bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based screening methods in biliary atresia: a systematic review and meta-analysis
Authors: Arshad Adam , Gardiner Julian , Ho Carmen , Rees Philippa , Chadda Karan , Baker Alastair , Sutcliffe Alastair G 
Published: February 2023

ObjectiveThe aim of this study was to investigate tested methods of population-based biliary atresia (BA) screening.DesignWe searched 11 databases between 1 January 1975 and 12 September 2022. Data extraction was independently done by two investigators.Main outcome measuresOur primary outcomes were: sensitivity and specificity of screening method in BA detection, age at Kasai, BA associated morbidity and mortality, cost-effectiveness of screening.ResultsSix methods of BA screening were evaluated: stool colour charts (SCCs), conjugated bilirubin measurements, stool colour saturations (SCSs), measurements of urinary sulfated bile acids (USBAs), assessments of blood spot bile acids and blood carnitine measurements.In a meta-analysis, USBA was the most sensitive and specific, with a pooled sensitivity and specificity of 100.0% (95% CI 2.5% to 100.0%) and 99.5% (95% CI 98.9% to 99.8%) (based on one study). This was followed by conjugated bilirubin measurements: 100.0% (95% CI 0.0% to 100.0%) and 99.3% (95% CI 91.9% to 99.9%), SCS: 100.0% (95% CI 0.00% to 100.0%) and 92.4% (95% CI 83.4% to 96.7%), and SCC: 87.9% (95% CI 80.4% to 92.8%) and 99.9% (95% CI 99.9% to 99.9%).SCC reduced the age of Kasai to ~60 days, compared with 36 days for conjugated bilirubin. Both SCC and conjugated bilirubin improved overall and transplant-free survival. The use of SCC was considerably more cost-effective than conjugated bilirubin measurements.ConclusionConjugated bilirubin measurements and SCC are the most researched and demonstrate improved sensitivity and specificity in detecting BA. However, their use is expensive. Further research into conjugated bilirubin measurements, as well as alternative methods of population-based BA screening, is required.PROSPERO registration numberCRD42021235133.
Does the addition of motor control or strengthening exercises to education result in better outcomes for rotator cuff-related shoulder pain? A multiarm randomised controlled trial
Authors: Dubé Marc-Olivier , Desmeules François , Lewis Jeremy S , Roy Jean-Sébastien 
Published: February 2023

ObjectiveTo compare the short-term, mid-term and long-term effects between three interventions (education only, education and strengthening exercises, education and motor control exercises) for rotator cuff-related shoulder pain (RCRSP) on symptoms and function.Methods123 adults presenting with RCRSP took part in a 12-week intervention. They were randomly assigned to 1 of 3 intervention groups. Symptoms and function were evaluated at baseline and at 3 weeks, 6 weeks, 12 weeks and 24 weeks using the Disability of Arm, Shoulder and Hand Questionnaire (QuickDASH) (primary outcome) and Western Ontario Rotator Cuff Index (WORC). Linear mixed modelling was used to compare the effects of the three programmes on the outcomes.ResultsAfter 24 weeks, between-group differences were −2.1 (-7.7 to 3.5) (motor control vs education), 1.2 (-4.9 to 7.4) (strengthening vs education) and −3.3 (-9.5 to 2.8) (motor control vs strengthening) for theQuickDASH and 9.3 (1.5 to 17.1) (motor control vs education), 1.3 (−7.6 to 10.2) (strengthening vs education) and 8.0 (−0.5 to 16.5) (motor control vs strengthening) for the WORC. There was a significant group-by-time interaction (p=0.04) withQuickDASH, but follow-up analyses did not reveal any clinically meaningful between-group differences. There was no significant group-by-time interaction (p=0.39) for the WORC. Between-group differences never exceeded the minimal clinically important difference ofQuickDASH or WORC.ConclusionIn people with RCRSP, the addition of motor control or strengthening exercises to education did not lead to larger improvements in symptoms and function compared with education alone. Further research should investigate the value of providing stepped care by identifying individuals who may only need education and those who would benefit from the addition of motor control or strengthening exercises.Trial registration numberNCT03892603.
Risk of stroke and transient ischaemic attack in patients with a diagnosis of resolved atrial fibrillation: retrospective cohort studies
Authors: Adderley Nicola J , Nirantharakumar Krishnarajah , Marshall Tom 
Published: February 2023

AbstractObjectivesTo determine rates of stroke or transient ischaemic attack (TIA) and all cause mortality in patients with a diagnosis of “resolved” atrial fibrillation compared to patients with unresolved atrial fibrillation and without atrial fibrillation.DesignTwo retrospective cohort studies.SettingGeneral practices contributing to The Health Improvement Network, 1 January 2000 to 15 May 2016.ParticipantsAdults aged 18 years or more with no previous stroke or TIA: 11 159 with resolved atrial fibrillation, 15 059 controls with atrial fibrillation, and 22 266 controls without atrial fibrillation.Main outcome measuresPrimary outcome was incidence of stroke or TIA. Secondary outcome was all cause mortality.ResultsAdjusted incidence rate ratios for stroke or TIA in patients with resolved atrial fibrillation were 0.76 (95% confidence interval 0.67 to 0.85, P<0.001) versus controls with atrial fibrillation and 1.63 (1.46 to 1.83, P<0.001) versus controls without atrial fibrillation. Adjusted incidence rate ratios for mortality in patients with resolved atrial fibrillation were 0.60 (0.56 to 0.65, P<0.001) versus controls with atrial fibrillation and 1.13 (1.06 to 1.21, P<0.001) versus controls without atrial fibrillation. When patients with resolved atrial fibrillation and documented recurrent atrial fibrillation were excluded the adjusted incidence rate ratio for stroke or TIA was 1.45 (1.26 to 1.67, P<0.001) versus controls without atrial fibrillation.ConclusionPatients with resolved atrial fibrillation remain at higher risk of stroke or TIA than patients without atrial fibrillation. The risk is increased even in those in whom recurrent atrial fibrillation is not documented. Guidelines should be updated to advocate continued use of anticoagulants in patients with resolved atrial fibrillation.
Asymptomatic cerebral small vessel disease in adults with low cardiovascular risk
Authors: Hernández-Díaz Zenaida Milagros , Peña-Sánchez Marisol , Pimienta-Medina Mayelin , González-García Sergio , Brown Martínez Marta , Arteche Prior Marianela , Martin Arias Yasmany , Hodelin-Maynard Edwin Humberto , Abreu Duque Armando , Gonzalez-Quevedo Alina 
Published: February 2023

IntroductionCerebral small vessel disease (CSVD) frequently occurs in individuals with vascular risk factors. This condition might go unrecognised or result in only mild functional deficits.ObjectiveTo evaluate the relationship between cardiovascular (CV) risk calculated with the HEARTS app and CSVD burden in a population without cardio-cerebrovascular diseases, and to estimate the prevalence of CSVD in low risk (LR) individuals.MethodsAsymptomatic subjects with vascular risk factors were included from primary health areas in Havana. The WHO’s revised CV disease risk prediction chart (HEARTS app) was applied to all individuals, who were classified into two groups: LR and moderate/high risk (M/HR). Brain MRI was performed in all subjects.Results170 patients were included: 43 (25.3%) classified as low CV risk and 127 (74.7%) had M/HR CV risk. Half of the neurologically healthy individuals included displayed cerebral small vessel involvement (51.2%). White matter hyperintensities (WMH) and enlarged perivascular spaces were the most frequent lesions observed in both groups. WMH were more severe and more severe global score for CSVD were more frequent in the M/HR group (57.5%). It was noteworthy that 32.6% of LR-patients also exhibited more severe CSVD. The multivariate regression analysis revealed an independent association of arterial hypertension and age with the severity of CSVD.ConclusionsCV risk stratification through the HEARTS app has limited utility for predicting brain health in individuals with low CV risk. Identifying silent CSVD in individuals with apparently low CV risk is important, especially if they suffer from arterial hypertension.
Is urban regeneration associated with antidepressants or sedative medication users: a registry-based natural experiment
Authors: Nygaard Siv Steffen , Jorgensen Terese Sara Hoj , Wium-Andersen Ida Kim , Brønnum-Hansen Henrik , Lund Rikke 
Published: February 2023

BackgroundArea deprivation is associated with adverse mental health outcomes. In Denmark, urban regeneration is being used to dissolve concentrated socio-economic area deprivation and ethnic segregation. However, evidence on how urban regeneration affects mental health of residents is ambiguous partly due to methodological challenges. This study investigates if urban regeneration affects users of antidepressant and sedative medication among residents in an exposed and control social housing area in Denmark.MethodsUsing a longitudinal quasi-experimental design we measured users of antidepressant and sedative medication in one area undergoing urban regeneration compared with a control area. We measured prevalent and incident users from 2015 to 2020 among non-Western and Western women and men and used logistic regression to measure annual change in users over time. Analyses are adjusted for a covariate propensity score estimated using baseline socio-demographic characteristics and general practitioner contacts.ResultsUrban regeneration did not affect the proportion of prevalent nor incident users of antidepressant and sedative medication. However, levels were high in both areas compared with the national average. Descriptive levels of prevalent and incident users were generally lower among residents in the exposed area compared with the control area for most years and stratified groups confirmed by the logistic regression analyses.ConclusionUrban regeneration was not associated with users of antidepressant or sedative medication. We found lower levels of antidepressant and sedative medication users in the exposed area compared with the control area. More studies are needed to investigate the underlying reasons for these findings, and whether they could be related to underuse.
Evaluating two approaches to the erector spinae plane block: an anatomical study
Authors: Harbell Monica W , Langley Natalie R , Seamans David P , Koyyalamudi Veerandra , Kraus Molly B , Carey Frederick J , Craner Ryan 
Published: February 2023

Background and objectivesStudies show variable spread with thoracic erector spinae plane (ESP) injections. Injection sites vary from lateral end of the transverse process (TP) to 3 cm from the spinous process, with many not describing the precise site of injection. This human cadaveric study examined dye spread of ultrasound-guided thoracic ESP block at two needle locations.MethodsUltrasound-guided ESP blocks were performed on unembalmed cadavers. Methylene blue (20 mL, 0.1%) was injected in the ESP at the medial TP at level T5 (medial transverse process injection (MED), n=7) and the lateral end of the TP between T4 and T5 (injection between transverse processes (BTWN), n=7). The back muscles were dissected, and the cephalocaudal and medial-lateral dye spread documented.ResultsDye spread cephalocaudally from C4-T12 in the MED group and C5-T11 in the BTWN group, and laterally to the iliocostalis muscle in five MED injections and all BTWN injections. One MED injection reached serratus anterior. Dorsal rami were dyed in five MED and all BTWN injections. Dye spread to the dorsal root ganglion and dorsal root in most injections, though more extensively in the BTWN group. The ventral root was dyed in 4 MED and 6 BTWN injections. Epidural spread in BTWN injections ranged from 3 to 12 levels (median: 5 levels), with contralateral spread in two cases and intrathecal spread in five injections. Epidural spread in MED injections was less extensive (median (range): 1 (0–3) levels); two MED injections did not enter the epidural space.ConclusionAn ESP injection administered between TPs exhibits more extensive spread than a medial TP injection in a human cadaveric model.
Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip arthroplasty
Authors: Bravo Daniela , Aliste Julián , Layera Sebastián , Fernández Diego , Erpel Hans , Aguilera Germán , Arancibia Hernán , Barrientos Cristián , Wulf Rodrigo , León Sebastián , Brañes Julián , Finlayson Roderick J , Tran De Q 
Published: February 2023

BackgroundThis randomized trial compared pericapsular nerve group block and periarticular local anesthetic infiltration in patients undergoing primary total hip arthroplasty. We hypothesized that, compared with pericapsular nerve group block, periarticular local anesthetic infiltration would decrease the postoperative incidence of quadriceps weakness at 3 hours fivefold (ie, from 45% to 9%).MethodsSixty patients undergoing primary total hip arthroplasty under spinal anesthesia were randomly allocated to receive a pericapsular nerve group block (n=30) using 20 mL of adrenalized bupivacaine 0.50%, or periarticular local anesthetic infiltration (n=30) using 60 mL of adrenalized bupivacaine 0.25%. Both groups also received 30 mg of ketorolac, either intravenously (pericapsular nerve group block) or periarticularly (periarticular local anesthetic infiltration), as well as 4 mg of intravenous dexamethasone.Postoperatively, a blinded evaluator carried out sensory assessment and motor assessment (knee extension and hip adduction) at 3, 6 and 24 hours. Furthermore, the blinded observer also recorded static and dynamic pain scores at 3, 6, 12, 18, 24, 36 and 48 hours; time to first opioid request; cumulative breakthrough morphine consumption at 24 hours and 48 hours; opioid-related side effects; ability to perform physiotherapy at 6, 24 and 48 hours; as well as length of stay.ResultsThere were no differences in quadriceps weakness at 3 hours between pericapsular nerve group block and periarticular local anesthetic infiltration (20% vs 33%; p=0.469). Furthermore, no intergroup differences were found in terms of sensory block or motor block at other time intervals; time to first opioid request; cumulative breakthrough morphine consumption; opioid-related side effects; ability to perform physiotherapy; and length of stay. Compared with pericapsular nerve group block, periarticular local anesthetic infiltration resulted in lower static pain scores (at all measurement intervals) and dynamic pain scores (at 3 and 6 hours).ConclusionFor primary total hip arthroplasty, pericapsular nerve group block and periarticular local anesthetic infiltration result in comparable rates of quadriceps weakness. However, periarticular local anesthetic infiltration is associated with lower static pain scores (especially during the first 24 hours) and dynamic pain scores (first 6 hours). Further investigation is required to determine the optimal technique and local anesthetic admixture for periarticular local anesthetic infiltration.Trial registration numberNCT05087862.
Convergence and Riemannian bounds on Lagrangian submanifolds
Authors: Chassé Jean-Philippe 
Published: February 2023

We consider collections of Lagrangian submanifolds of a given symplectic manifold which respect uniform bounds of curvature type coming from an auxiliary Riemannian metric. We prove that, for a large class of metrics on these collections, convergence to an embedded Lagrangian submanifold implies convergence to it in the Hausdorff metric. This class of metrics includes well-known metrics such as the Lagrangian Hofer metric, the spectral metric and the shadow metrics introduced by Biran et al. [Lagrangian shadows and triangulated categories, Astérisque 426 (2021) 1–128]. The proof relies on a version of the monotonicity lemma, applied on a carefully-chosen metric ball.
Fluoride Ion Conductivity of Rb Doped KSbF4
Authors: Kawahara Kazuaki , Ishikawa Ryo , Shibata Naoya , Ikuhara Yuichi 
Published: February 2023

Abstract
All solid-state fluoride ion batteries are considered to be high energy density and safe energy storage devices. However, the F– ion conductivities of solid electrolytes at room temperature are low (< 10-6 S cm-1), which requires the higher operating temperature of fluoride ion battery such as 420 K or higher. Therefore, the faster F– ion conductors is strongly desired to operate fluoride ion battery at lower or even room temperature. KSbF4 is one of the promising candidates to have a faster F– ion conductivity. To expand F– ion conduction pathways, we doped Rb in KSbF4 and further investigated the compositional dependence of ionic conductivity in K1-xRbxSbF4 system. We found that ionic conductivity strongly depends on the chemical composition and conductivity was maximized at x = 0.15. At room temperature, the F– ion conductivity in the bulk and at the grain boundary of K0.85Rb0.15SbF4 were σbulk = 1.01 × 10-4 S cm-1 and σGB = 4.80 × 10-5 S cm-1, respectively.
Factors Influencing Blood Concentration of Voriconazole and Therapeutic Drug Monitoring in Patients with Child–Pugh Class C Cirrhosis
Authors: Zhang Ying , Wu Rongrong , Liu Fangfang , Wang Yonggang , Zhang Junchang , Ji Chengcheng , Lu Xianghong , Chang Dan , Mu Jinsong 
Published: February 2023

What Is Known and Objective. CYP2C19 is an important influencing factor for voriconazole trough plasma concentration (Cmin); however, it is not verified in Child–Pugh C (CP-C) cirrhosis patients, and no voriconazole dosage regimen is recommended for these patients in the package insert. This retrospective study identified CYP2C19 and other factors influencing voriconazole Cmin for CP-C cirrhosis, and obtained an appropriate method of application of voriconazole for them. Methods. A total of 66 patients with CP-C cirrhosis who accepted voriconazole therapy were involved. The voriconazole Cmin, clinical characteristics, CYP2C19 genotype, and adverse effects (AEs) were recorded and analyzed. Results. Unlike other research studies, voriconazole Cmin was not different among normal metabolizers (NMs), intermediate metabolizers (IMs), and poor metabolizers (PMs) of the CYP2C19 enzyme in CP-C cirrhosis (

P

> 0.05). The maintenance dose regimen for voriconazole was the only independent influencing factor for Cmin (

P

= 0.045; OR = 3.753; 95% CI, 1.029–13.694). At about 1/3 of the recommended maintenance dose, only 16.7% (8/48) had Cmin >5.5 μg/mL, 4.5% (3/48) had Cmin <1 μg/mL, and only one AE happened. There were four voriconazole-related AEs that happened in this study, and three AEs occurred (3/4, 75%) when the maintenance dose was not adjusted with therapeutic drug monitoring (TDM). What Is New and Conclusion. Voriconazole Cmin did not significantly vary according to CYP2C19 enzyme metabolization status (being an NM, IM, or PM) in CP-C cirrhosis. Reducing the maintenance dose of voriconazole to approximately 1/3 the standard maintenance dose and administering in combination with TDM in patients with CP-C cirrhosis are recommended.
Hypothalamic Oxytocin Neuron Activation Attenuates Intermittent Hypoxia-Induced Hypertension and Cardiac Dysfunction in an Animal Model of Sleep Apnea
Authors: Rodriguez Jeannette , Escobar Joan B. , Cheung Emily C. , Kowalik Grant , Russo Rebekah , Dyavanapalli Jhansi , Alber Bridget R. , Harral Grey , Gill Aman , Melkie Makeda , Jain Vivek , Schunke Kathryn J. , Mendelowitz David , Kay Matthew W. 
Published: February 2023

Background:
Obstructive sleep apnea is a prevalent and poorly treated cardiovascular disease that leads to hypertension and autonomic imbalance. Recent studies that restore cardiac parasympathetic tone using selective activation of hypothalamic oxytocin neurons have shown beneficial cardiovascular outcomes in animal models of cardiovascular disease. This study aimed to determine if chemogenetic activation of hypothalamic oxytocin neurons in animals with existing obstructive sleep apnea-induced hypertension would reverse or blunt the progression of autonomic and cardiovascular dysfunction.

Methods:
Two groups of rats were exposed to chronic intermittent hypoxia (CIH), a model of obstructive sleep apnea, for 4 weeks to induce hypertension. During an additional 4 weeks of exposure to CIH, 1 group was treated with selective activation of hypothalamic oxytocin neurons while the other group was untreated.

Results:
Hypertensive animals exposed to CIH and treated with daily hypothalamic oxytocin neuron activation had lower blood pressure, faster heart rate recovery times after exercise, and improved indices of cardiac function compared with untreated hypertensive animals. Microarray analysis suggested that, compared with treated animals, untreated animals had gene expression profiles associated with cellular stress response activation, hypoxia-inducible factor stabilization, and myocardial extracellular matrix remodeling and fibrosis.

Conclusions:
In animals already presenting with CIH-induced hypertension, chronic activation of hypothalamic oxytocin neurons blunted the progression of hypertension and conferred cardioprotection after an additional 4 weeks of CIH exposure. These results have significant clinical translation for the treatment of cardiovascular disease in patients with obstructive sleep apnea.
Application of Machine Learning Techniques to Improve Multi-Radar Multi-Sensor (MRMS) Precipitation Estimates in the Western United States
Authors: Osborne Andrew P. , Zhang Jian , Simpson Micheal J. , Howard Kenneth W. , Cocks Stephen B. 
Published: February 2023

Abstract
The Multi-Radar Multi-Sensor (MRMS) system produces a suite of hydrometeorological products that are widely used for applications such as flash flood warning operations, water resource management, and climatological studies. The MRMS radar-based quantitative precipitation estimation (QPE) products have greater challenges in the western United States compared to the eastern two-thirds of the CONUS due to terrain-related blockages and gaps in radar coverage. Further, orographic enhancement of precipitation often occurs, which is highly variable in space and time and difficult to accurately capture with physically based approaches. A deep learning approach was applied in this study to understand the correlations between several interacting variables and to obtain a more accurate precipitation estimation in these scenarios. The model presented here is a convolutional neural network (CNN), which uses spatial information from small grids of several radar variables to predict an estimated precipitation value at the central grid point. Several case analyses are presented along with a yearlong statistical evaluation. The CNN model 24-h QPE shows higher accuracy than the MRMS radar QPE for several cool season atmospheric river events. Areas of consistent improvement from the CNN model are highlighted in the discussion along with areas where the model can be further improved. The initial findings from this work help set the foundation for further exploration of machine learning techniques and products for precipitation estimation as part of the MRMS operational system.

Significance Statement
This study explores the development and use of a deep learning model to generate precipitation fields in the complex terrain of the western United States. Generally, the model is able to improve on the statistical performance of existing radar-based precipitation estimation methods for several case studies and over a long-term period in 2021. We explore the patterns associated with certain areas of strong performance and suggest potential means of improving areas with weaker performance. These initial results indicate the potential of deep learning to supplement radar-based approaches in areas with observational limitations.