bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variability in Resource Utilization in the Evaluation and Management of Simple Febrile Seizures Inpatients in US Children’s Hospitals
Authors: Saksa Dane , Sun Lena S. , Rodean Jonathan , Berry Jay , Hall Matt , Leahy Izabela , Ferrari Lynne , Huang Yolanda Y. 
Published: December 2022

Objective:
To characterize resource utilization in the evaluation and treatment of hospitalized simple febrile seizure (SFS) patients in US tertiary pediatric hospitals.

Methods:
This is a retrospective cohort study using the Pediatric Health Information System from 2010 to 2015. Children 6 months to 5 years of age who were inpatients with a diagnosis of SFS. Children who had brain magnetic resonance imaging (MRI), electroencephalography (EEG), or received anticonvulsants were compared with those who did not have testing or anticonvulsant treatment. Hospital-level variation in the utilization rates of MRI, EEG, or treatment with anticonvulsants was also evaluated.

Results:
In Pediatric Health Information System-participating institutions, 8.4% (n=3640) of children presenting to the emergency department with SFS were hospitalized. Among these SFS inpatients, 57.8% (n= 2104) did not receive further evaluation with MRI/EEG or treatment with anticonvulsants. There was evidence of wide inter-hospital variation in resource utilization rates. The median (interquartile range) utilization rate was 6.2% (3.0 to 11.0%) for MRI, 28.5% (16.0 to 46.3%) for EEG and 17.1% (10.9 to 22.3%) for treatment with anticonvulsants.

Conclusion:
No specific hospital-level factors were identified that contributed to the variation in resource utilization in the evaluation and management of hospitalized SFS patients.
Introducing Nursing Students to Pastoral Care Providers Via Simulation
Authors: Joyce Lindsey K. , L'Ecuyer Kristine M. , Rubbelke Cynthia S. 
Published: December 2022

ABSTRACT:
During a mock code simulation scenario in a medical–surgical undergraduate nursing course, two priests as pastoral care providers were included as interprofessional team members. Perceptions of the inclusion of pastoral care in an end-of-life simulation were assessed as part of a mixed-method study that included a qualitative analysis of debriefing sessions. Students reported an increase in awareness of the role of pastoral care in healthcare and learned to consider the spiritual aspects of end-of-life care. Participation of priests in an end-of-life simulation enhanced students' learning of spirituality as an aspect of nursing care.
Predictors of an Academic Career in Radiation Oncology 5 to 10 Years After Residency
Authors: Culbert Matthew M. , Parekh Akash , Shah Anjay , Morris Christopher G. , Amdur Robert J. 
Published: December 2022

Objective:
To report the percentage of resident graduates in the modern era who establish careers in academic radiation oncology 5 to 10 years after residency.

Materials and Methods:
The study population included 1147 radiation oncologists who completed residency between 2011 and 2017 and were practicing radiation oncologists in 2021.

Results:
The percentage of 2011–2017 graduates with an academic career in 2021 (5 to 10 y after residency): Holman Pathway resident: Yes, 74% versus No, 43% (P<0.05); PhD degree before residency: Yes, 67% versus No, 38% (P<0.05), Doximity top-10 ranked residency program: Yes, 66% versus No, 37% (P<0.05).
Logistic regression multivariate analysis confirmed PhD and Doximity top-10 as strong independent predictors for all endpoints.
Regarding gender, no significant differences were observed for all 4 endpoints in the percentage of women versus men establishing academic careers at the 5-year to 10-year post-residency time point.

Conclusion:
Since 2011, at least one-third (~35%) of radiation oncology residents have gone into academic medicine and are academically productive 5 to 10 years after residency. Holman Pathway, PhD degree, or Doximity top-10 residency program approximately doubles the probability of an academic career. Moreover, radiation oncology is on track to achieve gender equity in academic medicine.
Evaluation of Treatment Patterns and Outcomes of Patients With PIK3CA-related Overgrowth Spectrum
Authors: Engel-Nitz Nicole M. , Martin Carolyn , Balu Sanjeev , Frieden Ilona J. , Anderson Amy , Belland Angela , Paul Mary Lisha 
Published: December 2022

Objectives:
PIK3CA-related overgrowth spectrum (PROS) is difficult to diagnose clinically and categorize in observational real-world data. This study used an innovative approach to identify and explore a population with suspected PROS. The purpose of this study was to describe characteristics, treatment patterns, and healthcare utilization among patients with evidence of PROS.

Methods:
This retrospective study used electronic health records (EHRs) identified using a key word search for PROS terms recorded in provider clinical notes from January 01, 2007 through June 30, 2019 from the Optum EHR database, which included records from more than 140,000 providers. Both structured data fields and clinician review of provider open text notes were used to evaluate disease status.

Results:
A total of 657 patients had records with PROS search terms and 82 patients had records eligible for clinician review of provider notes. Following clinician review, 41.5% of patients were confirmed PROS positive, 25.6% were PROS negative, and 32.9% were not able to be categorized. All patients identified with confirmed/suspected PROS from provider notes and from the PROS-specific structured data cohort had an ambulatory visit and more than half had an inpatient stay or emergency visit during the study period. More than half of patients were also prescribed an antiseizure medication and three-fourths were prescribed pain medications.

Conclusion:
Distinguishing patients with PROS using a search-term strategy remained difficult, even after clinician review of individual provider notes. Patients identified as having PROS experienced a considerable clinical burden with high rates of medication use and frequent healthcare visits.
Role of endoscopic ultrasound in the evaluation of unexplained extrahepatic bile duct dilatation
Authors: Chen Long-Jiang , Wang Xiao-Yi , Dai Jian-Hua , Tang Zhi-Gang 
Published: December 2022

Objective
This study was performed to assess the diagnostic performance of endoscopic ultrasonography (EUS) in patients with extrahepatic bile duct (EBD) dilatation and develop a novel model incorporating EUS-based signature with clinical parameters for distinguishing the malignant dilation of EBD.

Methods
The EUS data and clinical parameters of the patients were collected and analyzed retrospectively. First, we evaluated the diagnostic performance of EUS in detecting the cause of EBD dilatation. Then, we performed univariate and multivariate binary logistic regression analyses based on clinical and EUS features. Finally, a nomogram was established to aid in distinguishing between malignant dilation and noncalculous benign dilatation of EBD in patients.

Results
A total of 184 patients were enrolled. For the diagnosis of malignant dilation, EUS achieved an accuracy of 90.76%, sensitivity of 85.96%, and specificity of 92.91%. For the diagnosis of calculous dilation, EUS achieved an accuracy of 100%, sensitivity of 100%, and specificity of 100%. For the diagnosis of noncalculous benign dilatation, EUS achieved an accuracy of 90.76%, sensitivity of 90.90%, and specificity of 90.58%. Multivariable logistic regression analyses indicated that abnormal liver function test, elevated tumor markers, and EUS findings were the well-diagnostic factors of malignant EBD dilation. The nomogram established by these factors showed good calibration and discrimination.

Conclusion
EUS is a useful examinational modality in the work-up of EBD dilatation. In combination with abnormal liver function test and elevated tumor markers, EUS may provide additional information for the detection of malignant dilation of EBD and should be further investigated.
Hot Gloved Finger Sign in Endobronchial Metastasis From Hepatocellular Carcinoma on FDG PET/CT
Authors: Zhang Jun , Dong Aisheng , Wang Yang 
Published: December 2022

Abstract
Endobronchial metastasis from hepatocellular carcinoma is exceedingly rare. We describe FDG PET/CT findings in a case with isolated endobronchial metastasis from hepatocellular carcinoma 13 years after hepatectomy. The endobronchial metastasis appeared as hypermetabolic branching tubular opacities, producing a hot gloved finger sign on FDG PET/CT. This case indicates that the hot gloved finger sign may be suggestive of extensive endobronchial growing of a malignant condition but not endobronchial mucoid plug.
Unilateral Reduction of 18F-FDG Accumulation in Brown Adipose Tissue by Sympathectomy for Hyperhidrosis
Authors: Shirakawa Chigusa , Koyasu Sho , Takada Masahiro , Toi Masakazu , Nakamoto Yuji 
Published: December 2022

Abstract
A 30-year-old woman with left breast cancer underwent 18F-FDG PET/CT for staging. Intense FDG uptake was observed in the primary lesion, as well as on the left side of the neck to the supraclavicular fossa and left paravertebral region. History taking revealed that she had undergone a right thoracic sympathectomy for hyperhidrosis, which resulted in attenuated FDG uptake in the right-sided brown adipose tissue (BAT). With another examination keeping adequate warming, the accumulation of BAT was reduced and a diagnosis of cT1N1M0 was made. Unilateral sympathetic blockade can cause asymmetric FDG accumulation in BAT, which interferes with interpretation in tumors.
Solitary Scapular Metastasis as the First Presentation of Prostate Adenocarcinoma Identified on 99mTc-MDP SPECT/CT
Authors: Liu Wei , Zheng Xiao-Zuo , Dong Zi-Qian , Huang Jian-Min , Xie Peng 
Published: December 2022

AbstractMetastases of prostate carcinoma in the skeleton are usually multiple. Solitary metastasis in appendicular skeleton is extremely rare. We present bone scan findings of solitary scapular metastasis from prostate adenocarcinoma as the initial presentation of his malignancy in a 62-year-old man. The99mTc-MDP SPECT/CT demonstrated intense activity in the coracoid process of left scapula, whereas the tracer uptakes in other bones were not typical of metastases. The subsequent pathological results of the punctured left scapula confirmed as metastasis from prostate adenocarcinoma.
Optimal Measurement Sites of Coronary-Computed Tomography Angiography-derived Fractional Flow Reserve
Authors: Chen Yan Chun , Zhou Fan , Wang Yi Ning , Zhang Jia Yin , Yu Meng Meng , Hou Yang , Xu Peng Peng , Zhang Xiao Lei , Xue Yi , Zheng Min Wen , Zhang Bo , Zhang Dai Min , Hu Xiu Hua , Xu Lei , Liu Hui , Lu Guang Ming , Tang Chun Xiang , Zhang Long Jiang 
Published: December 2022

Objectives:
To investigate the optimal measurement site of coronary-computed tomography angiography-derived fractional flow reserve (FFRCT) for the assessment of coronary artery disease (CAD) in the whole clinical routine practice.

Materials and Methods:
This retrospective multicenter study included 396 CAD patients who underwent coronary-computed tomography angiography, FFRCT, and invasive FFR. FFRCT was measured at 1 cm (FFRCT-1 cm), 2 cm (FFRCT-2 cm), 3 cm (FFRCT-3 cm), and 4 cm (FFRCT-4 cm) distal to coronary stenosis, respectively. FFRCT and invasive FFR ≤0.80 were defined as lesion-specific ischemia. The diagnostic performance of FFRCT to detect ischemia was obtained using invasive FFR as the reference standard. Reduced invasive coronary angiography rate and revascularization efficiency were calculated. After a median follow-up of 35 months in 267 patients for major adverse cardiovascular events (MACE), Cox hazard proportional models were performed with FFRCT values at each measurement site.

Results:
For discriminating lesion-specific ischemia, the areas under the curve of FFRCT-1 cm (0.91) as well as FFRCT-2 cm (0.91) were higher than those of FFRCT-3 cm (0.89) and FFRCT-4 cm (0.88), respectively (all P<0.05). The higher reduced invasive coronary angiography rate (81.6%) was found at FFRCT-1 cm than FFRCT-2 cm (81.6% vs. 62.6%, P<0.05). Revascularization efficiency did not differ between FFRCT-1 cm and FFRCT-2 cm (80.8% vs. 65.5%, P=0.019). In 12.4% (33/267) MACE occurred and only values of FFRCT-2 cm were independently predictive of MACE (hazard ratio: 0.957 [95% CI: 0.925-0.989]; P=0.010).

Conclusions:
This study indicates FFRCT-2 cm is the optimal measurement site with superior diagnostic performance and independent prognostic role.
Myocardial Work Measurement With Functional Capacity Evaluation in Primary Systemic Hypertension Patients
Authors: Ran Hong , Ma Xiao-wu , Wan Lin-lin , Ren Jun-yi , Zhang Jian-xin , Zhang Ping-yang , Schneider Matthias 
Published: December 2022

Objective:
Noninvasive measurement of myocardial work (MW) incorporates left ventricular (LV) pressure, and, therefore, allows correction of global longitudinal strain for changing afterload conditions. We sought to investigate MW as a tool to detect early signs of LV dysfunction in primary systemic hypertension patients, particularly with different predictive indices.

Methods and Results:
None left ventricular hypertrophy (NLVH) and left ventricular hypertrophy (LVH) patients established were all primary systemic hypertension with preserved ejection fraction. Forty in NLVH and forty in LVH according to left ventricular end-diastolic mass index (LVEDmassI) were prospectively enrolled. The following indices of MW were assessed: global work index, global constructive work, global wasted work (GWW), and global work efficiency (GWE). Both global work index (P=0.348) and global constructive work (P=0.225) were increased in NLVH and decreased in LVH, and GWW (P<0.001) was increased significantly in NLVH and increased more in LVH, while GWE (P<0.001) was decreased significantly in NLVH and decreased more in LVH. The clinical utility of GWW (95% CI: 0.802-0.951) and GWE (95% CI: 0.811-0.950) were verified by receiver-operating characteristic curve analysis showing larger net benefits as evaluated with LVH and control comparisons. In multivariate linear regression analysis, 4-dimenaional LVEDmassI was independently associated with GWE (P=0.018) in systemic hypertension patients. Assessment of intraobserver and interobserver variability in the MW echocardiographic data documented good interclass correlation coefficients (all >0.85).

Conclusion:
GWW and GWE derived from MW are more accurate, sensitive, and reproducible predictors to detect early LV dysfunction in primary systemic hypertension patients, especially in distinguishing the potential functional abnormality of NLVH and LVH, even though the ejection fraction is preserved.
SEVERE CORONAVIRUS DISEASE 2019: FROM PATHOGENESIS TO THERAPY
Authors: Cavaillon Jean-Marc , Artigas Antonio , Barratt-Due Andreas , Giamarellos-Bourboulis Evangelos J. , Gómez Hernando , Hayem Gilles , Vlaar Alexander P. J. , Wiersinga W. Joost 
Published: December 2022

ABSTRACT
The COVID-19 pandemic has been a challenge to propose efficient therapies. Because severe SARS-CoV2 infection is a viral sepsis eventually followed by an immunological autoinflammatory phenomenon, many approaches have been inspired by the previous attempts made in bacterial sepsis, while specific antiviral strategies (use of interferon or specific drugs) have been additionally investigated. We summarize our current thinking on the use of SARS-CoV-2 antivirals, corticosteroids, anti–IL-1, anti-IL-6, anti-C5a, as well as stem cell therapy in severe COVID-19. Patient stratification and appropriate time window will be important to be defined to guide successful treatment.
Invasive terrestrial invertebrate detection in water and soil using a targeted eDNA approach
Authors: Villacorta-Rath Cecilia , Lach Lori , Andrade-Rodriguez Natalia , Burrows Damien , Gleeson Dianne , Trujillo-González Alejandro 
Published: December 2022

AbstractTerrestrial invasive invertebrates can rapidly colonize new areas, causing detrimental effects on biodiversity, economy, and lifestyle. Targeted environmental DNA (eDNA) methods could constitute an early detection tool given their sensitivity to small numbers of individuals.We hypothesized that terrestrial runoff would transport eDNA from the land into adjacent water bodies and used the invasive yellow crazy ant (Anoplolepis gracilipes) as a model species to test this hypothesis. We collected water samples from four waterbodies adjacent to infestations following rainfall events for eDNA analysis. We also collected soil samples from areas of known infestations and tested five eDNA extraction methods to determine their efficiency to extract eDNA from soil.Water samples resulted in positive yellow crazy ant eDNA amplification (20–100% field replicates across all sites), even at one site located 300 m away from where ants had been detected visually. Soil samples resulted in a high percentage of false negatives when sampled from ant transit areas than from nest entrances.Unpurified DNA extracts from soil also resulted in false negative detections, and only after applying a purification step of DNA extracts, we detected yellow crazy ant eDNA in 40–100% of field replicates across all methods and sites.This is the first study to empirically show that eDNA from a terrestrial invertebrate can be successfully isolated and amplified from adjacent or downstream waterbodies. Our results indicate that eDNA has the potential to be a useful method for detecting terrestrial invertebrates from soil and water.
Hexokinase 2 localizes to the nucleus in response to glucose limitation but does not regulate gene expression
Authors: Lesko Mitchell A. , Chandrashekarappa Dakshayini G. , Jordahl Eric M. , Oppenheimer Katherine G. , Bowman Ray Wesley , Shang Chaowei , Durrant Jacob , Schmidt Martin C. , O’Donnell Allyson F. 
Published: December 2022

AbstractGlucose is the preferred carbon source for most eukaryotes, and the first step in its metabolism is phosphorylation to glucose-6-phosphate. This reaction is catalyzed by a family of enzymes called either hexokinases or glucokinases depending on their substrate specificity. The yeastSaccharomyces cerevisiaeencodes three such enzymes, Hxk1, Hxk2 and Glk1. In yeast and mammals, some isoforms of this enzyme are found in the nucleus, suggesting a possible moonlighting function beyond glucose phosphorylation. In contrast to mammalian hexokinases, the yeast Hxk2 enzyme has been proposed to shuttle into the nucleus in glucose replete conditions where it reportedly moonlights as part of a glucose-repressive transcriptional complex. To achieve this role in glucose repression, Hxk2 reportedly binds the Mig1 transcriptional repressor, is dephosphorylated at serine 15 in its N-terminus, and requires an N-terminal nuclear localization sequence (NLS).In this study, we use high-resolution, quantitative, fluorescent microscopy of live cells to determine the conditions, residues, and regulatory proteins required for Hxk2 nuclear localization. In direct contradiction to previous yeast studies, our quantitative imaging demonstrates that Hxk2 is largely excluded from the nucleus under glucose replete conditions but is retained in the nucleus under glucose limiting conditions. Our data show that the Hxk2 N-terminus does not contain an NLS but instead comprises sequences necessary for nuclear exclusion and multimerization regulation. Amino acid substitutions of the phosphorylated residue, serine 15, disrupt Hxk2 dimerization but have no effect on its glucose-regulated nuclear localization. Substitution of alanine at the nearby residue, lysine 13, affects both dimerization and maintenance of nuclear exclusion under glucose replete conditions. Modeling and simulation provide insight into the molecular mechanisms of this regulation. In marked contrast to earlier studies, we find that the transcriptional repressor Mig1 and the protein kinase Snf1 have little effect on Hxk2 localization. Instead, the protein kinase Tda1 is a key regulator of Hxk2 localization.Finally, RNAseq analyses of the yeast transcriptome further dispel the idea that Hxk2 moonlights as a transcriptional repressor, demonstrating that Hxk2 has a negligible role in transcriptional regulation in both glucose replete and limiting conditions. Taken together, our studies provide a paradigm shift for the conditions, residues, and regulators controlling Hxk2 dimerization and nuclear localization. Based on our data, the nuclear translocation of Hxk2 in yeast occurs in glucose starvation conditions, a finding that aligns well with the nuclear regulation of mammalian orthologs of this enzyme. Our findings lay the foundation for future studies of Hxk2 nuclear activity.
Antibody Affinity Maturation to SARS-CoV-2 Omicron Variants in a Teachers Cohort
Authors: James-Pemberton Philip H. , Kohli Shivali , Westlake Aaron C. , Antill Alex , Olkhov Rouslan V. , Shaw Andrew M. 
Published: December 2022

AbstractIn summer of 2022, a cohort of 28 staff members were recruited from a UK primary school setting. The prevalent variants at the time were Omicron BA.1.159, BA.4/5 and BA.2: 61% of the cohort reported a lateral flow confirmed positive test for SARS-CoV-2 infection in late 2021 or 2022. A fully quantitative antibody screen for concentration and affinity was performed for spike protein variants Wuhan, Alpha, Beta, Gamma, Delta and Omicron BA.1, BA.2.75, BA.2.12.1, BA.4 and BA.5 and a pH dependent affinity was derived from disruption of the epitope-paratope complex at pH 3.2. The cohort showed a Universal positive immunity endotype, U(+), incidence of 78% (95% CI 60% - 88%) with good antibody concentrations to all ten variants; the incidence drops to 25% (95% CI 13% - 43%) when the affinity spectrum is measured. The antibody affinity profiles for each Omicron variant were all significantly better than Alpha, Beta, Gamma and Delta reflecting exposure to the antigens; we surmise either from the booster vaccines or continual contact with the virus, presenting in the school children either asymptomatically or symptomatically. Significant antibody affinity maturation was seen to the spike protein in all prevalent variants of SARS-CoV-2. Antibody concentrations were waning compared to the post-booster vaccine response. Using our hypothesised 3.4 mg/L nasal mucosal protection threshold, we postulate 46% of the cohort required boosting within 60 days and 66% within 120 days. We propose a smart boosting programme around the constant-exposure teacher cohort and parents of children could reduce community transmission.