bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of hemodynamically significant pericardial effusion by analysis of cardiac chambers volume by computed tomography
Authors: Granot Yoav , Rozenbaum Zach , Yashar Hila , Shalmon Tamar , Berliner Shlomo , Aviram Galit 
Published: September 2022

Objective: Pericardial effusion may present clinically as pleuritic chest pain, dyspnea, or hemodynamic compromise and is a frequent finding in computerized tomographic pulmonary angiography (CTPA) exams. We hypothesized that CTPA-based analysis of the cardiac chamber volumes can be used to predict the hemodynamic significance of pericardial effusion (HsPE) as compared with echocardiography. Methods: Retrospective analysis of consecutive patients who underwent CTPA and echocardiography between January 2009 and November 2017 that ruled-out acute pulmonary embolism was included. Differences in cardiac chamber volumes were investigated in correlation to echocardiographic evidence of HsPE. Results: The final cohort included 208 patients, of whom 22 (11%) were diagnosed with HsPE. The HsPE patients had much smaller right cardiac chamber volumes (Median 78.8 ml (IQR 72.4–89.1)) than patients without HsPE (Median 115.1 ml (IQR 87.4–150). A decision tree for the prediction of HsPE showed multiple cutoff values. Right atrium (RA) volume had the best accuracy (area under the curve 0.851, 95% confidence interval 0.776–0.925, p < .001) for predicting the presence of HsPE. An RA volume ≤86 ml yielded a sensitivity of 95.5%, a specificity of 64%, and a NPV of 99.2% for the presence of HsPE. Conclusion: CTPA-based volumetric information with focus on the RA volume may help predict the presence of HsPE. Advances in knowledge: Pericardial effusion is a frequent finding in CTPA exams. Our study shows that CTPA-based volumetric information can predict the presence of HsPE with RA volume as the best indicator.
Development of an improved diagnostic nomogram for preoperative prediction of small cell neuroendocrine cancer of the cervix
Authors: Li Yun-Zhi , Liu Peng , Mao Bao-Hong , Wang Li-Li , Ren Jia-Liang , Xu Yong-Sheng , Liu Guang-Yao , Xin Zhong-Hong , Lei Jun-Qiang 
Published: September 2022

Objectives: Accurate preoperative diagnosis of small cell neuroendocrine cancer of the cervix (SCNECC) is crucial for establishing the best treatment plan. This study aimed to develop an improved, non-invasive method for the preoperative diagnosis of SCNECC by integrating clinical, MR morphological, and apparent diffusion coefficient (ADC) information. Methods: A total of 105 pathologically confirmed cervical cancer patients (35 SCNECC, 70 non-SCNECC) from multiple centres with complete clinical and MR records were included. Whole lesion histogram analysis of the ADC was performed. Multivariate logistic regression analysis was used to develop diagnostic models based on clinical, morphological, and histogram data. The predictive performance in terms of discrimination, calibration, and clinical usefulness of the different models was assessed. A nomogram for preoperatively discriminating SCNECC was developed from the combined model. Results: In preoperative SCNECC diagnosis, the combined model, which had a diagnostic AUC (area under the curve) of 0.937 (95% CI: 0.887–0.987), outperformed the clinical-morphological model, which had an AUC of 0.869 (CI: 0.788–0.949), and the histogram model, which had an AUC of 0.872 (CI: 0.792–0.951). The calibration curve and decision curve analyses suggest that the combined model achieved good fitting and clinical utility. Conclusions: Non-invasive preoperative diagnosis of SCNECC can be achieved with high accuracy by integrating clinical, MR morphological, and ADC histogram features. The nomogram derived from the combined model can provide an easy-to-use clinical preoperative diagnostic tool for SCNECC. Advances in knowledge: It is clear that the therapeutic strategies for SCNECC are different from those for other pathological types of cervical cancer according to V 1.2021 of the NCCN clinical practice guidelines in oncology for cervical cancer. This research developed an improved, non-invasive method for the preoperative diagnosis of SCNECC by integrating clinical, MR morphological, and apparent diffusion coefficient (ADC) information.
On climate order: a policy brief
Authors: Feng Rui 
Published: September 2022

Background: Climate change, largely triggered by human-induced greenhouse gases (GHGs) emissions, seems unstoppable. There was a strong rebound of anthropogenic emissions of CO2, the preponderant GHG in terms of contribution to global warming, around the world after the COVID-19 lockdown. Also, there is still no widely accepted international treaty on curbing the anthropogenic emissions of CH4 and N2O, the second and third predominant GHG, respectively, so far. Thereby, prima facie, in respect to mitigating climate change, currently, humans have no aces up their sleeves. It seems that current temperature rise is not high enough to take alarm until the occurrence of tipping point. Policy: Climate-related international treaties, such as 2016 Paris agreement, are compromises among conflicting geopolitical pressures. However, currently, the climate treaties show little mandatory binding force on the signatories who are able to violate and then get off scot-free, thus may end up like a nostrum. Throughout the European history, I find that the only way, if at all, to achieve the peace or obedience of a treaty is via balancing powers, embodied in Bismarck’s Realpolitik of Germany and Richelieu’s Raison d'état of France. Similarly, the Chinese history in East Asia proved the significance of unadulterated ideological neutrality and Darwinian adaptability in the kaleidoscope of evolving circumstances in maintaining order and enforcement of international treaties through balancing the power of rivalries to constrain ever-recurring challengers for equilibrium. Recommendations: A successful policy needs to make a thorough analysis of all relevant factors to form a long-term strategic notion. Then, statesmen need to distill an array of nebulous, always contradictory options into a tenacious, controllable direction. Thereby, I suggest that, for better curbing global warming, climate agreements or climate club be incorporated into an overall geopolitical framework among the international communities.
Bladder Paraganglioma Presenting as Post-Micturition Syncope
Authors: Tomkins Maria , McCabe Mark , Crowther Stephen , Kilgallen Clive , Little Dilly , Smith Diarmuid , Agha Amar 
Published: September 2022

A 22-year-old female presented with a twelve-year history of intensifying paroxysms of anxiety, palpitations and recurrent syncope following micturition. The patient was referred to endocrinology upon discovery of hypertension. Extended family history revealed metastatic phaeochromocytoma and paraganglioma in two grand-uncles. Clinical examination revealed hypertension, mean 24hr ambulatory blood pressure of 150/100mmHg. Supine plasma normetanephrines were markedly elevated with a raised 3-methoxytyramine, plasma metanephrines were normal. Computed tomography identified a 4.4cm mass at the right inferolateral margin of the bladder wall. Scintigraphic imaging confirmed unifocal bladder lesion uptake with no additional metastatic lesions. Following pre-operative alpha blockade, the patient underwent a partial cystectomy. Histology confirmed a paraganglioma, SDHB staining was lost in neoplastic cells consistent with an SDHB-related paraganglioma. Plasma normetanephrine, 3-methoxytyramine and blood pressure returned to normal postoperatively. Genetic screening identified a germ line heterozygous SDHB gene variant c.723C>G. Bladder paragangliomas are a rare but important differential to consider when investigating post-micturition syncope. Extended family history should be sought and suspicion for a genetic cause should be raised, especially when presenting at a young age. This is the first reported case describing phaeochromocytoma or paraganglioma with the SDHB gene variant c.723C>G.
Obstructive sleep apnoea and perioperative medicine: a growing concern
Authors: Chambers Tom , Ruparelia Prina , Ellis Georgia , Bishop Thomas , Gooneratne Mevan , Singh Nanak 
Published: September 2022

Obstructive sleep apnoea represents a sizable public health and economic burden. Owing to rising obesity rates, the prevalence of obstructive sleep apnoea is increasing, and it is a condition that is significantly underdiagnosed. Exacerbated by the COVID-19 pandemic, the backlog of elective surgeries is also sizable and growing. A combination of these factors means that many patients due to have surgery will have obstructive sleep apnoea, either diagnosed or otherwise. Patients with obstructive sleep apnoea have a significantly increased risk of operative complications, but the evidence base for optimum perioperative management of these patients is limited. This article reviews sleep apnoea, its prevalence and its impact on operative management and perioperative outcomes for patients. The evidence base for screening and treating undiagnosed obstructive sleep apnoea is also comprehensively assessed. Finally, a pathway to manage patients with possible undiagnosed obstructive sleep apnoea is proposed, and areas for further research identified.
Diversity in surgery: the perceptions of aspiring surgeons
Authors: Galloway Richard , Chandrakumar Charmilie , Maceviciute Kornelija , Wong Jason , Jeyaseelan Lucky 
Published: September 2022

Background/Aims This study aimed to explore definitions of diversity, and views and attitudes towards diversity in healthcare among future generations of surgical trainees. Methods This was a prospective, cohort study via an online questionnaire during a virtual, nationwide surgical course, targeted at aspiring surgeons. Results Out of 202 participants, 166 met the inclusion criteria. Participants' definitions of diversity most frequently included race, gender and ethnicity, with fewer than 50.0% recognising pregnancy, communication style or political preference in their definition. Of the respondents, 56.0% (93/166) believed that the surgical community did not do enough to encourage diversity. The rising cost of training, lack of diverse role models and dated ideologies were identified as barriers to achieving greater diversity within surgery. Conclusions Important components of diversity continue to be under-recognised. Surgery must maximise diversity to attract, support and motivate the next generation of surgeons, for the benefit of the health service and the populations it serves.
Experimental generation of adjustable partially coherent optical vortices from coherent and incoherent light sources
Authors: Cadavid-Muñoz Juan José , Rueda Edgar , Restrepo René 
Published: September 2022

Adjustable spatial coherence systems allow the possibility to make
different intensity distributions using one source. Most common
adjustable sources are based on the Collet–Wolf system. However, it is
also possible to adjust the spatial coherence of the illumination
field from white light sources by spatially filtering the source
mutual intensity spectrum. We implement the Collet–Wolf source and the
LED-based system to experimentally contrast a variety of partially
coherent optical vortices that can be generated with spatial light
modulation. We experimentally study the effects of changing the
transverse coherence in partially coherent optical vortices, using a
proposed metric of vortex contrast depth that quantifies the change of
the vortex hollowness. To expand the analysis, we use a Michelson
interferometer to reconstruct the spiral wavefronts using phase
shifting. We found that the LED system at lower spatially correlated
light produces truncated triangular distributions (a 50 µm
pinhole is used), and with higher correlated light, it produces
partially coherent optical vortices (a 10 µm pinhole is used).
The Collet–Wolf system generates partially coherent optical vortices
up to 0.5 mm of focal shift in the diffuser. Our results
provide an experimental understanding and instrumental methodology
capable of steering the optical transverse coherence, producing
adjustable partially coherent optical vortices that can be obtained
using incoherent and coherent sources.
Changes in lung volume estimated by electrical impedance tomography during apnea and high-flow nasal oxygenation: A single-center randomized controlled trial
Authors: Riedel Thomas , Bürgi Fabian , Greif Robert , Kaiser Heiko , Riva Thomas , Theiler Lorenz , Nabecker Sabine 
Published: September 2022

Background
Previous studies concerning humidified, heated high-flow nasal oxygen delivered in spontaneously breathing patients postulated an increase in functional residual capacity as one of its physiological effects. It is unclear wheter this is also true for patients under general anesthesia.

Methodology
The sincle-center noninferiority trial was registered at ClinicalTrials.gov (NCT NCT03478774). This secondary outcome analysis shows estimated differences in lung volume changes using electrical impedance tomography between different flow rates of 100% oxygen in apneic, anesthetized and paralyzed adults prior to intubation. One hundred and twenty five patients were randomized to five groups with different flow rates of 100% oxygen: i) minimal-flow: 0.25 l.min-1 via endotracheal tube; ii) low-flow: 2 l.min-1 + continuous jaw thrust; iii) medium-flow: 10 l.min-1 + continuous jaw thrust; iv) high-flow: 70l.min-1 + continuous jaw thrust; and v) control: 70 l.min-1 + continuous video-laryngoscopy. After standardized anesthesia induction with non-depolarizing neuromuscular blockade, the 15-minute apnea period and oxygen delivery was started according to the randomized flow rate. Continuous electrical impedance tomography measurements were performed during the 15-minute apnea period. Total change in lung impedance (an estimate of changes in lung volume) over the 15-minute apnea period and times to 25%, 50% and 75% of total impedance change were calculated.

Results
One hundred and twenty five patients completed the original study. Six patients did not complete the 15-minute apnea period. Due to maloperation, malfunction and artefacts additional 54 measurements had to be excluded, resulting in 65 patients included into this secondary outcome analysis. We found no differences between groups with respect to decrease in lung impedance or curve progression over the observation period.

Conclusions
Different flow rates of humidified 100% oxygen during apnea result in comparable decreases in lung volumes. The demonstrated increase in functional residual capacity during spontaneous breathing with high-flow nasal oxygenation could not be replicated during apnea under general anesthesia with neuromuscular blockade.
Cognitive fusion and personality traits in the context of mindfulness: A cross-sectional study
Authors: Pux Sarah , Hahn Eric , Bergmann Niklas , Hahne Inge , Pauly Luca , Ta Thi Minh Tam , Pijenborg Gerdina H. M. , Böge Kerem 
Published: September 2022

Objectives
Meditation and mindfulness, though rooted in eastern traditions, have been increasingly embraced in western psychology. However, questions remain regarding the mechanisms through which the beneficial effects of mindfulness occur. The present study aimed to address cognitive fusion as a potential mediator between mindfulness and negative affect and whether the mindfulness-cognitive fusion link is moderated by personality factors in an international sample of frequent meditators.

Methods
An international sample of 739 frequent meditators completed measures of mindfulness (Southampton Mindfulness Questionnaire), cognitive fusion (Cognitive Fusion Questionnaire), negative affect (Brief Symptom Checklist), and personality (Big Five Inventory) in an online survey. Using SPSS Process Macro, cognitive fusion was examined as a mediator between mindfulness and negative affect. Furthermore, Extraversion, Conscientiousness, and Neuroticism were investigated as moderators in the mediation model.

Results
Cognitive fusion was found to be a partial mediator between mindfulness and negative affect (b = -0.249; 95% CI, [-0.289, -0.203]), whereas the examined personality factors were not found to moderate the present model (E: t(734) = 0.951, p = .342); C: t(734) = -0.042, p = .967; N: t(734) = -2.271, p = .023).

Conclusions
This study suggests that cognitive fusion plays a significant role in the association between mindfulness and negative affect. These findings indicate the importance of how individuals internally respond and relate to experiences and the instrumental value of mindfulness effects beyond and outside of mindfulness-based interventions.
Demand–supply-side barriers affecting maternal health service utilization among rural women of West Shoa Zone, Oromia, Ethiopia: A qualitative study
Authors: Shallo Seifadin Ahmed , Daba Deresa Bekele , Abubekar Abuzumeran 
Published: September 2022

Introduction
Despite the efforts and strategies being applied by the government and the partner organizations to increase maternal health service utilization, maternal health service utilization is low in the general population and very low in rural communities of the West Shoa Zone specifically.

Objective
This study intended to identify and describe barriers contributing to low maternal health service utilization in selected rural districts of the West Shoa Zone of Oromia regional state, Ethiopia, by 2021.

Methods
The study was conducted from February 01 to April 30/2021 in three districts of the West Shoa Zone. The districts were selected purposively based on the report of their last year’s (2020) performance on maternal health service utilization obtained from the Zonal health office, where the ANC follow-up and Institutional delivery were the lowest among the Districts in the Zone. A community-based qualitative phenomenological approach was used to explore the demand-supply side barriers affecting the utilization of maternal health services. Six Focus Group discussions, 9 In-depth Interviews, and 12 Key Informants Interviews were conducted with women who gave birth at home in the last 12 months and with health care providers at different health offices and health institutions. Data were tape-recorded, transcribed verbatim, translated, and analyzed thematically using MAXQDA software.

Results
Our findings revealed that though women strongly agree on the importance and advantage of maternal health services utilization, both demand and supply side barriers such as low awareness on when to use the services, not knowing ANC schedule, misinformation about ANC and institutional delivery, not knowing their estimated date of delivery and precipitated labor, shortage of manpower at health institutions, far distance health facilities, and unavailability or un-accessibility of ambulance services during an emergency time, lack of transportation to health facilities were hindering them not to use the services.

Conclusion
In general, rural women are facing many challenges yet to accessing and utilizing maternal health services. To achieve the SDG targets, addressing barriers prohibiting a woman from using MCH should be critically addressed.
Mortality over time among COVID-19 patients hospitalized during the first surge of the pandemic: A large cohort study
Authors: Marcilio Izabel , Lazar Neto Felippe , Lazzeri Cortez Andre , Miethke-Morais Anna , Dutilh Novaes Hillegonda Maria , Possolo de Sousa Heraldo , de Carvalho Carlos Roberto Ribeiro , Shafferman Levin Anna Sara , Ferreira Juliana Carvalho , Gouveia Nelson ,   HCFMUSP COVID-19 Study Group
Published: September 2022

Background
Capacity strain negatively impacts patient outcome, and the effects of patient surge are a continuous threat during the COVID-19 pandemic. Evaluating changes in mortality over time enables evidence-based resource planning, thus improving patient outcome. Our aim was to describe baseline risk factors associated with mortality among COVID-19 hospitalized patients and to compare mortality rates over time.

Methods
We conducted a retrospective cohort study in the largest referral hospital for COVID-19 patients in Sao Paulo, Brazil. We investigated risk factors associated with mortality during hospitalization. Independent variables included age group, sex, the Charlson Comorbidity Index, admission period according to the stage of the first wave of the epidemic (early, peak, and late), and intubation.

Results
We included 2949 consecutive COVID-19 patients. 1895 of them were admitted to the ICU, and 1473 required mechanical ventilation. Median length of stay in the ICU was 10 (IQR 5–17) days. Overall mortality rate was 35%, and the adjusted odds ratios for mortality increased with age, male sex, higher Charlson Comorbidity index, need for mechanical ventilation, and being admitted to the hospital during the wave peak of the epidemic. Being admitted to the hospital during the wave peak was associated with a 33% higher risk of mortality.

Conclusions
In-hospital mortality was independently affected by the epidemic period. The recognition of modifiable operational variables associated with patient outcome highlights the importance of a preparedness plan and institutional protocols that include evidence-based practices and allocation of resources.
Does exposure to social media content influence attitudes towards, and engagement in, road rule violations? A systematic review
Authors: Stefanidis Kayla B. , Davey Ben , Truelove Verity , Schiemer Carla , Freeman James 
Published: September 2022

Background/objectives
With the increasing popularity and saliency of social media, there is a pressing need to identify whether exposure to such content can affect road rule compliance, especially given that social media has been found to influence other risky behaviours. This systematic review (conducted in accordance with the PRISMA guidelines) summarised existing evidence concerning: (a) the nature of driving-related content on social media and (b) whether such content can influence attitudes and subsequent driving behaviour.

Methods
Peer-reviewed articles written in English, that explored social media content in relation to road safety or driving behaviours (e.g., speeding, tailgating, distraction, impaired driving, and seatbelt use), were eligible for review. Searches were conducted via SCOPUS, PUBMED, ProQuest and TRID in June 2021.

Results/discussion
A total of 8 studies met the requirements for this study, resulting in three key findings. First, it was found that very few studies have explored the type and extent of driving-related content on social media, and the small collection of existing research has focused solely on YouTube and Twitter. Second, whilst the nature of driving-related content on social media varies substantially across studies, a body of content exists that promotes or encourages risky driving behaviour or road rule violations. Third, and despite the array of available online content, there is a paucity of research illuminating the impact of social media messages on attitudes towards, and behaviours linked to road safety. This review highlights the need for research to keep pace with the rapidly changing nature of social media (not least the impacts upon human behaviour) and outlines pathways to increase current scientific understanding.