bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing pharmacotherapy regimens in adult patients receiving extracorporeal membrane oxygenation: A narrative review for clinical pharmacists
Authors: Dzierba Amy L. , Muir Justin , Dilawri Atul , Buckley Mitchell S. 
Published: March 2023

AbstractExtracorporeal membrane oxygenation (ECMO) is a complex therapy aimed at providing mechanical support for patients with severe, life‐threating cardiac and/or respiratory failure. Research has demonstrated variability in pharmacokinetic changes in the critically ill patient population receiving ECMO. There is a need to understand the complexity of these pharmacokinetic changes to provide optimal pharmacotherapeutic regimens thereby maximizing effectiveness and mitigating harm. However, the number of pharmacokinetic studies in patients receiving ECMO remains small, and very few prospective studies have been published addressing optimal analgesic, sedative, or antimicrobial therapy. Anticoagulation is an additional important component of ECMO therapy but the preferred agent as well as dosing and monitoring strategy are unclear. The purpose of this narrative review is to discuss analgesia and sedation, antimicrobial, and anticoagulation management strategies in adult patients receiving ECMO.
Hippocampus mitochondrial MnSOD activation by a SIRT3 activator, honokiol, correlates with its deacetylation and upregulation of FoxO3a and PGC1α in a rat model of ammonia neurotoxicity
Authors: Anamika  , Roy Anima , Trigun Surendra K. 
Published: March 2023

AbstractWe have recently reported that honokiol (HKL), by activating mitochondrial SIRT3, normalizes reactive oxygen species level and mitochondrial integrity in hippocampus of the moderate grade hepatic encephalopathy (MoHE) rat model of ammonia neurotoxicity. To delineate the mechanism by which HKL does so, the present study describes activity versus level of the deacetylated mitochondrial Mn‐superoxide dismutase (MnSOD) and expression of MnSOD versus levels of its main transcription regulators, FoxO3a and PGC1α, in the hippocampus of the MoHE rats. MoHE in rat was developed by administration of 100 mg/kg bw thioacetamide i.p. for 10 days. The study parameters were compared between the control, the MoHE rats and the MoHE rats treated with HKL (10 mg/Kg b.w.) for 7 days. As compared to control, the hippocampus mitochondria from MoHE rats showed a significantly declined activity of MnSOD vs enhanced lipid peroxidation coinciding with the increased level of its acetylated form. The HKL treatment could, however, normalize all these parameters in those MoHE rats. Also, a significantly reduced expression of MnSOD in the hippocampus of the MoHE rats coincided with a similar decline in transcript level of Foxo3a and Pgc1α. This was consistent with the reduced level of immuno‐stained Foxo3a and Pgc1α proteins in hippocampus DG, CA1 and CA3 regions of those MoHE rats. However, all these factors were observed to be restored back to their normal levels due to the treatment with HKL. As HKL is a specific activator of mitochondrial SIRT3, these findings suggest involvement of Sirt3 activation led deacetylation of MnSOD and upregulation of its transcription activators, FoxO3a and PGC1α, in restoring mitochondrial MnSOD level in the hippocampus of the MoHE rat model of ammonia neurotoxicity.
Optimal treatment options for uterine submucosal fibroids: Percutaneous microwave ablation versus transcervical resection of myoma
Authors: Jin Yanrong , Ma Wei , Chen Weizhi , Li Chunling , Gao Jie , Zhao Juan , Wang Yanan , Xiao Huan , Zhang Haiyan 
Published: March 2023

AbstractObjectivesTo compare the efficacy and safety of percutaneous microwave ablation (PMWA) and transcervical resection of myoma (TCRM) for submucosal fibroids.MethodsFrom January 2019 to January 2021, we conducted a randomized controlled study involving patients with symptomatic uterine submucosal fibroids. Questionnaires were also used to measure the uterine fibroid symptom (UFS) scores and quality of life (QoL) scores before and after treatment at 3, 6, and 12 months. Outcomes, adverse events, hemoglobin recovery, and submucosal fibroid volume of both groups were also compared. Operation time, amount of bleeding, hospital stay time, and occurrence of complications were compared in groups with fibroids of different lengths.ResultsFollow‐up after surgery showed that UFS scores at 3, 6, and 12 months were significantly lower in each group, while QoL scores increased significantly. For fibroids less than 3 cm, surgical time was 34.2 ± 9.9 min, incidence of perioperative complications was 4.2%, and both decreased significantly, compared to the surgical time of the PMWA group (40.0 ± 8.1 min) and incidence of perioperative complications (24%; p < .05 for both). For uterine submucosal fibroids >5 cm, the operation time in the PMWA group was 92.7 ± 16.0 min, intraoperative bleeding volume was 22.7 ± 6.4 mL, and hospital stay was 2.7 ± 1.1 days, which were significantly less than the procedural time (107 ± 11.9 min), intraoperative bleeding loss (45.9 ± 12.8 mL), and length of hospital stay (5.0 ± 1.1 days) in the TCRM group. The differences were statistically significant (p < .05).ConclusionsPMWA and TCRM were both effective treatments for uterine submucosal fibroids. For fibroids shorter than 3 cm in length, especially pedicled submucosal fibroids, TCRM has absolute advantages; however, for uterine submucosal fibroids >5 cm, PMWA avoids perioperative complications, such as uterine perforation, water poisoning syndrome, and the need for repeat surgery, and is considered the preferred mode of treatment. Therefore, personalized treatment should be used for different patients with uterine submucosal fibroids.
CODA standard 2–24 h—“replacement of teeth” dilemma: Unintended consequences and proposed solutions
Authors: Teich Sorin T. , McPherson Karen R. , Rizzante Fabio A. P. , Cayouette Monica J. 
Published: March 2023

BackgroundThe Commission on Dental Accreditation (CODA) was established in 1975 with the goal of serving the public and the dental profession by developing and implementing standards that guide and maintain the quality of dental educational programs. These standards are defined broadly around competencies reflective of an evidence‐based definition of general dentistry and that should be met by the new graduates to function as an entry level provider. Consequently, CODA “expects each school to develop specific competency definitions and assessment methods in the context of the broad scope of general dental practice”.CODA Standard 2–24 h was implemented a decade ago to address concerns that dental schools are not sufficiently proactive in incorporating implant‐related curricula and clinical competencies. When the standard was implemented, most patients already preferred dental implants over FPDs. This market trend, together with the prescriptive format of the standard, had the unintended consequence of creating pressure on programs that struggled to find enough patients who will chose FPDs as a treatment option.DiscussionAs a short term solution, we suggest a tooth replacement competency construct that has the potential to alleviate this burden. This solution incorporates principles of ethical decision making, patient‐centered care, and evidence‐based dentistry, without compromising educational aspects and competency development. For the longer term, we suggested to revise and rephrase the standard so that it will be clinically‐centered rather than focused on technical tools that may evolve, change, or disappear as a result of technological progress and other market trends. This, in turn, will be conducive to fulfill the intent of Standard 2–24 to allow the schools to identify “competencies that will be included in the curriculum based on the school's goals, resources, accepted general practitioner responsibilities and other influencing factors.”
Experiences of agency in historically underrepresented racial and ethnic dental faculty at predominantly white institutions
Authors: Yarbrough Lisa N. , Konopasky Abigail , Wyatt Tasha R. 
Published: March 2023

AbstractPurpose/objectivesHistorically underrepresented racial and ethnic (HURE) dentists remain underrepresented in dental education and dental practice, and surprisingly, little is known about the factors that enable them to thrive. The lack of information about their experiences is a critical gap in the literature. The purpose of this critical qualitative study is to describe how HURE dental faculty in predominantly white institutions (PWIs) exercise agency to thrive and advance in academic promotion when faced with challenges and adversity in the workplace.MethodsThirteen semi‐structured interviews were conducted in 2021 and 2022 with HURE dental faculty from 10 different institutions. Interviews were audio recorded, transcribed, and analyzed using the construct of agency and tenets of critical race theory to understand how they thrive in their institutions.ResultsHURE dental faculty experienced racism as normal from both faculty and students. Racism centered around white faculty guarding access to white spaces, including things that should be open to everyone like meetings and information about promotion. To counter this, HURE faculty engaged in individual agency by fighting for their perspectives to be heard, proxy agency by seeking and building relationships with mentors and colleagues who could use their whiteness to create change, and improvisational agency by going outside their institutions for support.Conclusion(s)To thrive in PWIs requires HURE faculty to exercise various forms of agency to directly or indirectly advocate for themselves as professionals. These findings have implications for dental leaders to change their existing structures and improve the work environments for HURE dental faculty.
The determination of optimum segmentation parameters using genetic algorithms: Application to different segmentation algorithms and transmission electron microscopy tomography reconstructed volumes
Authors: Fernandez Martinez Roberto , Okariz Ana , Iturrondobeitia Maider , Ibarretxe Julen 
Published: March 2023

AbstractA method for optimizing an automatic selection of values for parameters that feed segmentation algorithms is proposed. Evolutionary optimization techniques in combination with a fitness function based on a mutual information parameter have been used to find the optimal parameter values of region growing, fuzzy c‐means and graph cut segmentation algorithms. To validate the method, the segmentation of two transmission electron microscopy tomography reconstructed volumes of a carbon black‐reinforced rubber and a polylactic acid and clay nanocomposite is carried out (i) using evolutionary optimization techniques and (ii) manually by experts. The results confirm that the use of evolutionary optimization techniques, such as genetic algorithms, reduces the computational operation cost needed for a total grid search of segmentation parameters, reducing the probability of reaching a false optimum, and improving the segmentation quality.Highlights
A new approach to optimize 3D segmentation algorithms.
Methodology to optimize segmentation parameters and improve segmentation quality.
Improvement on the results when using region growing, fuzzy c‐means and graph cuts algorithms.
Disparate Radiation‐Induced Microstructural Injuries in Whole‐Brain White Matter of Patients With Nasopharyngeal Carcinoma: A Longitudinal Study Using Multishell Diffusion MRI
Authors: Liang Jiahui , Zhang Xinyuan , Lin Yuhao , Fu Gui , Pan Jie , Feng Yanqiu , Lv Xiaofei 
Published: March 2023

BackgroundEvidence for prevention strategies of radiotherapy (RT)‐related injury in patients with nasopharyngeal carcinoma (NPC) was lacking. Understanding the dynamic alterations in the cerebral white matter (WM) microstructure after RT may be helpful.PurposeTo investigate the dynamic alterations in the whole brain WM microstructure in patients with NPC in the 12 months after RT using multishell diffusion MRI (MS‐dMRI).Study TypeSingle‐center longitudinal study.PopulationA total of 28 treatment‐naïve patients with pathologically confirmed NPC (age: 39.68 ± 8.93 years, 11 female) and 20 healthy controls (age: 40.65 ± 9.76 years, 7 female).Field Strength/SequencesA 3 T, MS‐dMRI using a single‐shot echo planar imaging sequence.AssessmentMS‐dMRI was acquired at baseline for the NPC patients and healthy controls, at 0–3 (acute, AC), 6 (early delayed, ED) and 12 months (late delayed, LD) after RT for the NPC patients. The mean and maximum radiation doses to the temporal lobe were acquired. The quality of images was reviewed. MS‐dMRI was analyzed using tract‐based spatial statistics (TBSS). The presentations of injury were defined by the findings of TBSS.Statistical TestsChi‐square, t tests, repeated ANOVA, and Spearman‐rank correlation analysis were used. P < 0.05 was considered to be statistically significant.ResultsTBSS showed two WM injuries (injuries 1 and 2). Injury 1 emerged in the ED phase in the bilateral temporal poles and persisted throughout the ED and LD phases. Injury 2 developed from the AC to ED phase in the bilateral hemisphere and partially recovered in the LD phase. In the ED and LD phases, the multiple diffusion metrics were well correlated (r > 0.5 or <−0.5) with the RT dose, especially in the WM tracts in the temporal lobes.Data ConclusionDisparate WM injuries were observed in NPC patients after RT. The injuries may be primarily or secondarily induced by radiation. Injury 1 may be irreversible, while injury 2 seems to partially recover.Evidence Level2.Technical EfficacyStage 4.
A Multicenter Study on Preoperative Assessment of Lymphovascular Space Invasion in Early‐Stage Cervical Cancer Based on Multimodal MR Radiomics
Authors: Wu Yu , Wang Shuxing , Chen Yiqing , Liao Yuting , Yin Xuntao , Li Ting , Wang Rui , Luo Xiaomei , Xu Wenchan , Zhou Jing , Wang Simin , Bu Jun , Zhang Xiaochun 
Published: March 2023

BackgroundAs lymphovascular space invasion (LVSI) was closely related to lymph node metastasis and prognosis, the preoperative assessment of LVSI in early‐stage cervical cancer is crucial for patients.PurposeTo develop and validate nomogram based on multimodal MR radiomics to assess LVSI status in cervical cancer patients.Study TypeRetrospective.PopulationThe study included 168 cervical cancer patients, of whom 129 cases (age 51.36 ± 9.99 years) from institution 1 were included as the training cohort and 39 cases (age 52.59 ± 10.23 years) from institution 2 were included as the external test cohort.Field Strength/SequenceThere were 1.5 T and 3.0 T MRI scans (T1‐weighted imaging [T1WI], fat‐saturated T2‐weighted imaging [FS‐T2WI], and contrast‐enhanced [CE]).AssessmentSix machine learning models were built and selected to construct the radiomics signature. The nomogram model was constructed by combining the radiomics signature with the clinical signature, which was then validated for discrimination, calibration, and clinical usefulness.Statistical TestsThe clinical characteristics were compared using t‐tests, Mann–Whitney U tests, or chi‐square tests. The Spearman and LASSO methods were used to select radiomics features. The receiver operating characteristic (ROC) analysis was performed, and the area under the curve (AUC), accuracy, sensitivity, and specificity were calculated.ResultsThe logistic regression (LR) model performed best in each sequence. The AUC of CE‐T1‐T2WI‐combined was the highest in the LR model, with an AUC of 0.775 (95% CI: 0.570–0.979) in external test cohort. The nomogram showed high predictive performance in the training (AUC: 0.883 [95% CI: 0.823–0.943]) and test cohort (AUC: 0.830 [95% CI: 0.657–1.000]) for predicting LVSI. Decision curve analysis demonstrated that the nomogram was clinically useful.Data ConclusionOur findings suggest that the proposed nomogram model based on multimodal MRI of CE T1WI‐T2WI‐combined could be used to assess LVSI status in early cervical cancer.Evidence Level4.Technical EfficacyStage 2.
Porous tip radiofrequency ablation catheter reduced heart failure‐related complications and healthcare resource utilization in paroxysmal atrial fibrillation patients
Authors: Costea Alexandru , Haile Bereket , Barone Adam , Schenthal Maddie , Romanowicz Kathrine , Rajsheker Srinivas , Boo Lee Ming , Hunter Tina D. 
Published: March 2023

AbstractIntroductionA 56‐hole porous tip radiofrequency catheter was developed to provide more uniform cooling with less fluid delivery than a prior 6‐hole irrigated design. This study aimed to evaluate the impact of contact force (CF) ablation with the porous tip on complications (congestive heart failure [CHF] and non‐CHF related), healthcare resource utilization, and procedural efficiency in patients undergoing de novo paroxysmal atrial fibrillation (PAF) ablations in a real‐world setting.MethodsConsecutive de novo PAF ablations were performed between February 2014 and March 2019 by six operators at a single US academic center. The 6‐hole design was used through December 2016 with the 56‐hole porous tip adopted in October 2016. The outcomes of interest included symptomatic CHF presentation and CHF‐related complications.ResultsOf 174 patients who were included, mean age was 61.1 ± 10.8 years, 67.8% were male, and 25.3% had a history of CHF. Ablation with the porous tip catheter significantly decreased fluid delivery (1177 vs. 1912 mL with the 6‐hole design; p < .0001). CHF‐related complications within 7 days, particularly fluid overload, were substantially reduced with the porous tip (15.2% vs. 5.3% of patients; p = .0281) and the proportion of patients with symptomatic CHF presentation within 30 days postablation was significantly lower (14.7% vs. 32.5%; p = .0058).ConclusionThe 56‐hole porous tip led to significantly reduced CHF‐related complications and healthcare utilization in PAF patients undergoing CF catheter ablation when compared to the prior 6‐hole design. This reduction likely results from the significant decrease in fluid delivery during the procedure.
Spatio‐temporal pattern and driving mechanisms of land use conflicts changes (2010–2018) in the Bohai Rim transition zone
Authors: Zong Shanshan , Hu Yecui , Bai Yuping 
Published: March 2023

AbstractWith the rapid development of society and economy in the coastal regions, conflicts between ecological protection and human exploitation are inevitable. However, previous studies on the Spatio‐temporal evolution of conflicts in the coastal transition zone are insufficient, and the majority ignore the dependence of data on space. This study constructed a multi‐objective evaluation model from three angles (ecological, agriculture, and construction). It evaluated the dynamics of land use conflicts (LUCs) in the Bohai Rim transition zone for 2010, 2015, and 2018 at 30 m2 spatial resolution using the multi‐factor superposition method. The driving mechanism of LUCs was explored from the perspectives of natural and socio‐economic by applying the spatial econometric method. Major findings of this study indicated that there was a critical Spatio‐temporal mismatch in the spatial distribution of three types of land suitability around the Bohai Sea from 2010 to 2018. On the grid scale, an estimated LUCs area in 2010 was 1.21 × 105 km2, which decreased to 1.20 × 105 km2 in 2018. On the country scale, the conflict index displayed a polarized spatial distribution of “high in the south and low in the north,” and its spatial disparity showed a narrowing trend. Moreover, LUC types showed different change characteristics along the sea‐land direction. It ought to be noticed that the spatial clustering pattern of LUCs resulted from the combined action of various factors. This study's logical framework and outcomes could be utilized for formulating reasonable land use patterns to reduce the LUCs in the coastal transition zone.
Existence of ground‐state solutions for p‐Choquard equations with singular potential and doubly critical exponents
Authors: Liu Senli , Chen Haibo 
Published: March 2023

AbstractWe are concerned with the following Choquard equation:
where , , , , is the p‐Laplacian, is the Riesz potential, and F is the primitive of f which is of critical growth due to the Hardy–Littlewood–Sobolev inequality. Under different range of θ and almost necessary conditions on the nonlinearity f in the spirit of Berestycki–Lions‐type conditions, we divide this paper into three parts. By applying the refined Sobolev inequality with Morrey norm and the generalized version of the Lions‐type theorem, some existence results are established. It is worth noting that our method is not involving the concentration–compactness principle.
Environmental tax policy and optimal privatization in a polluting mixed duopoly
Authors: Xing Mingqing , Tan Tingting , Ma Xuejun , Wang Xia 
Published: March 2023

AbstractWe investigate the optimal privatization policy in a polluting mixed duopoly when environmental taxes are used. Firms adopt clean technology to reduce emissions. We consider the situation of exogenous tax and find that (i) partial privatization is always optimal under low marginal damage, while full nationalization may be optimal under high marginal damage; (ii) the optimal privatization level always increases with tax rate under low marginal damage, while it may decrease with tax rate under high marginal damage. As an extension, we consider the endogenous tax situation and show that full nationalization may be optimal under sufficiently high marginal damage.
The esthetic outcome of recipient sites of gracilis muscle flaps versus anterolateral thigh flaps: A retrospective study
Authors: Fricke A. , Rassner M. , Kiefer J. , Eisenhardt S. U. 
Published: March 2023

AbstractBackgroundAnterolateral thigh (ALT) and gracilis muscle flaps have been described as comparable reconstructive options regarding maximal flap dimension and indications. However, split‐thickness skin‐grafted muscle flaps are generally believed to be inferior to perforator flaps regarding the esthetic outcome of the recipient site. The purpose of this study was to challenge this assumption, comparing the long‐term esthetic outcome of the gracilis and the ALT flap.MethodsOne hundred forty‐eight patients who had undergone free flap reconstruction with either free split‐thickness skin‐grafted gracilis muscle flaps (n = 86) or ALT flaps (n = 62) were evaluated in the study. Patients' satisfaction with the esthetic outcome, rates of flap loss, wound healing disorders and the necessity for thinning the flap or scar correction procedures were assessed.ResultsFlap loss occurred in 4 of 86 gracilis flaps (4.7%) and 2 of 62 (3.2%) ALT flaps (p > .9999). Thinning or scar correction procedures were necessary for 6 of 86 gracilis (7.0%) and 4 of 62 (6.5%; p > .9999) ALT flap recipient sites. Regarding the overall patients' satisfaction with the esthetic outcome, scores were similar in both groups (2.667 [ALT] vs. 2.348 [gracilis]; p = .3739). Contour deformity, scar hypertrophy, and difference in flap color/texture in relation to the surrounding skin were comparable throughout the ALT and gracilis group (2.667 vs. 2.174, p = .2099; 3.333 vs. 2.739, p = .0912 and 2.500 vs. 2.174, p = .3159, respectively).ConclusionThe gracilis and ALT flap are two equivalent reconstructive options regarding the esthetic outcome of the recipient site and long‐term patient satisfaction.