bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Outcomes of Bicuspid Aortic Valve in Patients With Aneurysmal Sub‐Arachnoid Hemorrhage: A Prospective Neurology Registry Report
Authors: Vallabhajosyula Saarwaani , Yang Li‐Tan , Thomas Sarah C. , Maleszewski Joseph J. , Boler Amber N. , Thapa Prabin , Enriquez‐Sarano Maurice , Rabinstein Alejandro A. , Michelena Hector I. 
Published: April 2022

Background
Intracranial aneurysms are reported in 6%–10% of patients with bicuspid aortic valve (BAV), and routine intracranial aneurysm surveillance has been advocated by some. We assessed the prevalence and features of the most important patient‐outcome: aneurysmal sub‐arachnoid hemorrhage (aSAH), as compared with controls without aSAH, and tricuspid aortic valve (TAV) with aSAH.

Methods and Results

Adult patients with accurate diagnosis of aSAH and at least one echocardiogram between 2000 and 2019 were identified from a consecutive prospectively maintained registry of aSAH admissions. Controls without a diagnosis of SAH were age‐ and sex‐matched. BAV prevalence was confirmed echocardiographically. Severity of aSAH was categorized using modified Fisher and World Federation of Neurological Scale. Neurologic outcome was assessed using modified Rankin score. A total 488 aSAH cases and 990 controls were identified and BAV status was confirmed. Prevalence of BAV in patients with aSAH was 1.2% (6/488) versus 3.5% (35/990) in controls,
P
=0.01. BAV+aSAH were noted to be younger than TAV+aSAH (56±11 versus 68±14;
P
=0.03) with smaller aneurysms (5±2 versus 7±4;
P
=0.31). The severity of aSAH was lesser in BAV+aSAH than TAV (modified Fisher grade>2 50% versus 74%;
P
=0.19, World Federation of Neurological Scale grade>3 17% versus 36%;
P
=0.43). BAV+aSAH had less severe neurologic disability (modified Rankin score 3%–6 33% versus 49% in TAV;
P
=0.44) and comparable in‐hospital mortality rates (
P
=0.93). BAV had lower odds for aSAH on multivariate analysis (odds ratio 0.23[CI 0.08–0.65];
P
=0.01).

Conclusions
Prevalence of BAV was 3 times lower in the aSAH registry than in controls without aSAH. BAV+aSAH had clinically smaller aneurysms, clinically smaller bleeds, and better neurologic outcome as compared with TAV+aSAH, which needs to be confirmed in larger studies. These findings argue against routine surveillance for intracranial aneurysms in patients with BAV without aortic coarctation.
Health Care Use of Cardiac Specialty Care in Children With Muscular Dystrophy in the United States
Authors: Mejia Erika J. , Lin Kimberly Y. , Okunowo Oluwatimilehin , Iacobellis Katherine A. , Matesanz Susan E. , Brandsema John F. , Wittlieb‐Weber Carol A. , Katcoff Hannah , Griffis Heather , Edelson Jonathan B. 
Published: April 2022

Background
Duchenne and Becker muscular dystrophy are progressive disorders associated with cardiac mortality. Guidelines recommend routine surveillance; we assess cardiac resource use and identify gaps in care delivery.

Methods and Results
Male patients, aged 1 to 18 years, with Duchenne and Becker muscular dystrophy between January 2013 and December 2017 were identified in the IBM MarketScan Research Database. The cohort was divided into <10 and 10 to 18 years of age. The primary outcome was rate of annual health care resource per person year. Resource use was assessed for place of service, cardiac testing, and medications. Adjusted incidence rate ratios (IRRs) were estimated using a Poisson regression model. Medication use was measured by proportion of days covered. There were 1386 patients with a median follow‐up time of 3.0 years (interquartile range, 1.9–4.7 years). Patients in the 10 to 18 years group had only 0.40 (95% CI, 0.35–0.45) cardiology visits per person year and 0.66 (95% CI, 0.62–0.70) echocardiography/magnetic resonance imaging per person year. Older patients had higher rates of inpatient admissions (IRR, 1.46; 95% CI, 1.03–2.09), outpatient cardiology visits (IRR, 2.0; 95% CI, 1.66–2.40), cardiac imaging (IRR, 1.59; 95% CI, 1.40–1.80), and Holter monitoring (IRR, 3.33; 95% CI, 2.35–4.73). A proportion of days covered >80% for angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers was observed in 13.6% (419/3083) of total person years among patients in the 10 to 18 years group.

Conclusions
Children 10 to 18 years of age have higher rates of cardiac resource use compared with those <10 years of age. However, rates in both age groups fall short of guidelines. Opportunities exist to identify barriers to resource use and optimize cardiac care for patients with Duchenne and Becker muscular dystrophy.
Association Between Beta-Blocker or Statin Drug Use and the Risk of Hemorrhage From Cerebral Cavernous Malformations
Authors: Zuurbier Susanna M. , Hickman Charlotte R. , Rinkel Leon A. , Berg Rebecca , Sure Ulrich , Al-Shahi Salman Rustam ,   for the Scottish Audit of Intracranial Vascular Malformations Steering Committee and Collaborators
Published: April 2022

Background:
We aimed to determine the association between beta-blocker or statin drug use and the future risk of symptomatic intracranial hemorrhage or persistent/progressive focal neurological deficit from cerebral cavernous malformations (CCM).

Methods:
The population-based Scottish Audit of Intracranial Vascular Malformations prospectively identified adults resident in Scotland first diagnosed with CCM during 1999 to 2003 or 2006 to 2010. We compared the association between beta-blocker or statin drug use after first presentation and the occurrence of new intracranial hemorrhage or persistent/progressive focal neurological deficit due to CCM for up to 15 years of prospective follow-up. We confirmed proportional hazards and used survival analysis with multivariable adjustment for age, intracranial hemorrhage at CCM presentation, and brain stem CCM location.

Results:

Sixty-three (21%) of 300 adults used beta-blockers (27/63 [43%] used propranolol), and 73 (24%) used statin drugs over 3634 person-years of follow-up. At baseline, the only statistically significant imbalances in prespecified potential confounders were age by statin use and intracranial hemorrhage at presentation by beta-blocker use. Beta-blocker use was associated with a lower risk of new intracranial hemorrhage or persistent/progressive focal neurological deficit (adjusted hazard ratio, 0.09 [95% CI, 0.01–0.66];
P
=0.018). Statin use was associated with a nonsignificant lower risk of intracranial hemorrhage or persistent/progressive focal neurological deficit (adjusted hazard ratio, 0.37 [95% CI, 0.01–1.07];
P
=0.067).

Conclusions:
Beta-blocker, but not statin, use was associated with a lower risk of intracranial hemorrhage or persistent/progressive focal neurological deficit in patients with CCM.
The effect of a games-based intervention on wellbeing in adolescent girls
Authors: Murphy John , Sweeney Mary Rose , McGrane Bronagh 
Published: April 2022

Objective: To examine the impact of a self-determination theory-informed school-based lunchtime games intervention on wellbeing and symptoms of anxiety and depression among adolescent girls in Ireland. Design: Non-randomised controlled intervention design. Method: This self-determination theory-informed intervention consisted of lunchtime games for girls aged 13 ± 0.7 years, 3 days a week. After a 2-week ‘sampling’ period, students self-selected to 0, 1, 2 or 3 days of lunchtime games. Intervention and control groups were compared by pre- and post-testing. Participants were included in the intervention design via a survey to ascertain the most popular games and activities at the outset. Results: Participating in games twice a week led to significant decreases ( p < .01) in symptoms of anxiety and depression while the control group showed significant increases ( p < .01) in symptoms of anxiety and depression. Mental wellbeing significantly ( p < .01) increased among those who participated two and three times a week. Increases in mental wellbeing were similar in effect size to increases in self-efficacy. Conclusion: Higher frequencies of physical activity led to increased mental health. Self-efficacy may act as an underlying mechanism for increases in mental health through physical activity.
Evaluation of a road safety educational programme for senior elementary school students in Cambodia: A pilot study
Authors: An Bomi , Yang Sook Ja 
Published: April 2022

Purpose: Road accidents are the leading cause of non-disease-related deaths among teenagers in Cambodia. However, Cambodian schools continue to lack road safety education programmes and standardised guidelines. This study evaluated the effects of a customised comprehensive road safety educational programme for older elementary school students in Cambodia. Design: We conducted a road safety educational programme at an elementary school in Cambodia. The programme consisted of seven parts and included content related to pedestrian and vehicle (car, motorcycle and bike) safety. Methods: We used a mixed method to evaluate changes in knowledge, attitudes and practices following the programme. For the quantitative evaluation, we conducted a quasi-experimental study using a nonequivalent control group pre-test–post-test design involving 52 students. The experimental group comprised fourth graders (aged 10 years) and the control group consisted of fifth graders (aged 11 years). For the qualitative evaluation, we conducted focus group interviews with six participants from the experimental group. Results: Post-test road safety knowledge ( Z = −2.79; p = .005) and attitudes ( Z = −2.05, p = .041) improved significantly in the experimental group. Qualitatively, three themes were identified: participants acquired new insights into road safety, they adopted more positive attitudes and they made an effort to practise road safety. Conclusion: This pilot study demonstrated a possible positive effect of a road safety educational programme, suggesting that, following additional verification, it could be used to improve road safety for older elementary school students in Cambodia.
‘The apocalypse’: A qualitative pilot study of the psychological aftermath of the 2020 Beirut blast
Authors: El Hajj Magalie 
Published: April 2022

Background: There has been very limited data describing the psychological aftermath of the Beirut blast. Aims: This qualitative pilot study aimed to explore the psychological and physical reactions to the trauma experienced by Beirut blast survivors, as well as their coping strategies. Methods: From November 2020 to February 2021, in-depth, semi-structured interviews were conducted with eight Lebanese citizens who were within a 4 km radius of the Beirut port at the time of the explosion. A thematic analysis was adopted. Results: Three themes were identified: (1) the blast; (2) life after the blast: extended trauma; (3) coping strategies. First, almost all participants vividly remembered the moment of the blast and referred to it as a turning point in their lives. They also remembered being on an emotional rollercoaster, feeling physically numb, worried about another explosion and finding God in the midst of tragedy. Second, all participants reported several negative experiences in their post-blast life, which may have enhanced/prolonged their trauma, including losses of different kinds (of a country, home, loved ones, hope, safety/security, culture and heritage), the cumulative impact of the blast, the impossibility to ever return to ‘normality’, persistent survival guilt and somatisation. Lastly, different coping strategies were adopted to deal with trauma, such as talking it out, establishing a consistent daily routine, helping the community, overworking and detachment. Conclusions: This study highlights the many layers of psychological suffering of Beirut blast survivors in the current context of collective distress dominating Lebanon.
Gendered racial microaggressions, internalized racism, and suicidal ideation among emerging adult Asian American women
Authors: Keum Brian TaeHyuk , Wong Michele J. , Salim-Eissa Rangeena 
Published: April 2022

Background: Despite suicide being the leading cause of death among emerging adult Asian American women (AAW), little is known about the risk factors. Aim: We tested whether gendered racial microaggressions stress (GRMS) would be associated with AAW’s suicidal ideation, and whether internalized racism (self-negativity, IRSN; weakness stereotypes, IRWS; and appearance bias, IRAB) would exacerbate this link based on self-devaluating implications of internalized racism. Method: Using a sample of 309 AAW ( Mage = 20.00, SD = 6.26), we conducted a moderated logistic regression with GRMS predicting suicidal ideation (endorsement or no endorsement) and the three internalized racism factors (IRSN, IRWS, and IRAB) as moderators. Results: GRMS significantly predicted suicidal ideation with a threefold increase in the odds of suicidal ideation. Only IRSN significantly exacerbated this link at low to mean levels. Conclusion: Gendered racial microaggressions is likely a risk factor for suicidal ideation among AAW, particularly for those who internalize negative images of themselves as Asian individuals.
Diversity Wanted! Utilizing Transdisciplinary Scholarship on Structural Inequality to Educate Psychology Graduate Students
Authors: Gómez Jennifer M. 
Published: April 2022

Introduction The scholarship of teaching and learning (SoTL) should promote diversity, equity, inclusion, and social justice for the next generation of psychologists. Statement of the Problem I worry that the SoTL propagates an exclusionary field that becomes increasingly irrelevant in our diverse society given that graduate curricula largely exclude scholarship on structural inequality. Literature Review I detail the process of graduate curricular changes in my current department, with a focus on my new required graduate course, Diversity, Systems, and Inequality. I utilize scholarship from law, sociology, philosophy, women and gender studies, education, and psychology. Teaching Implications I provide the structure and content of the course—including syllabi and lecture slides—as well as modes of assessment that promote inclusivity and critical thinking. I detail how current faculty can learn to incorporate the content of this work into their own teaching and scholarship through weekly journal clubs. Conclusion SoTL outlets can publish transdisciplinary, inclusive course materials regarding structural inequality, thus mainstreaming and amplifying such work for the benefit of the field and our world.
Association Between Mean Platelet Volume, Platelet Count, and Distribution Width With Depth of Invasion in Oral Cancers
Authors: Demir Berat , Abuzaid Ghazi 
Published: April 2022

Introduction: To examine the potential predictive roles of the preoperative mean platelet volume (MPV), platelet count (PC), and platelet distribution width (PDW) in patients with oral cancer and their association with the depth of invasion (DOI). Methods: This retrospective study included 122 patients (66 males, 56 females) diagnosed with oral cancer between January 2009 and January 2015 by our Otolaryngology Department. At diagnosis, the mean age was 64.6 ± 13.9 years. The average follow-up period was 39.2 ± 23.9 months. Results: We found significant differences in all parameters (PDW, MPV, PC) based on the positivity of the lymph node and the tumor stage. The mean PDW, MPV, and PC were significantly higher in the exitus group than in the survivor group ( P = .010, .036, and .047, respectively). In patients with high PDW, we observed a lower progression-free survival. We observed that PDW had a significant impact on the recurrence of the disease. Platelet distribution width, MPV, and PC were significant prognostic factors. A high PDW increased fatality 4.1 times, and a high MPV increased fatality 4.7 times ( P = .040 and .032, respectively). We found in a univariate analysis that tumor grade, PDW, MPV, and PC were predictive factors for fatality. On multivariate analysis, we found that MPV, PC, and predictors were independent of tumor grade. We observed an association between MPV and DOI. Conclusion: High PC, MPV, and PDW could be meaningful prognostic predictors for low survival rates. Mean platelet volume appears to be a more effective marker because it is associated with the DOI and prognosis. However, further research is required to confirm our findings.
Preoperative Predictors of Free Flap Failure
Authors: Stevens Madelyn N. , Freeman Michael H. , Shinn Justin R. , Kloosterman Nicole , Carr Shane , Mannion Kyle , Rohde Sarah L. 
Published: April 2022

AbstractObjectiveMicrovascular free tissue transfer is an important reconstructive option for defects of the head and neck. The present study aims to identify preoperative patient‐ and tumor‐specific characteristics, laboratory values, and other risk factors associated with early free flap failure.Study DesignRetrospective cohort study of 1070 patients.SettingHead and neck surgical oncology service at a tertiary care center from 2005 to 2019.MethodsDemographics, comorbidities, preoperative laboratory values, treatment history, and cancer stage were collected for consecutive patients who underwent free flap reconstruction of the head and neck and experienced early free flap failure (<8 days from surgery).ResultsIn 1070 patients, the prevalence of early free flap failure was 3.8% (n = 41). Female sex (odds ratio [OR], 2.58; 95% CI, 1.36‐4.99), presence of peripheral vascular disease (OR, 2.78; 95% CI, 1.05‐6.57), and elevated preoperative platelet count (OR, 2.67; 95% CI, 1.20‐5.47) were independently associated with risk of early free flap failure.ConclusionFemale sex, peripheral vascular disease, and preoperative thrombocytosis are all strong predictors of early free flap failure. This suggests that hypercoagulability and poor vessel quality may predispose patients to flap loss. Patients with elevated platelets or peripheral vascular disease warrant careful reconstructive decision making and close monitoring in the perioperative period.
Repeat Fine‐Needle Aspiration With Molecular Analysis in Management of Indeterminate Thyroid Nodules
Authors: Papazian Michael R. , Dublin Jared C. , Patel Kepal N. , Oweity Thaira , Jacobson Adam S. , Brandler Tamar C. , Givi Babak 
Published: April 2022

AbstractObjectiveTo analyze clinical outcomes in a series of indeterminate thyroid nodules (ITNs) with repeat fine‐needle aspiration (FNA) biopsy and results of genomic classifier.Study DesignHistorical chart review.SettingTertiary care center.MethodsWe reviewed FNA samples from subjects with Bethesda III or IV diagnoses from January 2015 to December 2018 at a single institution and selected those with repeat FNA and ThyroSeq testing of the same nodule. Patient demographics, Bethesda classifications, ThyroSeq results, treatment detail, and surgical pathology, when available, were analyzed.ResultsNinety‐six patients with cytologic diagnosis of ITN, repeat FNA, and ThyroSeq testing were identified. Following repeat FNA, 55 nodules (57%) remained ITN; 40 (42%) were reclassified as benign; and 1 (1%) was reclassified as suspicious for malignancy. In 31 patients with ThyroSeq analysis accompanying initial and repeat FNA, 26 (84%) had the same result on each, while 5 (16%) tested ThyroSeq positive following an initially negative result (κ = 0.24). Most nodules that were downgraded to Bethesda II on repeat FNA (37/40, 93%) were managed nonsurgically. Patients with ThyroSeq‐positive results were treated with surgery more often (25/28, 89%) than patients with ThyroSeq‐negative results (11/68, 16%; P < .0001). In excised nodules, the prevalence of malignancy and noninvasive follicular thyroid neoplasm with papillary‐like nuclear features was 28% (n = 10) and 22% (n = 8), respectively, and all malignancies were low risk.ConclusionIn this case series, repeat FNA helped patients with ITNs avoid diagnostic surgery through reclassification to benign cytology. The risk of high‐risk malignancy in ThyroSeq‐positive nodules with repeat indeterminate cytology was low.
Cell saver blood transfusions may be associated with a decrease in inflammation and improved outcome measures in pediatric cardiac surgery patients
Authors: Martinez Michael J , Schwingshackl Andreas , Romero Tahmineh , Roach Gavin D , Belperio John A , Federman Myke D 
Published: April 2022

Objective Cardiopulmonary bypass (CPB) is a requisite for correction of congenital heart disease by open-heart surgery and induces a systemic inflammatory response that can lead to complications such as acute lung injury and acute kidney injury. In addition, blood transfusions are commonly required for this type of surgery, and they may further exacerbate this inflammatory response and increase morbidity and mortality. We hypothesized that, in contrast to red blood cells, intraoperative cell saver (CS) blood transfusions attenuate the post-CPB proinflammatory cytokine response. Methods Serum cytokine concentrations of IL-10, IL-1RA, IL-6, IL-8, and TNF-α were measured at four time points (preoperatively and postoperatively on postoperative days 0, 1, and 2). Results Anti-inflammatory IL-10 levels were significantly lower in the CS group on POD 0 than in the control group (mean 1083.2 pg/mL vs 2080.2 pg/mL, 95%CI 357.4–1636.6, p = .0026). Of the clinical parameters measured, mean BUN and creatinine levels on POD 2 were significantly lower in the CS group (13.79 vs 21.88, p = .004 and 0.45 vs 0.55, p = .055, respectively). In addition, the duration of milrinone use decreased by 80% in the CS group (0.20, 95%CI 0.04, 0.94; p = .048), the median time to extubation in hours was significantly lower in the CS group (3.5 vs 6.5; 95%CI −38.00, −0.50; p = .026), and hospital length of stay was decreased by 60% in the CS group ( p = .003). Conclusions CS transfusions in children may lower postoperative anti-inflammatory IL-10 levels, possibly due to an overall decrease in proinflammatory state, and may be associated with improvements in renal and pulmonary functions.
On the hoard of money and expanded reproduction
Authors: Saratchand C 
Published: April 2022

The paper incorporates the hoard of money in a simple three-department scheme of expanded reproduction. The sui-generis features of the hoard of money are briefly set out. The paper then demonstrates that due to the existence of the hoard of money, it is possible for there to be generalised over-production of all non-money commodities. The paper concludes with some suggestions for further work in this research direction.JEL classifications: B14, B24, B51, E11.