bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemia in Anomalous Aortic Origin of a Right Coronary Artery: Large Pediatric Cohort Medium-Term Outcomes
Authors: Doan Tam T. , Sachdeva Shagun , Bonilla-Ramirez Carlos , Reaves-O’Neal Dana L. , Masand Prakash , Mery Carlos M. , Binsalamah Ziyad , Heinle Jeffrey H. , Molossi Silvana 
Published: April 2023

Background:Anomalous aortic origin of a right coronary artery may cause myocardial ischemia and sudden death in the young. Data on myocardial ischemia or longitudinal outcomes are sparse in pediatric anomalous aortic origin of a right coronary artery population.Methods:Patients <21 years with anomalous aortic origin of a right coronary artery were prospectively enrolled. Computerized tomography angiography defined morphology. Exercise stress test and stress perfusion imaging (sPI) were performed if >7 years or younger with concern for ischemia. High-risk features included intramural length, slit-like/hypoplastic ostium, exertional symptoms, or evidence of ischemia.Results:A total of 220 patients (60% males) were enrolled December 2012 to April 2020 at a median age 11.4 years (interquartile range, 6.1–14.5), including 168 (76%) with no/nonexertional symptoms (group 1) and 52 (24%) with exertional chest pain/syncope (group 2). Computerized tomography angiography was available in 189/220 (86%), exercise stress test in 164/220 (75%), and sPI in 169/220 (77%). Exercise stress test was positive in 2/164 (1.2%) patients in group 1, both had positive sPI. Inducible ischemia (sPI) was detected in 11/120 (9%) in group 1 and 9/49 (18%) in group 2 (P=0.09). Intramural length was similar in patients with/without ischemia (5 [interquartile range, 4–7] versus 5 [interquartile range, 4–7] mm;P=0.65). Surgery was recommended in 56/220 (26%) patients with high-risk features. In 52 surgical patients (38 unroofing, 14 reimplantation), all subjects were alive and have returned to exercise at last median follow-up of 4.6 (interquartile range, 2.3–6.5) years.Conclusions:Anomalous aortic origin of a right coronary artery patients can present with inducible ischemia on sPI despite symptoms or intramural length. Exercise stress test is a poor predictor of ischemia and caution should be given to determine low-risk based solely on this assessment. All patients are alive at medium-term follow-up.
Flash Drought Intensification due to Enhanced Land–Atmospheric Coupling in India
Authors: Mahto Shanti Shwarup , Mishra Vimal 
Published: April 2023

Abstract
Land–atmospheric feedback influences the occurrence and severity of flash droughts. However, the observed and projected changes in flash droughts and associated land–atmospheric coupling have not been examined over India. Moreover, the causes of the rapid depletion of soil moisture during flash droughts are not well known. We identify major flash droughts and associated soil moisture–vapor pressure deficit (SM–VPD) coupling in India using ERA5 and simulations from global climate models (CMIP6-GCMs). The summer monsoon season (June–September) witnesses more than 60% of the flash drought events and a relatively higher rate of flash drought development. The flash drought frequency has mainly decreased during India’s observed climate (1980–2019), which is projected to decline further in the future warming climate. On the other hand, the flash drought development rate has significantly increased during the observed period, which is projected to enhance further under the warming climate. SM–VPD coupling during the flash drought onset-development phase is considerably higher (threefold to fivefold) than during the normal condition (in the absence of flash drought). The high (low) SM–VPD coupling explains the faster (slower) flash drought development rate in the observed and future warming climate. The strength of SM–VPD coupling has increased in the recent period and is projected to increase further in the future warming climate. The increased SM–VPD coupling can intensify future flash droughts in India, especially during the summer monsoon season, with considerable implications for agriculture, water resources, and ecosystems.
Significance Statement
This study aims to understand better the role of land–atmospheric coupling in explaining flash drought characteristics (frequency and development rate) in India. Strong land–atmospheric (SM–VPD) feedback might influence the regional weather patterns during flash drought, which often negatively impacts humans and the ecosystem. We explain the causes and drivers of increasing (decreasing) flash drought development rate (frequency) in India. The long-term change in SM–VPD coupling drives the frequency of flash drought, whereas an anomalous instantaneous change in coupling controls the flash drought development rate. More intense flash droughts contributed by the increased land–atmospheric coupling are projected in the future. Predicting the SM–VPD coupling metric can facilitate more time for preparedness, resulting in minimizing the flash drought impacts.
Presumptive Diagnosis in Tele-Health Laryngology: A Multi-Center Observational Study
Authors: Montalbaron Michael B. , Achlatis Efstratios , Johnson Aaron M. , Ma Yue , Young VyVy N. , Rosen Clark A. , Amin Milan R. , Kwak Paul E. 
Published: April 2023

Objectives: Early in the COVID-19 pandemic, outpatient visits were adapted for the virtual setting, forcing laryngologists to presume certain diagnoses without the aid of laryngoscopy, solely based on history and the limited physical exam available via video visit. This study aims to examine the accuracy of presumptive diagnoses made via telemedicine, compared to subsequent in-person follow up, where endoscopic examination could confirm or refute suspected diagnoses. Methods: A retrospective chart review was conducted of 38 patients evaluated for voice-related issues at NYU Langone Health and the University of California-San Francisco. Presumptive diagnoses at the initial telemedicine encounter were noted, along with diagnostic cues used for clinical reasoning and recommended treatment plans. These presumptive diagnoses were compared to diagnoses and plans established following laryngoscopy at follow-up in-person visits. Results: After laryngoscopy at the first in-person visit, 38% of presumptive diagnoses changed, as did 37% of treatment plans. The accuracy varied among conditions. Muscle tension dysphonia and Reinke’s edema were accurately diagnosed without laryngoscopy, but other conditions, including vocal fold paralysis and subglottic stenosis, were not initially suspected, relying on laryngoscopy for diagnosis. Conclusions: While some laryngologic conditions may be reasonably identified without in-person examination, laryngoscopy remains central to definitive diagnosis and treatment. Telemedicine can increase access to care, but it may provide more utility as a screening tool, triaging which patients should present more urgently for in-person laryngoscopy. Level of Evidence: 4
Level of Satisfaction Towards Healthcare Services in Patients Attending Psychiatry Outpatient Department of a Tertiary Care Hospital in Eastern India
Authors: Bandhu Arghya , Sarkar Sharmila , Karmakar Soumen , Singh Om Prakash 
Published: April 2023

Background: Patients’ satisfaction with healthcare services contributes to their compliance with the treatment and thus impacts their health. Therefore, patient satisfaction is increasingly being used as an indicator of health system performance in a country. Though several studies have been reported from different parts of India, most did not include psychiatric patients. This study assessed the level of satisfaction of psychiatric outpatients and its association with socio-demographic, hospital-related, and treatment-related variables. Methods: This cross-sectional study assessed 152 patients attending psychiatry outpatient department (OPD) of a tertiary care hospital. Treatment-related satisfaction was measured using the Short Assessment of Patient Satisfaction (SAPS) scale, and variables not related to treatment were assessed using Likert scales. Results: Most participants were satisfied with the overall cleanliness of the hospital (82.9%), the useable condition of toilets (73%), and waiting time in the OPD ticket counter, doctor’s room, and pharmacy. More than 80% were pleased with the OPD staff’s behavior and working efficiency. In the seven dimensions of the SAPS scale, satisfaction level was variable. Overall satisfaction with the care received in the hospital was 60.5%. Conclusions: The level of patient satisfaction is good in psychiatry OPD services of our hospital, and it depends on treatment-independent variables also. So, liaison between the medical- and non-medical-management teams is crucial to augment patient satisfaction.
Attitude Towards the Mentally Ill Among Accredited Social Health Activist (ASHA) Workers in the Ahmedabad City of Gujarat
Authors: Patel Hardik V. , Ilasariya Kalpesh J. , Vora Vaishal N. , Lakdawala Bhaveshkumar M.  
Published: April 2023

Background: The community misunderstands mental illness, resulting in stigmatizing attitudes toward persons with mental illness. High mental health literacy (MHL) among Accredited Social Health Activists (ASHA) workers can help spread mental health awareness to the community. The study aimed to assess the attitudes of ASHA workers toward the mentally ill. Method: A cross-sectional survey was conducted among ASHA workers in the city of Ahmedabad using the Community Attitude toward Mentally Ill (CAMI) scale – Gujarati version. Census sampling was used to collect data from ASHA workers at various Urban Health Centers (UHC). We analyzed 265 responses. Results: The mean (SD) of authoritarianism (AU), benevolence (BE), social restrictiveness (SR), and community mental health ideology (CMHI) subscales were 29.77(3.35), 35.33(3.78), 34.55(3.49), and 37.15(4.42), respectively (a higher mean suggests a negative attitude in the AU and SR subscales and a positive attitude in the BE and CMHI subscales). Conclusion: Although ASHA workers displayed goodwill and a welcoming attitude on the BE and CMHI subscales, they showed negative and stigmatizing attitudes on certain items of the AU and SR subscales. This necessitates a widespread mental health education campaign and training program for them.
Bonding and Infants’ Development and Quality of Life: A Study Among Mothers with Severe Mental Illnesses in Remission
Authors: Narayan Shweta , Kishore M. Thomas , Satyanarayana Veena , Bhaskarapillai Binukumar , Desai Geetha , Chandra Prabha 
Published: April 2023

Background: Maternal mental health has specific implications for bonding and infants’ mental health. However, most of the evidence comes from mothers who are either symptomatic or did not have adequate mental health support. In this context, our objective was to explore if symptom status in mothers and bonding share any significant association with the infants’ development and quality of life (QOL), in case of mothers with severe mental illnesses in remission. Methods: The study included 41 mother–infant dyads from the outpatient perinatal psychiatry services and the mother–baby unit of the current study center. Symptom status, self-reported bonding, mother–infant interactions, and infants’ development and QOL were assessed with Clinical Global Impressions, Postpartum Bonding Questionnaire, Pediatric Infant-Parent Exam, Developmental Assessment Scales for Indian Infants, and Pediatric Quality of Life Scale, respectively. Results: Most mothers had a complete recovery or minimal symptoms. Nine (22%) infants had a significant developmental delay. Atypical play-based interactions were observed in nine (22%) mothers. Self-reported bonding and bonding as evinced over play-based interactions did not significantly correlate with the QOL or development of the infants. Mothers who have recovered and are functioning well reported good bonding with their infants, though objective assessment revealed specific difficulties. Symptom severity correlated with poor physical QOL in infants. Conclusion: The association between mothers’ bonding and infants’ mental health is domain-specific and differential than linear and robust. Infants of mothers with severe mental illnesses postpartum should be routinely monitored for mother–infant bonding, development, and quality of life.
Blood versus crystalloid cardioplegia during triple valve surgery: A single center experience
Authors: Hoyer Alexandro , Noack Thilo , Kiefer Philipp , Kang Jagdip , Misfeld Martin , Borger Michael Andrew 
Published: April 2023

Background The efficacy of different cardioplegia solutions on outcomes of complex cardiac operations such as triple valve surgery (TVS) is scarce. Here we compared the outcomes in TVS patients receiving either crystalloid (Bretschneider) or blood (Calafiore) cardioplegia. Methods Screening of our institutional database with prospectively entered data identified 471 consecutive patients (mean age 70.3 ± 9.2 years; 50.9% male), who underwent TVS (replacement or repair of aortic, mitral and tricuspid valve) between December 1994 and January 2013. In 277 patients, cardiac arrest was induced with HTK-Bretschneider solution (HTK, n = 277, 58.8%), whereas 194 received cold blood cardioplegia (BCP) according to Calafiore ( n = 194, 41.2%). Comparisons of perioperative and follow up outcomes were made between cardioplegia groups. Results Preoperative patient characteristics and comorbidities were equally balanced between groups. 30-days mortality was similar between groups (HTK: 16.2%; BCP: 18.2%; p = 0.619). Incidence of the cumulative endpoint (30days mortality, myocardial infarction (MI), arrhythmia, low cardiac output syndrome or need for permanent pacemaker implantation) was also comparable (HTK: 47.6%; BCP: 54.8%, p = 0.149). In patients with reduced left ventricular ejection fraction (LVEF <40%), 30days mortality was higher in the HTK group (HTK 18/71 22.5%; BCP 5/50 10%; p = 0.037). Five-year survival was similar between groups (52 ± 6% for HTK and 55 ± 5% for BCP patients). In-Hospital mortality was best predicted by length of surgery and reperfusion ratio. Decreased age, shorter bypass time, preserved LVEF and concomitant surgical procedures have been found to be protective from long-term mortality. Conclusions Myocardial protection with HTK shows equivalent outcomes compared to BCP during TVS. Patients with reduced left ventricular function may benefit from BCP during TVS.
Agricultural-waste Sesamum indicum L./recycled-low density polyethylene bio-composites: Impact of gamma radiation on mechanical and thermal properties
Authors: Bansal Neha , Ahuja Simran , Lal Sohan , Arora Sanjiv 
Published: April 2023

Composites synthesized from natural waste and recycled plastic is quite a promising and interesting field for scientists and polymer industries. In the present study, bio-composites based on agriculture residue Sesamum indicum L. and recycled-low density polyethylene were synthesized by extrusion and injection molding technique at a fiber loading of 10–40 wt%. Additionally, 3% of maleic anhydride grafted low density polyethylene was used as a compatibilizer. The prepared composites were irradiated at 25 kGy, 75 kGy and 125 kGy doses of gamma rays. The effects of different fiber content and gamma doses on mechanical properties were studied statistically by Design Expert software. Response surface methodology was employed to depict the interaction among various factors and optimization was done by desirability index method. Findings indicated that composites having 30% Sesamum indicum L. irradiated at 125 kGy demonstrated best mechanical properties. A significant enhancement in tensile and flexural properties of irradiated composites can be explained effectively in terms of the cross-linking effect. The fiber–matrix adhesion and modifications in composite structure was characterized by fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM), and X-Ray diffraction (XRD) analysis. Furthermore, thermal stability of the composites was also found to be increased. In addition, gamma-irradiated composite exhibited the highest storage modulus and a decrease in mechanical loss factor was also observed.
Systematic Review and Meta-Analyses of Effective Programs for Reducing Ageism Toward Older Adults
Authors: Apriceno MaryBeth , Levy Sheri R. 
Published: April 2023

A systematic review and meta-analyses examined intervention strategies to reduce ageism toward older adults using AgeLine, EBSCO, Embase, Campbell Collaboration, CINAHL, CDSR, DARE, Google Scholar, MedlinePlus, PROSPERO, PsycINFO, PubMed, ProQuest for dissertations, and SSCI from inception to September 2021. These meta-analyses involved within-subject ( n = 74; 6271 participants) and between-subject designs ( n = 78; 6857 participants) across 11 countries and 45 years with participants ages 3–45 years. Examining PEACE model components (Levy, 2018), the aggregate effect sizes were statistically significant for between-subject (within-subject) studies measuring ageist attitudes, g = 0.326 ( g = 0.108) and aging knowledge, g = 0.583 ( g = 0.304). Separate meta-analyses of contact programs showed significant estimated effect sizes among between-subject ( g = 0.329) and within-subject studies ( g = 0.263). Along with results from moderation analyses, a main conclusion is that effective interventions include education about aging and positive intergenerational contact (individualized, equal status, and in-person).
Effects of the Affordable Care Act Insurance Expansions on Health Care Coverage, Access, and Health Status of 50–64-Year-Old Adults: Evidence From the First Six Years
Authors: Bin Abdul Baten Redwan , Wehby George L. 
Published: April 2023

Individuals aged 50–64 face a higher burden of chronic conditions and an increased probability of insurance coverage loss, making them particularly vulnerable to limited access than younger adults. This study examines the effects of the Affordable Care Act (ACA) insurance expansions, including both Medicaid eligibility and other expansions, on health care coverage, access, and health status of adults aged 50–64 years over 6 years since the initial expansions in 2014. Using a triple difference-in-difference-in-differences model and nationally representative data, we find that the ACA increased private insurance and Medicaid coverage. There is evidence of improved access based on having a personal provider, completing a routine checkup, and reducing forgoing medical care due to cost. There is little evidence for the effects on self-reported health outcomes. Findings suggest that coverage expansions have improved access to care but have thus far not had discernible and consistent effects on self-reported health for 50–64-year-olds.
Clinical Features, Non-Contrast CT Radiomic and Radiological Signs in Models for the Prediction of Hematoma Expansion in Intracerebral Hemorrhage
Authors: Chen Zejia Frank , Zhang Liying , Carrington André M , Thornhill Rebecca , Miguel Olivier , Auriat Angela M , Omid-Fard Nima , Hiremath Shivaprakash , Tshemeister Abitbul Vered , Dowlatshahi Dar , Demchuk Andrew , Gladstone David , Morotti Andrea , Casetta Ilaria , Fainardi Enrico , Huynh Thien , Elkabouli Marah , Talbot Zoé , Melkus Gerd , Aviv Richard I 
Published: April 2023

Purpose Rapid identification of hematoma expansion (HE) risk at baseline is a priority in intracerebral hemorrhage (ICH) patients and may impact clinical decision making. Predictive scores using clinical features and Non-Contract Computed Tomography (NCCT)-based features exist, however, the extent to which each feature set contributes to identification is limited. This paper aims to investigate the relative value of clinical, radiological, and radiomics features in HE prediction. Methods Original data was retrospectively obtained from three major prospective clinical trials [“Spot Sign” Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy (SPOTLIGHT)NCT01359202; The Spot Sign for Predicting and Treating ICH Growth Study (STOP-IT)NCT00810888] Patients baseline and follow-up scans following ICH were included. Clinical, NCCT radiological, and radiomics features were extracted, and multivariate modeling was conducted on each feature set. Results 317 patients from 38 sites met inclusion criteria. Warfarin use (p=0.001) and GCS score (p=0.046) were significant clinical predictors of HE. The best performing model for HE prediction included clinical, radiological, and radiomic features with an area under the curve (AUC) of 87.7%. NCCT radiological features improved upon clinical benchmark model AUC by 6.5% and a clinical & radiomic combination model by 6.4%. Addition of radiomics features improved goodness of fit of both clinical (p=0.012) and clinical & NCCT radiological (p=0.007) models, with marginal improvements on AUC. Inclusion of NCCT radiological signs was best for ruling out HE whereas the radiomic features were best for ruling in HE. Conclusion NCCT-based radiological and radiomics features can improve HE prediction when added to clinical features.
Chemical Composition, in vitro, and in vivo Antiparasitic Effects of Curcuma zedoaria Rhizome Essential Oil Against Giardia lamblia
Authors: Albalawi Aishah E , Alanazi Abdullah D 
Published: April 2023

Background The present experimental work aimed to evaluate the chemical composition and in vitro and in vivo effects of Curcuma zedoaria essential oil (CZEO) compared with metronidazole (MTZ) for Giardia lamblia infection treatment. The constituents of CZEO were recognized by gas chromatography/mass spectrometry (GC/MS) examination. Materials and Methods To assess the in vitro anti- Giardia effects of CZEO, clinical isolates of G. lamblia (cysts and trophozoites) were treated with various concentrations of CZEO (25–100 µg/mL) for 10–360 min. Infected BALB/c mice orally received the CZEO at 200–600 µg/kg/day doses for 7 days. The mean number and viability of excretory cysts were assessed using vital 0.1% eosin staining. Giardia parasite antigen in the stool of the tested mice was also detected on days 5, 10, 15, and 20 post-infection through ELISA using the monoclonal antibodies. Results Based on GC/MS, the major components were curzerenone (28.6%), 1,8-cineole (21.3%), and delta-3-carene (10.6%), respectively. CZEO significantly ( p < 0.0001) reduced the viability of G. lamblia cysts and trophozoites as a dose-dependent response. CZEO at the tested doses reduced the mean number and viability of the excreted G. lamblia cysts. The highest reduction of Giardia antigen was detected in mice cured with CZEO at the 600 µg/kg dose; on days 5, 10, 15, and 20, the rate of reduction was 85.97%, 77.86%, 97.09%, and 98.75%, respectively. Biochemical examinations confirmed no significant alteration between the liver and kidney enzymes of the mice cured with CZEO and the control group. Conclusion The C. zedoaria essential oil showed potent in vitro and in vivo anti- Giardia effects and can thus have Giardia infection therapeutic potentials. Still, more studies on the exact mechanisms of action of this plant and its toxicity are warranted.