bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination Therapy of High-flow Nasal Cannula and Upper-body Elevation for Postoperative Sleep-disordered Breathing: Randomized Crossover Trial
Authors: Sakaguchi Yuichi , Nozaki-Taguchi Natsuko , Hasegawa Makoto , Ishibashi Katsuhiko , Sato Yasunori , Isono Shiroh 
Published: April 2022

Background
The low acceptance rate of continuous positive airway pressure therapy in postoperative patients with untreated obstructive sleep apnea (OSA) indicates the necessity for development of an alternative postoperative airway management strategy. The authors considered whether the combination of high-flow nasal cannula and upper-body elevation could improve postoperative OSA.

Methods
This nonblinded randomized crossover study performed at a single university hospital investigated the effect on a modified apnea hypopnea index, based exclusively on the airflow signal without arterial oxygen saturation criteria (flow-based apnea hypopnea index, primary outcome), of high-flow nasal cannula (20 l · min–1 with 40% oxygen concentration) with and without upper-body elevation in patients with moderate to severe OSA. Preoperative sleep studies were performed at home (control, no head-of-bed elevation) and in hospital (30-degree head-of-bed elevation). On the first and second postoperative nights, high-flow nasal cannula was applied with or without 30-degree head-of-bed elevation, assigned in random order to 23 eligible participants.

Results
Twenty-two of the 23 (96%) accepted high-flow nasal cannula. Four participants resigned from the study. Control flow-based apnea hypopnea index (mean ± SD, 60 ± 12 events · h–1; n = 19) was reduced by 15 (95% CI, 6 to 30) events · h–1 with head-of-bed elevation alone (P = 0.002), 10.9 (95% CI, 1 to 21) events · h–1 with high-flow nasal cannula alone (P = 0.028), and 23 (95% CI, 13 to 32) events · h–1 with combined head-of-bed elevation and high-flow nasal cannula (P < 0.001). Compared to sole high-flow nasal cannula, additional intervention with head-of-bed elevation significantly decreased flow-based apnea hypopnea index by 12 events · h–1 (95% CI, 2 to 21; P = 0.022). High-flow nasal cannula, alone or in combination with head-of-bed elevation, also improved overnight oxygenation. No harmful events were observed.

Conclusions
The combination of high-flow nasal cannula and upper-body elevation reduced OSA severity and nocturnal hypoxemia, suggesting a role for it as an alternate postoperative airway management strategy.

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Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing
Authors: Mishra Srikanta K. , Saxena Udit , Rodrigo Hansapani 
Published: April 2022

Objectives:
Pediatric hearing impairment, regardless of degree and type, has a detrimental effect on speech perception, cognition, oral language development, academic outcomes, and literacy. Hearing assessment in the clinic is limited to 8 kHz although humans can hear up to 20 kHz. Hearing impairment in the extended high frequencies (EHFs > 8 kHz) can occur despite clinically normal hearing. However, to date, the nature and effects of EHF hearing impairment in children remain unknown. The goals of the present study were to determine the effects of EHF hearing impairment on speech-in-noise recognition in children and to examine whether hearing impairment in the EHFs is associated with altered cochlear functioning in the standard frequencies.

Design:
A volunteer sample of 542 participants (4 to 19 years) with clinically normal audiograms were tested. Participants identified with EHF impairment were assigned as cases in a subsequent case-control study. EHF loss was defined as hearing thresholds greater than 20 dB in at least one EHFs (10, 12.5, or 16 kHz). Speech recognition thresholds in multi-talker babble were measured using the digit triplet test. Distortion product otoacoustic emissions (f
2 = 2, 3, 4, and 5 kHz) were measured to assess cochlear functioning.

Results:
Thresholds in the EHFs were as reliable as those in the standard frequency range. Thirty-eight children had EHF hearing impairment regardless of a clinically normal audiogram. A linear mixed-effects model revealed that children with EHF hearing impairment had higher (poorer) mean speech recognition threshold than children with normal EHF sensitivity (estimate = 2.14 dB, 95% CI: 1.36 to 3.92; effect size = small). The overall magnitude of distortion product otoacoustic emissions was lower for children with EHF impairment (estimate = –2.47 dB, 95% CI: –4.60 to –0.73; effect size = medium). In addition, the pure-tone average for standard audiometric frequencies was relatively higher for EHF-impaired children (estimate = 3.68 dB, 95% CI: 2.56 to 4.80; effect size = small).

Conclusions:
Hearing impairment in the EHFs is common in children despite clinically normal hearing and can occur without a history of otitis media. EHF impairment is associated with poorer speech-in-noise recognition and preclinical cochlear deficits in the lower frequencies where hearing thresholds are normal. This study highlights the clinical need to identify EHF impairments in children.
Pragmatic Uncontrolled Study of Specialized Cognitive Behavioral Therapy for Adults With Chronic Tinnitus
Authors: Fuller Thomas E. , van Breukelen Gerard J. P. , Vlaeyen Johan W. S. , Cima Rilana F. F. 
Published: April 2022

Objectives:
Tinnitus is the perception of sound without an external source, affecting quality of life that can cause severe distress in approximately 1 to 3% of the population of people with tinnitus. Randomized controlled trials of cognitive behavioral therapy for tinnitus have demonstrated its effectiveness in improving quality of life, but the effects of their implementation on a large scale in routine practice remains unknown. Therefore, the main purpose of this study was to examine the effects of stepped-care cognitive behavioral therapy for tinnitus delivered in a tertiary audiological center of a regional hospital. Second, we wished to examine predictors of favorable outcome.

Design:
Four hundred three adults with chronic tinnitus were enrolled in this prospective observational study (at 3 months, N=334, 8 months, N=261; 12 months, N=214). The primary outcome was health-related quality of life as measured by the Health Utilities Index III (HUI-III) at 12 months. Secondary outcomes were self-reported levels of tinnitus-related distress, disability, affective distress and tinnitus-related negative beliefs and fear. Measures were completed pre-intervention at 3 months, 8 months, and 12 months. Multilevel modeling was used to examine effects and their predictors.

Results:
Younger participants with lower levels of tinnitus distress were more likely to dropout while those with higher tinnitus distress at baseline and quality of life were more likely to receive step 2 of treatment. MLM analyses revealed, with one exception, no relation between any baseline variable and outcome change over time. Most participants’ improvement exceeded minimally clinical important difference criteria for quality of life, tinnitus-related handicap, and tinnitus distress.

Conclusions:
Results from this large pragmatic study complements those from randomized controlled trials of cognitive behavioral therapy for chronic tinnitus distress and supports its implementation under “real-world” conditions.
Factors Related to Activation in Chinese Patients With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Survey Study
Authors: TANG Ting , DOU Bei , ZHA Hui-Xian , TAO Lian-Shan , GU Ze-Juan , LIU Kou-Ying , XIE Wei-Ping 
Published: April 2022

ABSTRACT

Background
Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China.

Purpose
This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors.

Methods
One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Sociodemographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed.

Results
Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (β = .463, p < .001), free medical insurance (β = .173, p = .007), smoking status (β = −.195, p = .002), and health status (β = −.139, p = .04).

Conclusions/Implications for Practice
The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.
Lifting Statewide Mask Mandates and COVID-19 Cases
Authors: Petersen Finn , Errore Anna , Karaca-Mandic Pinar 
Published: April 2022

Importance:
As states reopened their economies state and local officials made decisions on policies and restrictions that had an impact on the evolution of the pandemic and the health of the citizens. Some states made the decision to lift mask mandates starting spring 2021. Data-driven methods help evaluate the appropriateness and consequences of such decisions.

Objective:
To investigate the association of lifting the mask mandate with changes in the cumulative coronavirus case rate.

Design:
Synthetic control study design on lifting mask mandate in the state of Iowa implemented on February 7, 2021.

Setting:
Daily state-level data from the COVID-19 Community Profile Report published by the US Department of Health & Human Services, COVIDcast dataset of the Delphi Research Group, and Google Community Mobility Reports.

Exposures and Outcome:
Mask mandate policy lift at the state level. State-day observations of the cumulative case rate measured as the cumulative number of new cases per 100,000 people in the previous 7 days.

Results:
The cumulative case rate in Iowa increased by 20%–30% within 3 weeks of lifting the mask mandate as compared with a synthetic control unit. This association appeared to be related to people, in fact, reducing their mask-wearing habits.

Conclusions:
Lifting the mask mandate in Iowa was associated with an increase in new COVID-19 cases. Caution should be applied when making this type of policy decision before having achieved a more stable control of the pandemic.
Prognostic Value of Pathological Personality Traits for Treatment Outcome in Anxiety and Depressive Disorders
Authors: van Eeden Wessel A. , van Hemert Albert M. , Giltay Erik J. , Spinhoven Philip , de Beurs Edwin , Carlier Ingrid V.E. 
Published: April 2022

Abstract
Previous studies have failed to take baseline severity into account when assessing the effects of pathological personality traits (PPT) on treatment outcome. This study assessed the prognostic value of PPT (Dimensional Assessment of Personality Pathology–Short Form) on treatment outcome (Brief Symptom Inventory [BSI-posttreatment]) among patients with depressive and/or anxiety disorders (N = 5689). Baseline symptom level (BSI-pretreatment) was taken into account as a mediator or moderator variable. Results showed significant effects of PPT on outcome, of which Emotional Dysregulation demonstrated the largest association (β = 0.43, p < 0.001). When including baseline BSI score as a mediator variable, a direct effect (β = 0.11, p < 0.001) remained approximately one-third of the total effect. The effects of Emotional Dysregulation (interaction effect β = 0.061, p < 0.001) and Inhibition (interaction effect β = 0.062, p < 0.001), but not Compulsivity or Dissocial Behavior, were moderated by the baseline symptom level. PPT predicts higher symptom levels, both before and after treatment, but yields relatively small direct effects on symptom decline when the effect of pretreatment severity is taken into account.
Plasma Metabolomic Signature of Early Abuse in Middle-Aged Women
Authors: Huang Tianyi , Zeleznik Oana A. , Roberts Andrea L. , Balasubramanian Raji , Clish Clary B. , Eliassen A. Heather , Rexrode Kathryn M. , Tworoger Shelley S. , Hankinson Susan E. , Koenen Karestan C. , Kubzansky Laura D. 
Published: April 2022

ABSTRACT

Objective
Metabolomic profiling may provide insights into biological mechanisms underlying the strong epidemiologic links observed between early abuse and cardiometabolic disorders in later life.

Methods
We examined the associations between early abuse and midlife plasma metabolites in two nonoverlapping subsamples from the Nurses’ Health Study II, comprising 803 (mean age = 40 years) and 211 women (mean age = 61 years). Liquid chromatography–tandem mass spectrometry assays were used to measure metabolomic profiles, with 283 metabolites consistently measured in both subsamples. Physical and sexual abuse before age 18 years was retrospectively assessed by validated questions integrating type/frequency of abuse. Analyses were conducted in each sample and pooled using meta-analysis, with multiple testing adjustment using the q value approach for controlling the positive false discovery rate.

Results
After adjusting for age, race, menopausal status, body size at age 5 years, and childhood socioeconomic indicators, more severe early abuse was consistently associated with five metabolites at midlife (q value < 0.20 in both samples), including lower levels of serotonin and C38:3 phosphatidylethanolamine plasmalogen and higher levels of alanine, proline, and C40:6 phosphatidylethanolamine. Other metabolites potentially associated with early abuse (q value < 0.05 in the meta-analysis) included triglycerides, phosphatidylcholine plasmalogens, bile acids, tyrosine, glutamate, and cotinine. The association between early abuse and midlife metabolomic profiles was partly mediated by adulthood body mass index (32% mediated) and psychosocial distress (13%–26% mediated), but not by other life-style factors.

Conclusions
Early abuse was associated with distinct metabolomic profiles of multiple amino acids and lipids in middle-aged women. Body mass index and psychosocial factors in adulthood may be important intermediates for the observed association.
Role of Dopamine Transporter in the Relationship Between Plasma Cortisol and Cognition
Authors: Yang Kai-Chun , Liu Mu-N , Yang Bang-Hung , Chou Yuan-Hwa 
Published: April 2022

ABSTRACT

Objective
Cortisol is associated with cognition in both healthy individuals and patients with neuropsychiatric disorders. Regarding the effects of cortisol on the dopamine system and the association between dopamine transporter (DAT) and cognition, DAT might be a central target linking cortisol and cognition. This study explored the role of striatal DAT in the cortisol-cognition relationship.

Methods
We recruited 33 patients with carbon monoxide poisoning and 33 age- and sex-matched healthy controls. All participants underwent cognitive assessments of attention, memory, and executive function. Single-photon emission computed tomography with 99mTc-TRODAT was used to determine striatal DAT availability. Plasma cortisol, tumor necrosis factor α, and interleukin-10 levels were measured using enzyme-linked immunosorbent assays.

Results
Compared with healthy controls, patients with carbon monoxide poisoning had lower cognitive performance, bilateral striatal DAT availability, and plasma tumor necrosis factor-α levels and higher cortisol and interleukin-10 levels. In all participants, plasma cortisol level and bilateral striatal DAT availability were negatively and positively related to cognition, respectively, including memory and executive function with β from −0.361 (95% confidence interval [CI] = −0.633 to −0.090) to 0.588 (95% CI = 0.319 to 0.858). Moreover, bilateral striatal DAT mediated the cortisol-cognition relationship with indirect effects from −0.067 (95% CI = −0.179 to −0.001) to −0.135 (95% CI = −0.295 to −0.024). The cytokine levels did not influence the mediation effects.

Conclusions
This is the first study to demonstrate that striatal DAT mediates the cortisol-cognition relationship. Future studies are needed to comprehensively evaluate the role of the dopamine system in cortisol-cognition associations and treatment implications.
Use of Real-Life Safety Data From International Pharmacovigilance Databases to Assess the Importance of Symptoms Associated With Gadolinium Exposure
Authors: Shahid Imran , Joseph Alvin , Lancelot Eric 
Published: April 2022

Objective
Recent scientific publications have reported cases of patients who complained from a variety of symptoms after they received a gadolinium-based contrast agent (GBCA). The aim of this study was to appreciate the importance of these clinical manifestations in the overall population by assessing the weight of “symptoms associated with gadolinium exposure” (SAGE) among the bulk of safety experiences reported to major health authorities.

Materials and Methods
Symptoms associated with gadolinium exposure were identified from a review of the scientific literature, and the corresponding preferred terms were searched in each system organ class (SOC) category recorded in the European and North American pharmacovigilance databases EudraVigilance (EV) and FDA Adverse Event Reporting System (FAERS), respectively. The numbers of SAGE per preferred term, and cumulatively per SOC, were recorded and their weights in the overall spectrum of adverse events (AEs) were determined for each GBCA.

Results
The analysis of the selected AEs revealed a significantly higher SAGE weight for gadobenate dimeglumine (EV: 25.83%, FAERS: 32.24%) than for gadoteridol (EV: 15.51%; FAERS: 21.13%) and significantly lower SAGE weights for gadobutrol (EV: 7.75%; FAERS: 13.31%) and gadoterate meglumine (EV: 8.66%; FAERS: 12.99%). A similar ranking was found for most of the SOCs except for “nervous system disorders,” probably owing to a limitation in the methods of data selection. Furthermore, this analysis showed a greater percentage of reports mentioning a decrease in the quality of life of the patients when they were exposed to gadobenate dimeglumine or gadoteridol than to gadobutrol or gadoterate meglumine.

Conclusion
This study showed that SAGE represent a significant percentage of the bulk of AEs reported to the health authorities for each GBCA. It provided real-life arguments suggesting that SAGE may be more prevalent with linear than macrocyclic GBCAs and that gadoteridol may present a higher SAGE risk than the other macrocyclic contrast agents.
Relationship lending and financial performance of Savings and Credit Co-operative Societies in Tanzania
Authors: Towo Nathaniel Naiman , Ishengoma Esther , Mori Neema 
Published: April 2022

PurposeThis paper examines the influence of relationship lending on the financial performance of Savings and Credit Co-operative Societies (SACCOS) in Tanzania.Design/methodology/approachA panel data of 460 observations representing 115 SACCOS from Tanzania was used. Descriptive statistics and panel regression models were employed to analyse the data.FindingsThe results show that the duration of the relationship is negatively and significantly related to SACCOS financial performance, substantiating the relationship lending theories. The number of relationships has an insignificant effect on financial performance.Research limitations/implicationsThe study focused on the duration and the number of relationships as aspects of relationship lending. The paper is limited in the sense that other aspects of relationship lending such as the concentration of relationships that could affect financial performance are not included in this study. The results apply to SACCOS and not to other microfinance institutions with strong bargaining power.Originality/valueThis study positions relationship lending in the SACCOS context where the market for the wholesale loan is less competitive.
Evolving industrial districts and changing innovation patterns: the case of Montreal
Authors: Turkina Ekaterina , Oreshkin Boris 
Published: April 2022

Purpose
This paper aims to investigate the evolution of the phenomenon of industrial districts and explores the broader regional innovation systems that consist of multiple industrial districts.

Design/methodology/approach
This paper uses a combination of network analysis and patent analysis techniques to analyze the social structure of Montreal tech agglomeration and its innovation.

Findings
The findings indicate that the cores of modern regional innovation systems are composed of densely collaborating organizations belonging to different industrial clusters, and these organizations are responsible for the most radical innovations. The analysis also reveals the importance of brokers and international ties in generating radical innovations.

Research limitations/implications
The findings of our paper extend the initial concept of industrial district and call for the need to no longer focus exclusively on individual clusters, but to take into consideration broader competitive regional innovation systems that are composed of multiple clusters. The current trend of the core of such systems to be composed of organizations from multiple clusters indicates that the traditional understanding of industrial district confined to the borders of specific industry is no longer relevant and there is a need to revise the conceptualization of clusters and further analyze the social fabric of broader regional innovation systems. In future, such intense collaboration within the core of the regional innovation system network may give rise to new industrial and technological configurations. It is important to further investigate these structures, because they have important implications for innovation and are responsible for new innovation patterns.

Practical implications
To boost innovation in specific localities, policymakers could encourage collaboration between different clusters and support interdisciplinary projects and programs. Those would help the local community generate radical innovations.

Social implications
Using this research, local policymakers could help local companies understand and explore international markets, as well as focus on attracting multinational firms that are leaders in their respective fields. Finally, local policymakers could further support important cluster intermediaries

Originality/value
This paper offers original contributions to the studies of industrial districts as it explores a competitive ecosystem composed of multiple industrial districts and analyzes how these industrial districts interact and where the most innovative solutions lie in the social fabric of this big ecosystem.