bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive differentiation of molecular subtypes of adult nonenhancing glioma using MRI perfusion and diffusion parameters
Authors: Pruis Ilanah J , Koene Stephan R , van der Voort Sebastian R , Incekara Fatih , Vincent Arnaud J P E , van den Bent Martin J , Lycklama à Nijeholt Geert J , Nandoe Tewarie Rishi D S , Veldhuijzen van Zanten Sophie E M , Smits Marion 
Published: February 2022

Abstract

Background
Nonenhancing glioma typically have a favorable outcome, but approximately 19–44% have a highly aggressive course due to a glioblastoma genetic profile. The aim of this retrospective study is to use physiological MRI parameters of both perfusion and diffusion to distinguish the molecular profiles of glioma without enhancement at presentation.

Methods
Ninety-nine patients with nonenhancing glioma were included, in whom molecular status (including 1p/19q codeletion status and IDH mutation) and preoperative MRI (T2w/FLAIR, dynamic susceptibility-weighted, and diffusion-weighted imaging) were available. Tumors were segmented semiautomatically using ITK-SNAP to derive whole tumor histograms of relative Cerebral Blood Volume (rCBV) and Apparent Diffusion Coefficient (ADC). Tumors were divided into three clinically relevant molecular profiles: IDH mutation (IDHmt) with (n = 40) or without (n = 41) 1p/19q codeletion, and (n = 18) IDH-wildtype (IDHwt). ANOVA, Kruskal-Wallis, and Chi-Square analyses were performed using SPSS.

Results
rCBV (mean, median, 75th and 85th percentile) and ADC (mean, median, 15th and 25th percentile) showed significant differences across molecular profiles (P &lt; .01). Posthoc analyses revealed that IDHwt and IDHmt 1p/19q codeleted tumors showed significantly higher rCBV compared to IDHmt 1p/19q intact tumors: mean rCBV (mean, SD) 1.46 (0.59) and 1.35 (0.39) versus 1.08 (0.31), P &lt; .05. Also, IDHwt tumors showed significantly lower ADC compared to IDHmt 1p/19q codeleted and IDHmt 1p/19q intact tumors: mean ADC (mean, SD) 1.13 (0.23) versus 1.27 (0.15) and 1.45 (0.20), P &lt; .001).

Conclusions
A combination of low ADC and high rCBV, reflecting high cellularity and high perfusion respectively, separates IDHwt from in particular IDHmt 1p/19q intact glioma.
Bridging oxidase catalysis and oxygen reduction electrocatalysis by model single-atom catalysts
Authors: Lu Xiangyu , Gao Shanshan , Lin Han , Tian Han , Xu Deliang , Shi Jianlin 
Published: February 2022

Abstract
Nanocatalysts with enzyme-like catalytic activities, such as oxidase mimics, are extensively used in biomedicine and environmental treatment. Searching for enzyme-like nanomaterials, clarifying the origins of catalytic activity and developing activity assessment methodologies are therefore of great significance. Here, we report that oxidase catalysis and oxygen reduction reaction (ORR) electrocatalysis can be well bridged based on their identical activity origins, which makes facile electrocatalytic ORR activity measurements intrinsically applicable to oxidase-like activity evaluations. Inspired by natural heme-copper oxidases, Cu/Fe-doped single-atom catalysts (SACs) were first synthesized and used as model catalysts. Chromogenic reactions, electrochemical voltammetric measurements and density functional theory calculations further verified the linear relationship between the oxidase-like and ORR catalytic activities of the catalysts; thus, an effective descriptor ($| {\overline {{j_{\rm{n}}}} } |$) is proposed for rapid enzymatic catalyst evaluation. Evidence suggests that the enhanced tumour therapeutic efficacy of SACs is a result of their oxidase-like/ORR activities, which proves that numerous ORR electrocatalysts are promising candidates for oxidase mimics and tumour therapy. The synergistic catalytic effect of the biomimetic heterobinuclear Cu-Fe centres has also been thoroughly probed.
“Scary and Effective, Definitely Pushes Me to Quit Smoking”: Developing Waterpipe Pictorial Health Warnings Targeting Young Adults in Lebanon
Authors: Asfar Taghrid , Chehab Sara , Schmidt Michael , Ward Kenneth D , Maziak Wasim , Nakkash Rima 
Published: February 2022

Abstract

Introduction
Waterpipe (WP) smoking is the leading tobacco use method among young adults in Lebanon. WP use is harmful, yet misperceptions about its safety exist. Implementing pictorial health warning labels (HWLs) on WP products is a promising strategy to correct this misperception. This study aimed to culturally adapt a set of 12 pictorial HWLs recently developed by an international expert panel to young adults in Lebanon. HWLs were grouped into four themes: WP health risks, WP harm to others, WP-specific harms, and WP harm compared to cigarettes.

Aims and Methods
We conducted nine focus groups among WP smokers and nonsmokers (N = 77; 52% females; age 18–34 years) to explore participants’ perceptions of the developed HWLs on attention, reaction (fear, avoidance), effectiveness (harm perception), and improvement (design/content, relatedness). Sessions were audio-taped, transcribed verbatim, and analyzed using directed qualitative content analysis.

Results
Emotionally provocative warnings were perceived as most effective, while symbolic and abstract warnings were found not believable. Warnings depicting visible bodily health effects and harm to babies seemed most promising. Participants were generally skeptical about Theme 4 because it might encourage switching to cigarettes. For cultural adaptation, participants recommended using shorter text with affirmative phrases, increasing the picture’s size and improving their quality, adding the WP device picture to enhance HWLs’ relatability, and develop testimonial messages that depict real people and stories.

Conclusions
Results will provide Lebanon and perhaps other countries in the Eastern Mediterranean Region with evidence-based HWLs that they can further develop, test, and implement within their specific culture.

Implications
Results provide Lebanon with evidence-based WP-specific pictorial HWLs that can be further developed and tested. HWLs provoking negative affect, with visible health consequences, and depicting harm to babies are promising. Participants recommended using definitive scientific claims presenting the health risks in numerical form. However, this needs to be balanced against protecting the credibility of HWLs scientifically and legally. Increasing the HWLs size and adding the WP device picture to the HWLs can enhance their relatability. Further research can help address some questions raised by this study, such as the potential of testimonial warnings that depict real people.
Spatial dependency in child malnutrition across 640 districts in India: need for context-specific planning and interventions
Authors: Vennam Thirumal Reddy , Agnihotri Satish B , Chinnasamy Pennan 
Published: February 2022

AbstractBackgroundChild malnutrition remains a matter of concern in India as the current levels are high and the decline is slow. National Family Health Survey (NFHS–4, 2015-16) data, for the first time, provides credible, good quality data at district level on social, household and health characteristics.MethodsTechniques of spatial analysis on data in respect of 640 districts were used to identify spatial characteristics of the nutrition levels for children in the 0–60-month age group. Further, the principal component analysis (PCA) was used to identify 7 important correlates of the malnutrition out of 21 relevant components provided in the NFHS-4. The paper further uses three techniques, ordinary least squares (OLS), spatial lag model (SLM) and spatial error model (SEM) to assess the strength of correlation between the malnutrition levels and the shortlisted correlates.ResultsThe use of SLM and SEM shows improvement in the strength of the association (high R-square) compared to OLS. Women's height and Iodized salt in stunting, child anaemia in wasting, women's height and child anaemia in underweight were found to be significant factors (P &lt; 0.01) along with spatial autoregressive constant.ConclusionsSuch analysis, in combination with PCA, has shown to be more effective in prioritizing the programme interventions for tackling child malnutrition.
A taxonomy of high school students’ levels of understanding in solving algebraic problems
Authors: Egodawatte Gunawardena 
Published: February 2022

AbstractThe research reported in this article sought to develop a taxonomy of grade 11 students’ levels of understanding in algebraic problem-solving tasks. The student sample was from high schools in the province of Ontario in Canada. Problems from four areas in algebra namely, variables, expressions, equations and word problems were chosen to be represented in the test paper. A six-level taxonomy was constructed by analyzing the structure of students’ written responses and their subsequent interview transcripts. The first three levels of the taxonomy belong to the application of lower level thinking skills while the last two levels belong to the application of higher level thinking skills. The taxonomy serves two purposes. Teachers can use it for formulating objectives in classroom teaching, and they can also use it as an evaluation tool in constructing assessment items.
Old Enough to Perceive Things Differently? Detecting Measurement Invariance Across Age Groups Using Item-Focused Tree
Authors: Guo Feng , Min Hanyi , Jex Steve , Choi Yeeun 
Published: February 2022

AbstractThe current study applies a new technique, item-focused tree (IFT), to investigate measurement invariance (MI) across age groups. MI is violated when differential item functioning (DIF) is detected. Compared to traditional DIF techniques, IFT does not require researchers to artificially split respondents into multiple groups when the covariate is continuous (e.g., age). Moreover, with IFT, researchers can examine DIF induced by multiple covariates at one time. The current study applies IFT technique to better understand how items in various measures may be perceived differently by respondents of varying ages, where IFT examined DIF induced by sex, work experience, and age simultaneously. Results from a two-wave dataset suggested that age was the sole covariate associated with all the DIF identified. Specifically, across both waves, older workers were more likely to express disapproval toward a few negative stated items (e.g., not learning, not picking up new skills, and having no positive effect on others), with moderate effect sizes. The DIF tree plots built by IFT algorithm further indicated the age of 50 years old as the key point to split 2 age subgroups where DIF is mostly like to be observed. Additionally, education was found to induce DIF jointly with age in the exploratory analyses. Implications, limitations, and future directions are discussed. A brief tutorial on how to conduct IFT using R is also included.
Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery: A Multicenter Retrospective Cohort Analysis
Authors: Reale Sharon C. , Bauer Melissa E. , Klumpner Thomas T. , Aziz Michael F. , Fields Kara G. , Hurwitz Rachel , Saad Manal , Kheterpal Sachin , Bateman Brian T. ,   Multicenter Perioperative Outcomes Group Collaborators
Published: February 2022

Background
Estimates for the incidence of difficult intubation in the obstetric population vary widely, although previous studies reporting rates of difficult intubation in obstetrics are older and limited by smaller samples. The goals of this study were to provide a contemporary estimate of the frequency of difficult and failed intubation in women undergoing general anesthesia for cesarean delivery and to elucidate risk factors for difficult intubation in women undergoing general anesthesia for cesarean delivery.

Methods
This is a multicenter, retrospective cohort study utilizing the Multicenter Perioperative Outcomes Group database. The study population included women aged 15 to 44 yr undergoing general anesthesia for cesarean delivery between 2004 and 2019 at 1 of 45 medical centers. Coprimary outcomes included the frequencies of difficult and failed intubation. Difficult intubation was defined as Cormack–Lehane view of 3 or greater, three or more intubation attempts, rescue fiberoptic intubation, rescue supraglottic airway, or surgical airway. Failed intubation was defined as any attempt at intubation without successful endotracheal tube placement. The rates of difficult and failed intubation were assessed. Several patient demographic, anatomical, and obstetric factors were evaluated for potential associations with difficult intubation.

Results
This study identified 14,748 cases of cesarean delivery performed under general anesthesia. There were 295 cases of difficult intubation, with a frequency of 1:49 (95% CI, 1:55 to 1:44; n = 14,531). There were 18 cases of failed intubation, with a frequency of 1:808 (95% CI, 1:1,276 to 1:511; n = 14,537). Factors with the highest point estimates for the odds of difficult intubation included increased body mass index, Mallampati score III or IV, small hyoid-to-mentum distance, limited jaw protrusion, limited mouth opening, and cervical spine limitations.

Conclusions
In this large, multicenter, contemporary study of more than 14,000 general anesthetics for cesarean delivery, an overall risk of difficult intubation of 1:49 and a risk of failed intubation of 1:808 were observed. Most risk factors for difficult intubation were nonobstetric in nature. These data demonstrate that difficult intubation in obstetrics remains an ongoing concern.

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Quantitative Neuromuscular Monitoring in Clinical Practice: A Professional Practice Change Initiative
Authors: Weigel Wade A. , Williams Barbara L. , Hanson Neil A. , Blackmore C. Craig , Johnson Randy L. , Nissen Gary M. , James Andrew B. , Strodtbeck Wyndam M. 
Published: February 2022

Background
Residual neuromuscular blockade can be avoided with quantitative neuromuscular monitoring. The authors embarked on a professional practice initiative to attain documented train-of-four ratios greater than or equal to 0.90 in all patients for improved patient outcomes through reducing residual paralysis.

Methods
The authors utilized equipment trials, educational videos, quantitative monitors in all anesthetizing locations, and electronic clinical decision support with real-time alerts, and initiated an ongoing professional practice metric. This was a retrospective assessment (2016 to 2020) of train-of-four ratios greater than or equal to 0.9 that were documented before extubation. Anesthesia records were manually reviewed for neuromuscular blockade management details. Medical charts of surgical patients who received a neuromuscular blocking drug were electronically searched for patient characteristics and outcomes.

Results
From pre- to postimplementation, more patients were assigned American Society of Anesthesiologists Physical Status III to V, fewer were inpatients, the rocuronium average dose was higher, and more patients had a prereversal train-of-four count less than 4. Manually reviewed anesthesia records (n = 2,807) had 2 of 172 (1%) cases with documentation of train-of-four ratios greater than or equal to 0.90 in November 2016, which was fewer than the cases in December 2020 (250 of 269 [93%]). Postimplementation (February 1, 2020, to December 31, 2020), sugammadex (650 of 935 [70%]), neostigmine (195 of 935 [21%]), and no reversal (90 of 935 [10%]) were used to attain train-of-four ratios greater than or equal to 0.90 in 856 of 935 (92%) of patients. In the electronically searched medical charts (n = 20,181), postimplementation inpatients had shorter postanesthesia care unit lengths of stay (7% difference; median [in min] [25th, 75th interquartile range], 73 [55, 102] to 68 [49, 95]; P < 0.001), pulmonary complications were less (43% difference; 94 of 4,138 [2.3%] to 23 of 1,817 [1.3%]; P = 0.010; −1.0% difference [95% CI, –1.7 to –0.3%]), and hospital length of stay was shorter (median [in days] [25th, 75th], 3 [2, 5] to 2 [1, 4]; P < 0.001).

Conclusions
In this professional practice initiative, documentation of train-of-four ratios greater than or equal to 0.90 occurred for 93% of patients in a busy clinical practice. Return-of-strength documentation is an intermediate outcome, and only one of many factors contributing to patient outcomes.

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Improving In-Hospital Patient Rescue: What Are Studies on Early Warning Scores Missing? A Scoping Review
Authors: Esmaeilzadeh Sarvie , Lane Conor M. , Gerberi Danielle J. , Wakeam Elliot , Pickering Brian W. , Herasevich Vitaly , Hyder Joseph A. 
Published: February 2022

OBJECTIVES:
Administrative and clinical efforts to improve hospital mortality and intensive care utilization commonly focus on patient rescue, where deteriorating patients are systematically identified and intervened upon. Patient rescue is known to depend on hospital context inclusive of technologic environment, structural features, and hospital organizational behavioral features. With widespread adoption of electronic medical records, early warning score (EWS) systems, which assign points to clinical data elements, are increasingly promoted as a tool for timely patient rescue by referencing their prediction of patient deterioration. We describe the extent to which EWS intervention studies describe the hospital environment of the intervention—details that would be critical for hospital leaders attempting to determine the real-world utility of EWSs in their own hospitals.

DATA SOURCES:
We searched CINAHL, PubMed, and Scopus databases for English language EWS implementation research published between 2009 and 2021 in adult medical-surgical inpatients.

STUDY SELECTION:
Studies including pediatric, obstetric, psychiatric, prehospital, outpatient, step-down, or ICU patients were excluded.

DATA EXTRACTION:
Two investigators independently reviewed titles/abstracts for eligibility based on prespecified exclusion criteria.

DATA SYNTHESIS:
We identified 1,434 studies for title/abstract screening. In all, 352 studies underwent full-text review and 21 studies were summarized. The 21 studies (18 before-and-after, three randomized trials) detailed 1,107,883 patients across 54 hospitals. Twelve reported the staff composition of an EWS response team. Ten reported the proportion of surgical patients. One reported nursing ratios; none reported intensive care staffing with in-house critical-care physicians. None measured changes in bed utilization or availability. While 16 qualitatively described resources for education/technologic implementation, none estimated costs. None described workforce composition such as team stability or culture of safety in the hospitals.

CONCLUSIONS:
Despite hundreds of EWS-related publications, most do not report details of hospital context that would inform decisions about real-world EWS adoption. To make informed decisions about whether EWS implementation improves hospital quality, decision-makers may require alternatives such as peer networks and implementation pilots nested within local health systems.
Progressive Multiple Mononeuropathy in a Patient With Familial Transthyretin Amyloidosis After Liver Transplantation
Authors: Seibert Kaitlin , Wlodarski Richard , Sarswat Nitasha , Appelbaum Daniel , Issa Naoum P. , Soliven Betty , Rezania Kourosh 
Published: February 2022

Abstract
Valine 122 isoleucine (V122I) is the most common mutation associated with familial transthyretin-related amyloidosis (fATTR) in the metropolitan United States. V122I-related fATTR usually presents with cardiomyopathy. When polyneuropathy is encountered, it is usually mild, distal, and axonal in nature. Although liver transplantation improves survival for fATTR neuropathy patients, neuropathy may progress post liver transplantation because of the deposition of wild-type transthyretin. We report a patient with homozygous V122I mutation who presented with asymmetrical, upper limb predominant neuropathy rather early in his disease course, which progressed for a period of 5 years after liver transplantation before stabilization with the initiation of patisiran.
MULTICOLOR CONFOCAL SCANNING LASER OPHTHALMOSCOPE IMAGING IN POSTERIOR UVEITIS
Authors: Gupta Kajree , Agarwal Aniruddha , Arora Atul , Aggarwal Kanika , Bansal Reema , Katoch Deeksha , Marchese Alessandro , Singh Simar R. , Agrawal Rupesh , Gupta Vishali 
Published: February 2022

Purpose:
To study the utility of MultiColor confocal scanning laser ophthalmoscope imaging (MCI) in identifying the morphology of uveitic lesions compared with conventional color fundus photography (CFP) in patients with posterior uveitis.

Methods:
In this prospective observational study, subjects with posterior uveitis underwent MCI and CFP. The images obtained by the two modalities were analyzed by two independent reviewers for vitreoretinal surface abnormalities, retinal fluid and hemorrhages, and depth/location of lesions. These findings were compared with the clinical findings and other imaging techniques.

Results:
Sixty-nine eyes of 43 patients (25 men) with mean age of 33.5 ± 13.9 years were studied. MultiColor imaging had better sensitivity and specificity in detecting vitreoretinal interface abnormalities, such as epiretinal membrane and inner retinal striae, compared with CFP. MultiColor imaging failed to detect retinochoroiditis lesions in 5 of 6 eyes (83%) and choroiditis in 9 46 eyes (20%), which were detected on CFP and clinical examination. Also, MCI showed a high false-positive rate of 34% in detecting intraretinal hemorrhages.

Conclusion:
Retinochoroidal lesions in posterior uveitis may be poorly identified on MCI compared with CFP and clinical examination. One must exercise caution in commenting on disease morphology based on MCI alone.
POSTERIOR VITREOUS DETACHMENT STATUS AS A PREDICTIVE FACTOR FOR OUTCOMES OF VITRECTOMY FOR DIABETIC VITREOUS HEMORRHAGE
Authors: Tandias Rachel , Lemire Colin A. , Palvadi Karishma , Arroyo Jorge G. 
Published: February 2022

Purpose:
The purpose of this study was to evaluate the prognostic utility of the degree of vitreous attachment for predicting outcomes of vitrectomy for nonclearing vitreous hemorrhage associated with proliferative diabetic retinopathy.

Methods:
Medical records of patients who underwent primary vitrectomy for dense nonclearing vitreous hemorrhage secondary to proliferative diabetic retinopathy were examined retrospectively. Eyes were divided into four groups based on the intraoperatively assessed stage of posterior vitreous detachment (PVD), ranging from Stage 0/1 (complete or near-complete vitreoretinal adhesion) to Stage 4 (complete PVD).

Results:
Overall, 136 eyes (117 patients) were included. In comparison with eyes with a partial or complete PVD (Stages 2–4), eyes with no PVD (Stage 0/1) had a higher incidence of postoperative hypotony (8%, P = 0.03) and traction retinal detachment (27%, P = 0.002), an increased rate of repeat vitrectomy (49%, P = 0.04), and poorer best-corrected visual acuity at 6 months and 1 year postoperatively (P = 0.04 and P = 0.01, respectively). Presence of a complete PVD at baseline was independently associated with improved postoperative vision at 6 months (P = 0.04).

Conclusion:
More extensive vitreoretinal adhesion is associated with higher rates of reoperation and poorer visual outcomes after vitrectomy for dense nonclearing vitreous hemorrhage associated with proliferative diabetic retinopathy. Preoperative determination of PVD status using B-scan ultrasonography may be useful for predicting anatomical and functional outcomes after vitrectomy in these patients.