bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sport Participation, Extracurricular Activity Involvement, and Psychological Distress: A Latent Class Analysis of Canadian High School Student-Athletes
Authors: Sabourin Camille , Turgeon Stéphanie , Martin Laura , Rathwell Scott , Bruner Mark , Cairney John , Camiré Martin 
Published: May 2022

Although psychological distress has been shown to increase during adolescence, participation in organized activities may have protective effects. The present study aimed to identify whether there is a relationship between high school student-athletes’ breadth of participation in organized activities and psychological distress, using a latent class analysis. Canadian adolescent-athletes (n = 930) in Grades 11 and 12 completed an online survey that measured: (a) high school sport participation, (b) community sport participation, (c) nonsport extracurricular activities participation, and (d) psychological distress. The latent class analysis indicated that a two-class model (i.e., Class 1 = narrower breadth, low distress; Class 2 = wider breadth, moderate distress) was most appropriate. Results indicated that despite the divergent probability of organized activity participation, participants in both classes had a low to moderate probability of presenting elevated levels of psychological distress. However, levels of psychological distress were still higher than other Canadian adolescent populations, suggesting that overscheduling could be of concern. Gender and time (i.e., prior/during COVID-19 pandemic) were significant covariates in the model.
On the Generation of Plasma Jets in the Kilojoule Plasma Focus Device
Authors: Polukhin S. N. , Nikulin V. Ya. , Silin P. V. 
Published: May 2022

Abstract—
Laser–optic methods were used to study the properties of plasma jets generated in the KJ Plasma Focus device. Measurements of the plasma jet velocity were conducted immediately after its appearance. During the first 10 ns, the average velocity is about 5 × 107 cm/s, which corresponds to energy of 18 keV for the ions of nitrogen, which was the working gas of the PF setup. The jet density and velocity decrease manifold over distance of 2–3 cm from its generation point. The experiments confirm that the main reason of jet generation is the necking of the pinch. It was found that after the pinch decay, a new plasma column appears, which propagates in the axial direction.
Occult tension pneumothorax discovered following imaging for adult trauma patients in the modern major trauma system: a multicentre observational study
Authors: Naumann David N , Sellon E , Mitchinson S , Tucker H , Marsden M E R , Norris-Cervetto E , Bafitis V , Smith T , Bradley R , Alzarrad A , Naeem S , Smith G , Dillane S , Humphrys-Eveleigh A , Wordsworth M , Sanchez-Thompson N , Bootland D , Brown L 
Published: May 2022

BackgroundTension pneumothorax following trauma is a life-threatening emergency and radiological investigation is normally discouraged prior to treatment in traditional trauma doctrines such as ATLS. Some trauma patients may be physiologically stable enough for diagnostic imaging and occult tension pneumothorax is discovered radiologically. We assessed the outcomes of these patients and compared them with those with clinical diagnosis of tension pneumothorax prior to imaging.MethodsA multicentre civilian–military collaborative network of six major trauma centres in the UK collected observational data from adult patients who had a diagnosis of traumatic tension pneumothorax during a 33-month period. Patients were divided into‘radiological’(diagnosis following CT/CXR) or‘clinical’(no prior CT/CXR) groups. The effect of radiological diagnosis on survival was analysed using multivariable logistic regression that included the covariates of age, gender, comorbidities and Injury Severity Score.ResultsThere were 133 patients, with a median age of 41 (IQR 24–61); 108 (81%) were male. Survivors included 49 of 59 (83%) in the radiological group and 59 of 74 (80%) in the clinical group (p=0.487). Multivariable logistic regression showed no significant association between radiological diagnosis and survival (OR 2.40, 95% CI 0.80 to 7.95; p=0.130). There was no significant difference in mortality between the groups.ConclusionRadiological imaging may be appropriate for selected trauma patients at risk of tension pneumothorax if they are considered haemodynamically stable. Trauma patients may be physiologically stable enough for radiological imaging but have occult tension pneumothorax because they did not have the typical clinical presentation. The historical dogma of the‘forbidden scan’no longer applies to such patients.
Novel microenvironment-based classification of intrahepatic cholangiocarcinoma with therapeutic implications
Authors: Martin-Serrano Miguel A , Kepecs Benjamin , Torres-Martin Miguel , Bramel Emily R , Haber Philipp K , Merritt Elliot , Rialdi Alexander , Param Nesteene Joy , Maeda Miho , Lindblad Katherine E , Carter James K , Barcena-Varela Marina , Mazzaferro Vincenzo , Schwartz Myron , Affo Silvia , Schwabe Robert F , Villanueva Augusto , Guccione Ernesto , Friedman Scott L , Lujambio Amaia , Tocheva Anna , Llovet Josep M , Thung Swan N , Tsankov Alexander M , Sia Daniela 
Published: May 2022

ObjectiveThe diversity of the tumour microenvironment (TME) of intrahepatic cholangiocarcinoma (iCCA) has not been comprehensively assessed. We aimed to generate a novel molecular iCCA classifier that incorporates elements of the stroma, tumour and immune microenvironment (‘STIM’ classification).DesignWe applied virtual deconvolution to transcriptomic data from ~900 iCCAs, enabling us to devise a novel classification by selecting for the most relevant TME components. Murine models were generated through hydrodynamic tail vein injection and compared with the human disease.ResultsiCCA is composed of five robust STIM classes encompassing both inflamed (35%) and non-inflamed profiles (65%). The inflamed classes, namedimmune classical(~10%) andinflammatory stroma(~25%), differ in oncogenic pathways and extent of desmoplasia, with theinflammatory stromashowing T cell exhaustion, abundant stroma andKRASmutations (p<0.001). Analysis of cell–cell interactions highlights cancer-associated fibroblast subtypes as potential mediators of immune evasion. Among the non-inflamed classes, thedesert-like class(~20%) harbours the lowest immune infiltration with abundant regulatory T cells (p<0.001), whereas thehepatic stem-likeclass (~35%) is enriched in ‘M2-like’ macrophages, mutations inIDH1/2andBAP1,andFGFR2fusions. The remaining class (tumour classical: ~10%) is defined by cell cycle pathways and poor prognosis. Comparative analysis unveils high similarity between aKRAS/p19murine model and theinflammatory stromaclass (p=0.02). The KRAS-SOS inhibitor, BI3406, sensitises aKRAS-mutant iCCA murine model to anti-PD1 therapy.ConclusionsWe describe a comprehensive TME-based stratification of iCCA. Cross-species analysis establishes murine models that align closely to human iCCA for the preclinical testing of combination strategies.
Collateral status and recanalization after endovascular treatment for acute ischemic stroke
Authors: Uniken Venema Simone M , Dankbaar Jan Willem , Wolff Lennard , van Es Adriaan C G M , Sprengers Marieke , van der Lugt Aad , Dippel Diederik W J , van der Worp H. Bart 
Published: May 2022

BackgroundSuccessful recanalization and good collateral status are associated with good clinical outcomes after endovascular treatment (EVT) for acute ischemic stroke, but the relationships among them are unclear.ObjectiveTo assess if collateral status is associated with recanalization after EVT and if collateral status modifies the association between successful recanalization and functional outcome.MethodsWe retrospectively analyzed data from the MR CLEAN Registry, a multicenter prospective cohort study of patients with a proximal anterior occlusion who underwent EVT in the Netherlands. We determined collateral status with a previously validated four-point visual grading scale and defined successful recanalization as an extended Thrombolysis in Cerebral Infarction score ≥2B. Functional outcome was determined using the modified Rankin Scale score at 90 days. We assessed, with multivariable logistic regression models, the associations between (1) collateral status and successful recanalization, (2) successful recanalization and functional outcome, (3) collateral status and functional outcome. An interaction of collateral status and successful recanalization was assessed. Subgroup analyses were performed for patients treated with intravenous thrombolysis.ResultsWe included 2717 patients, of whom 1898 (70%) had successful recanalization. There was no relationship between collateral status and successful recanalization (adjusted common OR (95% CI) of grades 1, 2, and 3 vs 0: 1.19 (0.82 to 1.72), 1.20 (0.83 to 1.75), and 1.10 (0.74 to 1.63), respectively). Successful recanalization (acOR (95% CI): 2.15 (1.84 to 2.52)) and better collateral grades (acOR (95% CI) of grades 1, 2, and 3 vs 0: 2.12 (1.47 to 3.05), 3.46 (2.43 to 4.92), and 4.16 (2.89 to 5.99), respectively) were both associated with a shift towards better functional outcome, without an interaction between collateral status and successful recanalization. Results were similar for the subgroup of thrombolysed patients.ConclusionsCollateral status is not associated with the probability of successful recanalization after EVT and does not modify the association between successful recanalization and functional outcome.
Distal cerebral vasospasm treatment following aneurysmal subarachnoid hemorrhage using the Comaneci device: technical feasibility and single-center preliminary results
Authors: Thiery Louis , Carle Xavier , Testud Benoit , Boulouis Gregoire , Habert Paul , Tradi Farouk , Reyre Anthony , Lehmann Pierre , Dory-Lautrec Philippe , Stellmann Jan-Patrick , Girard Nadine , Brunel Herve , Hak Jean-Francois 
Published: May 2022

BackgroundBalloon-assisted mechanical angioplasty for cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) has a number of limitations, including transient occlusion of the spastic blood vessel. Comaneci is an FDA-approved device for temporary coil embolization assistance which has recently also been approved for the treatment of distal symptomatic refractory vasospasm. We aimed to report the feasibility, efficacy and safety of our experience with Comaneci angioplasty for refractory distal vasospasm (up to the second segment of the cerebral arteries) following aSAH.MethodsThis is a retrospective analysis of a prospective series of 18 patients included between April 2019 and June 2021 with aSAH and symptomatic vasospasm refractory to medical therapy, who were treated using Comaneci-17-asssisted mechanical distal angioplasty. Immediate angiographic results, procedure-related complications, and clinical outcomes were assessed. Inter-rater reliability of the scores was determined using the intraclass correlation coefficient.ResultsComaneci-assisted distal angioplasty was performed in 18 patients, corresponding to 31 target arteries. All distal anterior segments were easily accessible with the Comaneci-17 device. Vasospasm improvement after Comaneci mechanical angioplasty was seen in 22 distal arteries (71%) (weighted Cohen’s kappa (κw) 0.73, 95% CI 0.69 to 0.93). Vasospasm recurrence occurred in three patients (16.67%) and delayed cerebral infarction in three patients (16.67%), with a mean±SD delay between onset of symptoms and imaging follow-up (MRI/CT) of 32.61±8.93 days (κw0.98, 95% CI 0.88 to 1).ConclusionThis initial experience suggests that distal mechanical angioplasty performed with the Comaneci-17 device for refractory vasospasm following aSAH seems to be safe, with good feasibility and efficacy.
Predictors of early neurologic deterioration (END) following stroke thrombectomy
Authors: Bhole Rohini , Nouer Simonne S , Tolley Elizabeth A , Turk Aquilla , Siddiqui Adnan H , Alexandrov Andrei V , Arthur Adam S , Mocco J 
Published: May 2022

BackgroundEarly neurologic deterioration (END) following ischemic stroke is a serious event and is associated with poor outcomes. However, the incidence and predictors of END after stroke thrombectomy for emergent large vessel occlusion are largely unknown.MethodsThe baseline characteristics of patients enrolled in the COMPASS trial (NCT02466893) were analyzed. The primary outcome was worsening of ≥4 National Institutes of Health Stroke Scale (NIHSS) points 24 hours post thrombectomy (4+ END24) and the secondary outcome was deterioration of ≥2 points (2+ END24).ResultsAmong 270 patients, 27 (10%) developed 4+ END24and 42 (16%) had 2+ END24. Those with 4+ END24were older (76.4±12.9 vs 70.9±12.9 years; p=0.04), had a higher prevalence of hypertension (96% vs 69%; p=0.003), diabetes (41% vs 27%; p=0.13) and higher pretreatment systolic blood pressure (SBP) (170.4±32.6 vs 157.6±28.1 mmHg; p=0.03). More 4+ END24patients had failed reperfusion: Thrombolysis in Cerebral Infarction ≤2a (26% vs 8%; p=0.003). In unadjusted analysis, older patients and those with hypertension, diabetes, elevated SBP and failed reperfusion had higher odds of 4+ END24. In adjusted analysis, age increase by 5 years led to an increase in 4+ END24of 28%, diabetes increased odds of 2.6 and failed reperfusion increased odds of 4.5. In the multivariable analysis for the secondary outcome, age (OR 1.33; 95% CI 1.109 to 1.593), diabetes (OR 2.7; 95% CI 1.247 to 5.764) and failed reperfusion (OR 7.2; 95% CI 0.055 to 0.349) were also significant predictors of 2+ END24.ConclusionsOlder patients with acute ischemic stroke who have a history of diabetes or hypertension, with elevated pretreatment SBP and failed reperfusion are at a higher risk of END following stroke thrombectomy for emergent large vessel occlusion.
Environmental contamination byChlamydia trachomatisandNeisseria gonorrhoeae: is it time to change our infection control practices? Results of a regional study
Authors: Ramsden Sophie , Ovens Katie , Griffiths James , Muir Peter , Steele-Nicholson Ann , Horner Paddy J 
Published: May 2022

ObjectivesNucleic acid amplification tests (NAATs) are highly sensitive for the detection ofChlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) DNA/ribosomal RNA (rRNA). Previous studies have demonstrated contamination of surfaces in sexual health clinics (SHCs) with CT/NG. False positive results can occur if patient samples are contaminated by environmental DNA/rRNA. This can have a dramatic impact on patients’ lives and relationships. Previous attempts to reduce contamination, through staff training alone, have been unsuccessful. We aimed to investigate environmental contamination levels in SHCs and to assess a two-armed intervention aimed at reducing surface contamination.MethodsQuestionnaires were sent to 10 SHCs. Six clinics, with differing characteristics, were selected to participate in sample collection. Each clinic followed standardised instructions to sample surfaces using a CT/NG NAAT swab. Clinics were invited to introduce the two-armed intervention. The first arm was cleaning with a chlorine-based cleaning solution once daily. The second arm involved introducing clinic-specific changes to reduce contamination.Results7/10 (70%) clinics completed the questionnaire. Overall, 88/263 (33%) swabs were positive for CT/NG. Clinics 1, 3 and 4 had high levels of contamination, with 28/64 (44%), 17/33 (52%) and 30/52 (58%) swabs testing positive, respectively. Clinics 2 and 6 had lower levels of contamination, with 7/46 (15%) and 6/35 (17%), respectively. 0/33 (0%) of swabs were positive at clinic 5 and this was the only clinic already using a chlorine-based solution to clean all surfaces and delivering twice-yearly clinic-specific infection control training. Following both intervention arms at clinic 1, 2/50 (4%, p<0.0001) swabs tested positive for CT/NG. Clinic 4 introduced each arm separately. After the first intervention, 13/52 (25%, p=0.003) swabs tested positive and following the second arm 4/50 (8%, p<0.0001) swabs were positive.ConclusionsEnvironmental contamination is a concern in SHCs. We recommend that all SHCs monitor contamination levels and, if necessary, consider using chlorine-based cleaning products and introduce clinic-specific changes to address environmental contamination.
On light surfaces in black hole thermodynamics
Authors: Pugliese D. , Quevedo H. 
Published: May 2022

AbstractWe discuss the fundamentals of classical black hole (BH) thermodynamics in a new framework determined by light surfaces and their frequencies. This new approach allows us to study BH transitions inside the Kerr geometry. In the case of BHs, we introduce a new parametrization of the metric in terms of the maximum extractable rotational energy or, correspondingly, the irreducible mass, which is an alternative to the spin parametrization. It turns out that BH spacetimes with spins $$a/M= \sqrt{8/9}$$

a
/
M
=

8
/
9

and $$a/M=1/\sqrt{2}$$

a
/
M
=
1
/

2

show anomalies in the rotational energy extraction and surface gravity whereas the case $$a/M=\sqrt{3}/2$$

a
/
M
=

3

/
2

is of particular relevance to study the variations of the horizon area. We find the general conditions under which BH transitions can occur and express them in terms of the masses of the initial and final states. This shows that BH transitions in the Kerr geometry are not arbitrary but depend on the relationship between the mass and spin of the initial and final states. From an observational point of view, we argue that near the BH poles it is possible to detect photon orbits with frequencies that characterize the light surfaces analyzed in this work.
Just who do I think I am?
Authors: Yaffe Philip 
Published: May 2022

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.
Good advice is good advice no matter the source. However knowing something about its source can significantly reinforce one's desire to put that good advice into practice.
Exploring the Genetic Architecture of Spontaneous Coronary Artery Dissection Using Whole-Genome Sequencing
Authors: Tarr Ingrid , Hesselson Stephanie , Iismaa Siiri E. , Rath Emma , Monger Steven , Troup Michael , Mishra Ketan , Wong Claire M.Y. , Hsu Pei-Chen , Junday Keerat , Humphreys David T. , Adlam David , Webb Tom R. , Baranowska-Clarke Anna A. , Hamby Stephen E. , Carss Keren J. , Samani Nilesh J. , Bax Monique , McGrath-Cadell Lucy , Kovacic Jason C. , Dunwoodie Sally L. , Fatkin Diane , Muller David W.M. , Graham Robert M. , Giannoulatou Eleni 
Published: May 2022

Background:
Spontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndrome that predominantly affects women. Its pathophysiology remains unclear but connective tissue disorders (CTD) and other vasculopathies have been observed in many SCAD patients. A genetic component for SCAD is increasingly appreciated, although few genes have been robustly implicated. We sought to clarify the genetic cause of SCAD using targeted and genome-wide methods in a cohort of sporadic cases to identify both common and rare disease-associated variants.

Methods:
A cohort of 91 unrelated sporadic SCAD cases was investigated for rare, deleterious variants in genes associated with either SCAD or CTD, while new candidate genes were sought using rare variant collapsing analysis and identification of novel loss-of-function variants in genes intolerant to such variation. Finally, 2 SCAD polygenic risk scores were applied to assess the contribution of common variants.

Results:
We identified 10 cases with at least one rare, likely disease-causing variant in CTD-associated genes, although only one had a CTD phenotype. No genes were significantly associated with SCAD from genome-wide collapsing analysis, however, enrichment for TGF (transforming growth factor)-β signaling pathway genes was found with analysis of 24 genes harboring novel loss-of-function variants. Both polygenic risk scores demonstrated that sporadic SCAD cases have a significantly elevated genetic SCAD risk compared with controls.

Conclusions:
SCAD shares some genetic overlap with CTD, even in the absence of any major CTD phenotype. Consistent with a complex genetic architecture, SCAD patients also have a higher burden of common variants than controls.
Enhancing Diversity in Surgery: Association of Out Surgeons and Allies, a New Society to Support and Promote Lesbian, Gay, Bisexual, Transgender, and Queer Surgeons
Authors: St John Ace , Goulet Nicole 
Published: May 2022

Background Prejudice towards Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) people continues to decline. Despite this, LGBTQ surgeons still experience discrimination from colleagues, staff, and patients at an alarming rate. The Association of Out Surgeons and Allies (AOSA) was established to address this issue by fostering a more equitable and inclusive surgical environment. AOSA AOSA is a national surgical organization of LGBTQ students, trainees, faculty, and allies committed to enhancing equity in surgery through education, outreach, mentorship, and sponsorship. AOSA works in collaboration with national efforts and institutional initiatives to promote the inclusion and acceptance of LGBTQ surgeons. Future Directions Achieving these goals will require a community effort of LGBTQ surgeons and allies in addition to the support of prominent academic institutions and national surgical organizations. Conclusion Lesbian, Gay, Bisexual, Transgender, and Queer surgeons continue to face workplace discrimination. This new surgical society will help foster a supportive environment through visibility, mentorship, education, and community.
Complicated Abdominal Wall Hernias in the Elderly: Time Is Life and Comorbidities Matter
Authors: Proaño-Zamudio Jefferson A. , Gebran Anthony , Argandykov Dias , Paranjape Charudutt N. , Maroney Stephanie J. , Onyewadume Louisa , Kaafarani Haytham M. A. , Fagenholz Peter J. , King David R. , Velmahos George C. , Hwabejire John O. 
Published: May 2022

Background Abdominal wall hernias represent a common problem that can present as surgical emergencies with increased morbidity and mortality. The data examining outcomes in elderly patients with hernia emergencies is scant. Methods The 2007-2017 ACS-NSQIP database was queried. Patients ≥65 years old with a diagnosis of acute complicated abdominal wall hernia were included. Univariable and multivariable analyses were used to identify independent predictors of 30-day mortality and surgical site infection (SSI). Results Main predictors of 30-day mortality were admission from nursing home or chronic care facility (OR = 1.62, 95% CI: 1.10-2.38, P = .014), transfer from outside ED (OR = 1.81, 95% CI: 1.31-2.51, P < .001), days from admission to operation (OR = 1.05, 95% CI: 1.02-1.08, P = .002), recent significant weight loss (OR = 1.95, 95% CI: 1.12-3.37, P = .018), pre-operative septic shock (OR = 4.13, 95% CI: 2.44-6.99, P < .001), ventilator dependence (OR = 2.50, 95% CI: 1.29-4.81, P = .006), and ASA status. When compared to open repair, laparoscopic repair emerged as protective against SSI (OR = .34, 95% CI: .17-.66, P = .001). Bowel resection (OR = 2.15, 95% CI: 1.63-2.84, P < .001) and increasing wound class were risk factors for SSI. Conclusion In the elderly patient presenting with an acute complicated abdominal wall hernia, time to surgery is crucial for survival, and comorbidities influence outcome. Laparoscopy is an option in management due to its decreased risk of surgical site infection without increased mortality, whenever patient factors are favorable for this approach.