bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep learning automation of MEST-C classification in IgA nephropathy
Authors: Jaugey Adrien , Maréchal Elise , Tarris Georges , Paindavoine Michel , Martin Laurent , Chabannes Melchior , Funes de la Vega Mathilde , Chaintreuil Mélanie , Robier Coline , Ducloux Didier , Crépin Thomas , Felix Sophie , Jacq Amélie , Calmo Doris , Tinel Claire , Zanetta Gilbert , Rebibou Jean-Michel , Legendre Mathieu 
Published: February 2023

ABSTRACT

Background
Although the MEST-C classification is among the best prognostic tools in immunoglobulin A nephropathy (IgAN), it has a wide interobserver variability between specialized pathologists and others. Therefore we trained and evaluated a tool using a neural network to automate the MEST-C grading.

Methods
Biopsies of patients with IgAN were divided into three independent groups: the Training cohort (n = 42) to train the network, the Test cohort (n = 66) to compare its pixel segmentation to that made by pathologists and the Application cohort (n = 88) to compare the MEST-C scores computed by the network or by pathologists.

Results
In the Test cohort, &gt;73% of pixels were correctly identified by the network as M, E, S or C. In the Application cohort, the neural network area under the receiver operating characteristics curves were 0.88, 0.91, 0.88, 0.94, 0.96, 0.96 and 0.92 to predict M1, E1, S1, T1, T2, C1 and C2, respectively. The kappa coefficients between pathologists and the network assessments were substantial for E, S, T and C scores (kappa scores of 0.68, 0.79, 0.73 and 0.70, respectively) and moderate for M score (kappa score of 0.52). Network S and T scores were associated with the occurrence of the composite survival endpoint (death, dialysis, transplantation or doubling of serum creatinine) [hazard ratios 9.67 (P = .006) and 7.67 (P &lt; .001), respectively].

Conclusions
This work highlights the possibility of automated recognition and quantification of each element of the MEST-C classification using deep learning methods.
Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit: A Feasibility Study for Use in BACPAC
Authors: Quirk D Adam , Chung Jinwon , Schiller Gregory , Cherin Jason M , Arens Philipp , Sherman David A , Zeligson Emma R , Dalton Diane M , Awad Lou N , Walsh Conor J 
Published: February 2023

Abstract

Objective
Low back pain (LBP) is hallmarked by activity limitations, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending. To understand patient-reported usability and use cases for this device.

Methods
Fifteen individuals with LBP performed two experimental lifting blocks once with and without an exosuit. Trunk biomechanics were measured by muscle activation amplitudes, and whole-body kinematics and kinetics. To evaluate device perception, participants rated task effort, low back discomfort, and their level of concern completing daily activities.

Results
The back exosuit reduced peak back extensor: moments by 9%, and muscle amplitudes by 16% when lifting. There were no changes in abdominal co-activation and small reductions maximum trunk flexion compared to lifting without an exosuit. Participants reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without.

Conclusions
This study demonstrates a back exosuit not only imparts perceptual benefits of reduced task effort, discomfort, and increased confidence in individuals with LBP but that it achieves these benefits through measurable biomechanical reductions in back extensor effort. The combined effect of these benefits implies back exosuits might be a potential therapeutic aid to augment physical therapy, exercises, or daily activities.
LE2Pol: the Leicester dual-beam imaging polarimeter
Authors: Wiersema K , Starling R L C , Campagnolo J C N , Thanki D , McErlean R 
Published: February 2023

Abstract
We describe the development, construction, data analysis, initial calibration, and first results of the Leicester dual-beam imaging polarimeter (LE2Pol), an inexpensive dual-beam optical imaging polarimeter. LE2Pol is designed for a 20-inch telescope at the observatory of the University of Leicester, but can also be used as a visiting instrument on a wide range of small telescopes (≲1 m). We show how simple imaging polarimeters on small telescopes can be used to provide useful scientific and educational data at low cost.
A Theory of Falling Growth and Rising Rents
Authors: Aghion Philippe , Bergeaud Antonin , Boppart Timo , Klenow Peter J , Li Huiyu 
Published: February 2023

Abstract
Growth has fallen in the U.S. amid a rise in firm concentration. Market share has shifted to low labour share firms, while within-firm labour shares have actually risen. We propose a theory linking these trends in which the driving force is falling overhead costs of spanning multiple products or a rising efficiency advantage of large firms. In response, the most efficient firms (with higher markups) spread into new product lines, thereby increasing concentration and generating a temporary burst of growth. Eventually, due to greater competition from efficient firms, within-firm markups and incentives to innovate fall. Thus our simple model can generate qualitative patterns in line with the observed trends.
Self-monitoring combined with patient-initiated care in RA patients with low disease activity: cost-effectiveness analysis of an RCT
Authors: Seppen Bart F , Greuter Marjolein J E , Wiegel Jimmy , ter Wee Marieke M , Boers Maarten , Nurmohamed Michael T , Bos Wouter H 
Published: February 2023

Abstract

Objectives
Self-monitoring and patient-initiated care (PIC) leads to fewer outpatient clinic visits in patients with established RA with low disease activity (LDA) while healthcare outcomes are similar. This study assesses the cost-effectiveness of PIC with self-monitoring.

Methods
A 12-month randomized controlled trial was performed with 49 patients in the PIC with self-monitoring group (app-group) and 53 in usual care. The usual care group continued with preplanned visits. The app group had one planned follow-up visit after 12 months and monitored their RA disease activity in a smartphone app. Both groups could make additional appointments at liberty. We included adult RA patients with a disease duration of over 2 years, a disease activity score 28 (DAS28) below 3.2 that were stable on medication for at least 6 months. The effect measure, the DAS28, was measured at 12 months and healthcare resource usage and productivity losses were measured at 3, 6, 9 and 12 months.

Results
There was no significant difference in mean change of DAS28 (-0.04 mean difference, 95% CI: -0.39, 0.30), nor a statistically significant difference in total costs (mean difference €514, 95% CI:-€266, €3690) in the app group compared with the usual care group. The probability that the app was cost-effective was 0.37 and 0.57 at a willingness-to-pay threshold of 0 and 50 000 €/point improvement DAS28, respectively.

Conclusion
Although rheumatic care costs were significantly lower in the app group, total costs and effects of PIC with self-monitoring were not different from usual care in RA patients with LDA.
Football Casuals, Fanzines, and Acid House: Working Class Subcultures, Emotional Communities, and Popular Individualism in 1980s and 1990s England
Authors: Jones Ben 
Published: February 2023

Abstract
This article illuminates the dynamics of two of the most significant yet neglected youth subcultures of the late twentieth century: football’s casual culture and the acid house scene. Through the lens of two influential fanzines, Liverpool’s The End and London’s Boy’s Own I make a series of arguments about the relationship between ‘popular individualism’, emotion, and working-class communities. I argue that while conceptualizing the fanzines as ‘emotional communities’ can yield important insights about the role of feelings such as nostalgia in bonding people together, gendered sensibilities and satirical frameworks need to be taken into account in order to fully understand the subcultural affinities that the fanzines engendered. The framework of ‘popular individualism’ on the other hand can help to illuminate the tensions between individualism and collective belonging at a number of levels which the article discusses. The article concludes by noting that the analysis of these neglected subcultures offers fruitful ways of reconceptualizing community and belonging in a period when traditional forms of working-class organization were in decline.
Anesthetic management of patients with peripartum cardiomyopathy
Authors: Eerdekens Gert-Jan , Devroe Sarah , Budts Werner , Rex Steffen 
Published: February 2023

Purpose of review
Cardiovascular disease is increasingly emerging as a cause of peripartum morbidity and mortality. Peripartum cardiomyopathy (PPCM) is defined as pregnancy-related heart failure with a reduced left ventricular ejection fraction <45%. PPCM develops in the peripartum phase and is not an aggravation of an existing prepregnancy cardiomyopathy. Anesthesiologists typically encounter these patients in the peripartum phase in a variety of settings and should be aware of this pathology and its implications for the perioperative management of parturients.

Recent findings
PPCM has been investigated increasingly over the last few years. Significant progress has been made in the assessment of global epidemiology, pathophysiological mechanisms, genetics and treatment.

Summary
Although PPCM is an overall rare pathology, patients can potentially be encountered by any anesthesiologist in many different settings. Therefore, it is important to be aware of this disease and understand the basic implications for anesthetic management. Severe cases often require early referral to specialized centers for advanced hemodynamic monitoring and pharmacological or mechanical circulatory support.
“You’re Socially Distant and Trying Not to Be Emotionally Distant.” Physicians’ Perspectives of Communication and Therapeutic Relationships in the ICU During the COVID-19 Pandemic: A Qualitative Study
Authors: Nugent Shannon M. , Golden Sara E. , Chapa Joaquin , Tuepker Anaïs , Slatore Christopher G. , Vranas Kelly C. 
Published: February 2023

OBJECTIVES:
To: 1) characterize how COVID-19–related policies influence patient-clinician communication and relationships in the ICU, with attention to race and ethnicity as factors and 2) identify interventions that may facilitate patient-clinician communication.

DESIGN:
We conducted a qualitative study between September 2020 and February 2021 that explored facilitators and barriers to patient-clinician communication and the formation of therapeutic relationships. We used thematic analysis to develop findings describing patient-communication and therapeutic relationships within the ICU early in the COVID-19 pandemic.

SETTING:
We purposively selected hospital dyads from regions in the United States that experienced early and/or large surges of patients hospitalized with COVID-19.

SUBJECTS:
We recruited a national sample of ICU physicians from Veteran Affairs (VA) Health Care Systems and their associated academic affiliate hospitals.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Twenty-four intensivists from seven VA hospitals and six academic-affiliate hospitals participated. Intensivists noted the disproportionate impact of the pandemic on among people holding minoritized racial and ethnic identities, describing how language barriers and restrictive visitation policies exacerbated institutional mistrust and compromised physicians’ ability to develop therapeutic relationships. We also identified several perceived influences on patient-clinician communication and the establishment of therapeutic relationships. Barriers included physicians’ fear of becoming infected with COVID-19 and use of personal protective equipment, which created obstacles to effective physical and verbal interactions. Facilitators included the presence of on-site interpreters, use of web-based technology to interact with family members outside the ICU, and designation of a care team member or specialist service to provide routine updates to families.

CONCLUSIONS:
The COVID-19 pandemic has threatened patient-clinician communication and the development of therapeutic relationships in the ICU, particularly among people holding minoritized racial and ethnic identities and their families. We identified several facilitators to improve patient-clinician communication as perceived by intensivists that may help improve trust and foster therapeutic alliances.
Through the looking glass
Authors: Gifford Rachel , van de Baan Frank , Westra Daan , Ruwaard Dirk , Fleuren Bram 
Published: February 2023

Background
The challenges brought on by the pandemic triggered a renewed scholarly focus on managing during crises. Now, 3 years on, having covered the initial crisis response, it is important to reevaluate what the crisis has taught us about health care management more generally. In particular, it is useful to consider the persistent challenges that continue to face health care organizations in the wake of a crisis.

Purpose
The present article aims to identify the biggest challenges that currently face health care managers in order to formulate a postcrisis research agenda.

Methodology/Approach
We employ an exploratory qualitative study, utilizing in-depth interviews with hospital executives and management to explore the persistent challenges facing managers in practice.

Results
Our qualitative inquiry reveals three key challenges that extend beyond the crisis and are salient for health care managers and organizations in the years to come. Specifically, we identify the centrality of human resource constraints (amidst increasing demand), the necessity of collaboration (amidst competition), and a need to reconsider the approach to leadership (utility of humility).

Conclusion
We conclude by drawing upon relevant theories such as paradox theory to formulate a research agenda for health care management scholars that can support the creation of novel solutions and approaches to persistent challenges in practice.

Practice Implications
We identify several implications for organizations and health systems, including the need to eliminate competition and the importance of building human resource management capacities within organizations. In highlighting areas for future research, we provide organizations and managers with useful and actionable insights to address their most persistent challenges in practice.
Hemorrhagic Complications Following Trabecular Bypass Microstent Surgery in the Setting of Antithrombotic Therapy
Authors: Shalaby Wesam Shamseldin , Patel Sonali , Lam Sophia S. , Bechay Joseph , Zadrozny Izabella , Reyes Johannie , Zhang Qiang , Sharpe James , Lee Daniel , Myers Jonathan S. , Kolomeyer Natasha Nayak , Razeghinejad Reza , Pro Michael J. , Moster Marlene R. , Garg Shukla Aakriti 
Published: February 2023

Précis:
In this retrospective study, the use of chronic antithrombotic therapy (ATT) did not increase the risk of hemorrhagic complications after trabecular bypass microstent surgery and phacoemulsification. Stent type and female sex were associated with hyphema.

Purpose:
To report the incidence of hemorrhagic complications after trabecular bypass microstent surgery and phacoemulsification with and without (ATT).

Methods:
Retrospective case series on glaucoma patients on chronic ATT who underwent trabecular bypass microstent surgery (iStent, iStent inject, and Hydrus) combined with phacoemulsification between 2013 and 2019 with ≥3-month follow-up. The primary outcome measure was the incidence of hemorrhagic complications within a 3-month postoperative period. Generalized estimating equations were created to account for inter-eye correlation and logistic regression analysis was performed to identify factors predictive of hemorrhagic complications.

Results:
Of 333 patients (435 eyes), 161 patients (211 eyes) were on ATT and 172 patients (224 eyes) were not on ATT; both groups were similar in age and baseline ocular characteristics. The only hemorrhagic complication was hyphema, which occurred in 84 (19.3%) eyes (41 ATT, 43 non-ATT eyes; P = 1.00). Onset was at postoperative day 1 in 98.8% of eyes, with a duration of 1 week in 73.8% of eyes, without difference between ATT and non-ATT groups. Hyphema was most common with Hydrus microstent (36.4%) versus iStent (19.9%) and iStent inject (8.5%) (P = 0.003). In the multivariate model, the female sex was a predictor of hyphema [hazard ratio (HR) = 2.062; P = 0.009], iStent inject was protective against hyphema (HR = 0.379; P = 0.033), whereas Hydrus did not reach statistical significance (HR = 2.007; P = 0.081). Age, systemic comorbidities, ATT use, and baseline ocular characteristics were not significant predictors.

Conclusions:
Hemorrhagic complications after trabecular bypass microstent surgery were limited to transient hyphema and were not associated with chronic ATT use. Stent type and female sex were associated with hyphema.
Outcomes of Ultrasound Cyclo Plasty in Primary Angle Closure Glaucoma
Authors: Almobarak Faisal A. , Alrubean Ahmed , Alsarhani Waleed K. , Aljenaidel Abdullah , Osman Essam A. 
Published: February 2023

Précis:
Ultrasound cyclo plasty (UCP) can be useful in decreasing the intraocular pressure (IOP) and burden of antiglaucoma medications in eyes with primary angle closure glaucoma (PACG). Nevertheless, baselines IOP was an important determinant for failure.

Purpose:
To evaluate the intermediate-term outcomes of UCP in PACG.

Methods:
This retrospective cohort study included patients with PACG who underwent UCP. The main outcome measures were IOP, number of antiglaucoma medications, visual acuity, and presence of complications. The surgical outcomes of each eye were classified as a complete success, qualified success, or failure based on the main outcome measures. Cox regression analysis was performed to identify possible predictors for failure.

Results:
Sixty-two eyes of 56 patients were included in the study. The mean follow-up period was 28.81 months (±18.2). The IOP and number of antiglaucoma medications decreased from a mean of 23.03 (±6.4) mmHg and 3.42 (±0.9) to 15.57 (±6.4) mmHg and 2.04 (±1.3), respectively, in the 12th month and to 14.22 (±5.0) mmHg and 1.91 (±1.5) in the 24th month (P<0.01 for all). The cumulative probabilities of overall success were 72.6±5.7% and 54.8±6.3% at 12 and 24 months, respectively. A high baseline IOP was associated with a higher risk of failure (hazard ratio=1.10, P=0.03). The most common complications were cataract development or progression (30.6%), rebound or prolonged anterior chamber reaction (8.1%), hypotony with choroidal detachment (3.2%), and phthisis bulbi (3.2%).

Conclusions:
UCP offers reasonable 2-year IOP control and reduction of the antiglaucoma medication burden. However, counseling on possible postoperative complications is needed.
A Randomized, Controlled Comparison of 180 Versus 360 Degrees Selective Laser Trabeculoplasty in Open Angle Glaucoma and Glaucoma Suspects
Authors: Michaelov Evan , Sachdeva Robin , Raniga Aparna , Lin Tony 
Published: February 2023

Précis:
Three hundred sixty degrees selective laser trabeculoplasty (SLT) produces greater intraocular pressure (IOP) lowering effects with no changes in safety profile compared with 180 degrees SLT.

Purpose:
To determine whether there is any difference in the IOP lowering effects and safety profiles of 180 versus 360 degrees SLT, using a paired-eye design to limit confounders.

Methods:
This single-center randomized control trial included patients presenting with treatment naïve open angle glaucoma or glaucoma suspects. Once enrolled, 1 eye was randomized to 180 degrees SLT, and the other was treated with 360 degrees SLT. Patients were followed for 1 year and assessed for change in visual acuity, Goldmann IOP, Humphrey visual fields, retinal nerve fiber layer thickness, optical coherence tomography derived cup to disc ratio, and any adverse events or requirements for additional medical interventions.

Results:
A total of 40 patients (80 eyes) were included in the study. IOP in the 180 degrees group was reduced from 25.3±2.3 mm Hg to 21.5±2.7 mm Hg, and in the 360 degrees group, from 25.5±2.1 mm Hg to 19.9±2.6 mm Hg (P<0.01), both at 1 year. There was no significant difference in the number of adverse events or serious adverse events in the 2 groups. There were no statistically significant differences in visual acuity, Humphrey visual field mean deviation, retinal nerve fiber layer thickness, or C:D ratio at 1-year follow-up.

Conclusion:
At 1 year, 360 degrees SLT was more efficacious at lowering IOP compared with 180 degrees SLT with a similar safety profile in patients with open angle glaucoma and glaucoma suspects. Further studies are needed to determine the long-term effects.
Ultrasound Cyclo Plasty in Patients with Open Angle Glaucoma and High Myopia
Authors: Figus Michele , Palma Alessandro , Covello Giuseppe , Agnifili Luca , Posarelli Chiara 
Published: February 2023

Précis:
Ultrasound cyclo plasty (UCP) using high-intensity focused ultrasound is an effective and safe procedure in lowering intraocular pressure (IOP) in patients with glaucoma, even in those with high myopia.

Purpose:
This study aimed to evaluate the efficacy and safety of UCP in glaucoma patients with high myopia.

Materials and Methods:
In this retrospective, single-center study, we enrolled 36 eyes divided into 2 groups based on axial length: group A (≥26.00 mm) and group B (<26.00 mm). We collected data about visual acuity, Goldmann applanation tonometry, biomicroscopy, and visual field before the procedure and at 1, 7, 30, 60, 90, 180, and 365 days after the procedure.

Results:
Mean IOP significantly decreased in both groups after treatment (P<0.001). Mean IOP reduction from baseline to the last visit was 9.8±6.6 mmHg (38.7%) in group A and 9.6±6.3 mmHg (34.8%) in group B (P<0.001). Mean IOP at the last visit was 15.8±4.1 mmHg in the myopic group and 18.1±5.6 mmHg in the non-myopic one. Regarding the number of IOP-lowering eyedrops being taken by our patients, statistically significant differences were found between groups A and B neither at baseline (2.8±0.9 and 2.6±1.0; P=0.568) nor 1 year after the procedure (2.5±1.1 and 2.6±1.1; P=0.762). No major complications occurred. All minor adverse events resolved within a few days.

Conclusion:
UCP seems to be an effective and well-tolerated strategy to lower IOP in glaucoma patients with high myopia.