bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Inhaled Corticosteroids on Lung Function in Children With Post-infectious Bronchiolitis Obliterans in Remission
Authors: Zheng Haoqi , Yu Xiuhua , Chen Yuquan , Lin Wenying , Liu Li 
Published: May 2022

BackgroundPost-infectious bronchiolitis obliterans (PIBO) is a rare and irreversible chronic obstructive pulmonary disease with no specific treatment, especially for patients with PIBO in remission. In this study, we evaluated the effects of continuous inhaled corticosteroids (ICSs) and intermittent ICSs on lung function in the remission of PIBO.MethodsThis was a retrospective study, and all the subjects we included were divided into continuous ICS group and intermittent ICS group according to treatment regimens. Patients in continuous ICS group received continuous ICSs (2 times a day), and patients in intermittent ICS group received intermittent ICSs (inhaled corticosteroids after acute respiratory tract infection or wheezing). Different lung function tests were performed at different ages. Tidal breathing lung function tests were performed in patients with PIBO aged ≤ 5 years, and the lung ventilation function test and the bronchial dilation test were performed in patients with PIBO aged more than 5 years. Lung function was assessed at the beginning of follow-up and at the end of follow-up (1 year of ICSs).ResultsAfter 1 year of ICSs, patients aged more than 5 years, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1) were significantly higher than at the beginning of follow-up. After 1 year of ICSs, the difference in VT/Kg, TPTEF/TE, and VPEF/VE between the end and the beginning of follow-up in continuous ICS group shows an upward trend. But those showed a downward trend in intermittent ICS group. FVC, FEV1, and maximal mid-expiratory flow velocity 25–75% (MMEF25–75%) of continuous ICS group were significantly higher than at the beginning of follow-up. The difference in FEV1and MMEF25–75%between the end of follow-up and the beginning of follow-up in continuous ICS group was significantly higher than that in intermittent ICS group. A total of 52.94% of patients with PIBO aged more than 5 years were positive for bronchial dilation tests.ConclusionInhaled corticosteroids can effectively improve lung function and relieve airway obstruction in patients aged more than 5 years in PIBO remission, especially continuous ICSs. Patients with PIBO may have reversible airflow limitations.
Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
Authors: Ikuta Yoji , Miura Masaru , Goto Tomohide , Miyama Sahoko 
Published: May 2022

BackgroundVentricular hypertrophy is a well-known side effect of adrenocorticotropic hormone (ACTH) therapy in patients with West syndrome (WS), but there are only a few reports of echocardiographic evaluation of these patients’ diastolic function.MethodsThe present, retrospective study analyzed echocardiographic findings in 24 patients with WS treated with ACTH therapy between April 2010 and December 2014. The therapy protocol involved administering tetracosactide acetate 0.01–0.0125 mg/kg via intramuscular injection once a day for weeks 1–2, then gradually tapering off. Echocardiographic evaluation was done before treatment initiation and at weeks 1, 2, and 4 after the initiation of treatment.ResultsThe systolic and diastolic blood pressure values were elevated at week 1 after commencement of the therapy and remained elevated throughout its duration. Both the interventricular septal end-diastolic thickness and left ventricular posterior wall end-diastolic diameter increased in thickness at week 1 and remained thickened. None of the patients experienced heart failure or systolic dysfunction. Early diastolic mitral flow velocity (E)/early diastolic mitral annular velocity (E′) increased at week 1 and remained high at weeks 2 and 4. The E wave deceleration time (DcT) was prolonged at week 2 and returned to the baseline at week 4.ConclusionIncreased ventricular wall thickness, decreased diastolic capacity, and elevated BP were noted in children with WS during ACTH therapy. Cardiac function, including ventricular wall thickness and diastolic function, should be monitored during ACTH therapy. E/E′ and DcT are useful in evaluating diastolic function.
Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
Authors: MacPhail Sara L. , Bedoya-Pérez Miguel A. , Cohen Rhys , Kotsirilos Vicki , McGregor Iain S. , Cairns Elizabeth A. 
Published: May 2022

A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to the Therapeutic Goods Administration (TGA–the federal regulator) for approval to prescribe a category of product to an individual patient suffering from a specific indication. The dataset collected by the TGA provides a unique opportunity to examine MC prescribing trends over time in the Australian population. Here we analysed this TGA SAS-B dataset since inception with respect to age, gender, product type (e.g., oil, flower, etc.), CBD content, indication treated, and prescriber location. Results are presented descriptively as well as being analysed using non-linear regression models. Relationship between variables were explored via correspondence analyses. Indications were classified with reference to the International Statistical Classification of Diseases and Related Health Problems (10th Revision). As of 31 August 2021, a total of 159,665 SAS-B approvals had been issued for MC products, 82.4% of were since January 2020. Leading indications for approvals were for pain, anxiety, and sleep disorders. Oil products were the most popular product type, while CBD-dominant products (≥98% CBD) accounted for 25.1% of total approvals. Approvals for flower products increased markedly during 2020–2021, as did approvals involving younger age groups (18–31 years old), male patients, and non-CBD dominant products. A disproportionate number of SAS-B MC applications (around 50%) came from HCPs in the state of Queensland. Associations between patient gender and age and/or indication with product type were found. For example, approvals for oil products were commonly associated with approvals for pain. While, overall prescribing increased dramatically over the last 2 years of analysis, stabilization of approval numbers is evident for some indications, such as pain. Current prescribing practices do not always reflect provided TGA guidance documents for MC prescribing. While acknowledging some limitations around the SAS-B dataset, it provides a unique and valuable resource with which to better understand current prescribing practices and utilisation of MC products within Australia.
Pulmonary Congestion Assessed by Lung Ultrasound and Cardiovascular Outcomes in Patients With ST-Elevation Myocardial Infarction
Authors: Araiza-Garaygordobil Diego , Baeza-Herrera Luis A. , Gopar-Nieto Rodrigo , Solis-Jimenez Fabio , Cabello-López Alejandro , Martinez-Amezcua Pablo , Sarabia-Chao Vianney , González-Pacheco Héctor , Sierra-Lara Martinez Daniel , Briseño-De la Cruz José Luis , Arias-Mendoza Alexandra 
Published: May 2022

Background: Lung ultrasound (LUS) shows a higher sensitivity when compared with physical examination for the detection of pulmonary congestion. The objective of our study was to evaluate the association of pulmonary congestion assessed by LUS after reperfusion therapy with cardiovascular outcomes in patients with ST-segment Elevation acute Myocardial Infarction (STEMI) who received reperfusion therapy.Methods: A prospective observational study including patients with STEMI from the PHASE-Mx study. LUS was performed in four thoracic sites (two sites in each hemithorax). We categorized participants according to the presence of pulmonary congestion. The primary endpoint of the study was the composite of death for any cause, new episode or worsening of heart failure, recurrent myocardial infarction and cardiogenic shock at 30 days of follow-up.Results: A total of 226 patients were included, of whom 49 (21.6%) patients were classified within the “LUS-congestion” group and 177 (78.3%) within the “non-LUS-congestion” group. Compared with patients in the “non-LUS-congestion” group, patients in the “LUS-congestion” group were older and had higher levels of blood urea nitrogen and NT-proBNP. Pulmonary congestion assessed by LUS was significantly associated with a higher risk of the primary composite endpoint (HR: 3.8, 95% CI 1.91–7.53, p = 0.001). Differences in the primary endpoint were mainly driven by an increased risk of heart failure (HR 3.91; 95%CI 1.62–9.41, p = 0.002) and cardiogenic shock (HR 3.37; 95%CI 1.30–8.74, p = 0.012).Conclusion: The presence of pulmonary congestion assessed by LUS is associated with increased adverse cardiovascular events, particularly heart failure and cardiogenic shock. The application of LUS should be integrated as part of the initial risk stratification in patients with STEMI as it conveys important prognostic information.
Predicting Coronary Stenosis Progression Using Plaque Fatigue From IVUS-Based Thin-Slice Models: A Machine Learning Random Forest Approach
Authors: Guo Xiaoya , Maehara Akiko , Yang Mingming , Wang Liang , Zheng Jie , Samady Habib , Mintz Gary S. , Giddens Don P. , Tang Dalin 
Published: May 2022

Introduction: Coronary stenosis due to atherosclerosis restricts blood flow. Stenosis progression would lead to increased clinical risk such as heart attack. Although many risk factors were found to contribute to atherosclerosis progression, factors associated with fatigue is underemphasized. Our goal is to investigate the relationship between fatigue and stenosis progression based on in vivo intravascular ultrasound (IVUS) images and finite element models.Methods: Baseline and follow-up in vivo IVUS and angiography data were acquired from seven patients using Institutional Review Board approved protocols with informed consent obtained. Three hundred and five paired slices at baseline and follow-up were matched and used for plaque modeling and analysis. IVUS-based thin-slice models were constructed to obtain the coronary biomechanics and stress/strain amplitudes (stress/strain variations in one cardiac cycle) were used as the measurement of fatigue. The change of lumen area (DLA) from baseline to follow-up were calculated to measure stenosis progression. Nineteen morphological and biomechanical factors were extracted from 305 slices at baseline. Correlation analyses of these factors with DLA were performed. Random forest (RF) method was used to fit morphological and biomechanical factors at baseline to predict stenosis progression during follow-up.Results: Significant correlations were found between stenosis progression and maximum stress amplitude, average stress amplitude and average strain amplitude (p &lt; 0.05). After factors selection implemented by random forest (RF) method, eight morphological and biomechanical factors were selected for classification prediction of stenosis progression. Using eight factors including fatigue, the overall classification accuracy, sensitivity and specificity of stenosis progression prediction with RF method were 83.61%, 86.25% and 80.69%, respectively.Conclusion: Fatigue correlated positively with stenosis progression. Factors associated with fatigue could contribute to better prediction for atherosclerosis progression.
The Problem and Potential of TMS' Infinite Parameter Space: A Targeted Review and Road Map Forward
Authors: Caulfield Kevin A. , Brown Joshua C. 
Published: May 2022

BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a non-invasive, effective, and FDA-approved brain stimulation method. However, rTMS parameter selection remains largely unexplored, with great potential for optimization. In this review, we highlight key studies underlying next generation rTMS therapies, particularly focusing on: (1) rTMS Parameters, (2) rTMS Target Engagement, (3) rTMS Interactions with Endogenous Brain Activity, and (4) Heritable Predisposition to Brain Stimulation Treatments.MethodsWe performed a targeted review of pre-clinical and clinical rTMS studies.ResultsCurrent evidence suggests that rTMS pattern, intensity, frequency, train duration, intertrain interval, intersession interval, pulse and session number, pulse width, and pulse shape can alter motor excitability, long term potentiation (LTP)-like facilitation, and clinical antidepressant response. Additionally, an emerging theme is how endogenous brain state impacts rTMS response. Researchers have used resting state functional magnetic resonance imaging (rsfMRI) analyses to identify personalized rTMS targets. Electroencephalography (EEG) may measure endogenous alpha rhythms that preferentially respond to personalized stimulation frequencies, or in closed-loop EEG, may be synchronized with endogenous oscillations and even phase to optimize response. Lastly, neuroimaging and genotyping have identified individual predispositions that may underlie rTMS efficacy.ConclusionsWe envision next generation rTMS will be delivered using optimized stimulation parameters to rsfMRI-determined targets at intensities determined by energy delivered to the cortex, and frequency personalized and synchronized to endogenous alpha-rhythms. Further research is needed to define the dose-response curve of each parameter on plasticity and clinical response at the group level, to determine how these parameters interact, and to ultimately personalize these parameters.
Public Views About Involvement in Decision-Making on Health Data Sharing, Access, Use and Reuse: The Importance of Trust in Science and Other Institutions
Authors: Nwebonyi Ngozi , Silva Susana , de Freitas Cláudia 
Published: May 2022

BackgroundData-intensive and needs-driven research can deliver substantial health benefits. However, concerns with privacy loss, undisclosed surveillance, and discrimination are on the rise due to mounting data breaches. This can undermine the trustworthiness of data processing institutions and reduce people's willingness to share their data. Involving the public in health data governance can help to address this problem by imbuing data processing frameworks with societal values. This study assesses public views about involvement in individual-level decisions concerned with health data and their association with trust in science and other institutions.MethodsCross-sectional study with 162 patients and 489 informal carers followed at two reference centers for rare diseases in an academic hospital in Portugal (June 2019–March 2020). Participants rated the importance of involvement in decision-making concerning health data sharing, access, use, and reuse from “not important” to “very important”. Its association with sociodemographic characteristics, interpersonal trust, trust in national and international institutions, and the importance of trust in research teams and host institutions was tested.ResultsMost participants perceived involvement in decision-making about data sharing (85.1%), access (87.1%), use (85%) and reuse (79.9%) to be important or very important. Participants who ascribed a high degree of importance to trust in research host institutions were significantly more likely to value involvement in such decisions. A similar position was expressed by participants who valued trust in research teams for data sharing, access, and use. Participants with low levels of trust in national and international institutions and with lower levels of education attributed less importance to being involved in decisions about data use.ConclusionThe high value attributed by participants to involvement in individual-level data governance stresses the need to broaden opportunities for public participation in health data decision-making, namely by introducing a meta consent approach. The important role played by trust in science and in other institutions in shaping participants' views about involvement highlights the relevance of pairing such a meta consent approach with the provision of transparent information about the implications of data sharing, the resources needed to make informed choices and the development of harm mitigation tools and redress.
A Web-Based Prognostic Model for Pediatric Genitourinary Rhabdomyosarcoma: Analysis of Population-Based Cohort With External Validation
Authors: Li Jiayi , Huang Yangyue , Li Yunpeng , Liu Pei , Cheng Haiyan , Song Hongcheng , Sun Ning , Shamil Mina Ayad , Zhang Weiping 
Published: May 2022

BackgroundWe conduct an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database, intending to identify prognostic factors of pediatric genitourinary rhabdomyosarcoma (PGU–RMS). Prognostic nomogram and web-based calculator were developed for potential clinical use.MethodsData of PGU–RMS patients were extracted from the SEER database as training and internal validation cohort, patients diagnosed as PGU–RMS from 2001 to 2015 in Beijing Children's Hospital were collected as an external validation cohort. We used log-rank tests to seek risk factors on the overall survival (OS) in the overall SEER cohort, tumor site subgroups, radiation subgroups, and metastasis subgroups. The univariable and multivariate Cox regression analyses were applied to establish the prognosis model.ResultsA total of 372 PGU-RMS patients in SEER and 84 patients from our center were included. 1-, 3-, and 5-year OS of the overall SEER cohort were 95.8, 82.1, and 78.8%. Subgroup analysis indicated that tumors located in the prostate/bladder were associated with a worse prognosis than the paratesticular, female genital system, and other sites (P &lt; 0.001). Tumors of the T1/T2 stage, without regional lymph node, involvement or metastasis, can benefit from radiotherapy (P &lt; 0.05). For patients without metastasis, younger age, T1/T2 stage, and undergoing radiation were associated with better prognosis (P &lt; 0.05). The prognosis nomogram was well-calibrated, the concordance index (C-index) for the OS prediction was 0.823, 0.803, and 0.768 in training, internal and external validation cohort, the area under the receiver operating characteristic curve for 3-, and 5-year OS were 0.84, 0.84 in the training cohort, 0.90, 0.84 in internal validation cohort and 0.75, 0.80 in the external validation cohort. Decision curve analysis showed good clinical utility. The predictive performance of the nomogram was higher than the Intergroup Rhabdomyosarcoma Study Group (IRSG) pretreatment stage system based on the comparison of overtime C-index, net reclassification index, and integrated discriminatory index (P &lt; 0.001).ConclusionA comprehensive analysis of OS for PGU–RMS patients was conducted based on population cohort. The established prognosis nomogram has been fully validated and evaluated, exhibits better performance than the IRSG pretreatment stage system. Furthermore, a web-based risk calculator was developed to optimize clinical decisions.
How Media Use Influences the Fertility Intentions Among Chinese Women of Reproductive Age: A Perspective of Social Trust
Authors: Ning Chuanlin , Wu Jing , Ye Yijie , Yang Nan , Pei Huacheng , Gao Hao 
Published: May 2022

BackgroundThe low fertility level has become a serious social problem in China. Previous research has argued the significant influence of media use and social trust on fertility intentions, but the interaction between the two variables and how they influence fertility intentions remain further investigation. This study explored the influence mechanism of media use on Chinese women's fertility intentions from the perspective of social trust.MethodsThis study collected data from the 2017 China General Social Survey, investigated the relationships between variables through bivariate correlation coefficients, and explored the differences in fertility intentions among women of reproductive age (20–49). Also, this paper examined the influence of media use and social trust by regression analysis and tested the mediating role of social trust between media use and fertility intentions with Bootstrap sampling.ResultsWomen with different media use preferences, education levels, and family incomes have significant differences (p&lt; 0.01) in fertility intentions. New media use negatively influences women's fertility intentions, while traditional media use has no significant influence on women's fertility intentions. Social trust significantly influenced women's fertility intentions and partially mediated the impact of new media use on fertility intentions.ConclusionOnline communication influences fertility intentions among Chinese women of reproductive age. It tends to influence their social trust by amplifying negative social news, affecting their fertility intentions further. This paper suggests the importance of strengthening social trust and online agenda-setting to improve women's fertility intentions that strategic information communication can change their perceptions of social trust.
Biosafety in Dental Health Care During the COVID-19 Pandemic: A Longitudinal Study
Authors: Miguita Lucyene , Martins-Chaves Roberta Rayra , Geddes Victor Emmanuel Viana , Mendes Suellen da Rocha , Costa Sara Ferreira dos Santos , Fonseca Paula Luize Camargos , Menezes Diego , Souza Rafael Marques de , Queiroz Daniel Costa , Alves Hugo José , Freitas Raphaela Alvarenga Braga de , Cruz Aline Fernanda , Moreira Rennan Garcias , Moreira Filipe Romero Rebello , Bemquerer Larissa Marques , Aguilar Diego Rodrigues de , Souza e Silva Maria Elisa de , Sampaio Aline Araújo , Jardilino Francisca Daniele Moreira , Souza Leandro Napier de , Silva Tarcilia Aparecida da , Gomes Carolina Cavaliéri , de Abreu Mauro Henrique Nogueira Guimarães , Aguiar Renato Santana de , Souza Renan Pedra de , Gomez Ricardo Santiago 
Published: May 2022

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic had quite an impact on dental health care. Concerns about the risk of SARS-CoV-2 transmission through contaminant fluids and droplet formation during several dental procedures highly impacted dental health care, drastically reducing the number of dental practices worldwide. To monitor SARS-CoV-2 contamination in dental clinics, a longitudinal study was carried out during the return of dental practice at university.MethodsDental health care professionals [(DHCPs); teachers, undergraduate dental students, and dental assistants] and patients were screened for SARS-CoV-2 RNA in a dental school clinic environment from 11th January to 12th March 2021 (9 weeks). Serological testing was performed on DHCPs in two-time points. Additionally, samples with low Ct values were sequenced to identify the circulating SARS-CoV-2 variant and possible transmission clusters.ResultsWe found a low number of dental staff (5.8%), patients (0.9%), and environment sites (0.8%) positive for SARS-CoV-2. Most positive cases had asymptomatic to mild symptoms, and two asymptomatic DHCPs presented prolonged infection. In the first week after previous exposure to COVID-19, 16.2% of DHCPs had IgM or IgG antibodies against SARS-CoV-2, and 1/3 of them had undetected antibodies in the last weeks. The variant zeta (P.2) could be detected. No cross-infection was observed between participants.ConclusionOur study suggests that dental practice can be safely executed when adequate control measures and biosafety protocols are applied. DHCP and patient testing, patient telemonitoring, proper use of personal protection equipment, and sanitization of surfaces are essential to avoid SARS-CoV-2 cross-infection in dental practice.