bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clostridioides difficile toxin is infrequently detected in inflammatory bowel disease and does not associate with clinical outcomes
Authors: Bernard Rachel , Hammami Muhammad B. , Arnold Forest W. , Mcgrath Brian , Patel Alieysa , Wuerth Brandon , Nicholson Maribeth R. , Rao Krishna , Micic Dejan 
Published: August 2022

Abstract
Introduction
Clostridioides difficile infection (CDI) rates and outcomes can vary based on differences in testing strategy. Our aim was to assess the prevalence of toxin detection in inflammatory bowel disease (IBD) when compared to those without IBD. Secondly, the clinical outcomes of CDI in IBD were assessed using two-step testing strategies.

Methods
We included patients undergoing CDI testing from four academic centers in the United States between January 1, 2018 and June 30, 2020. First the prevalence of toxin detection was compared between individuals with IBD and those without IBD. Secondly, among patients with IBD a primary composite outcome of abdominal colectomy, admission to an intensive care unit (ICU) or death within 30 days of C. difficile testing was assessed across the three categorical groups (screen positive/toxin positive, screen positive/toxin negative and screen negative assay) resulting from the two-step testing strategy.

Results
When comparing individuals with a positive screening assay, patients with IBD were less likely to have toxin detected by enzyme immunoassay (EIA) as compared to the non-IBD population (22/145 (15.2%) vs. 413/1144 (36.1%), p < 0.0001). Among all patients with IBD (n = 300), twenty-five (8.3%) had a screen positive assay/toxin positive assay, 136 (45.3%) had a screen positive/toxin negative assay and 139 (46.3%) had a negative screening assay. No significant difference in the primary composite outcome was detected across the three groups (p = 0.566).

Conclusion
When compared to those without IBD, patients with IBD have a reduced proportion of cases of C. difficile with toxin positivity. Differences in clinical outcomes among patients with IBD were not detected and limited by the infrequent detection of expressed toxin.
Acute exacerbation of idiopathic hypereosinophilic syndrome following asymptomatic coronavirus disease 2019: a case report
Authors: Suzuki Satoshi , Suzuki Keiko , Ichikawa Takaya , Takahashi Kae , Minami-Hori Masako , Tanino Yoko 
Published: August 2022

Abstract
Background
Previous research has suggested that some autoimmune diseases develop after the occurrence of coronavirus disease 2019. Hypereosinophilic syndrome is a rare disease presenting with idiopathic eosinophilia and multiple organ involvement, including the skin, lungs, gastrointestinal tract, heart, and nervous system. The diagnosis of idiopathic hypereosinophilic syndrome poses a dilemma because clinical manifestation and serum biomarkers are similar to those of eosinophilic granulomatosis with polyangiitis. Only a few cases have been reported where coronavirus disease 2019 may have caused the new onset or exacerbation of eosinophilic granulomatosis with polyangiitis or idiopathic hypereosinophilic syndrome.

Case presentation
We present the case of a 48-year-old Japanese woman with history of asthma who developed deteriorating symptoms of insidiously developed idiopathic hypereosinophilic syndrome following asymptomatic coronavirus disease 2019. She developed acute-onset back pain, tachycardia, abdominal discomfort, loss of appetite, weight loss, skin rash on the back, and numbness of the extremities 3 days after the quarantine period. Extreme hypereosinophilia with multiple abnormal findings including pulmonary ground-glass opacity lesions and mononeuritis multiplex was consistent with hypereosinophilic syndrome. Normal cellularity with eosinophilic proliferation in the bone marrow and negative FIP1L1–PDGFRA raised the diagnosis of idiopathic hypereosinophilic syndrome. Although the patient tested negative for anti-neutrophilic cytoplasmic antibodies and skin biopsy was negative for vasculitis, eosinophilic granulomatosis with polyangiitis could not be excluded. Since glucocorticoids are a standard therapy for both idiopathic hypereosinophilic syndrome and eosinophilic granulomatosis with polyangiitis, we initiated glucocorticoids following a multidisciplinary discussion.

Conclusion
Although the relationship between asymptomatic coronavirus disease 2019 and acute idiopathic hypereosinophilic syndrome exacerbation was uncertain, the chronological order of the symptomatic development suggested a possible link. More clinical cases and population-based studies are needed to determine the potential effect of coronavirus disease 2019 on autoimmune diseases.
Introduction of ROSA robotic-arm system for total knee arthroplasty is associated with a minimal learning curve for operative time
Authors: Bolam Scott M. , Tay Mei Lin , Zaidi Faseeh , Sidaginamale Raghavendra P. , Hanlon Michael , Munro Jacob T. , Monk A. Paul 
Published: August 2022

Abstract
Purpose
The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic-assisted (RA) TKA within a multi-surgeon team.

Methods
This prospective cohort study included 83 consecutive conventional jig-based TKAs compared with 53 RA TKAs using the Robotic Surgical Assistant (ROSA) system (Zimmer Biomet, Warsaw, Indiana, USA) for knee osteoarthritis performed by three high-volume (> 100 TKA per year) orthopaedic surgeons. Baseline characteristics including age, BMI, sex and pre-operative Kellgren-Lawrence graded and Hip-Knee-Ankle Axis were well-matched between the conventional and RA TKA groups. Cumulative summation (CUSUM) analysis was used to assess learning curves for operative times for each surgeon. Peri-operative and delayed complications (infection, periprosthetic fracture, thromboembolism, and compromised wound healing) and revisions were reviewed.

Results
The CUSUM analysis for operative time demonstrated an inflexion point after 5, 6 and 15 cases for each of the three surgeons, or 8.7 cases on average. There were no significant differences (p = 0.53) in operative times between the RA TKA learning (before inflexion point) and proficiency (after inflexion point) phases. Similarly, the operative times of the RA TKA group did not differ significantly (p = 0.92) from the conventional TKA group. There was no discernible learning curve for the accuracy of component planning using the RA TKA system. The average length of post-operative follow-up was 21.3 ± 9.0 months. There was one revision for instability in the conventional TKA group and none in the RA TKA group. There were no significant difference (p > 0.99) in post-operative complication rates between the conventional TKA and RA TKA groups.

Conclusions
The introduction of the RA TKA system was associated with a learning curve for operative time of 8.7 cases. Operative times between the RA TKA and conventional TKA group were similar. The short learning curve implies this RA TKA system can be adopted relatively quickly into a surgical team with minimal risks to patients.
Multiparametric liver MRI for predicting early recurrence of hepatocellular carcinoma after microwave ablation
Authors: Zhang Zhaohe , Yu Jie , Liu Sisi , Dong Linan , Liu Tiefang , Wang Haiyi , Han Zhiyu , Zhang Xiaojing , Liang Ping 
Published: August 2022

Abstract
Background
High early recurrence (ER) of hepatocellular carcinoma (HCC) after microwave ablation (MWA) represents a sign of aggressive behavior and severely worsens prognosis. The aim of this study was to estimate the outcome of HCC following MWA and develop a response algorithmic strategy based on multiparametric MRI and clinical variables.

Methods
In this retrospective study, we reviewed the records of 339 patients (mean age, 62 ± 12 years; 106 men) treated with percutaneous MWA for HCC between January 2014 and December 2017 that were evaluated by multiparametric MRI. These patients were randomly split into a development and an internal validation group (3:1). Logistic regression analysis was used to screen imaging features. Multivariate Cox regression analysis was then performed to determine predictors of ER (within 2 years) of MWA. The response algorithmic strategy to predict ER was developed and validated using these data sets. ER rates were also evaluated by Kaplan–Meier analysis.

Results
Based on logistic regression analyses, we established an image response algorithm integrating ill-defined margins, lack of capsule enhancement, pre-ablative ADC, ΔADC, and EADC to calculate recurrence scores and define the risk of ER. In a multivariate Cox regression model, the independent risk factors of ER (p < 0.05) were minimal ablative margin (MAM) (HR 0.57; 95% CI 0.35 – 0.95; p < 0.001), the recurrence score (HR: 9.25; 95% CI 4.25 – 16.56; p = 0.021), and tumor size (HR 6.21; 95% CI 1.25 – 10.82; p = 0.014). Combining MAM and tumor size, the recurrence score calculated by the response algorithmic strategy provided predictive accuracy of 93.5%, with sensitivity of 92.3% and specificity of 83.1%. Kaplan–Meier estimates of the rates of ER in the low-risk and high-risk groups were 6.8% (95% CI 4.0 – 9.6) and 30.5% (95% CI 23.6 – 37.4), respectively.

Conclusion
A response algorithmic strategy based on multiparametric MRI and clinical variables was useful for predicting the ER of HCC after MWA.
The impact of biochar on wood-inhabiting bacterial community and its function in a boreal pine forest
Authors: Qu Zhao-lei , Li Xiao-li , Ge Yan , Palviainen Marjo , Zhou Xuan , Heinonsalo Jussi , Berninger Frank , Pumpanen Jukka , Köster Kajar , Sun Hui 
Published: August 2022

AbstractBiochar is considered to be a possible means of carbon sequestration to alleviate climate change. However, the dynamics of the microbial community during wood decomposition after biochar application remain poorly understood. In this study, the wood-inhabiting bacterial community composition and its potential functions during a two-year decomposition period after the addition of different amounts of biochar (0.5 kg m−2 and 1.0 kg m−2), and at different biochar pyrolysis temperatures (500 °C and 650 °C), in a boreal Scots pine forest, were analyzed using Illumina NovaSeq sequencing combined with Functional Annotation of Prokaryotic Taxa (FAPROTAX). The results showed that the wood decomposition rates increased after biochar addition to the soil surface in the second year. Treatment with biochar produced at high temperatures increased the diversity of wood-inhabiting bacteria more than that produced at low temperatures (P < 0.05). The wood-inhabiting bacterial diversity and species richness decreased with decomposition time. The biochar treatments changed the wood-inhabiting bacterial community structure during the decomposition period. The pyrolysis temperature and the amount of applied biochar had no effect on the bacterial community structure but shifted the abundance of certain bacterial taxa. Similarly, biochar application shifted the wood-inhabiting bacterial community function in the first year, but not in the second year. The wood-inhabiting bacterial community and function were affected by soil pH, soil water content, and soil total nitrogen. The results provide useful information on biochar application for future forest management practices. Long-term monitoring is needed to better understand the effects of biochar application on nutrient cycling in boreal forests.
Predictors of mental health deterioration from pre- to post-COVID-19 outbreak
Authors: Rius Ottenheim Nathaly , Pan Kuan-Yu , Kok Almar A. L. , Jörg Frederike , Eikelenboom Merijn , Horsfall Melany , Luteijn Rob A. , van Oppen Patricia , Rhebergen Didi , Schoevers Robert A. , Penninx Brenda W. J. H. , Giltay Erik J. 
Published: August 2022

Background
Mental health was only modestly affected in adults during the early months of the COVID-19 pandemic on the group level, but interpersonal variation was large.

Aims
We aim to investigate potential predictors of the differences in changes in mental health.

Method
Data were aggregated from three Dutch ongoing prospective cohorts with similar methodology for data collection. We included participants with pre-pandemic data gathered during 2006–2016, and who completed online questionnaires at least once during lockdown in The Netherlands between 1 April and 15 May 2020. Sociodemographic, clinical (number of mental health disorders and personality factors) and COVID-19-related variables were analysed as predictors of relative changes in four mental health outcomes (depressive symptoms, anxiety and worry symptoms, and loneliness), using multivariate linear regression analyses.

Results
We included 1517 participants with (n = 1181) and without (n = 336) mental health disorders. Mean age was 56.1 years (s.d. 13.2), and 64.3% were women. Higher neuroticism predicted increases in all four mental health outcomes, especially for worry (β = 0.172, P = 0.003). Living alone and female gender predicted increases in depressive symptoms and loneliness (β = 0.05–0.08), whereas quarantine and strict adherence with COVID-19 restrictions predicted increases in anxiety and worry symptoms (β = 0.07–0.11).Teleworking predicted a decrease in anxiety symptoms (β = −0.07) and higher age predicted a decrease in anxiety (β = −0.08) and worry symptoms (β = −0.10).

Conclusions
Our study showed neuroticism as a robust predictor of adverse changes in mental health, and identified additional sociodemographic and COVID-19-related predictors that explain longitudinal variability in mental health during the COVID-19 pandemic.
Multicentre, England-wide randomised controlled trial of the ‘Foundations’ smartphone application in improving mental health and well-being in a healthcare worker population
Authors: Gnanapragasam Sam N. , Tinch-Taylor Rose , Scott Hannah R. , Hegarty Siobhan , Souliou Emilia , Bhundia Rupa , Lamb Danielle , Weston Danny , Greenberg Neil , Madan Ira , Stevelink Sharon , Raine Rosalind , Carter Ben , Wessely Simon 
Published: August 2022

BackgroundHealthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated.AimsWe aimed to determine the effectiveness of the ‘Foundations’ application (app) on general (non-psychotic) psychiatric morbidity.MethodWe conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD).ResultsBetween 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44⋅3 years (interquartile range (IQR) 34–53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = −1.39, 95% CI −2.05 to −0.74), improvement in well-being (aMD = 0⋅54, 95% CI 0⋅20 to 0⋅89) and reduction in insomnia (adjusted odds ratio (aOR) = 0⋅36, 95% CI 0⋅21 to 0⋅60). No other significant findings were found, or adverse events reported.ConclusionsThe app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
Biomechanical energetics of terrestrial locomotion in California sea lions (Zalophus californianus)
Authors: Kerr Sarah J. , Fish Frank E. , Nicastro Anthony J. , Zeligs Jenifer A. , Skrovan Stephanie , Leftwich Megan C. 
Published: August 2022

ABSTRACT
Pinnipedia, an order of semi-aquatic marine mammals, adapted a body design that allows for efficient aquatic locomotion but limited terrestrial locomotion. Otariids, like the California sea lion (Zalophus californianus), have enlarged forelimbs and can bring their hindlimbs under the body to locomote quadrupedally on land, but phocids (true seals) have reduced forelimbs and are unable to bring their hindlimbs beneath them during terrestrial locomotion. Because of these differences, phocids are expected to have greater energetic costs when moving on land compared with otariids. The mechanical costs of transport (COT) and power outputs of terrestrial locomotion were first obtained from one male and two female adult California sea lions through video recording locomotion sequences across a level runway. The center of mass, along with six other anatomical points, were digitized to obtain variables such as velocity (V), amplitude of heave (A) and the frequency (f) of oscillations during the locomotion cycle. These variables represent the principal parameters of a biomechanical model that computes the power output of individuals. The three California sea lions in this study averaged a power output of 112.04 W and a COT of 0.63 J kg−1 m−1. This footage was compared against video footage previously recorded of three phocid species (harbor seal, gray seal and northern elephant seal). Power output and mechanical COT were compared for all four pinniped species by tracking the animals' center of mass. The quadrupedal gait of sea lions showed lower vertical displacements of the center of mass, and higher velocities compared with the terrestrial gait of phocids. Northern elephant seals, gray seals and harbor seals showed significantly higher COT and power outputs than the sea lions. California sea lions locomote with lower energetic costs, and thus higher efficiency compared with phocids, proving that they are a mechanically intermediate species on land between terrestrial mammals and phocids. This study provides novel information on the mechanical energy exerted by pinnipeds, particularly California sea lions, to then be used in future research to better understand the limitations of these aquatic mammals.
Locomotor resilience through load-dependent modulation of muscle co-contraction
Authors: Günzel Yannick , Schmitz Josef , Dürr Volker 
Published: August 2022

ABSTRACT
Terrestrial locomotor behavior in variable environments requires resilience to sudden changes in substrate properties. For example, walking animals can adjust to substantial changes in slope and corresponding changes in load distribution among legs. In insects, slope-dependent adjustments have mainly been examined under steady-state conditions, whereas the transition dynamics have been largely neglected. In a previous study, we showed that steady-state adjustments of stick insects to ±45 deg slopes involve substantial changes in joint torques and muscle activity with only minor changes in leg kinematics. Here, we took a close look at the time course of these adjustments as stick insects compensate for various kinds of disturbances to load distribution. In particular, we tested whether the transition from one steady state to another involves distinct transition steps or follows a graded process. To resolve this, we combined simultaneous recordings of whole-body kinematics and hindleg muscle activity to elucidate how freely walking Carausius morosus negotiated a step-change in substrate slope. Step-by-step adjustments revealed that muscle activity changed in a graded manner as a function of body pitch relative to gravity. We further show analogous transient adjustment of muscle activity in response to destabilizing lift-off events of neighboring legs and the disappearance of antagonist co-activation during crawling episodes. Given these three examples of load-dependent regulation of antagonist muscle co-contraction, we conclude that stick insects respond to both transient and sustained changes in load distribution by regulating joint stiffness rather than through distinct transition steps.
Virtual non-contrast images from dual-energy CT angiography of the abdominal aorta and femoral arteries: comparison with true non-contrast CT images
Authors: Lee Min Hee , Park Hee Jin , Kim Ji Na , Kim Myung Sub , Hong Seok Woo , Park Jai Hyung , Kang Chang Ho 
Published: August 2022

Objectives:
To assess whether virtual non-contrast (VNC) computed tomography (CT) images acquired from dual-energy CT (DECT) have sufficient image quality to replace true non-contrast (TNC) CT images in CT angiography (CTAG).

Methods:
This study enrolled 63 consecutive patients who underwent a CTAG that included a single-energy non-contrast scan, followed by a post-contrast DECT scan. Comparison of attenuation and noise between TNC and VNC images was made by drawing circular regions of interest (ROI) on a picture archiving and communication system (PACS) workstation within the aortic lumen at the levels of the renal arteries, the aortic bifurcation and right femoral artery. Mean attenuation and image noise (one standard deviation) were registered in Hounsfield units (HU). The VNC images were subjectively evaluated for artifacts such as subtraction of calcifications or architectural distortion based on TNC image as a standard of reference.

Results:
Most attenuations of the VNCs were higher than TNC, except right femoral artery of reader 2. Most image noises of TNC were higher than VNC, except abdominal aorta in reader 1. In qualitative image analysis, mean scores of VNC according to the 5-point scale were 3.68 and 3.63 (reader 1 and reader 2, respectively) which mean good to excellent to diagnose.

Conclusion:
HUs and VNC image noises are different from TNC images in CTAG. VNC images have sufficient image quality to replace TNC images in the diagnosis of calcific lesions.

Advances in knowledge:
VNC images acquired from DECT have image quality adequate to replace TNC images in the diagnosis of the calcific lesion on the CTAG. VNC images based on DECT can avoid excessive and unnecessary patient exposure to radiation during CTAG.