Bout on Postprandial Lipemic and Glycemic Responses in Metabolic Syndrome Patients: A Randomized, Open Label, Crossover Study
Authors: Methnani Jabeur , Hajbelgacem Marwa , Ach Taieb , Chaieb Faten , Sellami Sana , Bouslama Ali , Zaouali Monia , Omezzine Asma , Bouhlel Ezdine 
Published: February 2023

Introduction: Both exercise and pre-meal metformin could lower postprandial glucose and lipid profiles. Aims: To explore whether pre-meal metformin administration is superior to metformin administration with the meal in reducing postprandial lipid and glucose metabolism, and whether its combination with exercise confer superior benefits in metabolic syndrome patients. Materials and Methods: In a randomized crossover design, 15 metabolic syndrome patients were assigned to 6 sequences including 3 experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO2 peak performed the evening just before pre-meal-met condition. Only 13 participants (3 males, 10 females; age: 46 ± 9.86, HbA1c: 6.23 ± 0.36) were included in the final analysis. Results: Postprandial triglyceridemia was unaffected by any condition (all P > .05). However, both pre-meal-met (−7.1%, P = .009) and pre-meal-metx (−8.2%, P = .013) significantly reduced total cholesterol AUC with no significant differences between the two latter condition ( P = .616). Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met (−10.1%, P = .013) and pre-meal-metx (−10.7%, P = .021) compared to met-meal with no difference between latter conditions ( P = .822). Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met (−7.5%, P = .045) and met-meal (−8%, P = .03). Insulin AUC was significantly lower during pre-meal-metx compared to met-meal (−36.4%, P = .044). Conclusions: Metformin administration 30 minutes prior to meal seems to exert favorable effects on postprandial TC and LDL-Cholesterol levels compared to its administration with meal. Addition of one exercise bout only improved postprandial glycemia and insulinemia. Trial registry: Pan African clinical trial registry, Identifier PACTR202203690920424.
A national case–control study investigating demographic and environmental factors associated with NMOSD
Authors: Rotstein Dalia L , Wolfson Christina , Carruthers Robert , Freedman Mark S , Morrow Sarah A , Lee Liesly , Burton Jodie M , Nisenbaum Rosane , Konig Andrea , Magalhaes Sandra , Marrie Ruth Ann 
Published: February 2023

Background: Risk factors for aquaporin-4 (AQP4+) antibody neuromyelitis optica spectrum disorder (NMOSD) are not well-established. Objective: To investigate demographic and environmental factors associated with NMOSD using a validated questionnaire and case–control design. Methods: We enrolled patients with AQP4 + NMOSD through six Canadian Multiple Sclerosis Clinics. Participants completed the validated Environmental Risk Factors in Multiple Sclerosis Study (EnvIMS) questionnaire. Their responses were compared to those of 956 unaffected controls from the Canadian arm of EnvIMS. We calculated odds ratios (ORs) for the association between each variable and NMOSD using logistic regression and Firth’s procedure for rare events. Results: In 122 participants (87.7% female) with NMOSD, odds of NMOSD in East Asian and Black participants were ⩾8 times that observed in White participants. Birthplace outside Canada was associated with an increased risk of NMOSD (OR = 5.5, 95% confidence interval (CI) = 3.6–8.3) as were concomitant autoimmune diseases (OR = 2.7, 95% CI = 1.4–5.0). No association was observed with reproductive history or age at menarche. Conclusion: In this case–control study, risk of NMOSD in East Asian and Black versus White individuals was greater than that observed in many previous studies. Despite the preponderance of affected women, we did not observe any association with hormonal factors such as reproductive history or age at menarche.
Efficacy, safety and tolerability of Biktarvy in HIV-1 infection: A scoping review
Authors: Peters Ellen , Iwuji and Collins 
Published: February 2023

Background: Biktarvy is approved for use in HIV-1 infection in both treatment-naïve and treatment-experienced individuals, after a series of successful phase III trials. However, studies on real-world evidence on its efficacy, safety and tolerability are limited. Purpose: The study aims to collate real-world evidence on the use of Biktarvy in clinical practice to identify gaps in knowledge. Research Design: Scoping review was undertaken using PRISMA guidelines and a systematic search strategy. The final search strategy used was (Bictegravir* OR biktarvy) AND (efficac* OR safe* OR effect* OR tolerab* OR ‘side effect*’ OR ‘adverse effect*’). The last search was performed on the 12th of August 2021. Study Sample: Studies were eligible if they reported on the efficacy, effectiveness, safety or tolerability of bictegravir-based ART. Data Collection and/or Analysis: Data were collected from 17 studies that met the inclusion and exclusion criteria and summarised using a narrative synthesis. Results: The efficacy of Biktarvy in clinical practice is comparable to phase III trials. However, adverse effects and discontinuation rates were found to be higher in real-world studies. Conclusions: The cohorts in the included real-world studies showed more demographic diversity when compared to the drug approval trials, further prospective studies are required on under-represented groups such as women, pregnant people, ethnic minorities and older adults.