bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of model for sparing adrenal venous sampling in diagnosing unilateral primary aldosteronism
Authors: Song Ying , Yang Jun , Shen Hang , Ng Elisabeth , Fuller Peter J. , Feng Zhengping , Hu Jinbo , Ma Linqiang , Yang Yi , Du Zhipeng , Wang Yue , Luo Ting , He Wenwen , Li Qifu , Wu Fei-Fei , Yang Shumin 
Published: July 2022

Context:
Current guidelines recommend adrenal venous sampling (AVS) to identify unilateral primary aldosteronism (UPA) before offering adrenalectomy. However, AVS is costly and technically challenging, limiting its use to expert centres.

Objective:
To establish a model to predict UPA, and therefore, bypass the need for AVS prior to surgery.

Design and setting:
The model was developed in a Chinese cohort and validated in an Australian cohort. Previously published prediction models of UPA were also tested.

Participants:
primary aldosteronism patients with a definite subtyping diagnosis based on AVS and/or surgery.

Main outcome measure:
Diagnostic value of the model.

Results:
In the development cohort (268 UPA and 88 bilateral primary aldosteronism), combinations of different levels of low serum potassium (≤3.0 or 3.5 mmol/l), high PAC (≥15–30 ng/dl), low PRC (≤2.5–10 μIU/ml) and presence of unilateral nodule on adrenal CT (>8–15 mm in diameter) showed specificity of 1.00 and sensitivity of 0.16–0.52. The model of serum potassium 3.5 mmol/l or less, PAC at least 20 ng/dl, PRC 5 μIU/ml or less plus a unilateral nodule at least 10 mm had the highest sensitivity of 0.52 (0.45–0.58) and specificity of 1.00 (0.96–1.00). In the validation cohort (84 UPA and 117 bilateral primary aldosteronism), the sensitivity and specificity of the model were 0.13 (0.07–0.22) and 1.00 (0.97–1.00), respectively. Ten previous models were tested, and only one had a specificity of 1.00 in our cohorts but with a very low sensitivity [0.07 (0.04–0.10) and 0.01 (0.00–0.06) in our development and validation cohorts, respectively].

Conclusion:
A combination of high PAC, low PRC, low serum potassium and unilateral adrenal nodule could accurately determine primary aldosteronism subtype in 13–52% of patients with UPA and obviate the need for AVS before surgery.
Use of initial and subsequent antihypertensive combination treatment in the last decade: analysis of a large Italian database
Authors: Savaré Laura , Rea Federico , Corrao Giovanni , Mancia Giuseppe 
Published: July 2022

Objective:
The aim of the study was to assess the use of antihypertensive combination treatment, both as the initial and as a subsequent therapeutic step, in a large Italian population.

Methods:
The residents of the Lombardy Region (Italy), aged 40 years or older, who were newly treated with antihypertensive drugs during 2012, 2015 and 2018 were identified and the drug treatment strategy (monotherapy and combination of two, three and more than three antihypertensive drugs) was assessed at treatment initiation, and after 6 months, 1, 2, and 3 years of treatment. Data were also analysed after stratification for demographic and clinical categories.

Results:
About 100 000 patients were identified for each cohort. Monotherapy was the most common initial treatment strategy (75%), followed by two-drug single-pill combination (16%), two-drug free combination (6%), and combination of at least three drugs (3%). Use of two and three or more antihypertensive drugs increased during follow-up and reached about 32% (two drugs) and 11% (>2 drugs) of the patients after 3 years from treatment initiation. Among patients prescribed a two-drug combination, the single-pill was the most common approach, whereas the use of the three-drug single-pill combination was extremely rare. There were no substantial differences in the use of combination treatment between the three cohorts and the results were similar in all demographic and clinical categories.

Conclusion:
Our data show that in a real-life population use of antihypertensive drug combinations is low. They also show that, contrary to guideline recommendations, antihypertensive combination treatment did not show any noticeable increase in recent years.
Relationship and Latent Factors Between Clinical Concussion Assessments and the Functional Standardized Assessment of Reaction Time (StART)
Authors: Lempke Landon B. , Passalugo Scott , Baranker Ben T. , Hunt Danielle , Berkstresser Brant , Wang Francis , Meehan William P. , Howell David R. 
Published: July 2022

Objective:
To examine the relationships and latent factors within the Standardized Assessment of Reaction Time (StART), and between StART and current clinical assessments.

Design:
Cross-sectional study.

Setting:
Clinical medicine facility.

Participants:
Eighty-nine healthy collegiate student-athletes (63% male, age: 19.5 ± 0.9 years, 28% ≥1 concussion history).

Assessment of Risk Factors:
Student-athletes completed StART and clinical assessments during preinjury testing.

Main Outcome Measures:
Standardized Assessment of Reaction Time consisted of 3 conditions (standing, single-leg balance, cutting) under 2 cognitive states (single task and dual task) for 3 trials each condition. Clinical assessments were the Sport Concussion Assessment Tool (SCAT) symptom checklist, Standardized Assessment of Concussion (SAC), tandem gait (single task and dual task), and Immediate PostConcussion Assessment and Cognitive Testing (ImPACT). We used Pearson-r correlation coefficients and exploratory factor analysis (EFA) to examine relationships and latent factors between StART and clinical assessments.

Results:
Null to moderate correlations presented among the StART outcomes (r range: 0.06-0.70), and null to small correlations between StART and clinical assessments (r range: −0.16 to 0.34). The three-factor EFA for solely StART explained 70.6% total variance: functional movement (cutting), static dual-task (standing and single-leg balance), and static single task (standing and single-leg balance). The five-factor EFA for StART and clinical assessments explained 65.8% total variance: gait (single-task and dual-task tandem gait), functional movement (StART single-task and dual-task cutting), static dual-task (StART standing, single-leg balance), neurocognitive (ImPACT verbal memory, visual memory, visual-motor speed), and static single task (StART standing, single-leg balance). No other outcomes met the factor loading threshold.

Conclusions:
StART displayed 3 distinct categories and had minimal redundancy within its subtests. StART did not meaningfully correlate with clinical assessments, suggesting that StART provides unique information by examining more functional, reactive movement.
Prognosis is worse with elevated cardiac troponin in nonacute coronary syndrome compared with acute coronary syndrome
Authors: Horiuchi Yu , Wettersten Nicholas , Patel Mitul P. , Mueller Christian , Neath Sean-Xavier , Christenson Robert H. , Morgenthaler Nils G. , McCord James , Nowak Richard M. , Vilke Gary M. , Daniels Lori B. , Hollander Judd E. , Apple Fred S. , Cannon Chad M. , Nagurney John T. , Schreiber Donald , deFilippi Christopher , Hogan Christopher , Diercks Deborah B. , Headden Gary , Limkakeng Alexander T. , Anand Inder , Wu Alan H.B. , Ebmeyer Stefan , Jaffe Allan S. , Peacock W. Frank , Maisel Alan 
Published: July 2022

Background
Cardiac troponin (cTn) can be elevated in many patients presenting to the emergency department (ED) with chest pain but without a diagnosis of acute coronary syndrome (ACS). We compared the prognostic significance of cTn in these different populations.

Methods
We retrospectively analyzed the CHOPIN study, which enrolled patients who presented to the ED with chest pain. Patients were grouped as ACS, non-ACS cardiovascular disease, noncardiac chest pain and chest pain not otherwise specified (NOS). We examined the prognostic ability of cTnI for the clinical endpoints of mortality and major adverse cardiovascular event (MACE; a composite of acute myocardial infarction, unstable angina, revascularization, reinfarction, and congestive heart failure and stroke) at 180-day follow-up.

Results
Among 1982 patients analyzed, 14% had ACS, 21% had non-ACS cardiovascular disease, 31% had a noncardiac diagnosis and 34% had chest pain NOS. cTnI elevation above the 99th percentile was observed in 52, 18, 6 and 7% in these groups, respectively. cTnI elevation was associated with mortality and MACE, and their relationships were more prominent in noncardiac diagnosis and chest pain NOS than in ACS and non-ACS cardiovascular diagnoses for mortality, and in non-ACS patients than in ACS patients for MACE (hazard ratio for doubling of cTnI 1.85, 2.05, 8.26 and 4.14, respectively; P for interaction 0.011 for mortality; 1.04, 1.23, 1.54 and 1.42, respectively; P for interaction <0.001 for MACE).

Conclusion
In patients presenting to the ED with chest pain, cTnI elevation was associated with a worse prognosis in non-ACS patients than in ACS patients.
Nursing Handoff Education Using Experiential and Virtual Innovations
Authors: Vanderzwan Kathryn J. , Burt Leah , O'Rourke Jennifer 
Published: July 2022

Background:
Seventy percent of serious medical errors are the result of ineffective communication, including handoff errors.

Problem:
Nursing students have cited a need for more experience on how to give handoff; yet, handoff education remains variable.

Approach:
Two innovative curricular approaches were implemented on the basis of Bloom's taxonomy to teach handoff education: experiential and virtual. The outcomes of the 2 curricular innovations were evaluated for handoff completion, handoff accuracy, and handoff quality, based on context.

Outcomes:
During the experiential approach, students demonstrated average handoff completion rates of 84%. During the virtual approach, students' handoff completion rates rose from 25% to 63% and accuracy handoff rates rose from 13% to 31%.

Conclusions:
Evaluations support that varying educational methods successfully teach nursing students how to give handoffs. Complementary innovations grant educators flexibility to tailor innovations to curriculum and course context, as supported by Bloom's taxonomy.
A Simple Clinical Application for Locating the Anterior Ethmoidal Artery Using the Anterior Ethmoidal Foramen and the Anterior Nasal Spine
Authors: Xu Shuyi , Yang Jing , Yang Yang , Li Xiaomin , Qiu Jinghua , Yu Zhijian 
Published: July 2022

Purpose:
The anatomy and variations of the anterior ethmoidal artery (AEA) are clinically relevant. The anterior ethmoidal foramen (AEF) can be used to locate the initial site of the AEA, and the anterior nasal spine (ANS) is a constant bony marker in the anterior nasal atrium. However, there is no relevant research on AEF and ANS targeting the AEA. Hence, this study aimed to accurately locate the AEA through AEF and ANS using computed tomography.

Methods:
A total of 120 (240 sides) sinus computed tomography scans were retrospectively selected and studied. The AEA was classified into grades I, Ⅱ, and Ⅲ group based on the relationship between the AEA and the skull base. The distance between AEF and ANS and the angle between AEF-ANS and the axial plane were measured.

Results:
The average distance from AEF to ANS was 58.26±3.64 mm, and the corresponding angle was 60.05±5.93 degrees. The AEF-ANS distances and angles were negatively correlated with age. Moreover, the distances from AEF to ANS were significantly increased in the grade Ⅲ group compared with the grade Ⅱ group.

Conclusion:
The measurements obtained in this study add anatomic knowledge that can serve as a better intraoperative localization method of the AEA, which can help surgeons avoid relative complications during endoscopic sinus surgery.
Changes in Lower Eyelid Positions After Blepharoplasty and Levator Advancement Surgery
Authors: Kim Joohyun , Yoon Sumin , Lee Hyunkyu , Lee Hwa , Baek Sehyun 
Published: July 2022

Purpose:
To investigate changes in the upper and lower eyelid positions using information from before and immediately after surgery in patients who underwent upper blepharoplasty and ptosis surgery.

Materials and Methods:
We retrospectively reviewed the clinical records of patients who underwent upper blepharoplasty with a diagnosis of dermatochalasis and patients who underwent levator advancement or levator resection with a diagnosis of congenital or aponeurotic ptosis. The marginal reflex distance 1 (MRD1), marginal reflex distance 2 (MRD2), palpebral fissure height (PFH), and operation time were also investigated.

Result:
In the dermatochalasis group, the preoperative mean MRD1, MRD2, and PFH were 1.94±1.27, 4.71±0.95, and 6.65±1.65 mm, respectively. Mean MRD1, MRD2, and PFH values immediately after surgery were 1.80±0.79, 4.22±0.90, and 6.02±1.34 mm, respectively. In the ptosis group, the preoperative mean MRD1, MRD2, and PFH values were 0.27±1.34, 5.73±1.13, and 5.99±1.94 mm, respectively. Postoperative mean MRD1, MRD2, and PFH were 1.76±1.13, 4.22±1.01, and 5.98±1.60 mm, respectively.

Conclusions:
It is important to remember that MRD2 could decrease during surgery. Therefore, to prevent overcorrection after upper eyelid surgery, MRD1 (not the overall PFH) should be considered to determine the appropriate extent of surgery during the procedure.
Hernia Defect Closure With Barbed Suture: An Assessment of Patient-reported Outcomes in Extraperitoneal Robotic Ventral Hernia Repair
Authors: Tagerman Daniel , Pereira Xavier , Lima Diego , Romero-Velez Gustavo , Friedman Patricia , Sreeramoju Prashanth , Malcher Flavio 
Published: July 2022

Background:
Primary closure of a fascial defect during ventral hernia repair is associated with lower rates of recurrence and better patient satisfaction compared with bridging repairs. Robotic surgery offers enhanced ability to close these defects and this has likely been aided by the use of barbed suture. The goal of this study was to evaluate the perioperative safety and the long-term outcomes for the use of barbed suture for the primary closure of hernia defects during robotic ventral hernia repair (rVHR) with mesh.

Methods:
This is a retrospective study of adult patients who underwent rVHR with the use of a barbed suture for fascial defect closure from August 2018 to August 2020 in an academic center. All the patients included were queried by phone to complete a quality of life assessment to assess patient-reported outcomes (PROs). Subjective sense of a bulge and pain at the previous hernia site has been shown to correlate with hernia recurrence. These questions were used in conjunction with a Hernia-related Quality of Life Survey (HerQles) score to assess a patient’s quality of life.

Results:
A total of 81 patients with 102 hernias were analyzed. Sixty patients (74%) were successfully reached and completed the PRO form at median postoperative day 356 (range: 43 to 818). Eight patients (13% of patients with PRO data) claimed to have both a bulge and pain at their previous hernia site, concerning for possible recurrence. Median overall HerQLes score was 82 [Interquartile Range (IQR): 54 to 99]. Patients with a single hernia defect, when compared with those with multiple defects, had a lower rate of both a bulge (15% vs. 30%) and symptoms (33% vs. 48%), as well as a higher median HerQLes score (85 vs. 62) at the time of PRO follow-up. Patients with previous hernia repair had a lower median HerQLes score of 65 (IQR: 43 to 90) versus 88 (IQR: 62–100). These patients also had a higher rate of sensing a bulge (29% vs. 18%), whereas a sense of symptoms at the site was less (33% vs. 44%).

Conclusions:
Barbed suture for fascial defect closure in rVHR was found to be safe with an acceptable rate of possible recurrence by the use of PRO data. Patients with multiple hernias and previous repairs had a higher likelihood of recurrence and a lower quality of life after rVHR.
Three-dimensional multiple object tracking improves young adult cognitive abilities associated with driving: evidence for transfer to the useful field of view
Authors: Michaels Jesse , Chaumillon Romain , Mejia-Romero Sergio , Bernardin Delphine , Faubert Jocelyn 
Published: July 2022

Objectives
3-dimensional multiple object tracking (3D-MOT) and the useful field of view (UFOV) both claim to measure and train cognitive abilities, such as selective and divided attention implicated in driving safety. 3D-MOT is claimed to improve even young adult cognitive ability. If true, one would expect to observe the transfer of 3D-MOT training to UFOV performance mediated by way of shared underlying cognitive mechanisms.

Methods
We test this notion by assessing whether ten 30-min sessions of 3D-MOT training spread across 5 weeks improves UFOV performance relative to an active control group trained on a visual task and a challenging puzzle game (participants aged between 23 and 33 years old).

Results
The 3D-MOT training group exhibited significantly improved UFOV performance whereas the active control group exhibited only a small, statistically nonsignificant improvement in the task.

Conclusions
This suggests that 3D-MOT and UFOV performance are likely dependent on overlapping cognitive abilities and helps support the assertion that these abilities can be trained and measured even in young adults. Such training could have implications for improving driver safety in both young and older adults.
Determining the antiviral activity of two polyene macrolide antibiotics following treatment in Kidney Cells infected with SARS-CoV-2
Authors: Wasan Kishor M. , Galliano Chris 
Published: July 2022

AbstractBackgroundThere has been much speculation that polyene macrolide antibiotics, such as amphotericin B (AmB) and Nystatin (NYS) may have antiviral activity against several viruses including SARS-CoV-2.ObjectiveThe objective of this short communication was to determine the antiviral activity of two polyene macrolides, AmB and NYS, following treatment in kidney cells infected with SARS-CoV-2.MethodsA serial dilution of AmB, NYS, and irbesartan (a drug known to bind to the ACE-2 receptor as a positive control) were then added (n=4 at each concentration) to the infected Vero’76 kidney cells in 100 µL media. Cells were also examined for contamination at 24 hours, and for cytopathic effect (CPE) and cytotoxicity (if noticeable) under a microscope at 48 hours. In a second study, AmB and Remdesivir were incubated in kidney cells infected with the virus and inhibition of the virus was determined by an immunoassay.Results and ConclusionsAmphotericin B (AmB) showed a significant reduction in the TCID50 titer, with the 50% effective concentration (EC50) of 1.24 µM, which was 2.5 times lower than the cytotoxicity concentration. NYS and Irbesartan both exhibited substantially less active and would not be considered a suitable choice for further investigations. In addition, when measuring viral inhibition by immunoassay, AmB was significantly more potent than remdesivir (EC50 31.8 nM vs. 1.15 µM). Taken together, these preliminary findings suggest that AmB may have significant activity against SARS-CoV-2. However, further cell and animal studies are warranted.
“Sonohistology”: Ultrasonographic Tissue Characterization in the Diagnosis of Hepatic Steatosis
Authors: de Oliveira Andrade Luís Jesuino , de Oliveira Luís Matos , Andrade Maria Helena Ferreira , de Oliveira Gabriela Correia Matos 
Published: July 2022

ABSTRACTObjectiveTo correlate ultrasound imaging and histology in hepatic steatosis.Material and methodLiver biopsy slides of cases in which hepatic steatosis were classified as mild, moderate and severe was evaluated, determining the number of fat cells per microscopic field from the histological sections. The number of fat cells per field was correlated with the degree of hepatic steatosis suggested on ultrasound examination.ResultsMean number of fat cells per microscopic field was 50 in mild steatosis, 85 in moderate steatosis, and greater than 150 fat cells in severe steatosis. A significant correlation was observed between echogenicity and the number of fat cells, i.e. the more fat cell the higher the proportion of sound waves incident perpendicularly, being reflected back to the transducer (hyperechogenicity), while in normal liver tissue there is a greater dispersion of the sound wave (hypoechogenicity).ConclusionThe main interface of echo reflection in steatotic liver tissue is the boundary between the normal hepatocyte and fatty infiltration.
Use of tobacco and e-cigarettes among youth in Great Britain in 2022: analysis of a cross sectional survey
Authors: Williams Parris , Cheeseman Hazel , Arnott Deborah , Bunce Laura , Hopkinson Nicholas S , Laverty Anthony A 
Published: July 2022

ABSTRACTINTRODUCTIONAlthough e-cigarettes can be an effective form of nicotine substitution for adults attempting to quit smoking, their use among children and young people is a concern. Accurate data about this are needed to inform debates over policy and regulation in the UK and elsewhere.METHODSUsing data from an online survey of 2,613 people aged 11 to 18 years, conducted by the market research company YouGov in March 2022, we present prevalence estimates of e-cigarette and tobacco use.We use logistic regression models to assess differences in e-cigarette use, tobacco use and use of disposable e-cigarettes across a range of covariates including age, sex, tobacco smoking status, social class and country.RESULTSAmong the 18.0% of those surveyed who reported ever having smoked a cigarette, 83.9% were not regular (at least once per week) smokers and 16.1% were (15.1% and 2.9% of the total sample respectively). Among the 19.2% of those surveyed who had ever used an e-cigarette, 79.2% were not regular users, while 20.8% were (15.2% and 4.0% respectively. Regular e-cigarette use was more common than regular tobacco smoking (4.0% vs 2.9%). E-cigarette use was more common among those who also smoked tobacco, with 9.0% of never e-cigarette users ever smoking tobacco, compared with 89.4% of regular e-cigarette users. Both smoking and e-cigarette use were associated with increasing age and use by others within the home, but not with social class. Use of disposable e-cigarettes was reported by 53.8% of those who have ever used an e-cigarette, and more common among girls than boys.DISCUSSIONRegular e-cigarette use is now more common than smoking in children and youth, though the majority of this is among those who have also smoked tobacco. Measures to reduce the appeal of e-both e-cigarettes and tobacco to children and young people are warranted.
Direct observation of motor protein stepping in living cells using MINFLUX
Authors: Deguchi Takahiro , Iwanski Malina K. , Schentarra Eva-Maria , Heidebrecht Christopher , Schmidt Lisa , Heck Jennifer , Weihs Tobias , Schnorrenberg Sebastian , Hoess Philipp , Liu Sheng , Chevyreva Veronika , Noh Kyung-Min , Kapitein Lukas C. , Ries Jonas 
Published: July 2022

AbstractDynamic measurements of molecular machines can provide invaluable insights into their mechanism, but have been challenging in living cells. Here, we developed live-cell tracking of single fluorophores with nanometer spatial and millisecond temporal resolution in 2D and 3D using the recently introduced super-resolution technique MINFLUX. This allowed us to resolve the precise stepping motion of the motor protein kinesin-1 as it walks on microtubules in living cells. In addition, nanoscopic tracking of motors on microtubule of fixed cells enabled us to resolve their spatial organization with protofilament resolution. Our approach will enable futurein vivostudies of motor protein kinetics in complex environments and super-resolution mapping of dense microtubule arrays, and pave the way towards monitoring functional conformational changes of protein machines at high spatiotemporal resolution in living systems.