bluuebunny/crossref_metadata_2025_split huggingface dataset:
Invasive Lobular Carcinoma—Correlation Between Imaging and Final Pathology: Is MRI Better?
Authors: Ozcan Lerna C. , Donovan Cory A. , Srour Marissa , Chung Alice , Mirocha James , Frankel Steven D. , Hakim Paul , Giuliano Armando E. , Amersi Farin 
Published: May 2022

Background Invasive lobular carcinoma (ILC) is associated with high re-excision rates following breast-conserving surgery (BCS). The correlation between lesion size on different imaging modalities and final tumor size has not been well characterized. Methods A prospective database of patients with stage I-III breast cancer undergoing BCS between 2006 and 2016 was reviewed. Pearson correlation analysis was used to correlate tumor size on breast imaging to final pathology. Results Of these, 111 patients with ILC were identified. Mean lesion size was 1.93 cm for MMG, 1.61 cm for US, and 2.51 cm for MRI. Mean tumor size on surgical excision was 2.64 cm. The correlation coefficient between pathology and the different imaging modalities were as follows: MMG .17, US 0.37, and MRI .58. Actual tumor size was underestimated by 1 cm in 27.1% of MMGs, 50% of USs, and in 13.3% of MRIs. 38 patients (34.2%) underwent re-excision. No differences in re-excision rates were noted in patients with and without MRI, 30.3% vs 40.0%, respectively (P = .31). Conclusion While MRI provides a better estimate of tumor size than MMG and US, the size of the tumor on imaging only weakly correlated with pathology. The use of MRI does not decrease re-excision rates.
Simulated Acute Hypobaric Hypoxia Effects on Cognition in Helicopter Emergency Medical Service Personnel – A Randomized, Controlled, Single-Blind, Crossover Trial
Authors: Falla Marika , Hüfner Katharina , Falk Markus , Weiss Elisabeth M. , Vögele Anna , Jan van Veelen Michiel , Weber Bernhard , Brandner Jonas , Palma Martin , Dejaco Alexander , Brugger Hermann , Strapazzon Giacomo 
Published: May 2022

Objective To evaluate, under replicable, blinded and standardised conditions, the effect of acute exposure to hypobaric hypoxia (HH) (equivalent to 200 or 3000 or 5000 m above sea level (asl)) on selected cognitive domains and physiological parameters in personnel of helicopter emergency medical service (HEMS). Methods We conducted a randomized clinical trial using a single-blind crossover design in an environmental chamber ( terraXcube) to induce HH in 48 HEMS personnel. Participants performed cognitive tests (CT) before the ascent, after 5 min at altitude, and after simulated cardiopulmonary resuscitation (SCR). CT evaluated: sustained attention using the psychomotor vigilance test (PVT) that included measurement of reaction time (RT); risky decision making using the balloon analogue risk task (BART), and attention and speed of processing using the digit symbol substitution test (DSST). CT performance was subjectively rated with a visual analogue scale (VAS). Physiological data were recorded with a physiological monitoring system. Data were analysed using a linear mixed model and correlation analysis. Results Mean reaction time was significantly slower ( p = 0.002) at HH (5000 m asl), but there were no independent effects of HH on the other parameters of the PVT, BART or DSST. Participants did not detect subjectively the slower RT at altitude since VAS performance results showed a positive correlation with mean RT ( p = 0.009). DSST results significantly improved ( p = 0.001) after SCR. Conclusion Acute exposure of HEMS personnel to HH induced a slower RT but no changes in any other investigated measures of cognition. The reduced RT was not detected subjectively by the participants. Trial number 3489044136, ClinicalTrials.gov trial registration.
Assessing the attitude of surgical trainees towards virtual reality simulation: A national cross-sectional questionnaire study
Authors: Khatkar Harman , Ferro Ashley , Kotecha Sanjeev , Prokopenko Max , Evans Ashish , Kyriakides Jonathon , Botterill Jonathan , Sangha Miljyot Singh , See Abbas , Kerstein Ryan 
Published: May 2022

Background We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms. Methods The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities. Results VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons. Conclusion Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.
Comparing Undergraduate Student Participation in Online Discussion Boards Hosted on Reddit and Canvas
Authors: Neff Andrew S. , Mischel Jenny , Yang Evan 
Published: May 2022

Background Instructors often try to promote student engagement with discussion boards in learning management systems (LMS) like Canvas. Although convenient, alternatives like the social media platform Reddit may be more effective. Method A non-randomized controlled trial compared the use of Canvas and Reddit in two sections of two undergraduate psychology courses ( N = 77). Engagement was measured as the number and word-count of posts and responses and complemented with self-reported data. Results There was no difference between platforms in total number of posts or replies. In one course, the average word count per post was higher in Reddit than Canvas ( r = .44). However, in the other course, the average word count per post ( r = .47) and per reply ( r = .39) was significantly lower in Reddit. Neither course observed a significant difference in students’ perceived value of the discussion board. Conclusion This study provided no consistent evidence that Reddit supports student engagement relative to Canvas, and combined with additional survey data, it is possible that hosting the discussion board on Reddit may even be detrimental. Teaching Implications Given the issues we identified with moving discussion boards to Reddit, and the benefits of using Canvas, we recommend using a traditional LMS like Canvas.
Sex Differences in Presentation and Surgical Outcomes From a Prospective Multicenter Chronic Rhinosinusitis Study
Authors: Asokan Annapoorani , Mace Jess C. , Rice John D. , Smith Timothy L. , Soler Zachary M. , Ramakrishnan Vijay R. 
Published: May 2022

AbstractObjectiveDespite extensive research into chronic rhinosinusitis (CRS) epidemiology, presentation, and outcomes, there is scant knowledge on sex‐specific differences. The objective of this study was to identify differences between male and female patients with CRS in baseline disease severity at presentation, choice for surgery vs continued medical treatment, and postoperative response.Study DesignWe evaluated data on demographic and health characteristics, clinical objective disease measures, and sinus‐specific and general health patient‐reported outcome measures.SettingSecondary analysis of prospective multicenter outcome study.MethodsComparison of cohort characteristics and baseline and postoperative measures was performed with a t test, chi‐square test of independence, or Fisher exact test. Within‐subject improvement was compared between sexes with a linear mixed model.ResultsFemales reported worse quality of life on presentation and postsurgery, despite experiencing less severe disease by standard clinical measures. Overall, females and males showed similar within‐subject improvement after surgery. However, certain quality of life domains and disease measures showed sex‐specific improvement. Females demonstrated greater within‐subject improvement in SF6D‐derived health utility and the SNOT‐22 ear and facial, psychological, and sleep subdomains, although this did not reach statistical significance for the overall cohort.ConclusionIncorporating data on sex‐specific differences may be important to personalize CRS treatment decision making. The discordance between patient‐reported and clinical measures in CRS has been demonstrated in other pathologies and appears to be exaggerated by sex. Biological and psychological bases for sex‐specific differences in CRS manifestations are an intriguing topic for further research.
Postpartum depression: A role for psychedelics?
Authors: Jairaj Chaitra , Rucker James J 
Published: May 2022

Background: Postpartum depression (PPD) is a major public health concern and has, at its core, a sense of maternal ‘disconnection’ – from the self, the infant, and the support system. While PPD bears similarities with MDD, there is increasing evidence for its distinct nature, especially with the unique aspect of the mother-infant relationship. Current treatment modalities for PPD, largely based on those used in major depressive disorder (MDD), have low remission rates with emerging evidence for treatment resistance. It is, therefore, necessary to explore alternative avenues of treatment for PPD. Objective: In this narrative review, we outline the potential therapeutic rationale for serotonergic psychedelics in the treatment of PPD, and highlight safety and pragmatic considerations for the use of psychedelics in the postpartum period. Methods: We examined the available evidence for the treatment of PPD and the evidence for psychedelics in the treatment of MDD. We explored safety considerations in the use of psychedelics in the postpartum period. Results: There is increasing evidence for safety, and encouraging signals for efficacy, of psilocybin in the treatment of MDD. Psilocybin has been shown to catalyse a sense of ‘reconnection’ in participants with MDD. This effect in PPD, by fostering a sense of ‘reconnection’ for the mother, may allow for improved mood and maternal sensitivity towards the infant, which can positively impact maternal role gratification and the mother-infant relationship. Conclusion: Psychedelic assisted therapy in PPD may have a positive effect on the mother-infant dyad and warrants further examination.
Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomised controlled trial
Authors: McCartney Danielle , Suraev Anastasia S , Doohan Peter T , Irwin Christopher , Kevin Richard C , Grunstein Ronald R , Hoyos Camilla M , McGregor Iain S 
Published: May 2022

Background: Cannabidiol (CBD), a major cannabinoid of Cannabis sativa, is widely consumed in prescription and non-prescription products. While CBD is generally considered ‘non-intoxicating’, its effects on safety-sensitive tasks are still under scrutiny. Aim: We investigated the effects of CBD on driving performance. Methods: Healthy adults ( n = 17) completed four treatment sessions involving the oral administration of a placebo, or 15, 300 or 1500 mg CBD in a randomised, double-blind, crossover design. Simulated driving performance was assessed between ~45–75 and ~210–240 min post-treatment (Drives 1 and 2) using a two-part scenario with ‘standard’ and ‘car following’ (CF) components. The primary outcome was standard deviation of lateral position (SDLP), a well-established measure of vehicular control. Cognitive function, subjective experiences and plasma CBD concentrations were also measured. Non-inferiority analyses tested the hypothesis that CBD would not increase SDLP by more than a margin equivalent to a 0.05% blood alcohol concentration (Cohen’s dz = 0.50). Results: Non-inferiority was established during the standard component of Drive 1 and CF component of Drive 2 on all CBD treatments and during the standard component of Drive 2 on the 15 and 1500 mg treatments (95% CIs < 0.5). The remaining comparisons to placebo were inconclusive (the 95% CIs included 0 and 0.50). No dose of CBD impaired cognition or induced feelings of intoxication ( ps > 0.05). CBD was unexpectedly found to persist in plasma for prolonged periods of time (e.g. >4 weeks at 1500 mg). Conclusion: Acute, oral CBD treatment does not appear to induce feelings of intoxication and is unlikely to impair cognitive function or driving performance (Registration: ACTRN12619001552178).
Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial
Authors: Ofor Ifeanyichukwu Jude , Enebe Joseph Tochukwu , Ofor Nwadiuto Emmanuela , Onyia Christian Nnaemeka , Omeke Chidimma Akudo , Nevo Calistus Obiora , Enyinna Perpetua Cleopatra , Awkadigwe Fredrick Ikenna , Eleje George Uchenna , Ezugwu Frank Okechukwu 
Published: May 2022

Objective To measure postoperative pain relief following the use of rectal diclofenac combined with intramuscular pentazocine compared with intramuscular pentazocine alone in patients undergoing a caesarean delivery. Methods This single-blind randomized controlled trial enrolled pregnant women that had a caesarean section at the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Study participants were randomized to receive either 100 mg of rectal diclofenac given every 12 h plus 30 mg of intramuscular pentazocine given every 6 h (group A) or 60 mg of intramuscular pentazocine given every 6 h (group B). The primary outcome was the level of pain as measured using a visual analogue scale. The secondary outcomes were the level of satisfaction with pain relief and need for rescue analgesia. Results A total of 200 participants were randomized equally into the two groups. Participants in group A had significantly better pain control and satisfaction over the 48 h after surgery compared with group B. Significantly more of group B required rescue analgesia for breakthrough pain compared with group A. Conclusion Rectal diclofenac combined with intramuscular pentazocine was significantly better at controlling pain compared with pentazocine alone in the first 48 h following caesarean section. Trial registration number: PACTR202107706925314 at www.pactr.org on 28 July 2021.
State-specific Prevalence and Factors Associated With Current Marijuana, ENDS, and Cigarette use Among US Adults With Asthma
Authors: Ebrahimi Kalan Mohammad , Bursac Zoran , Jebai Rime , Zare Samane , Li Wei , Gautam Prem , Rahman Abir , Ward Kenneth D , Ben Taleb Ziyad 
Published: May 2022

Background The use of marijuana (MJ), combustible cigarettes (hereafter cigarettes), and electronic nicotine delivery systems (ENDS) is widespread among United States (US) adults and linked to worsening respiratory symptoms, especially among adults with asthma. This study examined state-specific prevalence and factors associated with MJ, ENDS, and cigarette use among US adults with asthma. Methods We analyzed data of 41 974 adults aged ≥18 years having self-reported current asthma from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). We reported weighted prevalence to account for complex survey design and performed multivariable logistic regression models to examine factors associated with current use of MJ, ENDS, and cigarettes. Results Overall prevalence of current MJ, ENDS, and cigarette use among adults with asthma was 14.5%, 6.6%, and 27.2%, respectively. Our results showed the US states and territories with highest and lowest use prevalence for MJ (California: 23.6% vs Guam: 3.2%), ENDS (Indiana: 12.8% vs North Dakota: 4.0%), and cigarettes (West Virginia: 42.1% vs Guam: 12.3%). Both MJ and ENDS users were more likely to be male, younger, and live in an urban area, but MJ users were more likely and ENDS users less likely to be Non-Hispanic (NH) American Indian/Alaskan Native. Cigarette users were more likely to be older, have at least 1 health condition, and were less likely to be NH Black or Hispanic and college-educated. Conclusion Many US adults with asthma use MJ, ENDS, and cigarettes. Our findings provide insights for clinicians about the urgent need for effective interventions to reduce tobacco and MJ use among adults with asthma.
Validation and comparison of multiple risk scores for prediction of symptomatic intracerebral hemorrhage after intravenous thrombolysis in VISTA
Authors: Wang Yanan , Liu Junfeng , Wu Qian , Cheng Yajun , Liu Ming ,   on behalf of the VISTA Collaborators
Published: May 2022

Background and aims: Prediction models/scores may help to identify patients at high risk of symptomatic intracerebral hemorrhage (sICH) after intravenous thrombolysis. We aimed to validate and compare the performance of different prediction models for sICH after thrombolysis using direct model estimation in the Virtual International Stroke Trials Archive (VISTA). Methods: We searched PubMed for potentially eligible prediction models from inception to 1 June 2019. Simple and practical models/scores were validated in VISTA. The primary outcome was sICH based on two criteria (National Institute of Neurological Diseases and Stroke, NINDS; Safe Implementation of Thrombolysis in Stroke-Monitoring Study, SITS-MOST) and the secondary outcome was parenchymal hematoma (PH). The discrimination performance of each model was evaluated using area under the curve (AUC) and calibration was evaluated by Hosmer–Lemeshow goodness-of-fit tests. Results: We found 13 prediction models and five models (HAT, MSS, SPAN-100, GRASPS and THRIVE) were finally validated in VISTA. A total of 1884 participants were eligible for our study, of whom the proportion with sICH was 4.6% (87/1884) per NINDS and 3.9% (73/1884) per SITS-MOST, and with PH was 11.3% (213/1884). MSS and GRASPS had the greatest predictive ability for sICH (NINDS criteria: MSS AUC 0.7, 95% CI 0.63–0.77, p < 0.001; GRASPS AUC 0.69, 95% CI 0.63–0.76, p < 0.001; SITS-MOST criteria: MSS, AUC 0.76, 95% CI 0.68–0.85, p < 0.001; GRASPS, AUC 0.79, 95% CI 0.71–0.87, p < 0.001). Similar results were found for PH (MSS AUC 0.68, 95% CI 0.64–0.73, p = 0.017; GRASPS AUC 0.68, 95% CI 0.63–0.72, p = 0.017). The calibration of each model was almost good. Conclusion: MSS and GRASPS had good discrimination and calibration for sICH and PH after thrombolysis as assessed in VISTA. These two models could be used in clinical practice and clinical trials to identity individuals with high risk of sICH.
High surface IgM levels associate with shorter response to ibrutinib and BTK bypass in patients with CLL
Authors: Chiodin Giorgia , Drennan Samantha , Martino Enrica A. , Ondrisova Laura , Henderson Isla , del Rio Luis , Tracy Ian , D’Avola Annalisa , Parker Helen , Bonfiglio Silvia , Scarfò Lydia , Sutton Lesley-Ann , Strefford Jonathan C. , Forster Jade , Brake Oliver , Potter Kathleen N. , Sale Benjamin , Lanham Stuart , Mraz Marek , Ghia Paolo , Stevenson Freda K. , Forconi Francesco 
Published: May 2022

AbstractChronic lymphocytic leukemia (CLL) cells have variably low surface IgM (sIgM) levels/signaling capacity, influenced by chronic antigen engagement at tissue sites. Within these low levels, CLL with relatively high sIgM (CLLhigh) progresses more rapidly than CLL with low sIgM (CLLlow). During ibrutinib therapy, surviving CLL cells redistribute into the peripheral blood and can recover sIgM expression. Return of CLL cells to tissue may eventually recur, where cells with high sIgM could promote tumor growth. We analyzed time to new treatment (TTNT) following ibrutinib in 70 patients with CLL (median follow-up of 66 months) and correlated it with pretreatment sIgM levels and signaling characteristics. Pretreatment sIgM levels correlated with signaling capacity, as measured by intracellular Ca2+ mobilization (iCa2+), in vitro (r = 0.70; P &lt; .0001). High sIgM levels/signaling strongly correlated with short TTNT (P &lt; .05), and 36% of patients with CLLhigh vs 8% of patients with CLLlow progressed to require a new treatment. In vitro, capacity of ibrutinib to inhibit sIgM-mediated signaling inversely correlated with pretherapy sIgM levels (r = −0.68; P = .01) or iCa2+ (r = −0.71; P = .009). In patients, sIgM-mediated iCa2+ and ERK phosphorylation levels were reduced by ibrutinib therapy but not abolished. The residual signaling capacity downstream of BTK was associated with high expression of sIgM, whereas it was minimal when sIgM expression was low (P &lt; .05). These results suggested that high sIgM levels facilitated CLL cell resistance to ibrutinib in patients. The CLL cells, surviving in the periphery with high sIgM expression, include a dangerous fraction that is able to migrate to tissue and receive proliferative stimuli, which may require targeting by combined approaches.
Bone Milling: On Monitoring Cutting State and Force Using Sound Signals
Authors: Ying Zhenzhi , Shu Liming , Sugita Naohiko 
Published: May 2022

AbstractEfficient monitoring of bone milling conditions in orthopedic and neurosurgical surgery can prevent tissue, bone, and tool damage, and reduce surgery time. Current researches are mainly focused on recognizing the cutting state using force signal. However, the force signal during the milling process is difficult and expensive to acquire. In this study, a neural network-based method is proposed to recognize the cutting state and force during the bone milling process using sound signals. Numerical modeling of the cutting force is performed to capture the relationship between the cutting force and the depth of cut in the bone milling process. The force model is used to calibrate the training data to improve the recognition accuracy. Wavelet package transform is used for signal processing to understand bone-cutting phenomena using sound signals. The proposed system succeeds to monitor the bone milling process to reduce the surgical risk. Experiments on standard bone specimens and vertebrae also indicate that the proposed approach has considerable potential for use in computer-assisted and robot-assisted bone-cutting systems used in various types of surgery.
The effect of nafamostat mesilate infusion after ERCP for post-ERCP pancreatitis
Authors: Kim Joo Seong , Lee Sang Hyub , Park Namyoung , Huh Gunn , Chun Jung Won , Choi Jin Ho , Cho In Rae , Paik Woo Hyun , Ryu Ji Kon , Kim Yong-Tae 
Published: May 2022

Abstract
Background
Nafamostat mesilate decreases the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). However, no studies have administered nafamostat mesilate after ERCP. So we investigated if the infusion of nafamostat mesilate after ERCP can affect the post-ERCP pancreatitis (PEP) in high-risk patients.

Methods
In a tertiary hospital, 350 high-risk patients of PEP were reviewed retrospectively. Among them, 201 patients received nafamostat mesilate after ERCP. Patient-related and procedure-related risk factors for PEP were collected. We performed a propensity score matching to adjust for the significant different baseline characteristics. The incidence and severity of PEP were evaluated according to the infusion of nafamostat mesilate. The risk factors of PEP were also analyzed by multivariate logistic regression.

Results
The baseline characteristics were not different after the matching. The PEP rate (17.4% vs. 10.3%, P = 0.141) was insignificant. Among the PEP patients, mild PEP was significantly higher in the nafamostat mesilate group (85.7% vs. 45.5%, P = 0.021). Only one patient in the nafamostat mesilate group developed severe PEP. Although young age (odds ratio [OR] 3.60, 95% CI 1.09–11.85, P = 0.035) was a risk factor, nafamostat mesilate (odds ratio [OR] 0.30, 95% CI 0.09–0.98, P = 0.047) was a protective factor for moderate to severe PEP.

Conclusions
The administration of nafamostat mesilate after ERCP in high-risk patients was not effective in preventing PEP, but may attenuate the severity of PEP.