bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethinking Religion and Political Participation: The Case of Voting Among Religiously Unaffiliated Americans
Authors: Stewart Evan 
Published: June 2023

Abstract
Is civic disengagement correlated across institutions? One case of this question is a long-observed “secular voting gap” where religiously unaffiliated Americans are less likely to vote than their affiliated counterparts. This work often uses self-reports or exit polls that cannot measure variation within the unaffiliated. Using an improved measure of validated voter turnout in four presidential election years (2008, 2012, 2016, and 2020), I find estimates of the secular voting gap are attenuated by demographic controls. More importantly, the mechanism that explains this finding is that more frequent church attendance associates with a lower probability of turnout among respondents who are unaffiliated, and results vary by voting method. These results support a theory of civic disengagement as a domain-specific process and demonstrate the substantive value of revisiting classic findings about religion and political behavior amid social change.
Probiotic-Associated Central Venous Catheter Bloodstream Infections Lead to Increased Mortality in the ICU*
Authors: Mayer Scott , Bonhag Colin , Jenkins Patrick , Cornett Brendon , Watts Paula , Scherbak Dmitriy 
Published: June 2023

OBJECTIVES:
To determine the occurrence rate and impact on patient outcomes of probiotic-associated central venous catheter bloodstream infections in the ICU.

DESIGN:
Retrospective observational cohort study.

SETTING:
The cohort was gathered using HCA Healthcare’s data warehouse.

PATIENTS:
Adult patients with central venous catheters in the ICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Blood culture data were used to determine whether an infection had occurred with an organism contained in an administered probiotic. Eighty-six probiotic-associated central venous catheter bloodstream infections were identified among the 23,015 patient cohort who received probiotics (0.37%). The number needed to harm was 270. Zero infections were found in the cohort that did not receive probiotics. Patients who contracted a probiotic infection had increased mortality (odds ratio, 2.23; 1.30–3.71; p < 0.01). Powder formulations had an increased rate of infection compared with nonpowder formulations (0.76% vs 0.33%; odds ratio, 2.03; 1.05–3.95; p = 0.04).

CONCLUSIONS:
Probiotic administration is associated with a substantial rate of probiotic-associated bloodstream infection in ICU patients with central venous catheters in place. Probiotic-associated bloodstream infections result in significantly increased mortality. Powder formulations cause bloodstream infections more frequently than nonpowder formulations. In ICU patients with central venous catheters, the risks of probiotic-associated central venous catheter bloodstream infection and death outweigh any potential benefits of probiotic administration.
Outcomes in Pregnant Adolescent Patients Infected With SARS-CoV-2
Authors: Nguyen Anh Quynh , Murrin Ellen , Nasrallah Sebastian , Hitchings Laura , Wang Jenny Q. , VanDillen Michael B. , Eletu Oluwafunmilayo , Maxwell G. Larry , Gomez Luis M. 
Published: June 2023

Background:
Pregnant patients with coronavirus disease 2019 (COVID-19) are at risk for adverse pregnancy outcomes. Although clinical outcomes for pregnant adults have been reported, the impact of COVID-19 on adolescents is lacking. We sought to evaluate obstetric outcomes of pregnant adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and compare them with uninfected adolescent controls.

Methods:
Retrospective cohort study of pregnant adolescents (14–19 years) who had a positive polymerase chain reaction test for SARS-CoV-2 from April 2020 to December 2020 at Inova Health System Hospitals. Controls included pregnant adolescents who tested negative. The primary outcome was a composite of preeclampsia, preterm delivery, cesarean delivery, fetal growth restriction and stillbirth. Secondary outcomes included maternal and neonatal morbidity.

Results:
Forty-eight pregnant adolescents who tested positive for SARS-CoV-2 were compared with 394 controls. Infected adolescents were more likely to be Hispanic (91.67% vs. 12.18%; risk ratio [RR] 41.85 [95% CI: 15.43–113.5]) and uninsured (50% vs. 7.87%; RR 7.04 [95% CI: 4.31–11.49]. Nearly 80% of infected adolescents remained asymptomatic, whereas one-third of symptomatic adolescents progressed to severe or critical COVID-19. The primary composite outcome was more prevalent in infected adolescents compared with noninfected controls (41.67% vs. 25.38%; adjusted RR 2.65 [95% CI: 1.19–5.93]). Maternal morbidity was more prevalent in infected adolescents (6.25% vs. 0.76%; adjusted RR 9.53 [95% CI: 3.83–23.71]). Primary and secondary maternal outcomes were more prevalent in younger adolescents and those with higher severity of COVID-19. Maternal SARS-CoV-2 infection was not associated with neonatal morbidity.

Conclusions:
Pregnant adolescents infected with SARS-CoV-2 are more likely to have adverse obstetric outcomes and maternal morbidity compared with noninfected pregnant adolescents.
Tracheal hemangioma: a case report and literature review
Authors: Sadidi Hossein , Bahrami Taqanaki Pegah , Amirfakhrian Hamed , Rezaei Reza 
Published: June 2023

Introduction and importance:
Hemangiomas are the most common vascular tumors in children. Although hemangiomas are common, they are rarely seen in areas like the trachea and larynx.The most common clinical manifestations in tracheal hemangiomas are stridor and respiratory distress. The main diagnostic method is bronchoscopy. Other imaging techniques like computed tomography scans and MRIs are also helpful. Various treatment options are now used for treating the disease, including beta blockers like propranolol, local and systemic steroids, and surgical resection.

Case presentation:
An 8-year-old boy with the chief complaint of severe progressive dyspnea and a history of neonatal postbreastfeeding cyanosis was admitted. On physical examination, he had tachypnea, and stridor was heard upon auscultation. There was no history of fever, chest pain, or coughing. He underwent a rigid bronchoscopy followed by a neck computed tomography scan. The results indicated a soft tissue mass with a vascular nature. An MRI of the neck confirmed the diagnosis of tracheal hemangioma. The mass was not resectable during surgery; hence, angioembolization was carried out. Treatment was successful and there was no recurrence on the follow-up.

Clinical discussion:
Based on the findings in this literature review tracheal hemangiomas present with stridor, progressive respiratory distress, dyspnea, hemoptysis, and chronic coughs. Advanced tracheal hemangiomas commonly do not reduce in size by themselves and need treatment. A close follow-up ranging from 3 months to 1 year is recommended.

Conclusion:
Although tracheal hemangiomas are rare they should be considered in the differential diagnosis of severe dyspnea and stridor.
Evaluating the association of antiretroviral therapy and immune status with hypertensive disorders of pregnancy among people with HIV
Authors: YEE Lynn M. , Jacobson Denise L. , Haddad Lisa B. , Jao Jennifer , Powis Kathleen M. , Kacanek Deborah , Zash Rebecca , Diperna Alexandria , Chadwick Ellen G. 
Published: June 2023

Objective:
To examine the association of timing of ART initiation and ART class with risk of new-onset hypertensive disorders of pregnancy (HDP) among people living with HIV (PLHIV).

Design:
Observational study of participants in the multisite Surveillance Monitoring for ART Toxicities (SMARTT) study.

Methods:
Data were abstracted from medical records of pregnant PLHIV enrolled in SMARTT (1/30/15–3/25/19). New-onset HDP included gestational hypertension, preeclampsia/eclampsia, or HELLP syndrome. We examined the associations of clinical risk factors and three exposures of interest, each in a separate model, with risk of new-onset HDP. Log-binomial regression models were fit using generalized estimating equations to account for correlations within people. Exposures included: timing of ART initiation, antiretroviral class among those on therapy at conception, and antiretroviral class among those initiating treatment during pregnancy.

Results:
Of 1038 pregnancies in this cohort, 973 were singletons with complete data on HDP, with ART use in 948. Overall, 9% had a new-onset HDP, 10% had chronic hypertension, and 81% had no hypertension. Diabetes (aRR 2.44, 95% CI 1.42–4.21) and first/second trimester CD4 count < 200 cells/mm3 (aRR 1.99, 95% CI 1.21–3.27) were associated with greater risk of new-onset HDP. Risk of new-onset HDP was similar by antiretroviral class, but those initiating ART after 20 weeks’ gestation had greater risk (aRR 1.93, 95% CI 1.12–3.30) compared with those receiving ART at conception.

Conclusion:
In this large, diverse cohort of pregnant PLHIV, worse early pregnancy immune status and later ART initiation were associated with increased risk of HDP while ART class was not.
A Randomized Prospective Trial Comparing Repository Corticotropin Injection and Intravenous Methylprednisolone for Neuroprotection in Acute Optic Neuritis
Authors: Bennett Jeffrey L. , Grove Nathan C. , Johnson Ruth K. , Mizenko Christopher , DuPont Joan C. , Wagner Brandie D. , Lynch Anne M. , Frohman Teresa C. , Shindler Kenneth S. , Frohman Elliot M. 
Published: June 2023

Background:
Repository corticotrophin injection (RCI, Acthar Gel) and intravenous methylprednisolone (IVMP) improve the rate but not the extent of visual recovery following acute optic neuritis. RCI has adrenal-stimulating and melanocortin receptor-stimulating properties that may endow it with unique anti-inflammatory properties relative to IVMP.

Methods:
Individuals with acute optic neuritis of less than 2 weeks duration were prospectively enrolled and randomized 1:1 to receive either RCI or IVMP. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell plus inner plexiform layer thickness (GC + IPL) were serially evaluated by OCT. In addition, patient-reported outcomes (PROs) for changes in fatigue, mood, visual function, depression, and quality of life (QOL) were measured, and high and low contrast visual acuity were recorded.

Results:
Thirty-seven subjects were enrolled (19 RCI; 18 IVMP); the average time from symptom to treatment was 8.8 days. At 6 months, there was no difference in the primary outcome: loss of average pRNFL thickness in the affected eye (RCI vs IVMP: −13.1 vs −11.7 µm, P = 0.88) 6 months after randomization. Additional outcomes also showed no difference between treatment groups: 6-month attenuation of GC + IPL thickness (RCI vs IVMP: −13.8 vs −12.0 µm, P = 0.58) and frequency of pRNFL swelling at 1 month (RCI vs IVMP: 63% vs 72%, P = 0.73) and 3 months (RCI vs IVMP: 26% vs 31%, P = 0.99). Both treatments resulted in improvement in visual function and PROs.

Conclusion:
Treatment of acute optic neuritis with RCI or IVMP produced no clinically meaningful differences in optic nerve structure or visual function.
Registry for vascular cognitive impairment treatment with traditional Chinese medicine (REVIEW-TCM): Rationale and design of a prospective, observational study
Authors: Yao Xie , Xie Le , Jiang Junlin , Yao Ting , Mao Guo , Fang Rui , Kang Fuliang , Wang Shiliang , Lin Anchao , Gao Ying , Ge Jinwen , Wu Dahua 
Published: June 2023

AbstractBackgroundVascular cognitive impairment (VCI) is one of the most common diseases among the elderly. However, few effective drugs have been approved for VCI. Traditional Chinese medicine (TCM) has been used in dementia for thousands of years. Currently, there is limited high-quality evidence for the efficacy of TCM, and the specific characteristics of its effects and the appropriate patient populations for TCM therapies remain unclear. Herein, we aim to explore the effectiveness and safety of TCM by conducting a longitudinal, patient-centered study.MethodsREgistry for Vascular cognitive Impairment trEatment With Traditional Chinese Medicine (REVIEW-TCM) is a prospective, observational disease registry study. 1000 VCI patients at the Hunan Hospital of Integrated Traditional Chinese and Western Medicine will be recruited based on the following criteria: aged 18 years or older, Montreal Cognitive Assessment (MoCA) score < 26, and Hachinski Ischemic Score (HIS)≥7. There is no strict limit on the intervention, and different TCM formulas will be focused. Cognition, activity of daily living, quality of life, mental, psychology,ZHENGof TCM, and burden of caregiver will be evaluated at admission, and 6, 12, 18, and 24 months. Meanwhile, biological tests and neuroimaging examination will be applied to further explore the mechanism of TCM. Especially, a mixed-methods embedded design will be applied by adopting quantitative and qualitative studies to explore patients-reported outcomes of TCM. Finally, propensity score matching will be adopted to analyze the effectiveness of TCM.DiscussionTo the best of our knowledge, the REVIEW-TCM study is the first comprehensive, prospective, mixed-methods, registry-based study to evaluate TCM treatment in VCI, which will analyze the effectiveness and safety of TCM in the real world and explore population characteristics and subtypes of VCI suitable for TCM.Study registrationThis study was registered onwww.chictr.org.cn(ChiCTR2200064756).
Purinergic P2Y2 Receptor-Induced Activation of Endothelial TRPV4 Channels Mediates Lung Ischemia-Reperfusion Injury
Authors: Kuppusamy Maniselvan , Ta Huy Q. , Davenport Hannah N. , Bazaz Abhishek , Kulshrestha Astha , Daneva Zdravka , Chen Yen-Lin , Carrott Philip W. , Laubach Victor E. , Sonkusare Swapnil K. 
Published: June 2023

AbstractLung ischemia-reperfusion injury (IRI), characterized by inflammation, vascular permeability, and lung edema, is the major cause of primary graft dysfunction after lung transplantation. We recently reported that endothelial cell (EC) TRPV4 channels play a central role in lung edema and dysfunction after IR. However, the cellular mechanisms for lung IR-induced activation of endothelial TRPV4 channels are unknown. In a left-lung hilar ligation model of IRI in mice, we found that lung IR increases the efflux of extracellular ATP (eATP) through pannexin 1 (Panx1) channels at the EC membrane. Elevated eATP activated elementary Ca2+influx signals through endothelial TRPV4 channels through purinergic P2Y2 receptor (P2Y2R) signaling. P2Y2R-dependent activation of TRPV4 channels was also observed in human and mouse pulmonary microvascular endothelium inex vivoandin vitrosurrogate models of lung IR. Endothelium-specific deletion of P2Y2R, TRPV4, and Panx1 in mice had substantial protective effects against lung IR-induced activation of endothelial TRPV4 channels, lung edema, inflammation, and dysfunction. These results identify endothelial P2Y2R as a novel mediator of lung edema, inflammation, and dysfunction after IR, and show that disruption of endothelial Panx1–P2Y2R–TRPV4 signaling pathway could represent a promising therapeutic strategy for preventing lung IRI after transplantation.
Examining the implementation of Facility-Based Integrated Management of Childhood Illness and Insecticide Treated Nets in Bangladesh: lessons learned through implementation research
Authors: Huda Fauzia Akhter , Mathewos Kedest , Mahmood Hassan Rushekh , Faruk Omar , Hirschhorn Lisa R , Binagwaho Agnes 
Published: June 2023

AbstractBackgroundBangladesh significantly reduced under-5 mortality (U5M) between 2000 and 2015, despite its low economic development and projected high mortality rates in children aged under 5 years. A portion of this success was due to implementation of health systems-delivered evidence-based interventions (EBIs) known to reduce U5M. This study aims to understand how Bangladesh was able to achieve this success between 2000 and 2015. Implementation science studies such as this one provides insights on the implementation process that are not sufficiently documented in existing literature.MethodsBetween 2017 and 2020, we conducted mixed methods implementation research case studies to examine how six countries including Bangladesh outperformed their regional and economic peers in reducing U5M. Using existing data and reports supplemented by key informant interviews, we studied key implementation strategies and associated implementation outcomes for selected EBIs and contextual factors which facilitated or hindered this work. We used two EBIs – facility-based integrated management of childhood illnesses and insecticide treated nets – as examples of two EBIs that were implemented successfully and with wide reach across the country to understand the strategies put in place as well as the facilitating and challenging contextual factors.ResultsWe identified strategies which contributed to the successful implementation and wide coverage of the selected EBIs. These included community engagement, data use, and small-scale testing, important to achieving implementation outcomes such as effectiveness, reach and fidelity, although gaps persisted including in quality of care. Key contextual factors including a strong community-based health system, accountable leadership, and female empowerment facilitated implementation of these EBIs. Challenges included human resources for health, dependence on donor funding and poor service quality in the private sector.ConclusionAs countries work to reduce U5M, they should build strong community health systems, follow global guidance, adapt their implementation using local evidence as well as build sustainability into their programs. Strategies need to leverage facilitating contextual factors while addressing challenging ones.
Automating the analysis of eye movement for different neurodegenerative disorders
Authors: Li Deming , Butala Ankur A. , Moro-Velazquez Laureano , Meyer Trevor , Oh Esther S. , Motley Chelsey , Villalba Jesús , Dehak Najim 
Published: June 2023

AbstractThe clinical observation and assessment of extra-ocular movements is common practice in assessing neurological disorders but remains observer-dependent and subjective. In the present study, we propose an algorithm that can automatically identify saccades, fixation, smooth pursuit, and blinks using a non-invasive eye-tracker and, subsequently, elicit response-to-stimuli-derived interpretable features that objectively and quantitatively assess patient behaviors. The cohort analysis encompasses persons with mild cognitive impairment (MCI) and Alzheimer’s disease (AD), Parkinson’s disease (PD), Parkinson’s disease mimics (PDM), and controls (CTRL). Overall, results suggested that the AD/MCI and PD groups exhibited significantly different saccade and pursuit characteristics compared to CTRL when the target moved faster or covered a larger visual angle during smooth pursuit. When reading a text passage silently, more fixations were an AD/MCI-specific feature. During visual exploration, people with PD demonstrated a more variable saccade duration than other groups. In the prosaccade task, the PD group showed a significantly smaller average hypometria gain and accuracy, with the most statistical significance and highest AUROC scores of features studied. The minimum saccade gain was a PD-specific feature distinguishing PD from CTRL and PDM. Furthermore, the PD and AD/MCI groups displayed more omitted antisaccades and longer average antisaccade latency than CTRL. These features, as oculographic biomarkers, can be potentially leveraged in distinguishing different types of NDs in their early stages, yielding more objective and precise protocols to monitor disease progression.
Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery
Authors: Männle David , Pohlmann Jan , Monji-Azad Sara , Hesser Jürgen , Rotter Nicole , Affolter Annette , Lammert Anne , Kramer Benedikt , Ludwig Sonja , Huber Lena , Scherl Claudia 
Published: June 2023

AbstractIntroductionDigital twins derived from 3D scanning data were developed to measure soft tissue deformation in head and neck surgery by an artificial intelligence approach. This framework was applied suggesting feasibility of soft tissue shift detection as a hitherto unsolved problem.MethodsIn a pig head cadaver model 104 soft tissue resection had been performed. The surface of the removed soft tissue (RTP) and the corresponding resection cavity (RC) was scanned (N=416) to train an artificial intelligence (AI) with two different 3D object detectors (HoloLens 2; ArtecEva). An artificial tissue shift (TS) was created by changing the tissue temperature from 7,91±4,1°C to 36,37±1,28°C.ResultsDigital twins of RTP and RC in cold and warm conditions had been generated and volumes were calculated based on 3D surface meshes. Significant differences in number of vertices created by the different 3D scanners (HoloLens2 51313 vs. ArtecEva 21694, p<0.0001) hence result in differences in volume measurement of the RTC (p=0.0015). A significant TS could be induced by changing the temperature of the tissue of RC (p=0.0027) and RTP (p=<0.0001). RC showed more correlation in TS by heating than RTP with a volume increase of 3.1 μl or 9.09% (p=0.449).ConclusionsCadaver models are suitable for training a machine learning model for deformable registration through creation of a digital twin. Despite different point cloud densities, HoloLens and ArtecEva provide only slightly different estimates of volume. This means that both devices can be used for the task.TS can be simulated and measured by temperature change, in which RC and RTP react differently. This corresponds to the clinical behaviour of tumour and resection cavity during surgeries, which could be used for frozen section management and a range of other clinical applications.