bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negotiating Belonging: Race, Class, and Religion in the Brazilian Quest for “Becoming American”
Authors: Serrão Rodrigo 
Published: February 2022

Abstract
This study examines how members of a majority second-generation Brazilian church in South Florida perceive their English-speaking, “American” congregation compared to the Portuguese-speaking Brazilian congregation from which they originated. Data for this research are drawn from in-depth, open-ended interviews with 32 members from different ethnoracial backgrounds, participant observation, and content analysis of the congregations’ social media. Findings show that the discourse of church differences portrays the two congregations in racialized and classist ways. Combining boundary-making and identity work theories, I argue that the perceptions espoused by members of the American congregation come from a place of pressure to assimilate to U.S. White middle-class culture, consequently reinforcing and legitimizing stereotypes in an effort to distance themselves from Brazilian immigrants.
Physician associates in the UK
Authors: Straughton Kate , Roberts Karen A. , Watkins Jeannie , Drennan Vari M. , Halter Mary 
Published: February 2022

ABSTRACT
Physician associates (PAs) have been part of the UK health workforce for almost 20 years. The profession is growing rapidly with statutory regulation, protection of the title, and career progression supported by a national-level framework all in the pipeline for the near future. This article provides a brief history of the profession in the United Kingdom and prospects for its future.
A teaspoon of sugar and a pinch of salt
Authors: Gilbert Brian W. , Dingman J. Spencer , Reeder Jacob A. , Paola Sean Di 
Published: February 2022

ABSTRACT
The traditional hyperosmolar agents used to treat patients with elevated intracranial pressure are mannitol and hypertonic sodium chloride solution. This article focuses on some of the pros and cons of these treatments for managing cerebral edema.
Study of diagnostic value of congenital hypertrophy of retinal pigment epithelium in Chinese familial adenomatous polyposis patients
Authors: Cai Shanrong , Yu Yibo , Xie Xin , Huang Yanqin , Song Yongmao , Zhan Suzhan , Zheng Shu 
Published: February 2022

Background
Congenital hypertrophy of retinal pigment epithelium (CHRPE) is an important characteristic of familial adenomatous polyposis (FAP) patients. However, more evidence about its sensitivity, specificity, and diagnostic value for FAP is needed to determine whether CHRPE is a reliable marker.

Methods
Clinical features of FAP patients were investigated using in-person evaluations. Family members of FAP patients were evaluated with an indirect ophthalmoscope to determine whether they had CHRPE. We defined three diagnostic criteria for CHRPE (criteria A, B and C) based on their shape, quantity and size. Those with negative colonoscopy results and gene mutation results were classified as healthy controls.

Results
Of a total of 23 FAP families, 21 families were CHRPE-positive (91.3%). Among those 21 families, 47 individuals had CHRPE, including 33 FAP patients, 9 APC gene mutation carriers, and 5 individuals younger than 18 years who were later confirmed to have FAP. Fifty individuals had no CHRPE (5 FAP patients and 45 individuals without APC gene mutations and colorectal adenoma). The average number of CHRPE lesions per person was 5.81, and CHRPE was located mostly in the posterior pole in the eye fundus; 76.7% of individuals had CHRPE in both eyes. The sensitivity of the three CHRPE criteria ranged from 78.8 to 90.4%, with the highest sensitivity found for criterion A (90.4%), which had a specificity of 100% for healthy controls and sporadic colorectal cancer patients.

Conclusion
CHRPE has vital diagnostic and screening value because of its high sensitivity for discovering FAP and APC gene mutation carriers.
From MAFLD to hepatocellular carcinoma and everything in between
Authors: Bae Sarah Da Won , George Jacob , Qiao Liang 
Published: February 2022

Abstract
Metabolic (dysfunction) associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most common cause of chronic liver disease worldwide. Many risk factors contribute to the pathogenesis of MAFLD with metabolic dysregulation being the final arbiter of its development and progression. MAFLD poses a substantial economic burden to societies, which based on current trends is expected to increase over time. Numerous studies have addressed various aspects of MAFLD from its risk associations to its economic and social burden and clinical diagnosis and management, as well as the molecular mechanisms linking MAFLD to end-stage liver disease and hepatocellular carcinoma. This review summarizes current understanding of the pathogenesis of MAFLD and related diseases, particularly liver cancer. Potential therapeutic agents for MAFLD and diagnostic biomarkers are discussed.
Ductal adenocarcinoma of the prostate or seminal vesicle adenocarcinoma: An multi-disciplinary team (MDT) case report and literature review
Authors: Ning Hao , Song Yufeng , Wu Haihu , Gao Dexuan , Lyu Jiaju 
Published: February 2022

Abstract
We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment. Multi-disciplinary team meetings organized by our hospital have shown great value in the whole process. The patient presented with gross hematuria accompanied by frequent urination initially, and was diagnosed with ductal adenocarcinoma of the prostate involving right seminal vesicle gland and urethra by urethroscopy biopsy. The clinical stage of tumor was T3bN0M0. After 4 cycles of neoadjuvant chemotherapy, the tumor shrank significantly and the patient underwent a laparoscopic radical prostatectomy. But the patient declined to continue chemotherapy postoperatively. After 10 months, the serum prostatic specific antigen increased to 0.05 ng/mL, and multiple metastases were found in the patient's bilateral lungs. However, an unexpected diagnosis of seminal vesicle adenocarcinoma was put forward from another hospital after supplementary pathologic immunohistochemical examination. Then, after careful discussion and demonstration by our multi-disciplinary team experts, we insisted on the diagnosis of ductal adenocarcinoma of the prostate and suggested that the original regimen of chemotherapy should be continued. Up-to-date, 14 months after the operation, the patient continues to survive while undergoing ongoing active treatment as recommended.
Traumatic cataract in a young patient with myopia
Authors: Nuijts Rudy M.M.A. , Ollivier Robin , Kermani Omid , Carones Francesco , Findl Oliver , Aramberri Jaime , Alió Jorge , Reus Nic J. , Rosen Paul 
Published: February 2022

A 36-year-old man was referred to our clinic because of traumatic cataract in his right eye, which had developed after being hit in the eye with a badminton shuttle as a child. He noticed that his vision in his right eye was gradually becoming worse.
His refraction, corrected with spectacles, was −4.25 −2.00 × 115 in his right eye and −5.50 −1.50 × 57 in his left eye, with a corrected distance visual acuity of 20/32 and 20/20, respectively. Because of allergies, the patient never tolerated contact lens wear for more than 2 hours.
On a slitlamp examination, we confirmed anterior subcapsular star-like cataract without any signs of zonulolysis. Optical biometry showed an axial length of 25.73 mm and 26.66 mm and an anterior chamber depth of 3.70 mm and 3.78 mm in the right and left eyes. Keratometric astigmatism measured by optical biometry was 1.56 diopters (D) at 30 degrees and 1.12 D at 138 degrees for the right and left eyes, and Scheimpflug tomography showed 1.1 D of regular astigmatism at 33 degrees in the right eye, and 0.9 D of regular astigmatism at 130 degrees in the left eye.
The patient is a professional photographer and asked for a treatment that would still allow him to be able to perform his job: he wants to read all the buttons on the camera up close and focus on the scenery in the distance.
What is your advice on this challenging case?
Impact of a Provider Tele-mentoring Learning Model on the Care of Medicaid-enrolled Patients With Diabetes
Authors: Cantor Joel C. , Chakravarty Sujoy , Farnham Jennifer , Nova Jose , Ahmad Sana , Flory James H. 
Published: February 2022

Background:
Project ECHO (Extension for Community Healthcare Outcomes), a tele-mentoring program for health care providers, has been shown to improve provider-reported outcomes, but there is insufficient research on patient-level outcomes.

Objectives:
To evaluate the impact of primary care provider (PCP) participation in Project ECHO on the care of Medicaid enrollees with diabetes.

Research Design:
New Jersey Medicaid claims and encounter data and difference-in-differences models were used to compare utilization and spending between Medicaid patients seen by PCPs participating in a Project ECHO program to those of matched nonparticipating PCPs.

Subjects:
A total of 1776 adult Medicaid beneficiaries (318 with diabetes), attributed to 25 participating PCPs; and 9126 total (1454 diabetic) beneficiaries attributed to 119 nonparticipating PCPs.

Measures:
Utilization and spending for total inpatient, diabetes-related inpatient, emergency department, primary care, and endocrinologist services; utilization of hemoglobin A1c tests, eye exams, and diabetes prescription medications among diabetics, and total Medicaid spending.

Results:
Participation in Project ECHO was associated with decreases of 44.3% in inpatient admissions (P=0.001) and 61.9% in inpatient spending (P=0.021) among treatment relative to comparison patients. Signs of most other outcome estimates were consistent with hypothesized program effects but without statistical significance. Sensitivity analyses largely confirmed these findings.

Conclusions:
We find evidence that Project ECHO participation was associated with large and statistically significant reductions of inpatient hospitalization and spending. The study was observational and limited by a small sample of participating PCPs. This study demonstrates the feasibility and potential value of quasi-experimental evaluation of Project ECHO patient outcomes using claims data.
Pediatric Neurogastroenterology and Motility Services in North America
Authors: Patel Dhiren , Safder Skaista S. , El‐Chammas Khalil , Kapavarapu Prasanna , Wheeler Justin , Mostamand Shikib , Khlevner Julie , Darbar Anil 
Published: February 2022

ABSTRACTTo characterize the current availability and scope of pediatric neurogastroenterology and motility (PNGM) services in North America (NA), the NASPGHAN‐NGM committee distributed a self‐reporting survey through the NASPGHAN bulletin board and mailing listserv, to compile a list of NA centers offering PNGM services, PNGM training, and the types of diagnostic and therapeutic PNGM procedures and services. We received responses that 54 centers in NA offer some form of PNGM services. Previously, the NASPGHAN website had last updated information from 2015 listing 36 centers in the USA and 2 in Canada. The American Neurogastroenterology and Motility Society (ANMS) website had 16 PNGM centers listed in NA in 2021. Neither of these resources capture additional information regarding training, research, advanced diagnostics, and therapeutics, and all available PNGM services. Our data highlights the growth in the field of PNGM services, and the variability of their distribution throughout the continent.
Augmented Renal Clearance of Vancomycin in Suspected Sepsis: Single-Center, Retrospective Pediatric Cohort
Authors: Scully Peter Thomas , Lam Weng Man , Coronado Munoz Alvaro Jose , Modem Vinai Modini 
Published: February 2022

OBJECTIVES:
To identify associations between augmented renal clearance (ARC) in pediatric patients treated for suspected sepsis and vancomycin pharmacokinetics. ARC has been associated with lower serum drug levels in both adult and pediatric cohorts for multiple drugs. We hypothesize that presence of ARC is associated with subtherapeutic initial vancomycin trough level (VTL).

DESIGN
Retrospective study, with patients divided into two groups based on the presence of ARC (estimated glomerular filtration rate [eGFR] above 130 mL/min/1.73 m2) in comparison with VTL. Multivariable logistic regression analysis was performed to evaluate the association between eGFR and subtherapeutic VTL.

SETTING:
Tertiary children’s hospital.

PATIENTS:
Hospitalized children (0–18 yr) initiated on empiric vancomycin therapy for suspected sepsis.

INTERVENTIONS:
Retrospective measurement of VTL, eGFR, and clinical variables.

MEASUREMENTS AND MAIN RESULTS:
Seventy-three patients were treated with empiric vancomycin for sepsis. ARC was present in 32 patients (44%). Subtherapeutic first VTL was present in 40 patients (55%). Higher eGFR was independently associated with subtherapeutic VTL in the multivariable logistic regression analysis.

CONCLUSIONS:
Subtherapeutic VTL is associated with ARC in our single-center retrospective cohort of children with suspected sepsis. This problem may present a potential risk of treatment failure in Gram-positive sepsis or longer time to clinical response. Prospective studies to investigate the clinical significance and effect of optimizing vancomycin dose in patients with ARC are recommended.
Current Medication Practices and Preferences Among Patients With Psoriatic Arthritis
Authors: Schwartzman Monica , Abutalib Zafir , Mandl Lisa A. 
Published: February 2022

Objective
The aim of this study was to evaluate real-world psoriatic arthritis (PsA) medication use and patient medication preferences.

Methods
This is a cross-sectional survey of Classification for Psoriatic Arthritis criteria defined PsA patients recruited from a single-center PsA registry from June to September 2020. Preferences were ranked on a 5-point Likert scale ranging from “not at all important” to “extremely important.”

Results
One hundred thirty-seven patients (29%) responded. The median duration (years) of PsA skin and joint symptoms was 19 (interquartile range, 10–34) and 12 (interquartile range, 8–21), respectively. The most common initial immunomodulatory medications were anti–tumor necrosis factor α (35%), methotrexate (19%), and anti–phosphodiesterase 4 (anti-PDE4) (12.4%). At survey administration, the most common immunomodulatory therapies were anti–tumor necrosis factor α (30%), anti–interleukin 17 (IL-17) (20.4%), and methotrexate (10.2%). After 2018, when updated guidelines from the American College of Rheumatology/National Psoriasis Foundation were published, a significantly higher percentage of patients' first medication was an anti–IL-17 compared with 2018 or earlier (30% vs 3.5%, p < 0.001), a pattern also seen with anti-PDE4 (40% vs 11.5%, p < 0.012). Medication preferences most ranked as “extremely” important were prevention of joint damage (80%), ability to perform daily activities (71%), prevention of pain (70.1%), rheumatologist recommendation (63%), and medication adverse effects (62%).

Conclusions
The significant increase of anti–IL-17 and anti-PDE4 medications as initial treatment after 2018 may reflect their inclusion as potential initial therapy in updated guidelines, along with the importance placed by patients on medication adverse effects. Given the expanding armamentarium of PsA medications, it is increasingly important to align patient preferences and therapeutic options to ensure durable use of effective therapy.
Dexmedetomidine alleviates the hypoxic-ischemic brain damage via miR-20a-5p/methionine adenosyltransferase 2B axis in rat pups
Authors: He Huan , Sun Mei , Chen Yun , Zhou Yang , Qie Wenbin , Tu Weifeng 
Published: February 2022

Objective
The neuroprotective effect of dexmedetomidine (DEX) has been demonstrated in hypoxic-ischemic brain damage (HIBD) animal models, the mechanism of which will be the foothold in this work.

Methods
After establishment of HIBD rat model, the rats were treated with DEX, miR-20a-5p agomir and adenoviral methionine adenosyltransferase 2B (MAT2B) overexpression vector, and then their brain tissues were harvested. The infarction volume and pathological changes of these brain tissues were measured using the triphenyl tetrazolium chloride (TTC), Nissl and hematoxylin–eosin (HE) stainings. The levels of miR-20a-5p, Bcl-2, Bax and MAT2B in these brain tissues were detected by Real-Time PCR (RT-PCR) and western blot. The binding sites of MAT2B and miR-20a-5p were predicted using the TargetScan and verified using the dual-luciferase reporter assay. The memory deficits and spatial learning of rat pups were assessed by Morris water maze test.

Results
MiR-20a-5p expression was upregulated, while MAT2B expression was downregulated in rats with HIBD. MAT2B was targeted by miR-20a-5p. DEX treatment improved the neurons and hippocampal tissue damage and decreased miR-20a-5p level in brain tissues of rats with HIBD. MiR-20a-5p overexpression overturned the protective effect of DEX on brain tissues and learning and memory abilities in rats with HIBD. Moreover, DEX promoted Bcl-2 level while inhibiting Bax level in HIBD rats’ brain tissues. Besides, overexpressed MAT2B reversed the effect of overexpressed miR-20a-5p on the levels of MAT2B, Bcl-2 and Bax, brain tissue damage, as well as the learning and memory abilities in rats with HIBD.

Conclusion
DEX alleviated HIBD via the miR-20a-5p/MAT2B axis in rats.
Accuracy of tongue swab testing using Xpert MTB-RIF Ultra for tuberculosis diagnosis
Authors: Andama A , Whitman GR , Crowder R , Reza TF , Jaganath D , Mulondo J , Nalugwa TK , Semitala C. F , Worodria W , Cook C , Wood RC , Weigel KM , Olson AM , Lohmiller Shaw J , Denkinger C , Nahid P , Cangelosi G , Cattamanchi A 
Published: February 2022

AbstractTongue dorsum swabs have shown promise as alternatives to sputum for detecting Mycobacterium tuberculosis (MTB) in patients with pulmonary tuberculosis (TB). Some of the most encouraging results have come from studies that used manual quantitative PCR (qPCR) to analyze swabs. Studies using the automated Cepheid Xpert® MTB/RIF Ultra qPCR test (Xpert Ultra) have yielded less encouraging results with tongue swabs, possibly because Xpert Ultra is optimized for testing sputum, not tongue swab samples. Using two new sample processing methods that demonstrated good sensitivity in preliminary experiments, we assessed diagnostic accuracy and semi-quantitative signals of 183 tongue swab samples using Xpert Ultra in a clinical setting. Relative to a sputum Xpert Ultra reference standard, the sensitivity of tongue swab Xpert Ultra was 68.5% (95% CI 54.4-80.5) and specificity was 100.0% (95% CI 97.2-100.0). When compared to a microbiological reference standard (MRS) incorporating both sputum Xpert Ultra and sputum culture, sensitivity was 64.9 (95% CI 51.1-77.1) and specificity remained the same. Higher sensitivity was observed (77.8% CI 64.4-88.0) when “trace” Xpert results were included among positive swabs. Semi-quantitative Xpert Ultra results were generally lower with swabs than with sputum. None of the eight sputum Xpert Ultra “trace” or “very low” results were detected using tongue swabs. Tongue swabs should be considered when sputum cannot be collected for Xpert Ultra testing, or in certain mass-screening settings. Further optimization of tongue swab analysis is needed to achieve parity with sputum-based molecular testing for TB.
Noncontact and high-precision sensing system for piano keys identified fingerprints of virtuosity
Authors: Oku Takanori , Furuya Shinichi 
Published: February 2022

ABSTRACTDexterous tool use is typically characterized by fast and precise motions performed by multiple fingers. One representative task is piano playing, which involves fast performance of a sequence of complex motions with high spatiotemporal precision. However, for several decades, a lack of contactless sensing technologies that are capable of precision measurement of piano key motions has been a bottleneck for unveiling how such an outstanding skill is cultivated. Here, we developed a novel sensing system that can record the vertical position of all piano keys with a time resolution of 1 ms and a spatial resolution of 0.01 mm in a noncontact manner. Using this system, we recoded the piano key motions while 49 pianists played a complex sequence of tones that required both individuated and coordinated finger movements to be performed as fast and accurately as possible. Penalized regression using various feature variables of the key motions identified distinct characteristics of the key-depressing and key-releasing motions in relation to the speed and accuracy of the performance. For the maximum rate of the keystrokes, individual differences across the pianists were associated with the peak key descending velocity, the key depression duration, and key-lift timing. For the timing error of the keystrokes, the interindividual differences were associated with the peak ascending velocity of the key and the interstrike variability of both the peak key descending velocity and the key depression duration. These results highlight the importance of dexterous control of the vertical motions of the keys for fast and accurate piano performance.
Effects of bilateral sequential theta-burst stimulation on 5-HT1A receptors on dorsolateral prefrontal cortex in treatment resistant depression
Authors: Murgaš Matej , Unterholzner Jakob , Stöhrmann Peter , Philippe Cécile , Godbersen Godber M. , Nics Lukas , Reed Murray B. , Vraka Chrysoula , Vanicek Thomas , Wadsak Wolfgang , Kranz Georg S. , Hahn Andreas , Mitterhauser Markus , Hacker Marcus , Kasper Siegfried , Lanzenberger Rupert , Baldinger-Melich Pia 
Published: February 2022

ABSTRACTTheta-burst stimulation (TBS) represents a brain stimulation technique effective for treatment-resistant depression (TRD) as underlined by meta-analyses. While the methodology undergoes constant refinement, bilateral stimulation of the dorsolateral prefrontal cortex (DLPFC) appears promising to restore left DLPFC hypoactivity and right hyperactivity found in depression. The post-synaptic inhibitory serotonin-1A (5-HT1A) receptor, also occurring in the DLPFC, might be involved in this mechanism of action. To test this hypothesis, we performed PET-imaging using the tracer [carbonyl-11C]WAY-100635 including arterial blood sampling before and after a three-week treatment with TBS in 11 TRD patients compared to sham stimulation (n=8 and n=3, respectively). Treatment groups were randomly assigned, and TBS protocol consisted in excitatory intermittent TBS to the left and inhibitory continuous TBS to the right DLPFC. A linear mixed model including group, hemisphere time and Hamilton Rating Scale for Depression (HAMD) score revealed a 3-way interaction effect of group time and HAMD on 5-HT1A receptor specific binding VS. While post-hoc comparisons showed no significant changes of 5-HT1A VS in either group, higher 5-HT1A VS after treatment correlated with greater difference in HAMD (r=-0.62), indicative of potential effects of TBS on the 5-HT1A receptor. Due to the small sample size, all results, however, must be regarded with caution.