bluuebunny/crossref_metadata_2025_split huggingface dataset:
Head/neck pain characteristics after spontaneous cervical artery dissection in the acute phase and on a long-run
Authors: Mayer-Suess Lukas , Frank Florian , Töll Thomas , Boehme Christian , Gizewski Elke R , Ratzinger Gudrun , Broessner Gregor , Kiechl Stefan , Knoflach Michael 
Published: March 2022

Objective Head/neck pain is one of the primary symptoms associated with spontaneous cervical artery dissection. Still, data on pain quality, intensity, and long-term dynamics are scarce. Methods Spontaneous cervical artery dissection subjects were included if mural hematoma was visualised through T1 fat-saturated MRI at baseline. All available medical records were evaluated and patients were invited to standardised clinical follow-up visits at least 1 year after the index event. Results In total, 279 subjects were included in the ReSect-study with head/neck pain being the most frequent symptom of spontaneous cervical artery dissection (220 of 273, 80.6%). Pain was of pulling nature in 107 of 218 (49.1%), and extended to the neck area in 145 of 218 (66.5%). In those with prior headache history, pain was novel in quality in 75.4% (42 of 55). Median patient-reported pain intensity was 5 out of 10 with thunderclap-type headache being uncommon (12 of 218, 5.5%). Prior to hospital admission, head/neck pain rarely responded to self-medication (32 of 218, 14.7%). Characteristics did not differ between subjects with and without cerebral ischemia. Pain resolved completely in all subjects within a median of 13.5 days (IQR 12). Upon follow-up in 42 of 164 (25.6%) novel recurring headache occurred, heterogeneous in quality, localisation and intensity. Conclusion We present an in-depth analysis of spontaneous cervical artery dissection-related head/neck pain characteristics and its long-term dynamics.
Experience with Pediatric Neurology e-Consults from a Specialist Perspective at an Academic Center
Authors: Abu Libdeh Amal , Flanigan Joseph , Heinan Kristen 
Published: March 2022

Introduction E-consults improve access to specialty expertise and increase satisfaction for patients and Primary Care Providers (PCPs). Pediatric neurology may be perceived as less amenable to e-consults compared to other specialties. Methods We performed a retrospective analysis of e-consults performed by pediatric neurologists at the University of Virginia. We reviewed the electronic medical records and analyzed the content of e-consults, recommendations from specialists, and subsequent actions by PCPs. Results Between April 2019 and April 2021, 58 e-consults were performed by pediatric neurologists. Most common indications included spells, headache, and tremor. In 56.9% of cases, the answer was provided without recommending a face-to-face (FTF) visit. For patients seen in clinic, e-consults reduced wait time and facilitated the clinic visit. Discussion E-consults are a suitable option for pediatric neurology, and they help with the workflow. Further education is needed to improve utility of e-consults in pediatric neurology.
The Use of Simulation Based Learning: With Bachelor of Science Pharmaceutical Science and PharmD Students
Authors: Gold Justin L. , Chichester Amanda M. , Chichester Clinton O. 
Published: March 2022

Background and purpose Interprofessional education between bachelor of science pharmaceutical science (BSPS) students and Doctor of Pharmacy (PharmD) students is rare. According to the Association of American Medical Colleges, more than 80% of medical schools incorporate simulation based teaching within all four years of the curriculum. Educational activity and setting: The University of Rhode Island College of Pharmacy healthcare simulation lab has developed integrated educational opportunities for both groups of students by offering independent study opportunities that allow BSPS students to collaborate with PharmD students. A recent example of this model includes BSPS student development of patient cases which are integrated into high-fidelity human patient simulators with faculty assistance. A senior BSPS student researched and designed four clinical patient cases which were presented to P3 pharmacy students. Findings: In all four cases, there was an increase in knowledge and attitudes following the simulation. Qualitative comments from students noted the importance of patient education and an enhanced ability to manage disease and side effects. Summary: The nature of the simulation lab at the University of Rhode Island is a platform that can be modeled by other institutions with both PharmD and BSPS programs.
The outcomes of a novel two-stage proximal brachial artery to proximal basilic/brachial vein arteriovenous graft extension for dialysis access
Authors: Tabbara Marwan , Manzur-Pineda Karen , Labove Hannah , Sanchez Priscilla G , Martinez Laisel , Vazquez-Padron Roberto , Duque Juan C 
Published: March 2022

Background: We describe a technique to mature a basilic/brachial vein in the mid-arm in preparation for a second stage loop proximal brachial artery to basilic/brachial vein arteriovenous graft (BBAVG). This can occur after a failed basilic/brachial vein transposition or a lack of adequate veins in the distal arm. This allows a mature vein to be used in an end-to-end configuration as an outflow to a BBAVG while preserving proximal vessels for the future. Methods: This single-center retrospective study was performed from 2015 to 2021, including 104 AVG patients divided into three groups: (1) Patients who failed a basilic vein transposition and had an enlarged vein suitable for an AVG outflow; (2) Patients who had a small caliber basilic/brachial vein after the transposition, requiring a mid-arm brachial artery to brachial/basilic arteriovenous fistula (AVF) creation with a subsequent AVG extension; (3) and lastly, patients who had no distal arm veins available and required a primary brachial artery to basilic/brachial AVF with AVG extension. A survival analysis was performed looking at time to loss of primary and secondary patency, calculated with Kaplan-Meier estimates and Cox regression models adjusted for covariates. Results: The median follow-up time was 11 months (IQ = 11–30 months). The survival analysis showed 28% lost primary patency at a median time of 9 months, and 14% lost secondary patency at a median time of 61 months. Overall secondary patency of the vascular access measured at 12 months was 85.6%. Loss of primary ( p = 0.008) and secondary patency ( p = 0.017), as well as patency during the first 12 months ( p = 0.036), were all significantly associated with increased age when adjusting for covariates. Conclusions: Our results suggest that the graft extension technique using a mature vein from a previous fistula can result in reliable and durable access. This is important for patients with limited access for hemodialysis, as the axillary vein is preserved for future use if needed.
The importance of social media users’ responses in tackling digital COVID-19 misinformation in Africa
Authors: Stewart Ruth , Madonsela Andile , Tshabalala Nkululeko , Etale Linda , Theunissen Nicola 
Published: March 2022

Objective Digital technologies present both an opportunity and a threat for advancing public health. At a time of pandemic, social media has become a tool for the rapid spread of misinformation. Mitigating the impacts of misinformation is particularly acute across Africa, where WhatsApp and other forms of social media dominate, and where the dual threats of misinformation and COVID-19 threaten lives and livelihoods. Given the scale of the problem within Africa, we set out to understand (i) the potential harm that misinformation causes, (ii) the available evidence on how to mitigate that misinformation and (iii) how user responses to misinformation shape the potential for those mitigating strategies to reduce the risk of harm. Methods We undertook a multi-method study, combining a rapid review of the research evidence with a survey of WhatsApp users across Africa. Results We identified 87 studies for inclusion in our review and had 286 survey respondents from 17 African countries. Our findings show the considerable harms caused by public health misinformation in Africa and the lack of evidence for or against strategies to mitigate against such harms. Furthermore, they highlight how social media users’ responses to public health misinformation can mitigate and exacerbate potential harms. Understanding the ways in which social media users respond to misinformation sheds light on potential mitigation strategies. Conclusions Public health practitioners who utilise digital health approaches must not underestimate the importance of considering the role of social media in the circulation of misinformation, nor of the responses of social media users in shaping attempts to mitigate against the harms of such misinformation.
The Perceived Risk of Hospitalization in Primary Health Care – The Importance of Multidimensional Assessment
Authors: Santos Sara , Veiga Pedro Mota , Paúl Constança 
Published: March 2022

Ageing has increased the use of health services, with a corresponding rise in avoidable hospitalizations. We aimed to assess and characterize the perceived risk of hospitalization in primary health care (PHC). 118 individuals aged ≥65 years, PHC patients, were assessed using the Community Risk Assessment Instrument by their General Practitioner, who identified their perceived risk of hospitalization, at one year. The instrument is composed of three domains (mental state, daily living activities (ADLs) state and medical state). Multivariate logistic regression was used to identify the best model to predict the risk of hospitalization. Four models were estimated, one for each domain and one with all the variables of the instrument. 58.5% were identified as being at risk of hospitalization. The best predictive models are those that include functionality assessment variables (ADL model and Community Assessment of Risk Instrument model). The model that includes all the variables of three domains presents the best predictive value. Mobility problems (Odds Ratio (OR) 16.18 [CI: 1.63–160.53]), meal preparation (OR 10.93 [CI: 1.59–75.13]), communication (OR 6.91 [CI: 1.37–34.80]) and palliative care (OR 4.84 [CI: 1.14–20.58]) are the best predictors of hospitalization risk. The use of multidimensional assessment tools can allow the timely identification of people at risk, contributing to a reduction in hospitalizations.
Long‐term Follow‐up of Cytologically Indeterminate Thyroid Nodules Found Benign on Molecular Testing: A Validation Study
Authors: White Michelle K. , Thedinger William B. , Dhingra Jagdish K. 
Published: March 2022

ObjectiveMolecular testing has revolutionized management of indeterminate thyroid nodules (Bethesda categories III and IV). Few studies have attempted to validate the negative predictive value of molecular tests. Using long‐term observation as a surrogate for surgical resection, we sought to examine the false‐negative rate of “benign” indeterminate thyroid nodules on molecular testing.Study DesignCase series with retrospective data collection and chart review.SettingLarge community‐based practice with multiple satellite offices.MethodsAll patients with thyroid nodules that underwent ultrasound‐guided fine‐needle aspiration biopsy between 2013 and 2019 were evaluated through retrospective analysis. Cytologically indeterminate nodules reflexively underwent molecular testing to guide clinical management. Observation was recommended for lesions with benign molecular testing, and these nodules were followed clinically and by ultrasound.ResultsA total of 2011 nodules underwent fine‐needle aspiration, of which 280 (14%) were indeterminate thyroid nodules. Of those 280 nodules, 100 (36%) were benign on molecular testing. Three samples were excluded from analysis due to patient deaths from unrelated causes. Surgical resection was recommended in 16 of the 97 nodules (17%), with the majority due to size and compressive symptoms. Histopathology was available in 14 nodules that underwent surgery, with 1 demonstrating minimally invasive follicular carcinoma.ConclusionWhile molecular testing is safe to use in guiding management of indeterminate thyroid nodules, consideration of individualized clinical factors and close long‐term follow‐up remains paramount.
Effects of cadmium contamination on bacterial and fungal communities in Panax ginseng-growing soil
Authors: Sun Hai , Shao Cai , Jin Qiao , Li Meijia , Zhang Zhenghai , Liang Hao , Lei Huixia , Qian Jiaqi , Zhang Yayu 
Published: March 2022

Abstract
Background
Cadmium (Cd) contamination in soil poses a serious safety risk for the development of medicine and food with ginseng as the raw material. Microorganisms are key players in the functioning and service of soil ecosystems, but the effects of Cd-contaminated ginseng growth on these microorganisms is still poorly understood. To study this hypothesis, we evaluated the effects of microorganisms and Cd (0, 0.25, 0.5, 1.0, 2.0, 5.0, and 10.0 mg kg-1 of Cd) exposure on the soil microbial community using Illumina HiSeq high-throughput sequencing.

Results
Our results indicated that Cd-contaminated soil affected the soil microbial diversity and composition, and bacterial diversity was affected more than fungal diversity in Cd-contaminated soil, especially according to Shannon indices. The abundance of the soil microbial community decreased and the composition changed according to the relative abundances at the phylum level, including those of Saccharibacteria and Gemmatimonadetes in bacteria and Mortierellomycota in fungi. The LEfSe algorithm was used to identify active biomarkers, and 45 differentially abundant bacterial taxonomic clades and 16 differentially abundant fungal taxonomic clades were identified with LDA scores higher than 4.0. Finally, a heatmap of Spearman's rank correlation coefficients and canonical discriminant analysis (CDA) indicated that some key biomarkers, Arenimonas, Xanthomonadales, Nitrosomonadaceae, Methylophilales, Caulobacterales, Aeromicrobium, Chitinophagaceae, Acidimicrobiales, Nocardioidaceae, Propionibacteriales, Frankiales, and Gemmatimonadaceae, were positively correlated with the total and available Cd (p<0.05) but negatively correlated with AK, AP, and pH (p<0.05) in the bacterial community. Similarly, in the fungal community, Tubaria, Mortierellaceae, and Rhizophagus were positively correlated with the total and available Cd but negatively correlated with AK, AP, TK, and pH.

Conclusion
Cd contamination significantly affected microbial diversity and composition in ginseng-growing soil. Our findings provide new insight into the effects of Cd contamination on the microbial communities in ginseng-growing soil.
Adjusting for verification bias in diagnostic accuracy measures when comparing multiple screening tests - an application to the IP1-PROSTAGRAM study
Authors: Day Emily , Eldred-Evans David , Prevost A. Toby , Ahmed Hashim U. , Fiorentino Francesca 
Published: March 2022

AbstractIntroductionNovel screening tests used to detect a target condition are compared against either a reference standard or other existing screening methods. However, as it is not always possible to apply the reference standard on the whole population under study, verification bias is introduced. Statistical methods exist to adjust estimates to account for this bias. We extend common methods to adjust for verification bias when multiple tests are compared to a reference standard using data from a prospective double blind screening study for prostate cancer.MethodsBegg and Greenes method and multiple imputation are extended to include the results of multiple screening tests which determine condition verification status. These two methods are compared to the complete case analysis using the IP1-PROSTAGRAM study data. IP1-PROSTAGRAM used a paired-cohort double-blind design to evaluate the use of imaging as alternative tests to screen for prostate cancer, compared to a blood test called prostate specific antigen (PSA). Participants with positive imaging (index) and/or PSA (control) underwent a prostate biopsy (reference standard).ResultsWhen comparing complete case results to Begg and Greenes and methods of multiple imputation there is a statistically significant increase in the specificity estimates for all screening tests. Sensitivity estimates remained similar across the methods, with completely overlapping 95% confidence intervals. Negative predictive value (NPV) estimates were higher when adjusting for verification bias, compared to complete case analysis, even though the 95% confidence intervals overlap. Positive predictive value (PPV) estimates were similar across all methods.ConclusionStatistical methods are required to adjust for verification bias in accuracy estimates of screening tests. Expanding Begg and Greenes method to include multiple screening tests can be computationally intensive, hence multiple imputation is recommended, especially as it can be modified for low prevalence of the target condition.
Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
Authors: Abassa Kodjo-Kunale , Wu Xiao-Ying , Xiao Xiu-Ping , Zhou Hao-Xiong , Guo Yun-Wei , Wu Bin 
Published: March 2022

Abstract
Background and aims
Although coexisting alcohol-induced liver disease and hepatitis B or C virus-induced liver cirrhosis (ALD + HBV or ALD + HCV) has been the center of recent hepatology researches, numerous controversies still persist. This study aimed to showcase the influence of alcohol on the laboratory values and on the clinical outcomes of patients with hepatitis B and C virus-induced liver cirrhosis.

Methods
Patients diagnosed with liver cirrhosis (n = 22,287) from January 2010 to December 2019 were enrolled, and divided into five groups according to the etiology: alcohol-induced liver disease (ALD, 1652 cases), hepatitis B virus (HBV, 18,079 cases), hepatitis C virus (HCV, 682 cases), ALD + HBV (1594 cases) and ALD + HCV (280 cases). Laboratory results and proportion of different liver cirrhosis complications were contrasted between groups.

Results
The proportions of patients with Child Pugh grade C (28.0% vs 18.8%, P < 0.001) or MELD greater than 18 (24.1% vs 18.5%, P < 0.001) in the ALD + HBV group exceeded significantly those in the HBV group. Multivariate logistic regression revealed that the risk of hepatocellular carcinoma (HCC) and that of esophageal gastric variceal bleeding (EGVB) in the ALD + HBV group was respectively 2.01-fold and 1.74-fold that in the HBV group (HCC: OR = 2.01, 95% CI [1.58–2.55]; EGVB: OR = 1.74, 95% CI [1.30–2.33]) after adjusting for potential confounders. Furthermore, a linear-by-linear analysis test showed a decrease in the risk of HCC and EGVB with the duration of alcohol abstinence. Moreover, patients with both antiviral treatment and alcohol abstinence had the lowest risk of HCC and EGVB (HCC: OR = 0.10, 95% CI [0.05–0.20], P < 0.001; EGVB: OR = 0.17, 95% CI [0.06–0.45], P < 0.001) compared to those without any treatment, those with abstinence alone and those with antiviral therapy alone. Similar pattern was noticed while comparing the ALD + HCV group to the HCV group.

Conclusion
Heavy alcohol use increased the severity of liver function impairment and the prevalence of HCC and EGVB in hepatitis virus-induced liver cirrhosis patients. Remarkably, long-term alcohol abstinence coupled with antiviral treatment effectively decreased the risk of HCC and EGVB in these populations.
Epidemiological characterization of Clonorchis sinensis infection in humans and freshwater fish in Guangxi, China
Authors: Xie Yihong , Kanankege Kaushi S. T. , Jiang Zhihua , Liu Shun , Yang Yichao , Wan Xiaoling , Perez Andres M. 
Published: March 2022

Abstract
Background
Clonorchiasis is a widespread yet neglected foodborne disease with over 85% of all cases found in China. Guangxi province, located in southeastern China, ranks among the highest endemic provinces. We explore the epidemiological status and determinants of Clonorchis sinensis (C. sinensis) infection in humans and freshwater fish in Guangxi, China.

Methods
Data on C. sinensis infection in humans from January 2008 to December 2017were extracted from the China Information System for Disease Control and Prevention. An active surveillance of C. sinensis infection in fish was conducted in 2016–2017. County level data including potential environmental, social-economical and behavioral determinants was also collected. Univariate and multivariate logistic regression models were used to explore the determinants of C. sinensis infection in humans and fish. Simple and multiple zero-inflated Poisson regression models were fit to assess the associated factors of clonorchiasis in humans at the county level.

Results
Totally, 4526 C. sinensis cases were reported between 2008 and 2017, with an annual prevalencerate of 0.96/100,000 persons. Of 101 counties in Guangxi, 97 reported at least 1 case. Among 2,098 fish samples, 203 (9.7%) from 70 counties contained C. sinensis. The rate was higher in small fish including Pseudorasbora parva (45.3%), Misgurnus anguillicaudatus (41.2%), Hemicculter leuciclus (34.5%), unclassified small fishes (30.9%), Cyprinidae (20.0%), Cirrhinus molitorella (16.4%), Carassius auratus (13.6%) and Cyprinus carpio (13.3%), while it was lower in fish species that are usually used in preparing raw fish dishes including Ctenopharyngodon idellus (3.6%), Spinibarbus denticulatus (3.7%), Monopterus albus (6.4%), Cyprinus carpio (4.4%), Oreochromis mossambicus (3.3%) and Spualiobarbus Curriculus (6.6%). The C. sinensis infection in fish was only associated with fish species. The estimated human clonorchiasis prevalence at the county level was positively associated with raw fish consumption habits and certain rivers.

Conclusions
Clonorchiasis is highly prevalent in both humans and freshwater fish in Guangxi. Environmental, social-economic and behavioral determinants contribute to the high prevalence as well as the significant differential distribution by county. Regular surveillance should be implemented for clonorchiasis to demonstrate the change in epidemiology and burden, which will benefit the design of interventions.