bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Review of Transpulmonary Pressure Guided Positive End-Expiratory Pressure Titration for Mechanical Ventilation in Class II and III Obesity
Authors: Liou Jesse , Doherty Daniel , Gillin Tom , Emberger John , Yi Yeonjoo , Cardenas Luis , Benninghoff Michael , Vest Michael , Deitchman Andrew 
Published: April 2022

OBJECTIVES:
Acute respiratory distress syndrome is treated by utilizing a lung protective ventilation strategy. Obesity presents with additional physiologic considerations, and optimizing ventilator settings may be limited with traditional means. Transpulmonary pressure (PL) obtained via esophageal manometry may be more beneficial to titrating positive end-expiratory pressure (PEEP) in this population. We sought to determine the feasibility and impact of implementation of a protocol for use of esophageal balloon to set PEEP in obese patients in a community ICU.

DESIGN:
Retrospective cohort study of obese (body mass index [BMI] ≥ 35 kg/m2) patients undergoing individualized PEEP titration with esophageal manometry. Data were extracted from electronic health record, and Wilcoxon signed rank test was performed to determine whether there were differences in the ventilatory parameters over time.

SETTING:
Intensive care unit in a community based hospital system in Newark, Delaware.

PATIENTS:
Twenty-nine mechanically ventilated adult patients with a median BMI of 45.8 kg/m2 with acute respiratory distress syndrome (ARDS).

INTERVENTION:
Individualized titration of PEEP via esophageal catheter obtained transpulmonary pressures.

MEASUREMENTS AND MAIN RESULTS:
Outcomes measured include PEEP, oxygenation, and driving pressure (DP) before and after esophageal manometry at 4 and 24 hr. Clinical outcomes including adverse events (pneumothorax and pneumomediastinum), increased vasopressor use, rescue therapies (inhaled pulmonary vasodilators, extracorporeal membrane oxygenation, and new prone position), continuous renal replacement therapy, and tracheostomy were also analyzed. Four hours after PEEP titration, median PEEP increased from 12 to 20 cm H2O (p < 0.0001) with a corresponding decrease in median DP from 15 to 13 cm H2O (p = 0.002). Subsequently, oxygenation improved as median Fio
2 decreased from 0.8 to 0.6 (p < 0.0001), and median oxygen saturation/Fio
2 (S/F) ratio improved from 120 to 165 (p < 0.0001). One patient developed pneumomediastinum. No pneumothoraces were identified. Improvements in oxygenation continued to be seen at 24 hr, compared with the prior 4 hr mark, Fio
2 (0.6–0.45; p < 0.004), and S/F ratio (165–211.11; p < 0.001). Seven patients required an increase in vasopressor support after 4 hours. Norepinephrine and epinephrine were increased by 0.05 (± 0.04) µg/kg/min and 0.02 (± 0.01) µg/kg/min on average, respectively.

CONCLUSIONS:
PL-guided PEEP titration in obese patients can be used to safely titrate PEEP and decrease DP, resulting in improved oxygenation.
The relative effectiveness of fecal immunochemical test-based colorectal cancer screening to detect adenomas and cancer in different demographic and socioeconomic groups. A nationwide cohort study
Authors: Larsen Mette Bach , Søborg Bo , Njor Sisse Helle , Jensen Thomas Møller , Ingeholm Peter , Andersen Berit 
Published: April 2022

Introduction
This study aimed at analyzing the relative effectiveness in removal of adenomas and detection of cancer of implementing colorectal cancer (CRC) screening in different demographic and socioeconomic groups.

Methods
This register-based retrospective cohort study included residents aged 50–72 years. Those randomly selected to be invited for CRC screening from 1 March 2014 to 30 June 2015 were classified as invited; those invited from 1 January 2016 to 31 December 2017 were classified as not yet invited. Strata-specific relative risks (RRs) of having adenomas removed and CRC detected were estimated.

Results
A total of 1 343 090 individuals were included. The RR of having adenomas removed were higher among men compared with women [RRwomen = 6.41 (95% confidence interval [CI]: 5.08–8.09), RRmen = 7.74 (95% CI: 6.16–9.73), P < 0.01] and among Danes compared with immigrants [RRDanes = 4.71 (95% CI: 3.73–5.93), RRWestern = 4.76 (95% CI: 3.39–6.69), RRnon-Western = 3.35 (95% CI: 2.39–4.69), P = 0.03]. Regarding detection of CRC, the effectiveness increased with increasing age ranging from RR = 1.53 (95% CI: 0.93– 2.51) to RR = 1.97 (95% CI: 1.22–3.17) (P = 0.04) and was higher among men compared with women (RRwomen = 1.75 (95% CI: 1.10–2.76), RRmen = 2.07 (95% CI: 1.32–3.26), P = 0.02.

Conclusion
Attention must be paid to the potential differences in screening effectiveness among diverse subpopulations; first, by securing equal opportunities for participation across subpopulations and second, by considering sex and age-specific screening programs.
Overcoming the Fukushima Wastewater Crisis: What the Japanese Authorities Could Do to Address Opposing Views
Authors: Ng Kwan Hoong , Yoong David , Gong Jiankun 
Published: April 2022

Abstract
In April 2021, the Japanese authorities’ announcement of their decision to release processed wastewater from the damaged Fukushima Daiichi nuclear power plant into the Pacific Ocean over 30 y, beginning in 2023, triggered strong domestic and international opposition. Failure to handle this situation tactfully can lead to public disorder, civil disobedience, loss of trust in the authorities, and even diplomatic sanctions. In this article, we explain the underlying reasons behind this resistance, and we offer some strategic methods that the Japanese authorities can deploy to address opposing views and overcome the Fukushima wastewater crisis.
The danger of underdiagnosing coronary microvascular disease in women
Authors: Behnke Lyn M. 
Published: April 2022

ABSTRACT
Heart disease is the number one killer of women in the United States. Part of the difficulty with diagnosing heart disease in women is related to a disease process called coronary microvascular disease (CMVD; previously called syndrome X). Also known as nonobstructive coronary artery disease, CMVD is challenging to identify because often there is a lack of convincing evidence of an acute problem during evaluation. In these patients, the epicardial coronary arteries do not have visible blockages, and stress tests often are interpreted as normal or false positive. Therefore, symptomatic patients often are left undiagnosed, frustrated, and at risk of adverse cardiac events. Frequently, the only method of diagnosis is treatment of the symptoms. This information is provided to help advanced practice nurses and other clinicians diagnose and treat CMVD.
Dilemma of identifying congenital hemolytic anemias in primary care
Authors: Kleinert Dorothy , Seibert Diane C. 
Published: April 2022

ABSTRACT
Anemia, the overall reduction of red blood cell (RBC) mass in an individual, occurs as a result of an underlying condition. It is probably the most common pathological state worldwide and can be acute, chronic, congenital, or acquired. It can be placed in one of three broad categories: blood loss, hypoproliferative, and hemolytic. The most common and easiest to correct is hypoproliferative anemia caused by nutritional deficiencies. The most common genetic anemias are caused by mutations on the alpha- or beta-globin genes, but there are other mutations that alter red cell membrane function or decrease the bone marrow's ability to manufacture RBCs. Understanding the mechanisms of anemia can help providers interpret the symptom(s)/presentation and guide the clinical workup. Nurse practitioners, especially those in primary care, should be able to recognize when a microcytic anemia is not caused by iron deficiency because these anemias are not corrected by iron supplementation and will need additional workup and referral to hematology.
Accessory Thyroid Tissue Detected Using 131I SPECT/CT Imaging
Authors: Tao Wilson Chun , Kang Owen , Russo Robert , Mansberg Robert 
Published: April 2022

Abstract
Thyroid ectopia has been described as a rare congenital anomaly, characterized by the presence of a thyroid gland in locations other than the orthotopic pretracheal location. The prevalence of accessory thyroid tissue in patients undergoing postablative radioiodine therapy in a 12-month period at a tertiary hospital nuclear medicine department was assessed. Fifty-seven patients were treated between September 2020 and September 2021. Retrospective analysis identified the presence and location of all accessory thyroid tissue separate from the orthotopic pretracheal thyroid gland. Accessory thyroid tissue was present in 21.1% (12/57) of the patients. Accessory thyroid tissue was most commonly located in the lingual region.
FAP-Targeted Radionuclide Therapy of Advanced Radioiodine-Refractory Differentiated Thyroid Cancer With Multiple Cycles of 177Lu-FAPI-46
Authors: Fu Hao , Huang Jingxiong , Sun Long , Wu Hua , Chen Haojun 
Published: April 2022

Abstract
Many recent studies began to explore the therapeutic potential of FAP-targeted radionuclide therapy for refractory cancers. In this case, we presented the experience of multiple cycles of 177Lu-FAPI-46 radionuclide therapy in a 34-year-old man with radioiodine-refractory differentiated thyroid cancer (RAIR-DTC). Intense radiotracer uptake was observed in RAIR-DTC metastatic lesions on the pretreatment 68Ga-FAPI PET/CT and posttherapeutic scintigraphy. Follow-up examinations after 4 cycles of 177Lu-FAPI-46 treatment revealed stable metastatic lesions, resulting in stable disease. This case demonstrated the potential feasibility of 177Lu-FAPI-46 in the treatment of advanced RAIR-DTC; further research on improving the FAP-targeting vector may be necessary.
Dysbiosis of the Female Murine Gut Microbiome Exacerbates Neutrophil-mediated Vascular Allograft Injury by Affecting Immunoregulation by Acetate
Authors: Rey Kevin M. , Tam Franklin F. , Enns Winnie , Rahim Javaria F. , Safari Kwestan , Guinto Elizabeth , Van Rossum Thea , Brinkman Fiona S.L. , Choy Jonathan C. 
Published: April 2022

Background.
The gut microbiota affects immune responses that cause organ transplant rejection, but the mechanisms by which this occurs remain poorly understood.

Methods.
We have examined, in a murine model, how disruption of the gut microbiota with antibiotics early in life alters this microbial community later in life to affect immune responses that injure vascular allografts.

Results.
Analysis of 16S rRNA and whole genome sequencing of the gut microbiota demonstrated that early life disruption of this microbial community with antibiotics caused a reduction in taxa and enzymatic genes involved in the synthesis of acetate, an immunoregulatory metabolite in mice and humans. When allograft vascular injury was examined, early life disruption of the gut microbiota increased neutrophil accumulation and related medial injury of transplanted arteries. Normalizing the gut microbiota by co-housing and oral administration of acetate prevented neutrophil-mediated vascular allograft injury.

Conclusions.
Dysbiosis of the gut microbiome that reduces its production of the immunoregulatory metabolite acetate exacerbates neutrophil-mediated allograft vascular injury.
Digging deeper into GWAS signal using GRIN implicates additional genes contributing to suicidal behavior
Authors: Sullivan Kyle A. , Lane Matthew , Cashman Mikaela , Miller J. Izaak , Pavicic Mirko , Walker Angelica M. , Cliff Ashley , Romero Jonathon , Qin Xuejun , Lindquist Jennifer , Mullins Niamh , Docherty Anna , Coon Hilary , Ruderfer Douglas M. ,   International Suicide Genetics Consortium,   VA Million Veteran Program,   MVP Suicide Exemplar Workgroup, Garvin Michael R. , Pestian John P. , Ashley-Koch Allison E. , Beckham Jean C. , McMahon Benjamin , Oslin David W. , Kimbrel Nathan A. , Jacobson Daniel A. , Kainer David 
Published: April 2022

AbstractGenome-wide association studies (GWAS) identify genetic variants underlying complex traits but are limited by stringent genome-wide significance thresholds. Here we dramatically relax GWAS stringency by orders of magnitude and apply GRIN (Gene set Refinement through Interacting Networks), which increases confidence in the expanded gene set by retaining genes strongly connected by biological networks from diverse lines of evidence. From multiple GWAS summary statistics of suicide attempt, a complex psychiatric phenotype, GRIN identified additional genes that replicated across independent cohorts and retained genes that were more biologically interrelated despite a relaxed significance threshold. We present a conceptual model of how these retained genes interact through neurobiological pathways to influence suicidal behavior and identify existing drugs associated with these pathways that would not have been identified under traditional GWAS thresholds. We demonstrate that GRIN is a useful community resource for improving the signal to noise ratio of GWAS results.
Weight-normative messaging predominates on TikTok – a qualitative content analysis
Authors: Minadeo Marisa , Pope Lizzy 
Published: April 2022

AbstractTiktok is a social media platform with many adolescent and young adult users. Food, nutrition, and weight-related posts are popular on TikTok, yet there is little understanding of the content of these posts, and whether nutrition-related content is presented by experts. The objective was to identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were downloaded and analyzed using template analysis. The one-hundred most viewed videos were downloaded from each of the ten chosen hashtags. Two coders then coded each video for key themes. Key themes included the glorification of weight loss in many posts, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to disordered eating behaviors and body dissatisfaction in the young people that are TikTok’s predominant users. Helping users discern credible nutrition information, and eliminate triggering content from their social media feeds may be strategies to address the weight-normative social media content that is so prevalent.
Aperiodic brain activity and response to anesthesia vary in disorders of consciousness
Authors: Maschke Charlotte , Duclos Catherine , Owen Adrian M. , Jerbi Karim , Blain-Moraes Stefanie 
Published: April 2022

AbstractThe analysis of human EEG has traditionally focused on oscillatory power, which is characterized by peaks above an aperiodic component in the power spectral density. This study investigates the aperiodic EEG component of individuals in a disorder of consciousness (DOC); how it changes in response to exposure to anesthesia; and how it relates to the brain’s information richness and criticality. High-density EEG was recorded from 43 individuals in a DOC, with 16 of these individuals undergoing a protocol of propofol anesthesia. The aperiodic component was defined by the spectral slope of the power spectral density. Our results demonstrate that the EEG aperiodic component is more informative about the participants’ level of consciousness than the oscillatory component. Importantly, the pharmacologically induced change in the spectral slope from 30-45 Hz positively correlated with individual’s pre-anesthetic level of consciousness. The pharmacologically induced loss of information-richness and criticality was associated with individual’s pre-anesthetic aperiodic component. During exposure to anesthesia, the aperiodic component was correlated with 3-month recovery status for individuals with DOC. The aperiodic EEG component has been historically neglected; this research highlights the necessity of considering this measure for the assessment of individuals in DOC and future research that seeks to understand the neurophysiological underpinnings of consciousness.
SARS-CoV-2 detection in wastewater as an early warning: the case of metropolitan area of the city of Buenos Aires (AMBA)
Authors: Barrio Alejandro , Borro Verónica , Cicchino Marcelo , Morón Adriana , Coronel Lorena , Vuolo Juan , Mayón Paula , Moroz Ayelén , Maisa Paula , Alcántara Sebastián , Torras María , Cervini Marcos , Arzeno Martín , Godoy Cristian , Campillay Diego , Filiel Nestor , Salas Ana , Salvio Paula 
Published: April 2022

AbstractAgua y Saneamientos Argentinos S.A. (AySA) delivers essential services as drinking water production and wastewater treatment for more than 14.5 million inhabitants of Buenos Aires Metropolitan Area (AMBA), Argentina, and collects residual liquids of 8.5 million through 16,178 km network. Since the very moment the World Health Organization (WHO) declared the COVID-19 pandemic, AySA developed a methodology to determine SARS-CoV-2 viral genetic load in untreated wastewater as an epidemiological surveillance tool, based on international experiences. In order to monitor viral load in the representative areas of the sewage collection system, more than 1500 samples where concentrated, by using an adapted ultracentrifugation method followed by RNA extraction and quantitative reverse transcription polymerase chain reaction (RT-qPCR), to measure the target Orf1ab gene of SARS-CoV-2 in our molecular microbiology laboratory.This research was developed for a period that lasted from January 01 to June 02, 2021, in order to anticipate to the current second wave. The results achieved have demonstrated that changes in SARS-CoV-2 RNA are satisfactorily related to local epidemiological data for COVID-19. The association of variables is statistically significant when analyzing data from four large wastewater treatment plants, (R2 > 0.5 and p-value < 0.05), obtaining significant correlations between log10 viral genomic load and log10 positive cases reported one and two weeks later after samples were analyzed.From the results obtained, it is concluded that the virus sewage system levels were a good predictor of clinical cases to be diagnosed in the immediate future and it is feasible to use this methodology, at local level, as an additional tool for decision-making in public health strategy.Highlights⍰Development of an integrated molecular sampling, analysis and detection system that can alert about the circulation of SARS-CoV-2.⍰Early warning of infected population.⍰First laboratory in a public water company to develop a monitoring method in Argentina.⍰Use of poly aluminum chloride (PAC) as a coagulant in the viral concentration stage.
Determinants of motivated behavior are linked to fatigue and its perturbation by SARS-CoV-2 vaccination
Authors: Stolz David S. , Luebber Finn , Lange Tanja , Borgwardt Stefan , Ziemann Malte , Riemekasten Gabriela , Rupp Jan , Müller-Pinzler Laura , Paulus Frieder M. , Krach Sören 
Published: April 2022

AbstractBackgroundFatigue has an adaptive function and serves as a temporary signal to rest and save energy often in response to immune activation. It may, however, also persist in a pathological condition incurring significant burden. While subjective symptoms and scientific consensus indicate that both physical and mental determinants of motivated behavior are affected in fatigue, the underlying processes are rarely examined using objective, task-based indicators.MethodsIn three consecutive studies, including validation (N = 48) and reliability assessments (N = 27), we use an experimental task to jointly objectify reward learning and effort execution as two determinants of behavioral motivation. In addition, we tested how fatigue and its acute perturbation in response to immune activation after SARS-CoV-2 vaccination are linked to these task-based indicators of motivation in a longitudinal cross-over design (N = 55).ResultsThe validation study showed the utility of the experimental task for simultaneously assessing learning, effort exertion, and its regulation based on subjective confidence. The reliability assessment over a one-week period indicated that symptoms of fatigue and task behavior are highly reliable and that repetition effects have little impact on motivated behavior. Finally, in the vaccination trial, we found significant links between fatigue and task behavior. Baseline levels of fatigue predicted how effort is gauged in dependence of current confidence about reward outcomes, and state perturbations of fatigue in the context of the SARS-CoV-2 vaccination reduced confidence during learning. Importantly, task success was significantly lower in subjects who reported high fatigue at baseline and who additionally experienced stronger increase in fatigue in response to vaccination.DiscussionOur results demonstrate that the experimental task allows to jointly assess determinants of motivated behavior, and to link its constituent processes to subjective fatigue. This suggests that our understanding of fatigue and its perturbation due to acute immune activation can benefit from objective, task-based indicators of the underlying motivational mechanisms. Future studies could build on these findings to further deepen the understanding of neurobehavioral mechanisms underlying fatigue in the context of immune activation.
Pronounced Regional Variation in Esketamine and Ketamine Prescribing to US Medicaid Patients
Authors: Aguilar Alexia G. , Beauregard Burke A. , Conroy Christopher P. , Khatiwoda Yashoda T. , Horsford Shantia M. E. , Nichols Stephanie D. , Piper Brian J. 
Published: April 2022

AbstractBackgroundKetamine, and its isomer esketamine are useful for treatment resistant depression (depression not responsive to traditional antidepressants). Compared to other antidepressants, ketamine and esketamine lack a therapeutic delay and do not increase risk of suicidality in adolescents. Esketamine gained FDA approval in March of 2019.ObjectiveThis study aimed to geographically characterize ketamine and esketamine prescriptions in the United States among Medicaid patients.MethodsKetamine and esketamine prescription rate data per state per quarter were obtained from the Medicaid State Drug Utilization Database for 2019-2020. Total prescription rates per year for ketamine and esketamine were obtained for 2009-2020.ResultsBetween 2009-2020, ketamine prescribing rates peaked in 2013 followed by a general decline. For ketamine and esketamine prescriptions in 2019, Montana and Indiana showed significantly higher prescription rates, respectively, relative to the national average. A total of 21 states prescribed neither ketamine or esketamine in 2019. Since its approval, esketamine prescriptions have surpassed those of ketamine. There was a 121.3% increase in esketamine prescriptions from 2019 to 2020. Ten states prescribed neither ketamine or esketamine in 2020.ConclusionDespite the effectiveness of ketamine and esketamine for treatment resistant depression, their use among Medicaid patients was limited and variable in many areas of the US.