bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus
Authors: Aljizeeri Ahmed , Ahmed Ahmed Ibrahim , Suliman Ihab , Alfaris Mousa Alali , Elneama Awadelkarim , Al-Mallah Mouaz H 
Published: February 2023

Abstract

Aims
We aimed to assess the incremental prognostic value of positron emission tomography (PET)-derived myocardial flow reserve (MFR) among patients with diabetes and those without diabetes.

Methods and results
Consecutive patients with clinically indicated PET MPI for suspected or established coronary artery disease (CAD) were included. Myocardial blood flow (MBF) in mL/min/g was obtained from dynamic images at rest and stress, while MFR was calculated as the ratio of stress to rest MBF. Patients were followed from the date of PET imaging for the occurrence of the primary outcome (composite of all-cause death, myocardial infarction, and un-planned percutaneous coronary intervention/coronary artery bypass graft occurring more than 90 days after imaging). The final cohort consisted of 6019 patients (63% with diabetes) (mean age 61 ± 11 years, 45% female, 55% obese, 76% hypertensive, and 62% dyslipidaemia). Over half (53%) of the patients had an impaired MFR (&lt;2). During a median follow-up of 22.6 (7.8–42.5) months, 619 patients (10%, 3.8 per 1000 person-years) experienced the primary outcome. Impaired MFR (MFR &lt; 2) was significantly associated with the primary outcome in patients with and without diabetes (diabetes: HR 1.8, 95% CI 1.4–2.3, P &lt; 0.001; no diabetes: 1.4, 95% CI 1.0–2.1, P = 0.046). There was no interaction between diabetes status and MFR (P = 0.234). Results were consistent across subgroups of patients with no CAD and normal perfusion study.

Conclusion
PET-derived MFR has a strong independent and incremental prognostic role in patients with diabetes and those without diabetes.
Mixed Hodge Structure on Local Cohomology with Support in Determinantal Varieties
Authors: Perlman Michael 
Published: February 2023

Abstract
We employ the inductive structure of determinantal varieties to calculate the mixed Hodge module structure of local cohomology modules with determinantal support. We show that the weight of a simple composition factor is uniquely determined by its support and cohomological degree. As a consequence, we obtain the equivariant structure of the Hodge filtration on each local cohomology module. Finally, as an application, we provide a formula for the generation level of the Hodge filtration on these modules.
Patterns of Screening Mammography and Breast MRI During the COVID-19 Pandemic: A Retrospective, Chart-Review Study
Authors: Sivanushanthan Shankarapryan , Wu Tianmin , Wahl Anastacia , Li Tengfei , Luta George , Song Judy H , O’Neill Suzanne , Conley Claire C 
Published: February 2023

Abstract

Objective
This study examined patterns of breast cancer screening during the COVID-19 pandemic.

Methods
This retrospective study was approved by the Georgetown University IRB. Review of electronic medical records identified screening mammograms and breast MRIs between March 13, 2018 and December 31, 2020, for female patients aged 18 to 85 years. Descriptive statistics characterized patterns of breast cancer screening before and during the COVID-19 pandemic. Logistic regression analyses examined whether receipt of breast MRI differed over time and demographic and clinical factors associated with receipt of breast MRI in 2020.

Results
Data included 47 956 mammography visits in 32 778 patients and 407 screening breast MRI visits in 340 patients. After an initial decrease following the declaration of the COVID-19 pandemic, both screening mammograms and screening breast MRI demonstrated early recovery. Although the mammography receipt remained sustained, the receipt of screening breast MRI decreased in late 2020. Odds of having a breast MRI did not differ between 2018 and 2019 (OR = 1.07; 95% CI = 0.92%–1.25%; P = 0.384) but were significantly lower in 2020 versus 2019 (OR = 0.76; 95% CI = 0.61%–0.94%; P = 0.011). No demographic or clinical factors were associated with receipt of breast MRI during the COVID-19 pandemic (all P-values ≥0.225).

Conclusion
Breast cancer screening decreased following the declaration of the COVID-19 pandemic. Although both procedures demonstrated early recovery, the rebound in screening breast MRI was not sustained. Interventions promoting return to screening breast MRI may be needed for high-risk women.
Effects of bioturbation by the fiddler crabLeptuca speciosa(Ives, 1891) (Decapoda: Brachyura: Ocypodidae) on mangrove peat in Barnes Sound, Florida, USA
Authors: Neely Samuel H 
Published: February 2023

AbstractBioturbation, which includes burrowing and foraging behaviors, is an important component of the functional role of fiddler crabs (Brachyura, Ocypodidae) within mangrove forests because it modifies sediment properties and composition of mangrove substrates. In this study, fiddler-crab population density and burrow architecture were measured to evaluate the influence of bioturbation by the fiddler crab Leptuca speciosa (Ives, 1891) on mangrove peat from Barnes Sound, Florida, USA. Measurements of burrow architecture were used to estimate the contribution of fiddler-crab burrowing to the bioturbation of mangrove peat. Comparisons were made between the total organic matter in bioturbated sediments, including feeding and burrowing pellets. A population density of 12 burrows m–2 was measured with no significant trends in the spatial distribution of fiddler crabs within the site. Although the deepest burrow depth was 18 cm, results show the upper 5 cm of the peat surface was consistently burrowed by crabs. Fiddler crabs were estimated to increase the total below-ground air-peat surface area m–2 by 5% and accounted for 22% of the excavated volume of mangrove peat per year. Fiddler crabs will thus rework the entire peat substrate within five years. Because data on carapace geometric mean size suggested that a juvenile population of L. speciosa was sampled, the bioturbation rate of the peat substrate will accelerate once this population matures. Feeding pellets had significantly lower percentages of total organic matter (P &lt; 0.01) than other bioturbated peat samples, suggesting that fiddler-crab foraging behaviors significantly (P &lt; 0.01) decrease the organic composition of surficial peats. These results imply that fiddler crab burrowing extends the depth of the taphonomically active zone thus enhancing mangrove peat decomposition and changing the bioavailability and distribution of organic matter in mangroves.
Translocation of aberrant right subclavian artery to the ascending aorta—a treatment for dysphagia lusoria
Authors: Chan Stephanie , Fermanis Gary 
Published: February 2023

AbstractGenerally, an aberrantly coursing right subclavian artery (ARSA), also known as ‘arteria lusoria’, is an incidental diagnosis of no clinical consequence. Where correction is indicated, popular practice is for decompression via staged percutaneous +/− vascular methods. Open/thoracic options for correction are not widely discussed. We report the case of a 41-year-old woman with dysphagia secondary to ARSA. Her vascular anatomy precluded staged percutaneous intervention. The ARSA was translocated to the ascending aorta via thoracotomy, utilizing cardiopulmonary bypass. Our technique is a safe option for low-risk patients with symptomatic ARSA. It obviates the need for staged surgery and removes the risk of carotid-to-subclavian bypass failure.
Clinical Approaches for Self-Injury
Authors: Lewis Stephen P. , Hasking Penelope A. 
Published: February 2023

Abstract
This chapter addresses the approaches most often used by clinicians when working with clients who engage in self-injury. It therefore begins by discussing the importance of rapport building, including ways to facilitate building a strong therapeutic alliance with individuals in clinical contexts. From here, it provides an overview of assessment recommendations, including domains that ought to be considered in the context of case formulation. This is followed by an overview of the intervention approaches commonly used to help individuals who self-injure. Also covered in this chapter are approaches that are typically not advised for use in clinical contexts. Collectively, the content is this chapter offers foundational information about how to address self-injury that is built on in Chapter 11, which discusses a person-centered framework with which to conceptualize self-injury, and then in Chapter 12, which discusses how recovery can be fostered by focusing on people’s strengths and resilience.
Building Resilience Through Recovery
Authors: Lewis Stephen P. , Hasking Penelope A. 
Published: February 2023

Abstract
Building on the model outlined in Chapter 11, this chapter discusses how resilience and strength can be realized through recovery. This involves addressing specific components of the framework presented in Chapter 11 and their role in fostering resilience. In doing so, the chapter addresses the need to be realistic about expectations for recovery and the importance of considering residual scarring, future self-injury disclosures, ongoing coping, and finding strengths within the ongoing process of recovery. We aim to offer concrete, practical strategies that therapists, family and friends, and individuals with lived experience of self-injury can use to help foster the recovery process.
Advocating for a Person-Centered, Strengths-Based Approach
Authors: Lewis Stephen P. , Hasking Penelope A. 
Published: February 2023

Abstract
Building on prior chapters, the final chapter in this book focuses on advocacy—in particular, how a person-centered approach can be imbued and accordingly realized in the field. To this end, it initially touches on lived experience initiatives in other areas. It then segues to a discussion of some of the different barriers that may impede such work. From here, it highlights why this work is nonetheless needed, followed by an overview of the current state of the literature concerning lived experience work in the field of self-injury. To conclude, the chapter brings attention to practical ways that address many of the previously mentioned barriers and thus articulate how a person-centered approach, which centers people’s lived experience, can be accomplished in research, clinical work, and outreach efforts.
Adopting a mentalizing approach to evaluating outcomes
Authors: Fuggle Peter , Fairbairn James , Oriol-Sanchez Anna 
Published: February 2023

Abstract
Evaluation is central to the AMBIT approach as an open system that is continually being developed and amended on the basis of the experience of workers and clients. Understanding the impact of the work on clients is a key part of the AMBIT quadrant Learning at Work. Given that AMBIT is designed to be applied to different professional groups working in different contexts, developing an evaluation approach has challenges. This chapter describes best practice in relation to outcome measurements in AMBIT, proposing five methods to create the conditions for evaluating in a mentalizing way. The chapter also reports the outcomes findings from existing AMBIT studies, and lastly proposes a new framework for outcome evaluation.
Pain and COVID-19
Authors: de Andrade Daniel Ciampi 
Published: February 2023

Abstract
This chapter presents the case of a woman who complains of persistent pain in the four limbs that started after intensive care unit (ICU) discharge due to COVID-19 infection. She fulfills criteria for Guillain–Barré syndrome, but her clinical picture may have been worsened by ICU stay. This case shows that Guillain–Barré syndrome is possible after COVID-19 and may induce neuropathic pain. Other potential causes of pain after COVID-19 mainly include post-ICU neuromuscular disorders for severe cases and long COVID syndrome. These consist of a constellation of symptoms, including headache or widespread pain, fatigue, respiratory or cardiovascular problems, and sleep disorders. These symptoms, which share similarities with other post-infectious disorders, might result from residual damage from acute infection, persistent immune activation, psychological factors, or unmasking of prior comorbidities.
Perineal Pain
Authors: Attal Nadine , Bouhassira Didier 
Published: February 2023

Abstract
This chapter presents the case of a man who reports chronic perineal pain, described as neuropathic (burning and stabbing), which started after intensive horseback riding and cycling. Pain involves the right genitals only, is increased by sitting, and is alleviated by standing. This is characteristic pudendal entrapment syndrome (Alcock syndrome), the most common cause of pudendal neuralgia. Management is difficult, and there are no international guidelines. Pudendal neuralgia corresponds to a peripheral neuropathic pain and as such may necessitate similar antineuropathic drugs as other neuropathic pains. Pudendal nerve blocks may have a diagnostic value in this context, and they may sometimes induce long-term benefit.
A Lightning in the Face
Authors: Truini Andrea , de Stefano Gianfranco 
Published: February 2023

Abstract
This chapter presents the case of an old woman who suffers from facial pain characterized by intense attacks, limited to the right side of the face, involving the cheek, upper and lower lips, and the underlying gums, lasting fractions of a seconds, and sometimes occurring in bursts. Her clinical picture is typical of trigeminal neuralgia. Diagnosis is clinical, but a magnetic resonance imaging scan or complete trigeminal reflex testing is mandatory to exclude major neurological diseases. First-line therapy is medical and includes carbamazepine or oxcarbazepine. If the occurrence of side effects prevents the patient from reaching the effective dosage, a neurosurgical referral should be considered.
Red Feet and Hands
Authors: Bennett David LH , Themistocleous Andreas 
Published: February 2023

Abstract
This chapter presents the case of a young woman who suffers from red burning feet since the age of 1 year, triggered by warmth and relieved by cooling. Clinical examination shows no sensory impairment, tendon reflexes are normal, and there is no motor deficit, but there is clear erythema of the feet. Pain is poorly relieved by codeine and acetaminophen. Erythromelalgia is a rare condition characterized by episodic burning pain and erythema of the distal extremities, aggravated by warmth and exercise. The diagnosis is clinical. Primary erythromelalgia is genetic, and oral mexiletine or topical lidocaine may be helpful. Secondary causes include myeloproliferative diseases, autoimmune disorders, small fiber neuropathy, vasodilated drugs, and collagen disorders/joint hypermobility.
Transcutaneous Electrical Nerve Stimulation
Authors: Attal Nadine , Bouhassira Didier 
Published: February 2023

Abstract
This chapter presents a case of a man with chronic sciatica and localized pain area at the leg who has not tolerated prior drug medications. Due to the necessity to maintain intellectual and professional activity because he is an active lawyer, transcutaneous electrical nerve stimulation (TENS) is a relevant therapeutic option. The efficacy of TENS has been shown (weak level) in peripheral neuropathic pain, the best indications being painful radiculopathy, painful neuropathies, and post-traumatic/postsurgical nerve lesions with circumscribed pain area. Safety and tolerability are excellent. TENS may also be used to conduct transcutaneous vagus nerve stimulation. TENS may be recommended as stand-alone therapy or add on to other treatments.
Peripheral Nerve Stimulation and Pulsed Radiofrequency
Authors: Attal Nadine , Bouhassira Didier 
Published: February 2023

Abstract
This chapter presents the case of a woman with occipital neuralgia and severe, paroxysmal, shooting pain who is refractory to conservative treatment, including nerve blocks and antineuropathic drugs. She is therefore a good candidate for peripheral nerve stimulation and, to a lesser extent, pulsed radiofrequency. The best potential indication for peripheral nerve stimulation is refractory peripheral neuropathic pain involving one nerve territory, although the level of evidence for efficacy remains low. Occipital nerve stimulation has been mainly studied in occipital neuralgia, migraine, and cluster headache. Pulsed radiofrequency works by delivering a targeted electrical field to the dorsal root ganglion and has been found effective mainly in thoracic postherpetic neuralgia and cervical radiculopathy, with a moderate quality of evidence.
Fast-Breathing Baby
Authors: Puri Ajay K. , Rattan Mantosh S. , McGuire Melissa A. 
Published: February 2023

Abstract
Neonatal respiratory distress is a leading cause of admission to neonatal intensive care units. As such, it is paramount that the emergency physician be familiar with the initial stabilization of neonates and understand the various pathologies that lead to respiratory distress in this patient population. Signs and symptoms suggesting neonatal respiratory distress include tachypnea, tachycardia, grunting, stridor, chest wall retractions, cyanosis, and apnea. It is important to stabilize the respiratory status of the infant with supplemental oxygen, noninvasive positive pressure ventilation, or endotracheal intubation prior to proceeding with diagnostics. More common conditions leading to respiratory distress include transient tachypnea of the newborn, pneumonia, neonatal respiratory distress syndrome, meconium aspiration syndrome, and pneumothorax. Uncommon conditions include tracheoesophageal fistulas (TEF) with esophageal atresia, congenital diaphragmatic hernias, and congenital heart disease.
Breathing through a Straw
Authors: Pizzitola Gina , Teng David , Assaad Peter 
Published: February 2023

Abstract
This chapter reviews a selection of imaging modalities (plain films and CT) to evaluate the child with stridor and details the signs that can be expected in different etiologies, including croup, foreign body aspiration, epiglottitis, and retropharyngeal abscess. It reviews when you may need to obtain imaging in a child originally suspected to have croup. It describes radiographic signs associated with stridor, including steeple sign, thumb sign, and prevertebral widening. Finally, it details the potential advantages of CT scan over plain films when evaluating retropharyngeal abscess.
What a Pain in the Neck
Authors: Sperandeo Michael , Sreedher Gayathri 
Published: February 2023

Abstract
Cervical spine injuries are challenging to diagnose based on clinical assessment alone for even the most seasoned pediatric emergency medicine physician. Traumatic cervical spine injuries in the pediatric population are quite rare; however, when present they have the potential for devastating neurological outcomes. Unlike adults, no well validated clinical assessment tool exists for pediatric patients. When imaging is obtained, what may appear as pathologic to the unseasoned eye may in reality be a normal variant, non-pathological, or normal growth pattern. On the other hand, detection of cervical spine injuries may be very subtle, and in some cases can only be identified on MRI. Any child presenting with abnormal vital signs, altered mental status, or an abnormal neurological exam should be assumed to have a cervical spine injury. Maintaining cervical spine precautions and obtaining prompt imaging and specialist evaluation are indicated when stable and in the appropriate clinical setting.
How to answer multiple-choice questions (MCQs)
Authors: Hill Sue 
Published: February 2023

Abstract
The multiple-choice questions (MCQs) in the European Diploma in Anaesthesiology and Intensive Care examination (EDAIC) are of the multiple true-false type (MTF). It is essential to understand the difference between these MTFs and the more commonly encountered one-from-five type of question. Preparation is essential and should cover the entire curriculum of the EDAIC. A strategy for answering questions during the exam is needed and should be practised beforehand. There is no penalty for guessing, so all questions should be answered. Paper A tests knowledge of Basic Science, while Paper B covers Clinical Practice. Basic Science has three sections: physiology; pharmacology; physics, equipment, methods of measurement and statistics. Clinical Practice will cover general anaesthesia, regional anaesthesia, and specialty areas of anaesthesia including chronic pain, intensive care, internal medicine, and emergency medicine. Each of these papers consists of 60 MCQ questions.
General anaesthesia
Authors: Varvinskiy Andrey , Hill Sue 
Published: February 2023

Abstract
This chapter provides 25 practice multiple-choice questions (MCQs) about general anaesthesia and the associated model answers, alongside references for more in-depth understanding. The chapter concentrates on the questions associated with providing general anaesthesia in both elective and emergency settings for patients treated in hospital and as a day case. The questions on the pre-operative assessment are also included in this chapter as well as the questions covering several types of critical incidents occurring during general anaesthesia. The latter questions are mainly based on the published guidelines (provided in the references) and require good understanding and detailed reading in order to answer them well.
Applied physiology
Authors: Ringvold Else-Marie , Varvinskiy Andrey 
Published: February 2023

Abstract
This chapter provides five examples of structured oral examination questions (SOEs) on applied physiology along with model answers and references to help you increase your knowledge and depth of understanding. One of the applied physiology questions, often related to cardiac or respiratory physiology, will be the first question for the first SOE of the Part II examination. You will receive a short introduction to the topic to be examined and pointers as to how the question will develop and be given ten minutes to prepare before you enter the examination hall. The list of questions given in each of the example SOEs here will not all appear in the introduction you receive, but you should make sure you think about the topic, draw any diagrams that you know will be useful to help demonstrate your understanding and anticipate what additional questions might be asked. You will take your preparatory work with you, so make your diagrams large enough for the examiners to see from across the exam table. Following this first question, you will be asked additional questions on applied physiology, which you will not have prepared, covering other areas of physiology of importance to the anaesthetist.
General anaesthesia
Authors: Ringvold Else-Marie , Zerafa Mario 
Published: February 2023

Abstract
This chapter provides six examples of structured oral examination questions (SOEs) on general anaesthesia along with model answers.The questions are in three pairs, each pair simulating the format of the first two questions of the EDAIC’s SOE 3 which deals with anaesthetic practice and pain management. The lead-in statement is what you would be given ten minutes before the start of the examination. This is meant to let you become familiar with the scenario and start making a management plan which includes a thorough pre-op evaluation and optimization and then the eventual intra-op anaesthetic management and post-op care plan.