bluuebunny/crossref_metadata_2025_split huggingface dataset:
How I manage myeloproliferative neoplasm‐unclassifiable: Practical approaches for 2022 and beyond
Authors: McLornan Donal P. , Hargreaves Rupen , Hernández‐Boluda Juan Carlos , Harrison Claire N. 
Published: February 2022

AbstractMyeloproliferative neoplasm (MPN)‐unclassifiable (MPN‐U) or not otherwise specified represents a rare, poorly defined and heterogeneous group of MPNs. Disease incidence is difficult to define but likely represents close to 5% of all MPNs when strict World Health Organisation (WHO) criteria are applied. Dynamic review over time is required to assess if the disease can be re‐classified into another MPN entity. A diagnosis of MPN‐U leads to many challenges for both the patient and physician alike including lack of agreed monitoring and therapeutic guidelines, validated prognostic markers and licenced therapies coupled with exclusion from clinical trials. MPN‐U has an inherent risk of an aggressive clinical course and transformation in some but who, and when to treat in the chronic phase, including identifying who may require more aggressive therapy at an earlier stage, remains elusive. Moreover, despite the significant thrombotic risk, there is no agreement on systematic primary thromboprophylaxis. We hereby provide a contemporary overview of MPN‐U in addition to four illustrative cases providing our collective suggested approaches to clinical challenges.
Reduced fracture incidence in patients having surgery for primary hyperparathyroidism
Authors: Nilsson Martin , Ståhl Elin , Åkesson Kristina E , Thier Mark , Nordenström Erik , Almquist Martin , Bergenfelz Anders 
Published: February 2022

AbstractObjectiveThe indication of surgery in primary hyperparathyroidism has been controversial, as many patients experience mild disease. The primary aim was to evaluate fracture incidence in a contemporary population‐based cohort of patients having surgery for primary hyperparathyroidism. The secondary aim was to investigate whether preoperative serum calcium, adenoma weight or multiglandular disease influence fracture incidence.DesignA retrospective cohort study with population controls. Primary outcomes, defined by discharge diagnoses and prescriptions, were any fracture and fragility fracture, secondary outcomes were multiple fractures anytime and osteoporosis. Subjects were followed 10 years pre‐ and up to 10 years postoperatively (or 31 December 2015). Multiple events per subject were allowed. Fracture incidence rate ratios (IRRs) for patients pre‐ and postoperatively were tabulated and evaluated with mixed‐effects Poisson regression. Secondary outcomes were evaluated using conditional logistic regression.PatientsA Swedish nationwide cohort of patients having surgery for primary hyperparathyroidism (n = 5009) from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery between 2003 and 2013 was matched with population controls (n = 14,983). Data were cross‐linked with Statistics Sweden and the National Board of Health and Welfare.MeasurementsPreoperative serum calcium and adenoma weight at pathological examination.ResultsPatients had an increased incidence rate of any fracture preoperatively, IRR 1.27 (95% confidence interval: 1.11–1.46), highest in the last year before surgery. Fracture incidence was not increased postoperatively. Serum calcium, adenoma weight and multiglandular disease were not associated with fracture incidence.ConclusionsFracture incidence is higher in patients with primary hyperparathyroidism but is normalized after surgery.
How to manage Graves’ disease in women of childbearing potential
Authors: Ashkar Claudia , Sztal‐Mazer Shoshana , Topliss Duncan J. 
Published: February 2022

AbstractThe management of Graves’ disease (GD) in women of childbearing potential has multiple specific complexities. Many factors are involved, which differ at the various stages from preconception, conception, first trimester, later pregnancy, postpartum and lactation, with both maternal and foetal considerations. The incidence and significance of the risks incurred from antithyroid drugs (ATDs) in pregnancy have been re‐evaluated recently and must be balanced against the risks of uncontrolled hyperthyroidism during childbearing years. Contraception is advised until hyperthyroidism is controlled. ATD cessation should be considered in those who are well controlled on low dose therapy before conception and in early pregnancy. Advice on iodine supplementation does not generally differ in those with GD. Radioiodine (RAI) is contraindicated from 6 months preconception until completion of breastfeeding. In all women who have a history of GD, monitoring of TSH receptor antibodies (TRAb) is strongly recommended during pregnancy, and if elevated, foetal monitoring and assessment of thyroid function in the neonate are required. Of note, RAI increases TRAb for up to a year, making this treatment option even less attractive in this patient group. A small amount of ATD is transferred into breast milk but low doses are safe during lactation. Routine periodic thyroid function testing is recommended in remission to detect postpartum GD recurrence. We present our approach to the Clinical Question ‘How to manage GD in women of childbearing potential?’
Impact of the COVID‐19 pandemic on acute otolaryngology inpatient activity at a tertiary referral centre: A retrospective analysis
Authors: Deekonda Praveena , Mirza Adal Hussain , Jones Huw 
Published: February 2022

AbstractObjectiveTo determine the impact of the COVID‐19 pandemic on acute admissions and inpatient activity at a tertiary referral centre.DesignRetrospective review of coding‐based inpatient electronic records.SettingAn otolaryngology and head and neck surgery department at a major UK trauma and tertiary referral centre.ParticipantsOtolaryngology patients admitted as an emergency over a period of 10 months pre‐COVID19 (01/04/2019‐23/01/2020) and 10 months post‐COVID19 (01/04/2020‐23/01/2021).Main outcome measuresBaseline characteristics, admission rates, length of stay (LoS), overall mortality and 30‐day mortality.ResultsA total of 1620 records were reviewed; (1066 pre‐COVID19, 554 post‐COVID19). Admissions across all age groups were reduced, with an increase in mean age from 39.88 to 47.4 years (p = .018). LoS remained unchanged (3.85 vs 3.82 days, p = .160). Infection remained the most common presentation, followed secondly by epistaxis which entailed an increased LoS compared to the pre‐COVID19 cohort. GP referrals reduced from 18.3% to 4.2% (n = 195 vs n = 23, p < .001) and ED referrals proportionally increased from 71.9% to 85.9% (n = 766 vs n = 476, p < .001). Critical care admissions were higher in the post‐COVID19 cohort (OR 1.78 (1.07–2.98) [95% CI], p = .027).There was no significant difference in overall mortality between groups (n = 60, 5.6% vs. n = 33, 6.0%; p = .844). Thirty‐day mortality increased from 0.9% (n = 12) pre‐COVID19 to 2.3% (n = 13) post‐COVID19 (p = .039).ConclusionsThis study demonstrates significant changes and a reduction in acute otolaryngology presentations. Our findings may suggest that sicker, frailer patients were admitted during the pandemic. This study reports the observational effect that the pandemic has had on acute otolaryngology admissions, which may be relevant in addressing unmet care needs in the post‐pandemic period.
Neural correlates of inhibitory control and associations with cognitive outcomes in Bangladeshi children exposed to early adversities
Authors: Sullivan Eileen F. , Xie Wanze , Conte Stefania , Richards John E. , Shama Talat , Haque Rashidul , Petri William A. , Nelson Charles A. 
Published: February 2022

AbstractThere is strong support for the view that children growing up in low‐income homes typically evince poorer performance on tests of inhibitory control compared to those growing up in higher income homes. Unfortunately, the vast majority of the work documenting this association has been conducted in high‐income countries. It is not yet known whether the mechanisms found to mediate this association would generalize to children in low‐ and middle‐income countries, where the risks of exposure to extreme poverty and a wide range of both biological and psychosocial hazards may be greater. We examined relations among early adversity, neural correlates of inhibitory control, and cognitive outcomes in 154 5‐year‐old children living in Dhaka, Bangladesh, an area with a high prevalence of poverty. Participants completed a go/no‐go task assessing inhibitory control and their behavioral and event‐related potential responses were assessed. Cortical source analysis was performed. We collected measures of poverty, malnutrition, maternal mental health, psychosocial adversity, and cognitive skills. Supporting studies in high‐income countries, children in this sample exhibited a longer N2 latency and higher P3 amplitude to the no‐go versus go condition. Unexpectedly, children had a more pronounced N2 amplitude during go trials than no‐go trials. The N2 latency was related to their behavioral accuracy on the go/no‐go task. The P3 mean amplitude, behavioral accuracy, and reaction time during the task were all associated with intelligence‐quotient (IQ) scores. Children who experienced higher levels of psychosocial adversity had lower accuracy on the task and lower IQ scores.
Yield, nutrient quality and water and phosphorus recovery efficiencies of alfalfa under different drip irrigation and phosphorus levels in Northern Xinjiang, China
Authors: Li Shengyi , Liu Xuanshuai , Sun Yanliang , Ma Chunhui , Gu Xinli , Zhang Qianbing 
Published: February 2022

AbstractRational water and fertiliser management have an important impact on alfalfa production. This research aimed to explore the effects of water and phosphorus (P) fertiliser on water‐use efficiency (WUE) and phosphorus‐recovery efficiency (PRE) of each cut of alfalfa under drip irrigation and to determine the optimal interaction ratio of water and phosphorus to improve the quality and yield of alfalfa. Different irrigation levels were set, i.e., 5250, 6000 and 6750 m3/ha (referred to as W1, W2, W3, respectively), and P fertiliser levels (0, 50, 100 and 150 kg/ha P2O5 referred to as P0, P1, P2, P3, respectively) were set to determine the hay yield and nutrient quality of each cut of alfalfa under drip irrigation. The hay yield of each cut of alfalfa increased first and then decreased with increased P fertiliser under the same irrigation amount. WUE decreased gradually with an increasing amount of irrigation under the same P application rate. The WUE of alfalfa increased first and then decreased with the increase of P application rate under the same irrigation amount, and WUE was 0.20%–4.75% (2016) and 1.31%–6.22% (2017) higher in the P treatments than in the non‐phosphorus treatments. PRE decreased gradually with increasing P application rate under the same irrigation amount. Therefore, we concluded that moderate irrigation (6000 m3/ha) and P fertiliser (100 kg/ha) optimised WUE, PRE, hay yield and nutrient quality.
Effect of fertilization and plant protection treatments on seed yield and seed quality of orchardgrass (Dactylis glomerata L.)
Authors: Gaier Lukas , Krautzer Bernhard , Graiss Wilhelm , Klingler Andreas , Poetsch Erich M. 
Published: February 2022

AbstractThe propagation and seed multiplication of site‐adapted and drought‐tolerant grass varieties are essential to provide high‐quality forage in temperate grasslands. A field experiment was conducted from 2016–2019 on orchardgrass (Dactylis glomerata L.) in the province of Styria, Austria. Treatment effects of sulfur, fungicide application and a plant growth regulator, singly and in combination, on seed yield and its reproduction parameters were tested under two different fertilizer nitrogen management systems (single application [N1] and split application [N2]). In terms of seed yield, a combination of all treatments compared to fertilization‐only treatment showed a significant increase of 22% under N2 fertilization. In terms of the thousand seed weight, the fungicide treatments and a combination of all treatments performed significantly better than other treatments within N1 and N2. The use of fungicide and a combination of all treatments also significantly increased the germination capacity in N1. Therefore, a combination of all plant protection treatments is recommended to optimize seed yield, thousand seed weight and germination capacity.
Sensitivity analysis of the flash flood hazard by coupling variable fuzzy method and mutual entropy
Authors: Wang Haofang , Yun Ruan , Zhang Jincun , Zhao Ranhang 
Published: February 2022

AbstractWatershed characteristics are one of the crucial factors affecting watershed hydrologic processes. Watershed hydrologic process regulation has been shown to be an effective tool for flash flood management. This study aims to propose a coupling method to evaluate the flash flood hazard degree of small hilly ungauged watersheds based on their watershed characteristic factors and identify sensitive factors influencing flash flood hazard. In this regard, nine watershed characteristic factors were selected for flash flood hazard sensitivity analysis. The variable fuzzy method (VFM) was proposed to calculate the eigenvalue of flash flood hazard degree for each small hilly watershed, and mutual entropy was proposed to identify sensitive factors influencing hazard degree. As an example, the sensitive factors in Licheng County with 119 small hilly watersheds in China are identified and further verified by stepwise regression analysis, which are mean watershed slope, soil moisture, average width of the mainstream, and watershed shape factor. This study shows that VFM and mutual entropy can be used jointly to identify the sensitive factors associated with the flash flood hazard in small hilly ungauged watersheds. The results can be used for engineering measure management in flash flood hazard control.
The COVID‐19 pandemic's impact on worry and medical disruptions reported by individuals with chromosome 22q11.2 copy number variants and their caregivers
Authors: White L. K. , Crowley T. B. , Finucane B. , Garcia‐Minaur S. , Repetto G. M. , van den Bree M. , Fischer M. , Jacquemont S. , Barzilay R. , Maillard A. M. , Donald K. A. , Gur R. E. , Bassett A. S. , Swillen A. , McDonald‐McGinn D. M. 
Published: February 2022

AbstractBackgroundThe world has suffered immeasurably during the COVID‐19 pandemic. Increased distress and mental and medical health concerns are collateral consequences to the disease itself. The Genes to Mental Health (G2MH) Network consortium sought to understand how individuals affected by the rare copy number variations of 22q11.2 deletion and duplication syndrome, associated with neurodevelopmental/neuropsychiatric conditions, were coping. The article focuses on worry and disruptions in medical care caused by the pandemic.MethodsThe University of Pennsylvania COVID‐19 Stressor List and care disruption questions were circulated by 22 advocacy groups in English and 11 other languages.ResultsA total of 512 people from 23 countries completed the survey; most were caregivers of affected individuals. Worry about family members acquiring COVID‐19 had the highest average endorsed worry, whilst currently having COVID‐19 had the lowest rated worry. Total COVID‐19 worries were higher in individuals completing the survey towards the end of the study (later pandemic wave); 36% (n = 186) of the sample reported a significant effect on health due to care interruption during the pandemic; 44% of individuals (n = 111) receiving care for their genetic syndrome in a hospital setting reported delaying appointments due to COVID‐19 fears; 12% (n = 59) of the sample reported disruptions to treatments; and of those reporting no current disruptions, 59% (n = 269) worried about future disruptions if the pandemic continued. Higher levels of care disruptions were related to higher COVID‐19 worries (Ps < 0.005). Minimal differences by respondent type or copy number variation type emerged.ConclusionsWidespread medical care disruptions and pandemic‐related worries were reported by individuals with 22q11.2 syndrome and their family members. Reported worries were broadly consistent with research results from prior reports in the general population. The long‐term effects of COVID‐19 worries, interruptions to care and hospital avoidance require further study.
Understanding the emotional landscape in the withdrawer re‐engagement and blamer softening EFCT change events
Authors: Myung Hannah S. , Furrow James L. , Lee Nicholas A. 
Published: February 2022

AbstractThe heart of change in emotionally focused couple therapy (EFCT) involves accessing key emotions and using them to redefine the self and create new relational responses. Two EFCT change events, withdrawer re‐engagement and blamer softening, represent the emotion and relationship restructuring process with couples who are stuck in blame‐withdraw interactions. These change events involve facilitating greater accessibility, responsiveness, and emotional engagement between more avoidant and anxious partners. This study tracked in‐session emotional states and sequences in each of these change events. Findings highlight the importance of primary and softer emotional expressions. Specific emotional states characterize the two EFCT change events with adaptive grief/hurt being unique to withdrawer re‐engagement and rejecting anger distinguishing blamer softening. Sequential patterns of emotional states were identified particularly for withdrawer re‐engagement where grief/hurt was followed by acceptance and agency. Clinical implications consider the role of emotional transformation and emotional expansion in the EFCT change process.
Accuracy of Digital Impressions at Varying Implant Depths: An In Vitro Study
Authors: Sequeira Vivia , Harper Matthew T. , Lilly Christa L. , Bryington Matthew S. 
Published: February 2022

AbstractPurposeImplants placed at variable depths may vary the amount of visible scannable surface of a scan body. Intraoral scanner technology uses advanced optical principles to record the surface of the scan body to accurately capture the implant position. The purpose of this study is to investigate the effect implant placement depth has on the accuracy of digital implant impressions using an intraoral scanner.Materials and methodsA partially edentulous gypsum master model was fabricated to allow the positioning of a single implant analog at different depths. Four groups were created based on the planned implant depths of 7, 6, 3, and 0 mm and corresponding visibility of the scan body at 2, 3, 6, and 9 mm. The model was digitized with a laboratory scanner for the reference scan and with an intraoral scanner to generate 15 test scans per group, with a total of 60 scans. The test scans were superimposed onto the reference scan using the best fit algorithm to analyze and measure the positional (dXYZ) and angular deviation (d⍬) of the scan body using three‐dimensional metrology software. Statistical analysis was performed using a one‐way ANOVA and pairwise comparison was done with a Tukey‐Kramer HSD test (α = 0.05).ResultsThe one‐way ANOVA of the groups for the dXYZ and dθ parameters was statistically significant (F3,56 = 11.45, p < 0.001, F3,56 = 24.04, p < 0.001). Group D (9 mm) showed the least positional deviation at 38.41 μm (95% CI 30.26; 46.56) and the least angular deviation of 0.17° (95% CI 0.12; 0.21). Group A (2 mm) showed the greatest positional deviation of 77.17 μm (95% CI 65.23; 89.11) and greatest angular deviation of 0.84° (95% CI 0.65; 1.03). The positional and angular deviation increased with increased implant depth.ConclusionsThe accuracy of digital impressions is influenced by the implant depth and the amount of visibility of the scan body. The trueness and precision are highest when the implant is placed at 0 mm depth with complete visibility of the scan body and decreases with subgingival implant placement.
School‐Based Health Services in Virginia and the COVID‐19 Pandemic
Authors: Kranz Ashley M. , Steiner Elizabeth D. , Mitchell Jean M. 
Published: February 2022

ABSTRACTBACKGROUNDSchools have a long history of delivering health services, but it is unclear how the COVID‐19 pandemic may have disrupted this. This study examined changes in school‐based health services and student needs before and during the pandemic and the factors important for delivering school‐based health services.METHODSA web‐based survey regarding the impact of the pandemic on school‐based health services was distributed via email to all 1178 Virginia public elementary schools during May 2021.RESULTSResponding schools (N = 767, response rate = 65%) reported providing fewer school‐based health services during the 2020‐2021 school year than before the pandemic, with the largest declines reported for dental screenings (51% vs 15%) and dental services (40% vs 12%). Reports show that mental health was a top concern for students increased from 15% before the pandemic to 27% (P < .001). Support from families and school staff were identified by most respondents (86% and 83%, respectively) as very important for the delivery of school‐based health services.CONCLUSIONSSchools reported delivering fewer health services to students during the 2020‐2021 school year and heightened concern about students' mental health. Understanding what schools need to deliver health services can assist state and local education and health officials and promote child health.
UK dogs eating raw meat diets have higher risk of Salmonella and antimicrobial‐resistant Escherichia coli faecal carriage
Authors: Groat E. F. , Williams N. J. , Pinchbeck G. , Warner B. , Simpson A. , Schmidt V. M. 
Published: February 2022

ObjectivesTo compare detection of Salmonella species and antimicrobial‐resistant Escherichia coli in the faeces of dogs eating raw meat or non‐raw diets and examine risk factors for their carriage.Materials and MethodsCanine faecal samples (raw fed n=114; non‐raw fed n=76) were collected from May to July 2015 from across the UK. Enrichment and selective culture and biochemical and PCR assays were used to identify isolates. Escherichia coli underwent susceptibility testing to a range of antimicrobials, including third‐generation cephalosporins; PCR assays were used to detect antimicrobial‐resistant genes. Questionnaires were used to collect data on independent variables as risks for antimicrobial‐resistant (resistant to ≥1 tested antimicrobial), multi‐drug‐resistant (resistant to ≥3 antimicrobial classes) and third‐generation cephalosporin resistant Escherichia coli.ResultsAntimicrobial‐resistant, multi‐drug‐resistant and third‐generation cephalosporin resistant Escherichia coli were significantly more likely to be detected in raw fed (54, 25 and 31%, respectively) compared to non‐raw fed (17, 4 and 4%, respectively) dogs; Salmonella species were detected in eight (4%) raw fed dogs only.Clinical SignificanceRaw fed dogs may be a source of Salmonella species and Escherichia coli, resistant to highest priority critically important antimicrobials, representing a potential animal welfare and public health issue. Owners should be aware of the risks, especially households with members, both human and canine, who are very young, elderly or immunocompromised.
The unexpected power of negative awards
Authors: Celse Jérémy , Frey Bruno S. , Grolleau Gilles , Mzoughi Naoufel 
Published: February 2022

AbstractWe characterize negative awards. Their pervasiveness in various domains as well as the objectives of their designers and promoters are documented. We discuss the outcomes generated by negative awards and provide some rationales explaining why individuals and organizations may be interested in getting them. Several issues deserve further exploration.