bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of race on pancreas transplant outcomes in the current era: It is not all Black and White
Authors: McElroy Lisa , Fridell Jonathan A. 
Published: February 2022

AbstractThe growth in pancreas transplant is driven in part by expansion of indications to include an increasing number of select patients with type 2 diabetes. Two papers in this month's issue of Clinical transplantation specifically investigate this association, and in parallel illustrate the complexity of defining the association of race with pancreas transplant outcomes from different perspectives and illustrate several important concepts related to health equity in organ transplantation.
Governance of organic cocoa production: An analysis of EU regulation through the framework of multilevel governance
Authors: Obeng Godfred Adduow 
Published: February 2022

SummaryMotivationWhile organic agriculture is seen as the best way to achieve sustainable agriculture, the question of how actors in the sector can help remains unresolved. This article seeks to contribute to the global determination to resolve environmental challenges through sustainable agricultural practices grounded in multilevel governance.PurposeThe article examines existing regulations governing the production and importation of organic cocoa.Methods and approachMultilevel governance is used as a theoretical and methodological tool to examine the discursive and material struggles which challenge the promotion of organic cocoa, using a content analysis of European Union (EU) regulations governing the production and importation of organic agricultural produce, including cocoa.FindingsThe article finds that the EU regulations on the production and importation of organic cocoa take a vertical approach to multilevel governance. Organic cocoa farmers, who come lower down in the governance hierarchy, have no role in policy‐making and have simply to follow these regulations.Policy implicationsThe regulations seem to ignore the inputs of actors at the lower level in the hierarchy. The absence of organic producers' (farmers) participation in the governance architecture may inhibit conventional farmers from venturing into organic cocoa production.
Sinus venosus defect of the pulmonary vein‐type: An easily missed diagnosis
Authors: Metcalf Meghan K. , Ghosh Reena M. , Harris Matthew A. , Savla Jill J. , Cohen Meryl S. 
Published: February 2022

AbstractAtrial septal defects are one of the most common forms of congenital heart disease, however sinus venosus communications, particularly pulmonary vein‐type defects, are rare and are easily misdiagnosed. Patients with pulmonary vein‐type sinus venosus defects often present earlier than those with ostium secundum defects with significant right heart dilation. Correct diagnosis has important implications for management. We discuss the clinical courses and review multimodality imaging of three patients correctly diagnosed with pulmonary vein‐type defects after an initial diagnosis of an ostium secundum atrial septal defect, in order to promote understanding of the unique anatomy of this entity.
Emulating a target trial of proton pump inhibitors and dementia risk using claims data
Authors: Ahn Nayeon , Nolde Michael , Günter Alexander , Güntner Florian , Gerlach Roman , Tauscher Martin , Amann Ute , Linseisen Jakob , Meisinger Christa , Rückert‐Eheberg Ina‐Maria , Baumeister Sebastian‐Edgar 
Published: February 2022

AbstractBackground and purposeUnderstanding the adverse effects of proton pump inhibitors (PPIs) is important due to their widespread use, but the available evidence for an increased dementia risk amongst patients taking PPIs is inconclusive. The present study aimed to estimate the causal effect of PPIs on the risk of dementia by target trial emulation and time‐varying exposure modeling.MethodsUsing claims data of 2,698,176 insured people of a large German statutory health insurer, a target trial was conceptualized in which individuals aged 40 years and older were classified as PPI initiators or non‐initiators between 2008 and 2018, and were followed until diagnosis of dementia, death, loss to follow‐up or end of study. Incidence of dementia (International Classification of Diseases 10 codes F00, F01, F03, F05.1, G30, G31.0, G31.1, G31.9 and F02.8+G31.82) was defined applying a 1‐year lag window. Weighted Cox models were used to estimate the effect of PPI initiation versus non‐initiation on dementia risk and weighted pooled logistic regression was used to estimate the effect of time‐varying use versus non‐use.ResultsIn all, 29,746 PPI initiators (4.4%) and 26,830 non‐initiators (1.3%) were diagnosed with dementia. Comparing PPI initiation with no initiation, the hazard ratio for dementia was 1.54 (95% confidence interval 1.51–1.58). The hazard ratio for time‐dependent PPI use versus non‐use was 1.56 (95% confidence interval 1.50–1.63). Differentiated subtypes, including unspecified dementia, Alzheimer's disease and vascular dementia, showed increased risk by PPI initiation and time‐varying PPI use.ConclusionsThis study suggests that PPI initiation and time‐varying PPI use may increase overall dementia risk.
A vision‐based clinical analysis for classification of knee osteoarthritis, Parkinson's disease and normal gait with severity based on k‐nearest neighbour
Authors: Kour Navleen , Gupta Sunanda , Arora Sakshi 
Published: February 2022

AbstractThe prevalence of musculoskeletal and neurological diseases such as knee osteoarthritis (KOA) and Parkinson's disease (PD) has grown speedily in recent years. The direct impact of these disorders on a person's gait has evoked many researchers to perform their analysis using gait because of its greater feasibility. In this paper, we proposed a framework to accurately classify abnormal considering KOA and PD and normal (NM) gait using a vision‐based (VB) approach. The aim of this study is four‐fold: firstly, a novel VB gait dataset is created and presented; secondly, the segmentation of the region of interest (ROIs) is performed using an improved technique; thirdly gait parameters, that is, spatiotemporal (SPT), linear kinematic (KNM) and additional body motion features are evaluated using statistical methods; fourthly, the classification of KOA, PD and NM subjects has been done based on artificial intelligence or a machine learning technique (MLT), that is, k‐nearest neighbour (KNN) at three severity levels and a comparison is performed with other methods namely support vector machine (SVM), random forest (RF) and linear regression (LR). The results reveal the relevance of considered gait features in this investigation. For classification purposes, the highest results are obtained by our proposed method in classifying the subjects with severity also, achieving an overall accuracy = 0.9006, sensitivity = 0.8554, specificity = 0.9044, and precision = 0.8966 respectively. This study thus successfully presents KOA, PD, and NM gait classification method based on the MLT which may be beneficial for clinicians to perform early diagnosis of such disorders objectively.
Diverging patterns at the forest edge: Soil respiration dynamics of fragmented forests in urban and rural areas
Authors: Garvey Sarah M. , Templer Pamela H. , Pierce Erin A. , Reinmann Andrew B. , Hutyra Lucy R. 
Published: February 2022

AbstractAs urbanization and forest fragmentation increase around the globe, it is critical to understand how rates of respiration and carbon losses from soil carbon pools are affected by these processes. This study characterizes soils in fragmented forests along an urban to rural gradient, evaluating the sensitivity of soil respiration to changes in soil temperature and moisture near the forest edge. While previous studies found elevated rates of soil respiration at temperate forest edges in rural areas compared to the forest interior, we find that soil respiration is suppressed at the forest edge in urban areas. At urban sites, respiration rates are 25% lower at the forest edge relative to the interior, likely due to high temperature and aridity conditions near urban edges. While rural soils continue to respire with increasing temperatures, urban soil respiration rates asymptote as temperatures climb and soils dry. Soil temperature‐ and moisture‐sensitivity modeling shows that respiration rates in urban soils are less sensitive to rising temperatures than those in rural soils. Scaling these results to Massachusetts (MA), which encompasses 0.25 Mha of the urban forest, we find that failure to account for decreases in soil respiration rates near urban forest edges leads to an overestimate of growing‐season soil carbon fluxes of >350,000 Mg C. This difference is almost 2.5 times that for rural soils in the analogous comparison (underestimate of <143,000 Mg C), even though rural forest area is more than four times greater than urban forest area in MA. While a changing climate may stimulate carbon losses from rural forest edge soils, urban forests may experience enhanced soil carbon sequestration near the forest edge. These findings highlight the need to capture the effects of forest fragmentation and land use context when making projections about soil behavior and carbon cycling in a warming and increasingly urbanized world.
Will forest dynamics continue to accelerate throughout the 21st century in the Northern Alps?
Authors: Thom Dominik , Rammer Werner , Laux Patrick , Smiatek Gerhard , Kunstmann Harald , Seibold Sebastian , Seidl Rupert 
Published: February 2022

AbstractObservational evidence suggests that forests in the Northern Alps are changing at an increasing rate as a consequence of climate change. Yet, it remains unclear whether the acceleration of forest change will continue in the future, or whether downregulating feedbacks will eventually decouple forest dynamics from climate change. Here we studied future forest dynamics at Berchtesgaden National Park, Germany by means of a process‐based forest landscape model, simulating an ensemble of 22 climate projections until the end of the 21st century. Our objectives were (i) to assess whether the observed acceleration of forest dynamics will continue in the future, (ii) to analyze how uncertainty in future climate translates to variation in future forest disturbance, structure, and composition, and (iii) to determine the main drivers of future forest dynamics. We found that forest dynamics continue to accelerate in the coming decades, with a trend towards denser, structurally more complex and more species rich forests. However, changes in forest structure leveled off in the second half of the 21st century regardless of climate scenario. In contrast, climate scenarios caused trajectories of tree species change to diverge in the second half of the 21st century, with stabilization under RCP 2.6 and RCP 4.5 scenarios and accelerated loss of conifers under RCP 8.5. Disturbance projections were 3 to 20 times more variable than future climate, whereas projected future forest structure and composition varied considerably less than climate. Indirect effects of climate change via alterations of the disturbance regime had a stronger impact on future forest dynamics than direct effects. Our findings suggest that dampening feedbacks within forest dynamics will decelerate forest change in the second half of the 21st century. However, warming beyond the levels projected under RCP 4.5 might profoundly alter future forest disturbance and composition, challenging conservation efforts and ecosystem service supply.
Effectiveness of a nurse‐led smartphone‐based self‐management programme for people with poorly controlled type 2 diabetes: A randomized controlled trial
Authors: Jiang Ying , Ramachandran Hadassah Joann , Teo Jun Yi Claire , Leong Foon Leng , Lim Suan Tee , Nguyen Hoang D. , Wang Wenru 
Published: February 2022

AbstractAimTo evaluate the effectiveness of a nurse‐led smartphone‐based self‐management programme (NSSMP) on improving self‐efficacy, promoting diabetes self‐care, increasing health‐related quality of life (HRQoL) and decreasing HbA1c, acute complications and unplanned medical consultation for people with poorly controlled type 2 diabetes compared with a nurse‐led diabetic service (NDS).DesignA two‐arm randomized controlled trial with repeated measures was conducted.MethodsParticipants were recruited from June 2018 to September 2020. Eligible participants were assigned to either the intervention or control group randomly. Participants assigned to intervention group received the 6‐month NSSMP, while those in the control group received existing NDS provided by the study hospital. Outcomes were measured at baseline, and at 3 and 6 months from baseline.ResultsA total of 114 participants were recruited. There were no significant interactions between group and time for all the outcomes except for blood glucose testing activities (F = 4.742, p = .015). Both groups had reduced HbA1c over 6 months. The intervention group had a lower HbA1c than the control group at follow‐ups, but the differences were not statistically significant. None of the participants had acute diabetes complications at follow‐up. Similarly, the differences in the number of unplanned medical consultation at 6‐month follow‐up between two groups were statistically insignificant.ConclusionThe NSSMP is as effective as existing NDS provided by the study hospital in improving most of the outcomes. NSSMP can liberate valuable time for nurses to provide care to critically ill patients and supports healthcare resource constraints in the current COVID‐19 pandemic.ImpactThe existing diabetes service is labour intensive as nurses are required to deliver education, follow‐up telephone calls to trace blood sugar monitoring and provide therapeutic consultations and necessary referrals. The outbreak of COVID‐19 pandemic has added further strain on the overworked professionals. NSSMP provides an alternative programme that is just as effective, to reduce nurses' workload by delegating them back to the individuals through self‐management strategies. This enables nurses to increase contact time with patients, and individuals to take onus of their disease through increased self‐efficacy, facilitated by technology.Clinical TrialThis study is registered under clinical registration number NCT03088475.
Addressing the contributions of electricity from biomass in Brazil in the context of the Sustainable Development Goals using life cycle assessment methods
Authors: Souza Nariê Rinke Dias de , Souza Alexandre , Ferreira Chagas Mateus , Hernandes Thayse Aparecida Dourado , Cavalett Otávio 
Published: February 2022

AbstractThe implications of bioenergy deployment for sustainable development goals (SDGs) have been gaining importance worldwide, as bioenergy may contribute to other sustainability impacts besides climate change. Decarbonization of the energy sector can promote major co‐benefits between Climate Action and other SDGs and lead to important tradeoffs. Life cycle assessment (LCA) methods have been proposed to monitor the SDGs as many of them are closely interconnected but often separately studied. A harmonized application of environmental and social LCA can reveal additional relevant aspects of SDGs. This work proposes an interpretation of combined environmental and socioeconomic LCA impacts by comparing the SDG impacts of electricity from sugarcane biomass with other technological options, which altogether represent 96% of the Brazilian electricity matrix. Our analysis indicates that sugarcane electricity has a higher SDGs score (58 points) compared to coal and oil electricity (42 and 47 points, respectively); however, it is lower than natural gas (78). Sugarcane SDG internal normalization related to the biosphere is very close to natural gas, varying only 3–4 points. On the Economy and Society SDG score, sugarcane electricity is also lower than natural gas. Key areas in sugarcane electricity production that need to be enhanced to better contribute to achieving the SDGs include improving its awareness levels, increasing wages and women representation on the workforce, and promoting measures to decrease work accidents as well as the use of fertilizers and pesticides. This approach may help design specific measures for different value chains for them to significantly contribute to the achievement of SDGs.
Porous diaphragm syndrome presenting as hemothorax secondary to hemoperitoneum after laparoscopic myomectomy: A case report and literature review
Authors: Ota Kuniaki , Katagiri Yukiko , Katakura Masafumi , Maemura Toshimitsu , Takahashi Toshifumi , Morita Mineto 
Published: February 2022

AbstractPorous diaphragm syndrome includes all pleural cavity conditions, including pleural effusion, hemothorax, or pneumothorax, that occur secondary to peritoneal cavity disorders through defects in the diaphragm. In this report, we describe the first known case of porous diaphragm syndrome presenting as hemothorax after laparoscopic myomectomy. A 46‐year‐old nulliparous woman underwent laparoscopic myomectomy for multiple fibroids. Eight hours after surgery, the patient developed exertional dyspnea followed by hemoptysis. Radiological diagnosis revealed massive hemothorax in the right thoracic cavity. Thoracoscopic findings showed the presence of small fenestrae at the center of the right diaphragm, which were repaired thoracoscopically. Hence, quick postoperative diagnosis resulted in successful treatment. In this case, porous diaphragm syndrome is believed to be caused by retention of intraoperative bleed and saline from intra‐abdominal lavage, in the abdominal cavity. Porous diaphragm syndrome is a potential life‐threatening condition that gynecological surgeons should consider in this era of laparoscopic surgery.
Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden
Authors: Piersiala Krzysztof , Kakabas Lara , Bruckova Anna , Starkhammar Magnus , Cardell Lars Olaf 
Published: February 2022

AbstractObjectiveThe objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS‐CoV‐2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID‐19 patients seeking emergency care with symptoms similar to the life‐threatening condition epiglottitis. Here, we present a case series and discuss management.MethodsWe performed a retrospective single‐center case study of patients diagnosed with COVID‐19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020‐02579). Informed consent was obtained from all patients included in the study.ResultsTwenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID‐19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID‐19‐associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics.ConclusionPrevious variants of SARS‐CoV‐2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID‐19 patients.
Rurality impacts pain care for female veterans similarly to male veterans
Authors: Hadlandsmyth Katherine , Driscoll Mary A. , Mares Jasmine G. , Au Vanessa , Miell Kelly Richardson , Lund Brian C. 
Published: February 2022

AbstractPurposeRural disparities exist in access to multidisciplinary pain care with higher rates of opioid prescribing in rural regions. Among Veterans, who have prevalent rates of chronic pain, women often evidence complex presentations, multiple comorbidities, and dissatisfaction with care. This study investigates the impact of rurality on pain care for women specifically, and whether this varies from the impact of rurality for men.MethodsA cohort of Veterans with chronic pain in 2018 was built utilizing VA administrative data. Variables of interest included: demographic, comorbidities, medications, and health care utilization for chronic pain.FindingsThe cohort included 2,261,030 Veterans; 11% (n = 248,977) were women. Significantly fewer women (7%) compared to men (10.7%) received long‐term opioids (adjusted OR = 0.77, 95% CI: 0.75‐0.78). Men, relative to women, were also more likely to receive gabapentinoids and nonsteroidal ant‐inflammatory drugs, whereas women, relative to men, were more likely to receive muscle relaxants and duloxetine. Women were more likely to receive most psychiatric medications. Rural women received more primary care visits compared to urban women (adjusted OR = 1.19, 95% CI: 1.15‐1.22), but fewer women's clinic visits (a subset of primary care visits: adjusted OR = 0.69, 95% CI:0.67‐0.71) and fewer pain specialty care visits (physical therapy, pain clinic, and mental health visits with pain codes). Rural effects did not vary substantially between women and men.ConclusionsRural‐dwelling Veterans received more pain and psychiatric medications compared to urban Veterans and fewer specialty care visits. Rural Veterans may benefit from increased access to specialty chronic pain care.
Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva
Authors: Soria‐Contreras Diana C. , Perng Wei , Rifas‐Shiman Sheryl L. , Hivert Marie‐France , Chavarro Jorge E. , Oken Emily 
Published: February 2022

AbstractBackgroundRetrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias.ObjectiveTo evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes.MethodsSecondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight‐for‐gestational age z‐scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre‐pregnancy body mass index.ResultsMean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26–34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U‐shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk.ConclusionsVariation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.