bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic diastolic pressure decay explains sex-related differences in the subendocardial viability ratio: the Wakuya study
Authors: Tagawa Kaname , Tsuru Yusuke , Yokoi Katsumi , Aonuma Takanori , Hashimoto Junichiro 
Published: January 2022

Objective:
Coronary heart disease is the leading cause of mortality in women. Despite a higher risk of heart failure after the first myocardial infarction in women compared with men, the sex-specific mechanisms are unknown. We hypothesized that myocardial ischemia is attributable to sex-related diastolic alterations in the central hemodynamics.

Methods:
We investigated the subendocardial viability ratio (myocardial oxygen supply/demand) and aortic diastolic pressure decay index in 962 apparently healthy adults (mean age, 56 ± 10 years). Using noninvasive applanation tonometry, the subendocardial viability ratio, aortic diastolic pressure decay index, and aortic augmentation index were estimated in all participants. The aortic diastolic pressure decay index was quantified by fitting an exponential curve: P(t) = P
0e−λt (λ, decay index; P
0, end-systolic pressure; t, time from end-systole).

Results:
Women showed a significantly higher aortic diastolic pressure decay index, even after adjusting for age, hypercholesterolemia, and diabetes, and a significantly lower subendocardial viability ratio than men (P < 0.001). Analysis demonstrated a mediating effect of the aortic decay index on the sex-related differences in the subendocardial viability ratio (71%), despite different effects of the augmentation index (5%).

Conclusion:
These results suggest that the predisposition of women to coronary heart disease is more likely attributable to impaired myocardial perfusion caused by accelerated aortic diastolic pressure decay, rather than increased myocardial load due to augmented aortic systolic pressure.
Mapping of corneal birefringence in thin and asymmetric keratoconus corneas with ultrahigh-resolution polarization-sensitive OCT
Authors: Patil Rahul , Shetty Rohit , Narasimhan Raghav , Patel Yash , Khamar Pooja , Pircher Michael , Hitzenberger Christoph K. , Nuijts Rudy M.M.A. , Sinha Roy Abhijit 
Published: January 2022

Purpose:
To evaluate phase retardation (PR) across healthy eyes and eyes with thin corneas (<500 μm) and with asymmetric and bilateral keratoconus (KC).

Setting:
Narayana Nethralaya Eye Hospital, Bangalore, India.

Design:
Observational cross-sectional.

Methods:
There were 4 eye groups: healthy eyes (Group 1; n = 10 eyes), eyes with thin corneas and no clinical disease (Group 2; n = 10 eyes), eyes with asymmetric KC (Group 3; n = 5 eyes), and eyes with clinical KC (Group 4; n = 15 eyes). All eyes were imaged with polarization-sensitive optical coherence tomography (PS-OCT), MS-39, and Corvis-ST. Using PS-OCT, PR was analyzed in annular regions. The anterior (A-E) and Bowman (E-B) wavefront aberrations, epithelial Zernike indices (EZI), total corneal thickness, Corvis biomechanical index (CBI), total biomechanical index (TBI), and Belin-Ambrósio overall deviation index (BAD-D) were analyzed.

Results:
Only CBI, TBI, BAD-D, A-E and E-B aberrations, EZI, and total corneal thickness distributions of Groups 1 (n =10), 2 (n =10), and 3 (n =5) were similar (P > .05) but not CCT (P < .05). PR distributions clearly showed that the eyes in Groups 1, 2, and 3 had a normal corneal birefringence unlike Group 4 (n = 10) eyes (P < .05). The PR map was similar to the preferred orientations of collagen fibers seen in X-ray diffraction ex vivo studies of corneal stroma.

Conclusions:
PR distributions may eliminate the uncertainty associated with the stromal status of thin and asymmetric KC corneas. Group 2 and 3 eyes appeared as healthy because of normal corneal birefringence at the time of imaging, but a longitudinal follow-up of these eyes with PS-OCT may assist in early detection of onset of disease.
Are objective measures of sleep and sedentary behaviours related to low back pain flares?
Authors: Costa Nathalia , Smits Esther J. , Kasza Jessica , Salomoni Sauro , Rodriguez-Romero Beatriz , Ferreira Manuela L. , Hodges Paul W. 
Published: January 2022

Abstract
Risk factors for low back pain (LBP) flares have been considered about self-reported measures. This case–crossover study aimed to investigate whether (1) objective measures of physical activity and sleep were associated with the risk of experiencing LBP flares and (2) these associations differed for flares defined as pain 2 or more points greater than average pain over the period using an 11-point Numerical rating scale (0-no pain and 10-worst pain imaginable) (pain-defined flare: PDF) and flares identified by participants according to a broader definition that considered emotions or coping (self-reported flare [SRF]). We included 126 participants who had experienced LBP for >3 months. Physical activity and sleep were monitored for 28 days using wearable sensors. Occurrence of flares (PDF or SRF) was assessed daily using a smartphone application. Data on exposure to risk factors 1, 2, and 3 days preceding PDF or SRF were compared with nonflare control periods. Conditional logistic regression determined association between each factor and flares. Data show that day-to-day variation in physical activity and in-bed time are associated with the risk of LBP flares, but associations differ depending on how flare is defined. Longer in-bed time increased the risk of PDF but not SRF. Although physical activity was not associated with the risk of PDF, greater sedentary behaviour increased the risk of SRF and being more physically active decreased the risk for SRF. These results highlight the potential role of targeting sleep and physical activity in interventions to prevent LBP flares and indicate that risk factors differ depending on how LBP flares are defined.
Joint effects of back pain and mental health conditions on healthcare utilization and costs in Ontario, Canada: a population-based cohort study
Authors: Wong Jessica J. , Côté Pierre , Tricco Andrea C. , Watson Tristan , Rosella Laura C. 
Published: January 2022

Abstract
We assessed the joint effects of back pain and mental health conditions on healthcare utilization and costs in a population-based sample of adults in Ontario. We included Ontario adult respondents of the Canadian Community Health Survey between 2003 and 2012, followed up to 2018 by linking survey data to administrative databases. Joint exposures were self-reported back pain and mental health conditions (fair/poor mental health, mood, and anxiety disorder). We built negative binomial, modified Poisson and linear (log-transformed) models to assess joint effects (effects of 2 exposures in combination) of comorbid back pain and mental health condition on healthcare utilization, opioid prescription, and costs. The models were adjusted for sociodemographic, health-related, and behavioural factors. We evaluated positive additive and multiplicative interaction (synergism) between back pain and mental health conditions with relative excess risk due to interaction (RERI) and ratio of rate ratios (RRs). The cohort (n = 147,486) had a mean age of 46 years (SD = 17), and 51% were female. We found positive additive and multiplicative interaction between back pain and fair/poor mental health (RERI = 0.40; ratio of RR = 1.12) and mood disorder (RERI = 0.41; ratio of RR = 1.04) but not anxiety for back pain–specific utilization. For opioid prescription, we found positive additive and multiplicative interaction between back pain and fair/poor mental health (RERI = 2.71; ratio of risk ratio = 3.20) and anxiety (RERI = 1.60; ratio of risk ratio = 1.80) and positive additive interaction with mood disorder (RERI = 0.74). There was no evidence of synergism for all-cause utilization or costs. Combined effects of back pain and mental health conditions on back pain–specific utilization or opioid prescription were greater than expected, with evidence of synergism. Health services targeting back pain and mental health conditions together may provide greater improvements in outcomes.
Association of Adverse Events in Opioid Addiction Treatment With Quality Measure for Continuity of Pharmacotherapy
Authors: Liu Ying , Becker Andrew , Mattke Soeren 
Published: January 2022

ABSTRACT
Several quality measures for continuity of substance use care are being used in accountability programs, but it is not known whether they are predictive of better patient outcomes. We analyzed whether opioid use disorder (OUD) patients in the care of clinicians and practices with higher rates on one of these measures—continuity of pharmacotherapy for OUD—have a lower risk of overdose and detox events using Medicare data. For a 10-percentage point increase in an individual clinician's measure rate, the estimated odds ratios of a patient experiencing each of these two events were 0.92 (95% confidence interval [CI] 0.85 to 0.99) for overdose and 0.83 (95% CI 0.75 to 0.92) for detox. The corresponding estimates at the practice level were 0.90 (95% CI 0.85 to 0.95) for overdose and 0.83 (95% CI 0.77 to 0.89) for detox. These results suggest that a clinician's or practice's higher measure rate for continuity of pharmacotherapy for OUD is predictive of their patients' lower likelihood of having an adverse event. The findings contribute to a growing body of evidence on the importance of treatment continuity for OUD and support the validity of measuring continuity in provider-level accountability programs.
High Number of Medical Conditions Detected in Elite Athlete Periodic Health Evaluations, But Only Mild Consequences
Authors: de Vries Jesse T. , Wiggers Tom G. H. , Goedegebuure Simon , Reurink Guus 
Published: January 2022

Objective:
To evaluate the number of medical conditions detected by periodic health evaluations (PHEs) in elite athletes, and their consequences for management and medical clearance.

Design:
Retrospective design.

Participants:
Elite athletes of various sports in a high-performance program in The Netherlands, in the period between 2009 and 2020.

Interventions:
The PHEs consisted of a questionnaire, general and musculoskeletal physical examination, laboratory blood test, electrocardiogram, pulmonary function testing, and (cardiopulmonary) exercise test.

Main Outcome Measures:
We extracted and analyzed the medical conditions that led to advice, clinical follow-up, further diagnostic investigation or treatment, and the medical clearance status of the athlete (clearance, temporarily no clearance, or permanently no clearance).

Results:
We included 721 PHEs of 451 elite athletes. We found 1389 medical conditions that led to advice (n = 923, 66%), clinical follow-up (n = 124, 9%), further diagnostic investigation (n = 190, 14%), treatment (n = 132, 10%), or sports restriction (n = 20, 1%). Only 20 cases (3%) led to temporarily no medical clearance. After further investigation or treatment, no permanent sports restriction was imposed on any of the athletes.

Conclusions:
We found a high number of medical conditions detected with a PHE in elite athletes. However, the vast majority of detected conditions were mild, with consequences limited to preventive advice and follow-up. The yield of PHE to detect (potentially) severe pathological conditions seems low. Clinical relevance of PHE in elite athletes and potential future health benefits remain unclear.
Quantification of Maternal Microchimeric Cells in the Liver of Children With Biliary Atresia
Authors: Tamaoka Satoshi , Fukuda Akinari , Katoh‐Fukui Yuko , Hattori Atsushi , Uchida Hajime , Shimizu Seiichi , Yanagi Yusuke , Kanaan Sami B. , Sakamoto Seisuke , Kasahara Mureo , Yoshioka Takako , Fukami Maki 
Published: January 2022

ABSTRACTBiliary atresia (BA) is a rare disorder of unknown etiology. There is a debate as to whether maternal microchimerism plays a significant role in the development of BA or in graft tolerance after liver transplantation. Here, we performed quantitative‐PCR‐based assays for liver tissues of children with BA and other diseases. Maternal cells were detected in 4/13 and 1/3 of the BA and control groups, respectively. The estimated number of maternal cells ranged between 0 and 34.7 per 106 total cells. The frequency and severity of maternal microchimerism were similar between the BA and control groups, and between patients with and without acute rejection of maternal grafts. These results highlight the high frequency of maternal microchimerism in the liver. This study provides no evidence for roles of microchimerism in the etiology of BA or in graft tolerance. Thus, the biological consequences of maternal microchimerism need to be clarified in future studies.
Prenatal Symptom Cluster of Psychopathology and Associations With Mindfulness and Rumination
Authors: Sun Yaoyao , Chen Qingyi , Li Yanyan , Wang Juan , Bazzano Alessandra N. , Cao Fenglin 
Published: January 2022

Abstract
The present study aimed to examine the interrelationships of prenatal psychopathology (specifically symptom cluster), dispositional mindfulness, and rumination using network analysis. Network analysis estimates the links between symptoms and can evaluate the presence and strength of the links. A total of 1122 pregnant women were recruited from a tertiary hospital in China. Psychopathology symptoms (including anxiety, depression, stress, fatigue, sleep, fear of childbirth [FOC], and memory problems) were assessed and used along with mindfulness and rumination to construct networks of association using R. Results illustrated five communities within the network. Anxiety resulted in the highest strength of centrality followed by two symptoms: FOC and retrospective memory. Paths showed that mindfulness was directly connected to depression, prospective memory, retrospective memory, and lack of positive anticipation in FOC, whereas mindfulness was connected indirectly through rumination to anxiety, fatigue, stress, and sleep problems. The findings reinforce that anxiety is a key symptom of prenatal psychopathology and requires priority consideration. The direct associations between mindfulness and prenatal psychopathology symptoms provide potential targets for future mindfulness-based interventions, and mindfulness reducing rumination thus in turn decrease anxiety, suggesting potential mediating mechanism of mindfulness.
Evaluating the Strength of Association of Human Papillomavirus Infection With Penile Carcinoma: A Meta-Analysis
Authors: Catalfamo Collin J. , Brown Heidi E. , Dennis Leslie K. 
Published: January 2022

Background
Human papillomavirus (HPV) is a common sexually transmitted infection that is strongly associated with cervical cancer. A link to penile cancers has been suggested by case series. We sought to assess the strength of the association between HPV infection and penile cancer by meta-analysis.

Methods
A literature search to identify population-based studies evaluating the risk of HPV infection with penile cancer was conducted via PubMed and Google Scholar databases through December 2020. Studies were included in the pooled analyses if they presented relative risk (RR) estimates comparing penile cancer cases with noncases by HPV exposure status. They were stratified by (1) type of HPV, (2) test used to determine past HPV infection, and (3) the penile cancer type. Pooled analyses were conducted for stratum with at least 2 independent studies using fixed-effects and random-effects models.

Results
Fourteen articles representing 9 study populations fit the inclusion criteria and were included in the pooled analysis. Based on these studies, the pooled RRs are 2.9 (95% confidence interval [CI], 1.7–5.0; n = 4 studies) for invasive penile cancer and seropositivity to HPV16 L1, 4.5 (95% CI, 1.3–15.5; n = 2) for seropositivity to HPV18, and 8.7 for anogenital warts (95% CI, 5.1–14.8; n = 5). For the 3 studies reporting invasive and in situ penile cancer, the risk was 7.6 for anogenital warts.

Conclusions
The pooled RRs indicate up to a 4.5-fold increased risk between seropositivity for HPV infection and invasive penile cancer. This is much lower than associations seen between HPV and cervical cancer.
Distal Triceps Tendon Tears: Magnetic Resonance Imaging Patterns Using a Systematic Classification
Authors: Vicentini Joao R.T. , Hilgersom Nicolaas F.J. , Martinez-Salazar Edgar L. , Simeone F. Joseph , Bredella Miriam A. , Palmer William E. , Oh Luke S. , Torriani Martin 
Published: January 2022

Objective
This study aimed to evaluate distal triceps tendon tear patterns using a systematic classification based on the tendon's layered structure.

Methods
We retrospectively identified Magnetic resonance imaging (MRI) examinations with triceps tendon tears that underwent reconstructive surgery. Magnetic resonance images were reviewed independently by 2 musculoskeletal radiologists to determine tendon layer involvement and ancillary findings, including tear size, involvement of triceps lateral expansion, and presence of olecranon bursal fluid. Surgical reports were scrutinized for level of anatomic detail and correlation with imaging findings.

Results
We identified 69 triceps tendon tears in 68 subjects (61 men, 7 women; mean age, 45 ± 12 years) who underwent surgical reconstruction. On MRI, the superficial layer was always involved with either a partial or full-thickness tear. The most common tear pattern was a combination of superficial layer full-thickness tear with deep layer partial tear (25 of 69 [36%]). Mean tear length was 24 ± 12 mm. We found no cases of isolated deep layer tears. Involvement of triceps lateral expansion and presence of bursal fluid correlated positively with tear severity of superficial and deep layers (P < 0.001). Detailed surgical correlation was limited, with only 9 of 69 (13%) of surgical reports containing information specifically addressing individual tendon layers.

Conclusions
Triceps tendon tears show tear patterns following its layered structure and can be assessed by MRI. Radiologists and surgeons are encouraged to describe tear patterns considering both superficial and deep tendon layers.
Differentiation Between Solitary Pulmonary Inflammatory Lesions and Solitary Cancer Using Gemstone Spectral Imaging
Authors: Zhu Liu-hong , Wang Fu-nan , Wang Yan-wei , Cheng Qi-hua , Zhou Jian-jun 
Published: January 2022

Background
The distinction between solitary inflammatory lesion and solitary lung cancer remains a challenge because of their considerable overlapping computed tomography (CT) imaging features.

Purpose
This study aimed to verify whether spectral CT parameters can differentiate solitary lung cancer from solitary inflammatory lesions and to find their correlations with lesion size.

Methods
A total of 78 patients with solitary lung lesions were included in our study. All of them underwent enhanced CT scans with Gemstone Spectral Imaging (GSI) mode, which was one of the dual-energy imaging technologies. According to maximum diameter (D
max) of the lesion, regions of interest were collected and divided into inflammatory (group I: <3 cm [IA], n = 17; ≥3 cm [IB], n = 14) and cancer groups (group II: <3 cm [IIA], n = 20; ≥3 cm [IIB], n = 27). Computed tomography values (HU40keV, HU70keV), effective atomic number (Z
eff), iodine concentration (IC), normalized IC (NIC), and spectral curve slopes (λ
30, λ
40) of each region of interest were calculated. The NIC was defined as the IC ratio of the lesion to the descending aorta. Mann-Whitney U test was used for intergroup (I vs II, IA vs IIA, IB vs IIB) and intragroup (IA vs IB, IIA vs IIB) comparisons, and receiver operating characteristic curve analysis was performed. Correlation analysis was applied to find the relationship between D
max and GSI parameters.

Results
No significant correlation was found between GSI parameters and D
max in the inflammatory group, whereas inverse correlations were found in the cancer group. Gemstone spectral imaging parameters (except HU70keV) of group IIA were significantly higher than those of group IIB. There were significant differences in HU40keV, IC, NIC, λ
30, and λ
40 between groups IB and IIB under both arterial and venous phase (P values < 0.05), whereas the area under the curve for λ
30 under venous phase was largest, and sensitivity and specificity were 96.32% and 85.71%, respectively. However, only HU40keV and HU70keV values under the arterial phase of IIA were significantly higher than those of IA.

Conclusions
Quantitative parameters of GSI demonstrated an inverse correlation with the lesion size of solitary lung cancer, and GSI parameters can be new ways to differentiate solitary lung cancer from solitary inflammatory lesions.
The Potential Value of 320-Row Computed Tomography Angiography in Digital Subtraction Angiography–Negative Spontaneous Subarachnoid Hemorrhage Patients
Authors: Wu Shengfeng 
Published: January 2022

Objective
This study aimed to investigate the clinical value of multiphase and multiparametric 320-row computed tomography (CT) in the long-term follow-up of spontaneous subarachnoid hemorrhage (SAH) with initially negative CT angiography (CTA) and digital subtraction angiography (DSA) results.

Methods
We retrospectively analyzed the clinical data of 35 patients with nontraumatic angiographically negative SAH results from February 2012 to December 2015. Regular follow-up was performed with 320-row CTA, CT venography, and CT perfusion.

Results
All patients received 320-row CT follow-up for 0.5 to 4 years. The diagnostic yield of the follow-up examinations was 4 of 35 (11.4%), 3 of 31 (9.7%), and 1 of 28 (3.6%) for the first, second, and third time points, respectively. Two patients were admitted to the hospital because of recurrent subarachnoid hemorrhage during the follow-up period and diagnosed with ruptured aneurysms.

Conclusions
Patients with SAH with negative findings in the first DSA examination require to follow up. Follow-up using 320-row CTA, CT venography, and CT perfusion allows for a noninvasive diagnostic test for cerebrovascular diseases with higher compliance and fewer complications when compared with follow-up using DSA.
A Renal Cyst Invaded by Infiltrating Renal Cell Carcinoma With Multiple Hypermetabolic Bone Metastases as the Initial Presentation
Authors: Wang Shu , Du Bulin , Li Xuena , Li Yaming 
Published: January 2022

Abstract
Cystic renal cell carcinoma (RCC) refers to an indolent version of RCC composed predominantly of cysts, and it is associated with good prognosis. We showed the FDG PET/CT findings in a patient with multiple hypermetabolic bone metastases presenting with pain in the left shoulder and upper abdomen, who was later found to have cystic RCC. FDG PET/CT demonstrated hypermetabolic bone lesions and slight thickening of the renal cyst wall with light metabolism. This report indicates the risk of misdiagnosing cystic RCC as a renalcyst.