bluuebunny/crossref_metadata_2025_split huggingface dataset:
PURSUING OPTIMAL RADIATION DOSE IN PEDIATRIC CARDIAC CT: A REPORT FROM UNIVERSITY HOSPITAL LEUVEN
Authors: Hustings Nico , Bosmans Hilde , Dymarkowski Steven 
Published: January 2022

Abstract

Background
Computed tomography (CT) balances between high resolution and low radiation dose. Given the greater radiosensitivity of children, it is appropriate to use child-friendly CT-protocols that reduce radiation dose at acceptable image quality.
This article states the radiation dose in pediatric cardiac CT-examinations at university hospital Leuven (Belgium) and compares with findings published by similar medical centers. The diagnostic accuracy was simultaneously compared, as it correlates with radiation dose.

Material and methods
his retrospective observational study analyzed 58 CT-scans of 52 patients. The radiation dose was calculated in effective dose. The image quality was scored qualitatively with a 5-point scale. The diagnostic accuracy, a derivative representation of the image quality, was checked with findings from surgery or conventional angiography.

Results
The mean effective dose in our study population was 1.3 ± 0.4 mSv. The qualitative image quality was on average ‘good’, elaborated with a score of 4.0 ± 0.2. The diagnostic accuracy was 92%. Comparative literature study provides a mean effective dose of 1.5 mSv and the reported diagnostic accuracy from other centers reaches ≥90%.

Conclusions
At our center pediatric cardiac CT-scans are obtained with good-to-excellent image quality and high diagnostic accuracy at low radiation doses. These results meet the radiation dose and diagnostic accuracy as published by comparable medical centers.
Carceral Liberalism: The Coloniality and Antiblackness of Coercive Benevolence
Authors: Tillman Korey 
Published: January 2022

AbstractDue to hyper-imprisonment and its collateral consequences, the United States has become a carceral state where even non-criminal justice institutions have adopted punitive techniques to address social problems. This study examines how state and non-state actors who ostensibly intend to end homelessness perpetuate it through their use of coercive benevolent policing. Drawing on nearly three years of ethnographic fieldwork with a homeless service provider in Southern Nevada, this article shows that the coercive benevolent techniques used by those who attempt to assist the unhoused are deeply rooted in antiblack and colonial practices forged in the development of liberalism. I offer carceral liberalism as the conceptual link between contemporary U.S. policing and a transnational and historical past dedicated to racialized economic domination. I argue that carceral liberalism reveals the long and ongoing history of state and non-state actors marking marginalized individuals as non-subjects to the state through coercive benevolence and that these findings make a case for the abolition of larger systems of racialized punishment.
Time-On-Task Effects on Working Memory Gating Processes—A Role of Theta Synchronization and the Norepinephrine System
Authors: Yu Shijing , Mückschel Moritz , Rempel Sarah , Ziemssen Tjalf , Beste Christian 
Published: January 2022

Abstract
Performance impairment as an effect of prolonged engagement in a specific task is commonly observed. Although this is a well-known effect in everyday life, little is known about how this affects central cognitive functions such as working memory (WM) processes. In the current study, we ask how time-on-task affects WM gating processes and thus processes regulating WM maintenance and updating. To this end, we combined electroencephalography methods and recordings of the pupil diameter as an indirect of the norepinephrine (NE) system activity. Our results showed that only WM gate opening but not closing processes showed time-on-task effects. On the neurophysiological level, this was associated with modulation of dorsolateral prefrontal theta band synchronization processes, which vanished with time-on-task during WM gate opening. Interestingly, also the modulatory pattern of the NE system, as inferred using pupil diameter data, changed. At the beginning, a strong correlation of pupil diameter data and theta band synchronization processes during WM gate opening is observed. This modulatory effect vanished at the end of the experiment. The results show that time-on-task has very specific effects on WM gate opening and closing processes and suggests an important role of NE system in the time-on-task effect on WM gate opening process.
Maternal exposure to PM2.5 induces the testicular cell apoptosis in offspring triggered by the UPR-mediated JNK pathway
Authors: Ren Lihua , Jiang Jianjun , Huang Jing , Zang Yu , Huang Qifang , Zhang Lianshuang , Wei Jialiu , Lu Hong , Wu Shaowei , Zhou Xianqing 
Published: January 2022

AbstractContemporary exposure to PM2.5 has been reported to disrupt spermatogenesis. However, the subsequent toxicological responses and the mechanisms of male reproductive damage in offspring induced by maternal exposure to PM2.5 remain largely unknown. For the first time, this study aimed to explore the apoptotic response in spermatogenesis of male offspring following maternal exposure to PM2.5 and its mechanisms. The C57BL/6 mice with vaginal plugs were randomly divided into four groups. Mice in the PM2.5 groups were intratracheally exposed to PM2.5 (4.8 mg/kg body weight, 43.2 mg/kg body weight) during pregnancy (every 3 days, six times in total). The mice in the membrane control group were treated similarly to the PM2.5 groups, applying only PM2.5 sampling membrane, while mice in the control group were kept untreated. The results showed that maternal exposure to PM2.5 during pregnancy resulted in structural lesions of the testis, reduced numbers of primary spermatocytes and spermatids, decreased sperm count and quality, shortened diameter of seminiferous tubules, and reduced testosterone and ABP in the offspring testes. Furthermore, cell apoptosis was increased and protein expression of IRE-1/P-JNK/cleaved caspase-12/cleaved caspase-3 was activated. These findings suggested that maternal exposure to PM2.5 may affect spermatogenesis by increasing apoptosis through activation of UPR-mediated JNK apoptotic pathway in offspring testicles and by reducing testosterone secretion.
Co-infection of intestinal helminths in humans and animals in the Philippines
Authors: Kajero Olumayowa T , Janoušková Eva , Bakare Emmanuel A , Belizario Vicente , Divina Billy , Alonte Allen Jethro , Manalo Sheina Macy , Paller Vachel Gay , Betson Martha , Prada Joaquin M 
Published: January 2022

Abstract

Background
A large number of studies have assessed risk factors for infection with soil-transmitted helminths (STH), but few have investigated the interactions between the different parasites or compared these between host species across hosts. Here, we assessed the associations between Ascaris, Trichuris, hookworm, strongyle and Toxocara infections in the Philippines in human and animal hosts.

Methods
Faecal samples were collected from humans and animals (dogs, cats and pigs) in 252 households from four villages in southern Philippines and intestinal helminth infections were assessed by microscopy. Associations between worm species were assessed using multiple logistic regression.

Results
Ascaris infections showed a similar prevalence in humans (13.9%) and pigs (13.7%). Hookworm was the most prevalent infection in dogs (48%); the most prevalent infection in pigs was strongyles (42%). The prevalences of hookworm and Toxocara in cats were similar (41%). Statistically significant associations were observed between Ascaris and Trichuris and between Ascaris and hookworm infections in humans, and also between Ascaris and Trichuris infections in pigs. Dual and triple infections were observed, which were more common in dogs, cats and pigs than in humans.

Conclusions
Associations are likely to exist between STH species in humans and animals, possibly due to shared exposures and transmission routes. Individual factors and behaviours will play a key role in the occurrence of co-infections, which will have effects on disease severity. Moreover, the implications of co-infection for the emergence of zoonoses need to be explored further.
Wy’east: An Innovative, Culturally Responsive Postbaccalaureate Pathway for American Indians and Alaska Natives
Authors: Empey Allison , Zeisman-Pereyo Shoshana , Mayinger Peter , Zuckerman Katharine E. , Rasmussen-Rehkopf Sarah , Carney Patricia A. , Taylor Cynthia L. , Morris Cynthia , Bruegl Amanda , Olsen Polly , Brodt Erik 
Published: January 2022

Problem
American Indians and Alaska Natives (AIANs) face significant health disparities that are exacerbated by limited access to high-quality, culturally congruent health care providers. There are no premedical postbaccalaureate programs focused on AIAN students.

Approach
The Northwest Native American Center of Excellence designed the Wy’east Pathway in 2018 to increase the number of AIANs matriculating to U.S. medical schools by supporting those on the cusp of matriculation. Wy’east scholars undertake 10 months of structured programming to augment their academic preparation, improve their Medical College Admission Test (MCAT) scores, and enhance their confidence and cultural identity. Cultural events and mentorship opportunities with AIAN faculty, staff, and cultural liaisons are threaded throughout the pathway curriculum to foster cultural resilience, mentorship, and community. Scholars earn conditional acceptance to Oregon Health and Science University (OHSU) School of Medicine if they complete Wy’east and meet the following criteria: pass all examinations in the primary curricular threads, obtain a qualifying MCAT score, and meet professionalism standards.

Outcomes
All 14 scholars who successfully completed Wy’east and met criteria in the first 2 cohorts (academic years 2018–2019 and 2019–2020) earned conditional acceptance to OHSU School of Medicine. Ten of the 14 scholars (71.4%) matriculated to OHSU School of Medicine, 2 (14.3%) matriculated to other medical schools, and 2 (14.3%) chose to pursue other health care fields. Wy’east scholars rated the foundational science of medicine and population health and epidemiology threads higher in terms of making them feel better prepared for medical school (mean = 4.71 and 4.83, respectively) than the academic skills and wellness thread (mean = 3.43).

Next Steps
Over the next 5 years, Wy’east will grow incrementally to offer a total of 18 conditional acceptance spots per cohort across 3 medical schools. Longitudinal tracking of Wy’east scholars’ medical training and career outcomes will be conducted.
Retention With Medication for Opioid Use Disorder: The Role of the Primary Care Relationship
Authors: Munger Jordan , Back Ephraim 
Published: January 2022

Objectives
Primary care providers (PCPs) prescribe medication for opioid use disorder (MOUD), but patients may receive MOUD from a provider who only prescribes MOUD, and who does not provide routine medical care that would be expected from a PCP. The importance of receiving MOUD from one’s own PCP versus another provider on patient MOUD retention is not known.

Methods
All patients receiving MOUD from December 2016 through November 2019 within a rural, Federally Qualified Health Center were included. Patient sociodemographic, PCP-MOUD concordance, and retention time in MOUD were extracted from the electronic health record. Travel-time from patients’ home to the clinic where MOUD was provided was calculated. The risk of premature discontinuation was estimated with Kaplan-Meier curves and with hazard ratios (HR) with 95% confidence intervals (CI). All analyses were performed using R version 3.4.4.

Results
Among (n = 353) patients receiving MOUD from 2016 to 2019, n = 77 (21.8%) patients receivedMOUD from their PCP (PCP-MOUD concordance). PCP-MOUD concordance was associated with reduced risk of premature discontinuation (HR = 0.41, 95% CI = 0.18–0.95), however, after multivariable adjustment, PCP-MOUD concordance was not significant (HR = 0.45, 95% CI = 0.19–1.05).

Conclusions
In this rural Federally Qualified Health Center, MOUD provision by a patient's own PCP, as compared to a separate provider, did not reach statistical significance for an association with improved retention in treatment. These findings are likely due to a small sample size, and support expanding buprenorphine access as part of comprehensive primary care to combat the opioid crisis, especially in rural areas.
Thermal Dynamics of a Novel Radio-Frequency Device for Endoscopic Spine Surgery
Authors: Lee Han-Joo , Heo Dong-Hwa , Han Sang Kuy , Choi Hae Won , Kim Seungtaek , Cho Byeong Chan , Song Min Chul , Yang Sun Choel , Lee Kang Moo , Lee Mun-Hwan , Yoon Tae Ho , Shin Ju Ho , Lee Woo Cheol , Park Jeong-Yoon 
Published: January 2022

Study Design.
Experimental study.

Objective.
In this study, the ambient temperature of a radiofrequency (RF) electrode tip was compared and analyzed in terms of products, mode, flow quantity, and flow rate.

Summary of Background Data.
Endoscopic spine surgery is a widely used operation for degenerative lumbar stenosis and herniated lumbar disc. To perform endoscopic spine surgery, dedicated instruments like a RF generator and electrode are essential.

Methods.
An evaluation system capable of measuring temperature under equal conditions at a certain distance from the electrode tip was manufactured. The distance between the electrode tip and the temperature sensor was set to 1, 5, and 10 mm. The flow quantities of 0, 50, 100, and 150 mL/min and the flow rates of 0, 0.20, 0.53, and 0.80 m/s were compared and statistically analyzed.

Results.
The temperatures measured in the experiments conducted on the four combinations of RF device showed similar values, and showed differences according to the characteristics of each mode of the RF. As the distance between the electrode tip and the temperature sensor increased, the temperature decreased, and as flow quantity or flow rate increased, the temperature decreased. The maximum temperatures differed significantly according to flow quantity, between flow quantities of 0 and 100 mL/min (P
= 0.03) and between 0 and 150 mL/min (P ≤ 0.01). The maximum temperatures also differed significantly between the flow rate of 0 m/s, and the flow rates of 0.20, 0.53, and 0.80 m/s, with P ≤ 0.01 in all three comparisons.

Conclusion.
This is the first study in which we made a customized RF temperature evaluation system and verified the temperature changes in various environments. When irrigation was performed, we could confirm that the maximum temperature was less than 60°C. Irrigation is considered essential in endoscopic spine surgery.

Level of Evidence.
3
Could Machine Learning Better Predict Postoperative C5 Palsy of Cervical Ossification of the Posterior Longitudinal Ligament?
Authors: Kim Soo Heon , Lee Sun Ho , Shin Dong Ah 
Published: January 2022

Study Design:
This was a retrospective cohort study.

Objective:
The objective of this study was to investigate whether machine learning (ML) can perform better than a conventional logistic regression in predicting postoperative C5 palsy of cervical ossification of the posterior longitudinal ligament (OPLL) patients.

Summary of Background Data:
C5 palsy is one of the most common postoperative complications after surgical treatment of OPLL, with an incidence rate of 1.4%–18.4%. ML has recently been used to predict the outcomes of neurosurgery. To our knowledge there has not been a study to predict postoperative C5 palsy of cervical OPLL patient with ML.

Methods:
Four sampling methods were used for data balancing. Six ML algorithms and conventional logistic regression were used for model development. A total of 35 ML prediction model and 5 conventional logistic prediction models were generated. The performances of each model were compared with the area under the curve (AUC). Patients who underwent surgery for cervical OPLL at our institute from January 1998 to January 2012 were reviewed. Twenty-five variables of each patient were used to make a prediction model.

Results:
In total, 901 patients were included [651 male and 250 female, median age: 55 (49–63), mean±SD: 55.9±9.802]. Twenty-six (2.8%) patients developed postoperative C5 palsy. Age (P=0.043), surgical method (P=0.0112), involvement of OPLL at C1–3 (P=0.0359), and postoperative shoulder pain (P≤0.001) were significantly associated with C5 palsy. Among all ML models, a model using an adaptive reinforcement learning algorithm and downsampling showed the largest AUC (0.88; 95% confidence interval: 0.79–0.96), better than that of logistic regression (0.69; 95% confidence interval: 0.43–0.94).

Conclusions:
The ML algorithm seems to be superior to logistic regression for predicting postoperative C5 palsy of OPLL patient after surgery with respect to AUC. Age, surgical method, and involvement of OPLL at C1–C3 were significantly associated with C5 palsy. This study demonstrates that shoulder pain immediately after surgery is closely associated with postoperative C5 palsy of OPLL patient.
ICU Versus High-Dependency Care Unit for Patients With Acute Myocardial Infarction: A Nationwide Propensity Score-Matched Cohort Study
Authors: Ohbe Hiroyuki , Matsui Hiroki , Yasunaga Hideo 
Published: January 2022

OBJECTIVES:
To compare the outcomes of patients with acute myocardial infarction who were treated in ICUs versus high-dependency care units (HDUs).

DESIGN:
A nationwide, propensity score-matched, retrospective cohort study of a national administrative inpatient database in Japan from July 2010 to March 2018.

SETTING:
Six hundred sixty-six acute-care hospitals with ICU and/or HDU beds covering about 75% of all ICU beds and 70% of all HDU beds in Japan.

PATIENTS:
Adult patients who were hospitalized for acute myocardial infarction and admitted to the ICU or HDU on the day of hospital admission. Propensity score-matching analysis was performed to compare the inhospital mortality between patients treated in the ICU and HDU on the day of hospital admission.

INTERVENTIONS:
ICU or HDU admission on the day of hospital admission.

MEASUREMENTS AND MAIN RESULTS:
Of 135,142 eligible patients, 89,382 (66%) were admitted to the ICU and 45,760 (34%) were admitted to the HDU on the day of admission. After propensity score matching, there was no statistically significant difference in inhospital mortality between the ICU and HDU groups (5.0% vs 5.5%; difference, –0.5%; 95% CI, –1.0% to 0.1%). In the subgroup analyses, inhospital mortality was significantly lower in the ICU group than that in the HDU group among patients with Killip class IV (25.6% vs 28.4%; difference, –2.9%; 95% CI, –5.4% to –0.3%), patients who underwent intubation (40.0% vs 46.6%; difference, –6.6%; 95% CI, –10.6% to –2.7%), and patients who received mechanical circulatory support (21.8% vs 24.7%; difference, –2.8%; 95% CI, –5.5% to –0.2%).

CONCLUSIONS:
Critical care in the ICU compared with that in the HDU was not associated with reduced inhospital mortality among the entire cohort of patients with acute myocardial infarction but was associated with reduced inhospital mortality among the subsets of patients with Killip class IV, intubation, or mechanical circulatory support.
Cancer Risk of Angiotensin II Receptor Blocker Valsartan: A Population-based Study
Authors: Chan Tak Hon , Tsoi Man Fung , Yung Cheung Bernard Man 
Published: January 2022

Abstract:
Nitrosamine contamination of generic valsartan was found in 2018. This study aimed to investigate whether long-term use of valsartan increases cancer risk. Patients prescribed valsartan or amlodipine (control group) from 1 January 1, 2003, to June 30, 2010, were identified using the Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority, a territory-wide database in Hong Kong. Patients previously diagnosed with cancer, prescribed both medications, taking the medication, or followed up for <1 year were excluded. Cancer incidence, adjusted for age, sex, and Charlson Comorbidity Index, was the primary outcome and was estimated using Poisson regression in R version 3.6.1. Among 5023 valsartan users and 3692 amlodipine users, 887 and 740 were diagnosed with cancers during median follow-up periods of 10.97 and 12.12 years, respectively. The adjusted incidence of cancer in valsartan and amlodipine users was 165.29 (95% confidence interval 154.76–175.53) and 180.12 (167.35–193.67) per 10,000 person-years, respectively. The cancer incidence rate ratio of valsartan relative to amlodipine was 0.94 (0.88–1.01). Adjusted incidence rate ratios of valsartan relative to amlodipine were significant for breast cancer (0.63, 0.46–0.86) only. Our findings do not suggest an increase in incidence of cancer with long-term valsartan use. The duration of follow-up of more than 10 years of the study provides the reassurance that an increase in cancer risk is unlikely. Further studies are needed to elucidate the long-term effect of valsartan use on the risk of specific types of cancer.
Repair of Breast Defect by Transfer of a Contralateral Internal Mammary Artery Perforator Flap
Authors: Yang Qingfeng , Wu Zankai , Zhang Xue , Feng Juan , Zhao Hengqiang , Liao Lingxia , Cui Le , Gong Yiping 
Published: January 2022

Summary:
This is a case report of a patient with a borderline phyllodes tumor in the left breast. Seventeen months after the resection of the phyllodes tumor from the patient’s left breast, the tumor occurred again 5 months ago in the surgical region. A large defect was generated after the extended resection of the left breast mass, and it was repaired with a contralateral internal mammary artery perforator flap. After the operation, bilateral breast symmetry was good, and the patient was satisfied with the shape of the breast. Postoperative follow-up was performed for 15 months, and no local recurrence was observed.
The risk of insomnia after surgical operation: A longitudinal, population-based, case-crossover study
Authors: Lin Wei-Chen , Chang Wen-Han , Bai Ya-Mei , Li Cheng-Ta , Chen Mu-Hong , Su Tung-Ping 
Published: January 2022

Background:
The acute onset of insomnia following surgical operations has long been neglected, and long-term outcomes are not clear. Our aims were (1) to evaluate the risk of postoperative insomnia, (2) to identify which surgeries are related, and (3) to follow patients with postoperative insomnia for the development of major mental and physical disorders.

Methods:
We conducted a case-crossover study comprising 9898 participants with new-onset insomnia from the Taiwan National Health Insurance Research Database between 1997 and 2011. We determined the odds of having surgery in the case period (30 days) before the onset of insomnia by logistic regression analysis. Types of surgery that postoperative insomniacs had undergone were compared with age-/gender-/timing-matched controls. Longitudinal follow-up of postoperative and non-postoperative insomniacs was performed.

Results:
The odds ratio of surgical exposure vs. nonexposure within 30 days was 12.05 (p < 0.001) before new-onset insomnia. Surgery of musculoskeletal and nervous systems predisposed to insomnia. The duration of hypnotic drug use (0.83 years) was shorter and with a nearly 2-fold faster remission rate in postoperative than in non-postoperative insomniacs (1.45 years). Approximately 25% of each insomnia group developed persistent sleep disturbance.

Conclusion:
Surgery is associated with subsequent insomnia, which has a shorter duration and a faster remission than non-postoperative insomnia. Our data provide a reference for postoperative care, and warrant future studies.