bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is in-utero exposure to cannabis associated with the risk of attention deficit with or without hyperactivity disorder? A cohort study within the Quebec Pregnancy Cohort
Authors: Tchuente Vanina , Sheehy Odile , Zhao Jin-Ping , Gorgui Jessica , Gomez Yessica-Haydee , Berard Anick 
Published: August 2022

Importance and objectivePrenatal cannabis effect on attention deficit with or without hyperactivity disorder (ADHD) remains to be determined. Our aim is to quantify the impact of in-utero exposure to cannabis on the risk of ADHD.DesignCohort study.SettingQuestionnaires were mailed to women sampled from the Quebec Pregnancy Cohort (QPC). Data from questionnaires were then linked with their QPC (built with administrative health databases, hospital patient charts and birth certificate databases).ParticipantsRespondents who gave birth to a singleton live born between January 1998 and December 2003 and were continuously enrolled in the Régie de l’assurance maladie du Québec (RAMQ) medication insurance plan for at least 12 months before the first day of gestation and during pregnancy.ExposureIn-utero cannabis exposure was based on mothers’ answers to the question on cannabis use during pregnancy (yes/no) and categorised as occasionally, regularly exposed and unexposed if they chose one of these categories.OutcomesADHD was defined by a diagnosis of ADHD through the RAMQ medical services or MedEcho databases or a prescription filled for ADHD medication through RAMQ pharmaceutical services between birth and the end of the follow-up period. Follow-up started at the birth and ended at the index date (first diagnosis or prescription filled for ADHD), child death (censoring), end of public coverage for medications (censoring) or the end of study period, which was December 2015 (censoring), whichever event came first.ResultsA total of 2408 children met the inclusion criteria. Of these children, 86 (3.6%) were exposed to cannabis in-utero and 241 (10.0%) had an ADHD diagnosis or medication filled. After adjustments for potential confounders, no significant association was found between in-utero cannabis exposure (occasional (1.22 (95% CI 0.63 to 2.19)) or regular (1.22 (95% CI 0.42 to 2.79))) and the risk of ADHD in children.ConclusionsIn-utero exposure to cannabis seemed to not be associated with the risk ADHD in children.
Long-term outcomes following antenatal exposure to low-dose aspirin: study protocol for the 4-year follow-up of the APRIL randomised controlled trial
Authors: Landman Anadeijda J E M C , van Limburg Stirum Emilie V J , van 't Hooft Janneke , Leemhuis Aleid G , Finken Martijn J J , van Baar Anneloes L , Roseboom Tessa J , Ravelli Anita C J , van Wely Madelon , Oosterlaan Jaap , Painter Rebecca C , Pajkrt Eva , Oudijk Martijn A , de Boer Marjon A 
Published: August 2022

IntroductionThe use of low-dose aspirin by pregnant women to prevent preterm pre-eclampsia is gradually increasing. The administration of aspirin during pregnancy improves perinatal outcome, which could translate into improved child outcome in the long term. However, antenatal exposure to aspirin could have adverse effects on child development that may manifest later in life. The aim of this follow-up study is to assess the long-term effects of antenatal exposure to low-dose aspirin compared with placebo on survival, (neuro)development, behaviour and general health at 4 years corrected age.Methods and analysisThis is a follow-up study of the Dutch double-blind randomised controlled APRIL trial which assessed the effectiveness of treatment with aspirin (80 mg daily) compared with placebo for the prevention of preterm birth in women with a previous spontaneous preterm birth. Treatment was initiated before 16 weeks of gestation and continued until 36 weeks or birth. We aim to follow-up all 379 children born to women who participated in the APRIL trial and survived the neonatal period, at the corrected age of 4 years. The main outcomes are (neuro)development as assessed by the Ages and Stages Questionnaire, and behaviour as assessed by the Strength and Difficulties Questionnaire. Additional outcomes include mortality, growth and general health from birth up to 4 years, and a composite outcome including mortality, abnormal (neuro)development and problem behaviour. Analyses will be performed by intention-to-treat using a superiority design.Ethics and disseminationInstitutional Review Board approval was obtained from the Medical Research Ethics Committee from Amsterdam Medical Center (no. W20 289#20.325). The results will be published in a peer-reviewed journal and presented at conferences.Trial registration numberThe APRIL trial (NTR5675, NL5553; EudraCT number 2015-003220-31) and the APRIL follow-up study (NL8950) are registered in the Dutch trial register. The study is funded by the Amsterdam Reproduction & Development research institute.
PreScription DigitaL ThErapEutic for Patients with Insomnia (SLEEP-I): a protocol for a pragmatic randomised controlled trial
Authors: Dreyer Rachel P , Berkowitz Alyssa , Yaggi Henry Klar , Schneeberg Lynelle , Shah Nilay D , Emanuel Lindsay , Kolla Bhanuprakash , Jeffery Molly Moore , Deeg Mark , Ervin Keondae , Thorndike Frances , Ross Joseph S 
Published: August 2022

IntroductionCognitive behavioural therapy for insomnia (CBT-I) is effective at treating chronic insomnia, yet in-person CBT-I can often be challenging to access. Prior studies have used technology to bridge barriers but have been unable to extensively assess the impact of the digital therapeutic on real-world patient experience and multidimensional outcomes. Among patients with insomnia, our aim is to determine the impact of a prescription digital therapeutic (PDT) (PEAR-003b, FDA-authorised as Somryst; herein called PDT) that provides mobile-delivered CBT-I on patient-reported outcomes (PROs) and healthcare utilisation.Methods and analysisWe are conducting a pragmatically designed, prospective, multicentre randomised controlled trial that leverages Hugo, a unique patient-centred health data-aggregating platform for data collection and patient follow-up from Hugo Health. A total of 100 participants with insomnia from two health centres will be enrolled onto the Hugo Health platform, provided with a linked Fitbit (Inspire 2) to track activity and then randomised 1:1 to receive (or not) the PDT for mobile-delivered CBT-I (Somryst). The primary outcome is a change in the insomnia severity index score from baseline to 9-week postrandomisation. Secondary outcomes include healthcare utilisation, health utility scores and clinical outcomes; change in sleep outcomes as measured with sleep diaries and a change in individual PROs including depressive symptoms, daytime sleepiness, health status, stress and anxiety. For those allocated to the PDT, we will also assess engagement with the PDT.Ethics and disseminationThe Institutional Review Boards at Yale University and the Mayo Clinic have approved the trial protocol. This trial will provide important data to patients, clinicians and policymakers about the impact of the PDT device delivering CBT-I on PROs, clinical outcomes and healthcare utilisation. Findings will be disseminated to participants, presented at professional meetings and published in peer-reviewed journals.Trial registration numberNCT04909229.
Community-based interventions to prevent stroke in low-income and middle-income countries: a protocol for a systematic review and meta-analysis
Authors: Nowrin Iffat , Bhattacharyya Dipika Shankar , Saif-Ur-Rahman K M 
Published: August 2022

IntroductionStroke is the second leading cause of death and morbidity across the globe. In low-income and middle-income countries (LMICs), it has become an overwhelming burden over the past few decades. This burden is escalating at a much greater pace compared with that of high-income countries. It is considered the most frequent cause of adult disability that affects the quality of life. ‘Prevention’ is one of the key components to combating stroke. In this regard, community-based interventions can play a vital role in improving population-level health and well-being. Considering the escalating trend of stroke in LMICs, this systematic review aims to map the available community-based interventions in preventing stroke and to conduct further analysis regarding the effectiveness of the identified interventions.Methods and analysisWe have searched Medline, Web of Science and Scopus using a comprehensive search strategy in October 2021. Two reviewers will independently perform screening, data extraction and risk of bias (ROB) assessment. The ROB assessment and applicability of results of eligible studies will be performed using the Cochrane ROB tool for assessing randomised controlled trials and the ROBANS (Risk Of Bias Assessment tool for Non-randomised Studies) to assess non-randomised studies. A random-effect model meta-analysis will be used to calculate pooled results and to obtain weighted OR and risk ratio of incidence of stroke along with corresponding 95% CI.Ethics and disseminationThe results will be disseminated through publishing in a peer-reviewed journal and public presentations at relevant national and international conferences. Ethical approval is not required as this is a systematic review of publicly available data.PROSPERO registration numberCRD42021283670.
Use of a penicillin allergy clinical decision rule to enable direct oral penicillin provocation: an international multicentre randomised control trial in an adult population (PALACE): study protocol
Authors: Copaescu Ana-Maria , James Fiona , Vogrin Sara , Rose Morgan , Chua Kyra , Holmes Natasha E , Turner Nicholas A , Stone Cosby , Phillips Elizabeth , Trubiano Jason 
Published: August 2022

IntroductionPenicillin allergies are highly prevalent in the healthcare setting and associated with the prescription of second-line inferior antibiotics. More than 85% of all penicillin allergy labels can be removed by skin testing and 96%–99% of low-risk penicillin allergy labels can be removed by direct oral challenge. An internally and externally validated clinical assessment tool for penicillin allergy, PEN-FAST, can identify a low-risk penicillin allergy without the need for skin testing; a score of less than 3 has a negative predictive value of 96.3% (95% CI, 94.1 to 97.8) for the presence of a penicillin allergy. It is hypothesised that PEN-FAST is a safe and effective tool for assessing penicillin allergy in an outpatient clinic setting.Methods and analysisThis is an international, multicentre randomised control trial using the PEN-FAST tool to risk-stratify penicillin allergy labels in adult outpatients. The study’s primary objective is to evaluate the non-inferiority of using PEN-FAST score-guided management with direct oral challenge compared with standard care (defined as prick and intradermal skin testing followed by oral penicillin challenge). Participants will be randomised 1:1 to the intervention arm (direct oral penicillin challenge) or standard of care arm (skin testing followed by oral penicillin challenge, if skin testing is negative). The sample size of 380 randomised patients (190 per treatment arm) is required to demonstrate non-inferiority.Ethics and disseminationThe study will be performed according to the guidelines of the Helsinki Declaration and is approved by the Austin Health Human Research Ethics Committee (HREC/62425/Austin-2020) in Melbourne Australia, Vanderbilt University Institutional Review Board (IRB #202174) in Tennessee, USA, Duke University Institutional Review Board (IRB #Pro00108461) in North Carolina, USA and McGill University Health Centre Research Ethics Board in Canada (PALACE/2022-7605). The results of this study will be published and presented in various scientific forums.Trial registration numberNCT04454229.
Quality improvement initiative: how the setting up of an anaesthesia consultant-led perioperative outreach service addressed anaesthesia-specific issues to improve anaesthesia consult and surgery timings for hip fracture patients
Authors: Siow Wei Shyan , Tay Leeanna , Mah Chou Liang 
Published: August 2022

BackgroundSurgery is recommended within 48 hours of hip fractures for better perioperative outcomes. Yet, such targets still commonly remain a challenge. Our institution is no exception.As part of a hospital-wide initiative, our anaesthesia department focused on improving perioperative processes with aims to reduce the time to first anaesthesia consult and surgery for hip fracture patients. Acknowledging multiple causes for surgical delay, we decided first to address anaesthesia-specific factors—(a) first anaesthetist contact usually happens after surgery is offered which leaves a short runway for preoptimisation, (b) this is compounded by varying degrees of anaesthetist involvement for follow-up thereafter. (c) There is a need to calibrate our perioperative care standards and (d) enforce more consistent auditing in quality assurance. This project was conducted in a 1000-bed hospital serving eastern Singapore.InterventionWe created an integrated anaesthesia consultant-led outreach service for hip fracture patients, based on a perioperative workflow system to provide proactive anaesthetist consults within 24 hours of admission in advance of surgical decision. This was streamlined with a coordinated follow-up system for preoptimisation until surgery.MethodsOur quality improvement project applied the iterative Plan-Do-Study-Act model from pilot to sustainability stage. We collected data at baseline followed by 6-monthly audits from electronic databases.Primary outcomes measured were time to first anaesthesia consult and surgery. Secondary outcomes included rate of critical care reviews and admission, mortality rate, length of stay and time to nerve blocks.ResultsPost implementation, our service reviewed >600 hip fracture patients. Median time to anaesthesia consult reduced significantly from 35.3 hours (2019) to 21.5 hours (2021) (p=0.029). Median time to surgery was reduced from 61.5 hours (2019) to 50 hours (2021) (p=0.897) with a 13.6% increase in patients operated <48 hours. Critical care admissions, 6-monthly and 12-monthly mortality rates and time to nerve block were reduced with a greater percentage of patients discharged within 10 days.ConclusionOur project focused on improving anaesthesia perioperative processes to address surgical delays in hip fracture patients. Our consultant-led anaesthesia service ensured that proactive anaesthesia care was delivered to provide sufficient time for preoptimisation with greater standardisation to follow-up, better communication and quality assurance.
Semirigid Ureteroscopy Therapy against Childhood Kidney Stones
Authors: Mu Xiao-Nan , Guo Long-Fei , Wang Peng-Xin , Zhang Long-Yang , Wang Si-Jun 
Published: August 2022

Objective. The purpose of the current study was to assess the effectiveness of semirigid ureterorenoscopy (URS) as first-line therapy for early childhood patients with <20 mm stones in the pelvic, middle, or upper calices. Methods. In all, 61 pediatric kidney stone patients who had flexible ureteroscopy (fURS) between January 1, 2010, and December 31, 2019, were included in this study. Before fURS, semirigid URS employed the UreTron or holmium: YAG (Ho : YAG) laser was conducted. When semirigid URS was unsuccessful, fURS was used for retrograde intrarenal surgery (RIRS). All participants were monitored clinically for a minimum of three months after each procedure. Results. The patient’s mean age was

4.52
±
1.53

years, and 52 (83.61%) participants underwent semirigid URS successfully. Mean procedural duration of semirigid URS was

36.49
±
7.72

min. The stone-free rate after semirigid URS was 92.16% (47/51). During the postprocedural medical observation, there were no serious adverse effects. Conclusions. Based on the present study’s findings, semirigid URS is a low-risk, effective therapy for kidney stones in selected pediatric patients.
Pulmonary Blood Volume Among Older Adults in the Community: The MESA Lung Study
Authors: Hermann Emilia A. , Motahari Amin , Hoffman Eric A. , Allen Norrina , Bertoni Alain G. , Bluemke David A. , Eskandari Ali , Gerard Sarah E. , Guo Junfeng , Hiura Grant T. , Kaczka David W. , Michos Erin D. , Nagpal Prashant , Pankow Jim , Shah Sanjiv , Smith Benjamin M. , Hinckley Stukovsky Karen , Sun Yifei , Watson Karol , Barr R. Graham 
Published: August 2022

Background:
The pulmonary vasculature is essential for gas exchange and impacts both pulmonary and cardiac function. However, it is difficult to assess and its characteristics in the general population are unknown. We measured pulmonary blood volume (PBV) noninvasively using contrast enhanced, dual-energy computed tomography to evaluate its relationship to age and symptoms among older adults in the community.

Methods:

The MESA (Multi-Ethnic Study of Atherosclerosis) is an ongoing community-based, multicenter cohort. All participants attending the most recent MESA exam were selected for contrast enhanced dual-energy computed tomography except those with estimated glomerular filtration rate <60 mL/min per 1.73 m
2
. PBV was calculated by material decomposition of dual-energy computed tomography images. Multivariable models included age, sex, race/ethnicity, education, height, weight, smoking status, pack-years, and scanner model.

Results:

The mean age of the 727 participants was 71 (range 59–94) years, and 55% were male. The race/ethnicity distribution was 41% White, 29% Black, 17% Hispanic, and 13% Asian. The mean±SD PBV in the youngest age quintile was 547±180 versus 433±194 mL in the oldest quintile (
P
<0.001), with an approximately linear decrement of 50 mL per 10 years of age ([95% CI, 32–67];
P
<0.001). Findings were similar with multivariable adjustment. Lower PBV was associated independently with a greater dyspnea after a 6-minute walk (
P
=0.04) and greater composite dyspnea symptom scores (
P
=0.02). Greater PBV was also associated with greater height, weight, lung volume, Hispanic race/ethnicity, and nonsmoking history.

Conclusions:
Pulmonary blood volume was substantially lower with advanced age and was associated independently with greater symptoms scores in the elderly.
What the Flip? What the P-N Flip Can Tell Us about Proactive Suppression
Authors: Tam Joyce , Callahan-Flintoft Chloe , Wyble Brad 
Published: August 2022

Abstract
It has been debated whether salient distractors in visual search can be proactively suppressed to completely prevent attentional capture, as the occurrence of proactive suppression implies that the initial shift of attention is not entirely driven by physical salience. While the presence of a Pd component in the EEG (associated with suppression) without a preceding N2pc component (associated with selection) has been used as evidence for proactive suppression, the link between these ERPs and the underlying mechanisms is not always clear. This is exemplified in two recent articles that observed the same waveform pattern, where an early Pd-like component flipped to a N2pc-like component, but provided vastly different interpretations (Drisdelle, B. L., & Eimer, E. PD components and distractor inhibition in visual search: New evidence for the signal suppression hypothesis. Psychophysiology, 58, e13898, 2021; Kerzel, D., & Burra, N. Capture by context elements, not attentional suppression of distractors, explains the PD with small search displays. Journal of Cognitive Neuroscience, 32, 1170–1183, 2020). Using RAGNAROC (Wyble et al., Understanding visual attention with RAGNAROC: A Reflexive Attention Gradient through Neural AttRactOr Competition. Psychological Review, 127, 1163–1198, 2020), a computational model of reflexive attention, we successfully simulated this ERP pattern with minimal changes to its existing architecture, providing a parsimonious and mechanistic explanation for this flip in the EEG that is unique from both of the previous interpretations. Our account supports the occurrence of proactive suppression and demonstrates the benefits of incorporating computational modeling into theory building.
Beyond Drift Diffusion Models: Fitting a Broad Class of Decision and Reinforcement Learning Models with HDDM
Authors: Fengler Alexander , Bera Krishn , Pedersen Mads L. , Frank Michael J. 
Published: August 2022

AbstractComputational modeling has become a central aspect of research in the cognitive neurosciences. As the field matures, it is increasingly important to move beyond standard models to quantitatively assess models with richer dynamics that may better reflect underlying cognitive and neural processes. For example, sequential sampling models (SSMs) are a general class of models of decision-making intended to capture processes jointly giving rise to RT distributions and choice data in n-alternative choice paradigms. A number of model variations are of theoretical interest, but empirical data analysis has historically been tied to a small subset for which likelihood functions are analytically tractable. Advances in methods designed for likelihood-free inference have recently made it computationally feasible to consider a much larger spectrum of SSMs. In addition, recent work has motivated the combination of SSMs with reinforcement learning models, which had historically been considered in separate literatures. Here, we provide a significant addition to the widely used HDDM Python toolbox and include a tutorial for how users can easily fit and assess a (user-extensible) wide variety of SSMs and how they can be combined with reinforcement learning models. The extension comes batteries included, including model visualization tools, posterior predictive checks, and ability to link trial-wise neural signals with model parameters via hierarchical Bayesian regression.
Surgeon Preference on Sending Routine Tonsillectomy Specimens for Pathological Evaluation
Authors: Rossi Nicholas A. , Freeman Cecilia G. , Ohlstein Jason F. , Daram Shiva , Darling Robert A. , McKinnon Brian J. , Pine Harold S. 
Published: August 2022

Introduction Despite the presence of a growing body of literature suggesting cost-ineffectiveness of routine pathologic analysis of tonsillectomy specimens, little is known about common institutional policies and practice patterns of pediatric otolaryngologists. The objectives of this study were to determine the prevalence of routine pathological evaluation of tonsillectomy specimens for uncomplicated pediatric adenotonsillectomy procedures and to evaluate opinions regarding this controversy among board-certified pediatric otolaryngologists. Methods This was a cross-sectional survey study sent to board-certified pediatric otolaryngologists currently practicing and registered with the American Society of Pediatric Otolaryngology (ASPO) assessing their institutions’ or practices’ current policies on sending routine tonsillectomy specimens for pathology, their experience with this practice, and their opinions on whether routine pathologic analysis should be employed. Basic statistical analysis was then conducted. Results Respondents mostly practiced in an academic setting (68.4%), with the next most common being academically affiliated private practice (21.8%), and private practice was the least common (9.8%). Most respondents (85.1%) did not agree with routine pathologic analysis of otherwise uncomplicated pediatric tonsillectomy specimens. Conclusion Most pediatric otolaryngologists who responded to this survey do not support routine pathological analysis of otherwise uncomplicated pediatric tonsillectomy specimens. However, the results are likely biased and should be interpreted carefully, since only a small percentage of pediatric otolaryngologists responded to the survey. Potential cost savings could be seen by patients, payers, and hospital systems with judicious use of surgical pathology, specifically in cases with concurrent signs or symptoms suspicious for malignancy.