bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between Forearm Bone Mineral Density Measured by Dual Energy X-ray Absorptiometry and Hounsfield Units Value Measured by CT in Lumbar Spine
Authors: Chen Qian , Wei Peng , Pu Hong Yu , Huang Kun 
Published: January 2023

Abstract
Background Our aim was to determine if the dual-energy X-ray absorptiometry (DXA)-measured forearm bone mineral density (BMD) correlates with the Hounsfield unit (HU) values obtained from computed tomography (CT).
Methods A retrospective analysis of 164 patients with degenerative diseases of the lumbar spine was performed. DXA was used to measure the BMD and T-scores of each patient’s forearm. Lumbar CT was used to measure the CT HU values in three axial images of the L1–L4 vertebral bodies, and the average was calculated. According to the preoperative DXA T-score, they were divided into a normal group, an osteopenia group, and an osteoporosis group. Pearson’s correlation coefficient was used to analyze the correlations of CT HU values in L1–L4 with BMD and T-scores in the corresponding vertebral body. The receiver operating characteristic curve (ROC) was used to determine the CT HU thresholds between osteoporosis and non-osteoporosis groups.
Results Forearm BMD was moderately correlated with L1–L4 CT HU values (0.4 < R2 < 0.6), and the correlation coefficients (R2) were 0.552, 0.578, 0.582, and 0.577, respectively (all p < 0.001). Forearm T-scores were moderately correlated with L1–L4 CT HU values (0.4 < R2 < 0.6), and the correlation coefficients (R2) were 0.595, 0.609, 0.605, and 0.605, respectively (all p < 0.001). The thresholds of L1–L4 between the osteoporosis group (t ≤ -2.5) and the non-osteoporosis group (t > −2.5) were 110.0 HU (sensitivity 74% and specificity 76%), 112.5 HU (sensitivity 67% and 83% specificity), 92.4 HU (81% sensitivity and 70% specificity), and 98.7 HU (74% sensitivity and 78% specificity), respectively.
Conclusions Based on the moderate positive correlation between forearm DXA-measured BMD and HU values, forearm DXA provides a theoretical basis for evaluating lumbar vertebral bone mass. Preoperative forearm DXA may be useful in the formulation of surgical plans and the prevention of postoperative complications in patients with lumbar degenerative diseases.
Occupational radiation dose from gastrointestinal endoscopy procedures with special emphasis on eye lens doses in endoscopic retrograde cholangiopancreatography
Authors: Kaasalainen Touko , Pekkarinen Antti , Kylänpää Leena , Rainio Mia , Tenca Andrea , Jokelainen Kalle , Barner-Rasmussen Nina , Puustinen Lauri , Udd Marianne , Lindström Outi 
Published: January 2023

Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) procedures may result in remarkable radiation doses to patients and staff. The aim of this prospective study was to determine occupational exposures in gastrointestinal endoscopy procedures, with a special emphasis on eye lens dose in ERCP.
Methods Altogether 604 fluoroscopy-guided procedures, of which 560 were ERCPs belonging to four American Society for Gastrointestinal Endoscopy procedural complexity levels, were performed using two fluoroscopy systems. Personal deep-dose equivalent Hp(10), shallow-dose equivalent Hp(0.07), and eye lens dose equivalent Hp(3) of eight interventionists and Hp(3) for two nurse dosimeters were measured. Thereafter, conversion coefficients from kerma-area product (KAP) for Hp(10), Hp(0.07), and Hp(3) were determined and dose equivalents per procedure to an operator and assisting staff were estimated. Further, mean conversion factors from Hp(10) and Hp(0.07) to Hp(3) were calculated.
Results The median KAP in ERCP was 1.0 Gy·cm2, with mobile c-arm yielding higher doses than a floor-mounted device (P < 0.001). The median Hp(3) per ERCP was estimated to be 0.6 µSv (max. 12.5 µSv) and 0.4 µSv (max. 12.2 µSv) for operators and assisting staff, respectively. The median Hp(10) and Hp(0.07) per procedure ranged from 0.6 to 1.8 µSv. ERCP procedural complexity level (P ≤ 0.002) and interventionist (P < 0.001) affected dose equivalents.
Conclusions Occupational dose limits are unlikely to be exceeded in gastrointestinal endoscopy practice when following radiation-hygienic working methods and focusing on dose optimization. The eye lens dose equivalent Hp(3) may be estimated with sufficient agreement from the Hp(10) and Hp(0.07).
Intravenous paracetamol for persistent pain after endoscopic mucosal resection discriminates patients at risk of adverse events and those who can be safely discharged
Authors: Desomer Lobke , Tate David J. , Pillay Leshni , Awadie Halim , Sidhu Mayenaaz , Ahlenstiel Golo , Bourke Michael J. 
Published: January 2023

Introduction The frequency and severity of abdominal pain after endoscopic mucosal resection (EMR) of colonic laterally spreading lesions (LSLs) of ≥ 20 mm is unknown, as are the risk factors to predict its occurrence. We aimed to prospectively characterize pain after colonic EMR , determine the rapidity and frequency of its resolution after analgesia, and estimate the frequency of needing further intervention.
Methods Procedural and lesion data on consecutive patients with LSLs who underwent EMR at a single tertiary referral center were prospectively collected. If pain after colonic EMR, graded using a visual analogue scale (VAS), lasted > 5 minutes, 1 g of paracetamol was administered. Pain lasting > 30 minutes lead to clinical review and upgrade to opiate analgesics. Investigations and interventions for pain were recorded.
Results 67/336 patients (19.9 %, 95 %CI 16.0 %–24.5 %) experienced pain after colonic EMR (median VAS 5, interquartile range 3–7). Multivariable predictors of pain were: lesion size ≥ 40 mm, odds ratio [OR] 2.15 (95 %CI 1.22–3.80); female sex, OR 1.99 (95 %CI 1.14–3.48); and intraprocedural bleeding requiring endoscopic control, OR 1.77 (95 %CI 0.99–3.16). Of 67 patients with pain, 51 (76.1 %, 95 %CI 64.7 %–84.7 %) had resolution of their “mild pain” after paracetamol and were discharged without sequelae. The remaining 16 (23.9 %) required opiate analgesia (fentanyl), after which 11/16 patients (68.8 %; “moderate pain”) could be discharged. The 5/67 patients (7.5 %) with “severe pain” had no resolution despite fentanyl; all settled during hospital admission (median duration 2 days), intravenous analgesia, and antibiotics.
Conclusion Pain after colonic EMR occurs in approximately 20 % of patients and resolves rapidly and completely in the majority with administration of intravenous paracetamol. Pain despite opiates heralds a more serious scenario and further investigation should be considered.
Derivatization of Dihydropyrrolidone-Thiadiazole Heterocyclic Compounds and an Evaluation of their Antibacterial and Anti-Biofilm Activities
Authors: Xuecheng Chen , Yanpeng Xiong , Zhijian Yu , Shiqing Han , Yue Luo , Yalan Peng , Zhong Chen 
Published: January 2023

AbstractDihydropyrrolidone-thiadiazole inhibitors targeting YycG histidine kinase have been designed, synthesized and evaluated for their antibacterial, bactericidal, anti-biofilm, cytotoxic and hemolytic activities, and for their ability to promote autophosphorylation. 4-(Benzofuran-2-carbonyl)-1-(5-(benzylthio)-1,3,4-thiadiazol-2-yl)-3-hydroxy-5-(2-hydroxyphenyl)-1,5-dihydro-2H-pyrrol-2-one exhibits the best bacteriostatic activity against Gram-positive bacteria such as S. epidermidis SE1457, MSSA SA113, and E. faecalis FB1 (MIC = 3.13–25 μM). Its antibacterial activity against methicillin-sensitive Staphylococcus aureus (MSSA) SA113 is comparable to that of linezolid. Most of the products exhibit good inhibitory effects against the biofilms of the tested strains. Among the products, three show strong inhibitory effects on the biofilm formation of S. epidermidis SE1457, MSSA SA113, and E. faecalis FB1, and their inhibition rates reach more than 90% at 6.25 μM. Cytotoxicity and hemolytic activity tests suggest that all the synthesized compounds have little effect on the growth of mammalian cells (Vero cells) and exhibit no hemolytic activity toward healthy human red blood cells.
Investigating Relations between the NICU Speech Environment and Weight Gain in Infants Born Very Preterm
Authors: Kumar Komal , Marchman Virginia A. , Morales Maya C. , Scala Melissa , Travis Katherine E. 
Published: January 2023

Objective Children born preterm, especially those born very preterm (<32 weeks of gestational age [GA]) are at risk for poor growth and adverse neurodevelopmental outcomes. Adverse growth and neurodevelopmental outcomes in preterm children have been attributed, in part, to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant to neurodevelopment. Few studies have examined whether natural variations in the speech environment of the NICU are related to short-term health outcomes in preterm infants. Such data are important for optimizing the sound environment of the NICU. Our objective was to examine relations between the NICU speech environment and the rate of weight gain during hospitalization.
Study Design Participants were infants born very preterm (n = 20). The speech environment of each infant was assessed at 32 to 36 weeks of postmenstrual age using an automatic speech-counting device. Average rates of weight gain (g/kg/d) were ascertained over the same period. Calories were derived from charted intake (kcals/kg/d). Linear regressions examined caloric intake and speech counts as predictors of infant weight gain.
Results Infant weight gain was significantly predicted by caloric intake and speech exposure, each uniquely accounting for approximately 27% variance (total R
2 = 60.2%; p < 0.001). Speech counts were uncorrelated with rates of family visitation, time in incubator, or health acuity.
Conclusion While future research should establish causality and direction of effects, enhancing speech exposure in the NICU may be beneficial for physical growth. NICU care plans should consider opportunities to increase speech exposure.
Key Points
Executive Function Assessment in 2-Year-Olds Born Preterm
Authors: Van den Brande Astrid , Bollen Bieke , Boets Bart , Naulaers Gunnar , Ortibus Els 
Published: January 2023

Abstract
Objective Our objective was to investigate the executive function and its relationship with gestational age, sex, maternal education, and neurodevelopmental outcome at 2 years corrected age in children born preterm.
Method Executive function was assessed by means of the Multisearch Multilocation Task (MSML), Reversed Categorization Task (RevCat), and Snack Delay Task (SDT). Infant and maternal characteristics were gathered from the child's record. The developmental outcome was measured by the Bayley Scales and a multidisciplinary risk evaluation for autism.
Results The executive function battery was completed by 97 children. The majority were able to successfully complete the MSML and SDT but failed RevCat. The lower the gestational age and the maternal education, the lower the executive function scores. Better cognition and motor function, as well as low autism risk, were associated with better executive function scores. Executive function was not related to sex.
Interpretation This cohort study provides evidence that it is feasible to assess executive function in 2-year-olds born preterm. Executive function is related to gestational age and maternal education and is positively correlated with behavioral outcome. Therefore, executive functions can be a valuable target for early intervention, resulting in improvements in neurodevelopmental outcomes in children born preterm.
Caudal Block versus Wound Infiltration for Inguinal Procedures in Young Children: A Randomized Clinical Study
Authors: Zundel Sabine , Conz Franziska , Fuchs Jörg , Blumenstock Gunnar , Guerrero-Rodrigues Aida , Grasshoff Christian , Schlisio Barbara 
Published: January 2023

Abstract
Introduction Inguinal procedures in children are frequent and typically performed in an outpatient setting. We aimed to analyze whether there is a difference in postoperative pain scores and setup time (start of anesthesia management to incision time) when comparing caudal block (CB) with local wound infiltration.
Materials and Methods We enrolled pediatric outpatients scheduled for inguinal procedures. Patients were randomized to receive either preincision CBs or end-of-procedure local wound infiltration. Postoperative pain scores until 24 hours postoperatively and setup time were analyzed.
Results Fifty-two patients were included in the study. Thirty patients received a CB, and 22 patients received local infiltration (LI). There was no significant difference in postoperative pain scores. Setup time was significantly higher in the CB group: median 22.5 minutes IQR (16–46 minutes) compared with 17 minutes in the LI group IQR (10–35 minutes), p-value of 0.0026.
Conclusion Both CB and LI result in good postoperative pain control after inguinal procedures in pediatric outpatients. Since LI is less time consuming and has lower risks for complications, we recommend this technique for inguinal procedures in pediatric outpatients. Our findings will need to be confirmed in larger cohorts, but we believe the evidence generated with this study has the potential to positively influence patient care, operating room efficiency, and costs.
Classification of Adverse Events in Adult Surgery
Authors: Kalt Fabian , Mayr Hemma , Gero Daniel 
Published: January 2023

AbstractSuccessful surgery combines quality (achievement of a positive outcome) with safety (avoidance of a negative outcome). Outcome assessment serves the purpose of quality improvement in health care by establishing performance indicators and allowing the identification of performance gaps. Novel surgical quality metric tools (benchmark cutoffs and textbook outcomes) provide procedure-specific ideal surgical outcomes in a subgroup of well-defined low-risk patients, with the aim of setting realistic and best achievable goals for surgeons and centers, as well as supporting unbiased comparison of surgical quality between centers and periods of time. Validated classification systems have been deployed to grade adverse events during the surgical journey: (1) the ClassIntra classification for the intraoperative period; (2) the Clavien–Dindo classification for the gravity of single adverse events; and the (3) Comprehensive Complication Index (CCI) for the sum of adverse events over a defined postoperative period. The failure to rescue rate refers to the death of a patient following one or more potentially treatable postoperative adverse event(s) and is a reliable proxy of the institutional safety culture and infrastructure. Complication assessment is undergoing digital transformation to decrease resource-intensity and provide surgeons with real-time pre- or intraoperative decision support. Standardized reporting of complications informs patients on their chances to realize favorable postoperative outcomes and assists surgical centers in the prioritization of quality improvement initiatives, multidisciplinary teamwork, surgical education, and ultimately, in the enhancement of clinical standards.
The Morbidity and Mortality Conference: A Century-Old Practice with Ongoing Potential for Future Improvement
Authors: de Vos Marit S. , Verhagen Merel J. , Hamming Jaap F. 
Published: January 2023

Abstract
Objective To discuss practical strategies to consider for morbidity and mortality conferences (M&M).
Materials and Methods This article reflects on (i) insights that can be drawn from the M&M literature, (ii) practical aspects to consider when organizing M&M, and (iii) possible future directions for development for this long-standing practice for routine reflection.
Results M&M offers the opportunity to learn from past cases in order to improve the care delivered to future patients, thereby serving both educational and quality improvement purposes. For departments seeking to implement or improve local M&M practice, it is difficult that a golden standard or best practice for M&M is nonexistent. This is partly because comparative research on different formats is hampered by the lack of objective outcome measures to evaluate the effectiveness of M&M. Common practical suggestions include the use of (i) a skillful and active moderator; (ii) structured formats for case presentation and discussion; and (iii) a dedicated committee to guide improvement plans that ensue from the meeting. M&M practice is affected by various sociological factors, for which qualitative research methods seem most suitable, but in the M&M literature these are sparsely used. Moreover, aspects influencing an open and blame-free atmosphere underline how local teams should tailor the format to best fit the local context and culture.
Conclusion This article presents practice guidance on how to organize and carry out M&M This practice for routine reflection needs to be tailored to the local setting, with attention for various sociological factors that are at play.
Impact of Social Vulnerability on Long-Term Growth Outcomes in Sutureless Versus Sutured Repair of Gastroschisis
Authors: Barry Mark , Gozali Aileen , Vu Lan 
Published: January 2023

Abstract
Introduction The purpose of this study is to describe the long-term growth and nutrition outcomes of sutureless versus sutured gastroschisis repair. We hypothesized that weight z-score at 1 year would be affected by social determinants of health measured by the U.S. Centers for Disease Control Social Vulnerability Index (SVI).
Materials and Methods We conducted a single-center retrospective review of patients who underwent gastroschisis repair (n = 97) from 2007 to 2018. Growth z-scores collected through 5 years of age and long-term clinical outcomes were compared based on the closure method and the type of gastroschisis (simple vs. complicated). Multiple regression analysis was performed to identify the impact of SVI themes and other covariates on weight for age z-score at 1 year.
Results In total, 46 patients underwent sutureless repair and 51 underwent sutured repair with median follow-up duration of 2.5 and 1.9 years, respectively. Weight and length z-scores decreased after birth but normalized within the first year of life. Growth and long-term clinical outcomes were similar regardless of the closure method, while patients with complicated gastroschisis had higher rates of hospitalizations, small bowel obstructions, and additional abdominal surgeries. Using multiple regression, both low discharge weight and high SVI in the “minority status and language” theme were associated with lower weight for age z-scores at 1 year (p = 0.003 and p = 0.03).
Conclusion Sutureless and sutured gastroschisis repairs result in similar growth and long-term outcomes. Patients living in areas with greater social vulnerability may be at increased risk of poor weight gain. Patients should be followed at least through their first year to ensure appropriate growth.
Fostering the learning of the Russian motion verbs system in Italian-speaking students
Authors: Comisso Elena , Della Putta Paolo 
Published: January 2023

AbstractThis study reports on the differential effectiveness of two pedagogical approaches to teaching L1-Italian students the Russian verbs of motion (глаголы движения, VoMs). The first is a Cognitive Linguistics, embodied approach, where the teacher used techniques such as image schemas, drawings and bodily activation to help the learners explore and understand the logic of VoMs. The second is a classic PPP approach, that works with mnemonic exercises, drills, and reproduction techniques, and that used classic metalinguistic terms to explain VoMs.54 L1-Italian Russian students enrolled at the second year of University have been recruited in the study. Two groups were created: group A received a 160 minutes embodied treatment about VoMs, whereas group B received a 160 minutes classical PPP treatment on VoMs.The informants have been tested in a classical pre, post and delayed-post test fashion with three different temporized tasks. Results show an accrued competence on VoMs of group A, that outperformed group B in all the tests. The relevance of these findings for L2 teaching will be discussed.
Enhancement of temperature-modulated NbO2-based relaxation oscillator via interfacial and bulk treatments
Authors: Ang Jia Min , Dananjaya Putu Andhita , Chow Samuel Chen Wai , Lim Gerard Joseph , Seet Chim Seng , Lew Wen Siang 
Published: January 2023

Abstract
This work demonstrates oscillation frequency modulation in a NbO2-based relaxation oscillator device, in which the oscillation frequency increases with operating temperature and source voltage, and decreases with load resistance. An annealing-induced oxygen diffusion at 373 K was carried out to optimize the stoichiometry of the bulk NbO2 to achieve consistent oscillation frequency shift with device temperature. The device exhibits stable self-sustained oscillation in which the frequency can be modulated between 2 and 33 MHz, and a wider operating voltage range can be obtained. An additional surface treatment step was employed during fabrication to reduce the surface roughness of the bottom electrode and to remove surface contaminants that affect the interfacial properties of the device. The device frequency tunability coupled with high oscillating frequency and high endurance capability of more than 1.5 × 108 cycles indicates that the Pt/NbO2/Pt device is particularly suitable for applications in an oscillatory neural network.
Arcsine law for random dynamics with a core
Authors: Nakamura Fumihiko , Nakano Yushi , Toyokawa Hisayoshi , Yano Kouji 
Published: January 2023

Abstract
In their recent paper, Hata and Yano (2021 Stoch. Dyn. 2350006) first gave an example of random iterations of two piecewise linear interval maps without (deterministic) indifferent periodic points for which the arcsine law—a characterization of intermittent dynamics in infinite ergodic theory—holds. The key in the proof of the result is the existence of a Markov partition preserved by each interval maps. In the present paper, we give a class of random iterations of two interval maps without indifferent periodic points but satisfying the arcsine law, by introducing a concept of core random dynamics. As applications, we show that the generalized arcsine law holds for generalized Hata–Yano maps and piecewise linear versions of Gharaei–Homburg maps, both of which do not have a Markov partition in general.
Systematic analysis of the quench process performance and simulation of the 9.4 T-800 mm whole-body MRI magnet
Authors: Chen Shunzhong , Wang Lei , Zhang Zili , Wang Yaohui , Wang Hui , Cheng Junsheng , Dai Yinming , Wang Qiuliang 
Published: January 2023

Abstract
In 2021, the Institute of Electrical Engineering, Chinese Academy of Sciences successfully reached 9.4 T in a whole-body magnetic resonance imaging (MRI) superconducting magnet with an inner diameter of 800 mm. In this study, a systematic analysis of both the real quench protection performance and a simulation are reported. The four successful quench protections during the entire energization process proved the feasibility of the ‘in-out-in’ quench protection protocol for a 9.4 T-800 mm superconducting magnet. The quench trigger sequence was shown to be adjusted by changing the heater thickness, which demonstrates the flexibility of the ‘in-out-in’ quench protection protocol to fit a different MRI magnet design. The high accuracy of the quench protection simulation method and code was confirmed through comparison of the simulation results with the real performance. Moreover, the limitations of the current quench protection and reference value to other MRI magnets were discussed. It is believed that this study will be useful to other research groups and promote the development of an extremely high-field whole-body MRI system.