bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression: A Modifiable Risk Factor for Poor Outcomes in Fibromyalgia
Authors: Munipalli Bala , Allman Madeleine E. , Chauhan Mohit , Niazi Shehzad K. , Rivera Fernando , Abril Andy , Wang Benjamin , Wieczorek Mikolaj A. , Hodge David O. , Knight Dacre , Perlman Adam , Abu Dabrh Abd Moain , Dudenkov Daniel , Bruce Barbara K. 
Published: August 2022

Background: About 4 out of 10 fibromyalgia patients suffer from depression. The European Alliance of Associations for Rheumatology (EULAR) guidelines recommend using antidepressants to treat fibromyalgia. Objective: To determine predictors of improved outcomes following a multicomponent treatment program. Design: We designed this longitudinal treatment outcome study to evaluate the prevalence of depression symptoms in patients diagnosed with fibromyalgia at a tertiary care facility, and the impact of depression on functional outcomes after completing a multicomponent fibromyalgia treatment program. Setting: Tertiary care center. Patients: This study included 411 adult patients with fibromyalgia who completed a multicomponent treatment program for fibromyalgia. Expert physicians performed comprehensive evaluations following American College of Rheumatology (ACR) criteria to confirm fibromyalgia before referral to the program. Intervention: An intensive outpatient multicomponent treatment program consisting of 16 hours of cognitive behavioral strategies served as the intervention. Measurements: Functional status was assessed using the Fibromyalgia Impact Questionnaire Revised (FIQR). Depression was evaluated with the Center for Epidemiologic Study of Depression (CES-D) measure. Measures were administered prior to participation in the program and approximately 5 months following completion of the program. Results: The cohort had a high prevalence of depressive symptoms (73.2% had depression at admission). Higher depression scores at baseline predicted poorer outcomes following multi-component treatment. Effectively treated depression resulted in improved functioning at follow-up. Limitations: Findings limited to tertiary care center cohort of fibromyalgia patients. Patients did not undergo a structured clinical diagnostic interview to diagnose depression. Conclusions: The current data links depression to poorer outcomes in patients with fibromyalgia. Depression is an important modifiable factor in the management of fibromyalgia. Guidelines should reflect the importance of assessing and effectively treating depression at the time of diagnosis of fibromyalgia, to improve functional outcomes. Registration: Specific registry and specific study registration number—Institutional Review Board—(IRB# 19-000495). Funding Source: No funding.
Association of Drain Use in Ankle Arthrodesis With Increased Blood Transfusion Risk: A National Observational Study
Authors: Okewunmi Jeffrey , Chan Jimmy J. , Poeran Jashvant , Zubizarreta Nicole , Mazumdar Madhu , Vulcano Ettore 
Published: August 2022

Background: Closed wound drainage has been extensively studied in the hip and knee arthroplasty literature with equivocal results on its clinical benefits. Although also used in orthopaedic surgeries like ankle arthrodesis and ankle arthroplasty, large-scale data are currently lacking on utilization patterns and real-world effectiveness. We, therefore, aimed to address this research gap in this distinct surgical cohort using national claims data. Methods: Using the Premier Healthcare claims database from 2006 to 2016, ankle arthrodesis (n=10,085) and ankle arthroplasty (n=4,977) procedures were included. The main effect was drain use, defined by detailed billing descriptions. Outcomes included blood transfusion, 90-day readmission, and length and cost of hospitalization. Mixed-effects models measured associations between drain use and outcomes. Odds ratios (OR, or % change), 95% CIs, and P values are reported. Results: Overall, drains were used in 11% (n=1,074) and 15% (n=755) of ankle arthrodesis and ankle arthroplasty procedures, respectively. Drain use dramatically decreased over the years in both surgery types: from 14% to 6% and 24% to 7% between 2006 and 2016, for arthrodesis and ankle arthroplasty procedures, respectively. After adjustment for relevant covariates, drain use was associated with increased odds of blood transfusion in ankle arthrodesis surgery (OR 1.4, CI 1.1-1.8, P = .0168), whereas differences that were statistically but not clinically significant were seen in cost and length of stay. In total ankle arthroplasty, no statistically significant associations were observed between drain use and the selected outcomes. Conclusion: This is the first national study on drain use in ankle surgery. We found a decrease in use over time. Drain use was associated with higher odds of blood transfusion in ankle arthrodesis patients. Although this negative effect may be mitigated by the rapidly decreasing use of drains, future studies are needed to discern drivers of drain use in this distinct surgical population. Level of Evidence: Level III, retrospective cohort study
Research on the wood processing method of helium-assisted laser process
Authors: Yang Chunmei , Tian Xinchi , Xue Bo , Liu Qingwei , Zhang Jiawei , Liu Jiuqing , Yu Wenji 
Published: August 2022

AbstractIn order to promote the development of environmental protection, and the usage rate of green energy utilization, a progressive, innovative laser process method employing helium assisted is proposed, which optimizes the joint cutting process under the same energy consumption. This method provides a new idea for the wood process industry. The uniqueness of this paper establishes a mathematical model to address the diffusion of helium injection and the heat transfer of the laser beam on the processed surface. From the results, it can be exhibited that the oxygen concentration reduces when the helium is injected on the processed surface. The helium could destroy the combustion-supporting conditions and decrease the combustion zone of the processed joint cutting. Thus, the carbonized area of the processed surface is reduced, which could effectively enhance the processing quality of joint cutting. Notably, the helium with injection speed forms a sweeping effect on the processed surface, which could remove parts of the carbonized particles and residues on the processed surface, as well as improve the processing quality. Comparing the traditional laser process and helium-assisted laser process, the gas-assisted laser process owns higher process quality than that of traditional laser processing and cutting. In detail, it features the advantages of smaller joint cutting width, lower surface roughness and smoother surface. Eventually, a mathematical model based on the response surface method with the evaluation criteria of the kerf width, kerf depth, and surface roughness is established to analyze the interaction of laser power, cutting speed and inert gas pressure on the response factors. Comparing the error between the predicted and experimental measurement value, and the optimized process parameters could be acquired. In this paper, the helium-assisted laser process method proposed is meaningful and encouraging, which not only obtains better processing quality, but also provides a guide for developing green industry.
EEG resting-state functional connectivity: evidence for an imbalance of external/internal information integration in autism
Authors: Wantzen Prany , Clochon Patrice , Doidy Franck , Wallois Fabrice , Mahmoudzadeh Mahdi , Desaunay Pierre , Christian Mille , Guilé Jean-Marc , Guénolé Fabian , Eustache Francis , Baleyte Jean-Marc , Guillery-Girard Bérengère 
Published: August 2022

AbstractBackgroundAutism spectrum disorder (ASD) is associated with atypical neural activity in resting state. Most of the studies have focused on abnormalities in alpha frequency as a marker of ASD dysfunctions. However, few have explored alpha synchronization within a specific interest in resting-state networks, namely the default mode network (DMN), the sensorimotor network (SMN), and the dorsal attention network (DAN). These functional connectivity analyses provide relevant insight into the neurophysiological correlates of multimodal integration in ASD.MethodsUsing high temporal resolution EEG, the present study investigates the functional connectivity in the alpha band within and between the DMN, SMN, and the DAN. We examined eyes-closed EEG alpha lagged phase synchronization, using standardized low-resolution brain electromagnetic tomography (sLORETA) in 29 participants with ASD and 38 developing (TD) controls (age, sex, and IQ matched).ResultsWe observed reduced functional connectivity in the ASD group relative to TD controls, within and between the DMN, the SMN, and the DAN. We identified three hubs of dysconnectivity in ASD: the posterior cingulate cortex, the precuneus, and the medial frontal gyrus. These three regions also presented decreased current source density in the alpha band.ConclusionThese results shed light on possible multimodal integration impairments affecting the communication between bottom-up and top-down information. The observed hypoconnectivity between the DMN, SMN, and DAN could also be related to difficulties in switching between externally oriented attention and internally oriented thoughts.
Association between short-term exposure to air pollution and COVID-19 mortality in all German districts: the importance of confounders
Authors: Miller Gregor , Menzel Annette , Ankerst Donna P. 
Published: August 2022

Abstract
Background
The focus of many studies is to estimate the effect of risk factors on outcomes, yet results may be dependent on the choice of other risk factors or potential confounders to include in a statistical model. For complex and unexplored systems, such as the COVID-19 spreading process, where a priori knowledge of potential confounders is lacking, data-driven empirical variable selection methods may be primarily utilized. Published studies often lack a sensitivity analysis as to how results depend on the choice of confounders in the model. This study showed variability in associations of short-term air pollution with COVID-19 mortality in Germany under multiple approaches accounting for confounders in statistical models.

Methods
Associations between air pollution variables PM2.5, PM10, CO, NO, NO2, and O3 and cumulative COVID-19 deaths in 400 German districts were assessed via negative binomial models for two time periods, March 2020–February 2021 and March 2021–February 2022. Prevalent methods for adjustment of confounders were identified after a literature search, including change-in-estimate and information criteria approaches. The methods were compared to assess the impact on the association estimates of air pollution and COVID-19 mortality considering 37 potential confounders.

Results
Univariate analyses showed significant negative associations with COVID-19 mortality for CO, NO, and NO2, and positive associations, at least for the first time period, for O3 and PM2.5. However, these associations became non-significant when other risk factors were accounted for in the model, in particular after adjustment for mobility, political orientation, and age. Model estimates from most selection methods were similar to models including all risk factors.

Conclusion
Results highlight the importance of adequately accounting for high-impact confounders when analyzing associations of air pollution with COVID-19 and show that it can be of help to compare multiple selection approaches. This study showed how model selection processes can be performed using different methods in the context of high-dimensional and correlated covariates, when important confounders are not known a priori. Apparent associations between air pollution and COVID-19 mortality failed to reach significance when leading selection methods were used.
Development and validation of a predictive model for adverse left ventricular remodeling in NSTEMI patients after primary percutaneous coronary intervention
Authors: Wang Lili , Liu Tao , Wang Chaofan , Xuan Haochen , Xu Xianzhi , Yin Jie , Li Xiaoqun , Chen Junhong , Li Dongye , Xu Tongda 
Published: August 2022

Abstract
Introduction
To develop and validate clinical evaluators that predict adverse left ventricular remodeling (ALVR) in non-ST-elevation myocardial infarction (NSTEMI) patients after primary percutaneous coronary intervention (PCI).

Methods
The retrospective study analyzed the clinical data of 507 NSTEMI patients who were treated with primary PCI from the Affiliated Hospital of Xuzhou Medical University and the Second Affiliated Hospital of Xuzhou Medical University, between January 1, 2019 and September 31, 2021. The training cohort consisted of patients admitted before June 2020 (n = 287), and the remaining patients (n = 220) were assigned to an external validation cohort. The endpoint event was the occurrence of ALVR, which was described as an increase ≥ 20% in left ventricular end-diastolic volume (LVEDV) at 3–4 months follow-up CMR compared with baseline measurements. The occurrence probability of ALVR stemmed from the final model, which embodied independent predictors recommended by logistic regression analysis. The area under the receiver operating characteristic curve (AUC), Calibration plot, Hosmer–Lemeshow method, and decision curve analysis (DCA) were applied to quantify the performance.

Results
Independent predictors for ALVR included age (odds ratio (OR): 1.040; 95% confidence interval (CI): 1.009–1.073), the level of neutrophil to lymphocyte ratio (OR: 4.492; 95% CI: 1.906–10.582), the cardiac microvascular obstruction (OR: 3.416; 95% CI: 1.170–9.970), peak global longitudinal strain (OR: 1.131; 95% CI: 1.026–1.246), infarct size (OR: 1.082; 95% CI: 1.042–1.125) and left ventricular ejection fraction (OR: 0.925; 95% CI: 0.872–0.980), which were screened by regression analysis then merged into the nomogram model. Both internal validation (AUC: 0.805) and external validation (AUC: 0.867) revealed that the prediction model was capable of good discrimination. Calibration plot and Hosmer–Lemeshow method showed high consistency between the probabilities predicted by the nomogram (P = 0.514) and the validation set (P = 0.762) and the probabilities of actual occurrence. DCA corroborated the clinical utility of the nomogram.

Conclusions
In this study, the proposed nomogram model enabled individualized prediction of ALVR in NSTEMI patients after reperfusion and conduced to guide clinical therapeutic schedules.
The impact of clinical experience on working tasks and job-related stress: a survey among 1032 Norwegian GPs
Authors: Johnsen Tor Magne , Norberg Børge Lønnebakke , Krogh Frode Helgetun , Vonen Hanne Dahl , Getz Linn Okkenhaug , Austad Bjarne 
Published: August 2022

Abstract
Background
General practice is a generalist discipline fraught with complexity. For inexperienced physicians, it may be demanding to get to grips with the clinical challenges. The purpose of this article is to describe possible differences in the range of tasks between inexperienced and experienced general practitioners (GPs), and the extent to which clinical experience affects the way in which GPs perceive their daily work.

Methods
An online questionnaire was sent to all regular GPs in Norway (N = 4784) in 2018. The study sought to document the tasks performed during a typical working day and how the GPs perceived their working situation. In this study, we compare the tasks, working situation and occurrence of potentially conflictual consultations among ‘less experienced physicians’ (≤ 5 years of experience in general practice) versus ‘more experienced physicians’ (> 5 years of experience). The findings are discussed in light of theories on development of expertise.

Results
We received responses from 1032 GPs; 296 (29%) were less experienced and 735 (71%) more experienced. The two groups reported virtually the same number of consultations (19.2 vs. 20.5) and clinical problems handled (40.4 vs. 44.2) during the study day. The less experienced physicians reported a higher proportion of challenging and/or conflictual consultations, involving prescriptions for potentially addictive medication (5.7% vs. 3.1%), sickness certification (4.1% vs. 2.4%) and referral for medical investigations on weak clinical indication (8.1% vs. 5.6%). For other clinical issues there were minor or no differences. Both GP groups reported high levels of work-related stress with negative effect on self-perceived health (61.6% vs 64.6%). GPs who felt that high job demands harmed their health tended to handle a slightly higher number of medical issues per consultation and more consultations with elements of conflict.

Conclusions and implications
Inexperienced GPs in Norway handle a workload comparable to that of experienced GPs, but they perceive more conflictual consultations. These findings have relevance for training and guidance of future GP specialists. Irrespective of experience, the GPs report such high levels of negative work-related stress as to indicate an acute need for organisational changes that imply a reduced workload.
Development of a core outcome set for the evaluation of interventions to prevent COVID-19 in care homes (COS-COVID-PCARE Study)
Authors: Shepherd Victoria , Islam Ishrat , Wood Fiona , Williamson Paula R. , Goodman Claire , Bath Philip M. , Thompson Carl , Knapp Martin , Gordon Adam L. , Hood Kerenza 
Published: August 2022

Abstract
Background
People living in care homes have experienced devastating impact from COVID-19. As interventions to prevent the transmission of COVID-19 are developed and evaluated, there is an urgent need for researchers to agree on the outcomes used when evaluating their effectiveness. Having an agreed set of outcomes that are used in all relevant trials can ensure that study results can be compared.

Objective
The aim of the study was to develop a core outcome set (COS) for trials assessing the effectiveness of pharmacological and non-pharmacological interventions for preventing COVID-19 infection and transmission in care homes.

Methods
The study used established COS methodology. A list of candidate outcomes was identified by reviewing registered trials to evaluate interventions to prevent COVID-19 in care homes. Seventy key stakeholders participated in a Delphi survey, rating the candidate outcomes on a nine-point scale over two rounds, with the opportunity to propose additional outcomes. Stakeholders included care home representatives (n = 19), healthcare professionals (n = 20), people with personal experience of care homes (n = 7), researchers (n = 15) and others (n = 9). Outcomes were eligible for inclusion if they met an a priori threshold. A consensus meeting with stakeholders resulted in agreement of the final outcome set.

Results
Following the Delphi and consensus meeting, twenty-four outcomes were recommended for inclusion. These are grouped across four domains of infection, severity of illness, mortality, and ‘other’ (intervention specific or life impact). Due to the considerable heterogeneity between care homes, residents, and interventions, the relevance and importance of outcomes may differ between trial contexts. Intervention-specific outcomes would be included only where relevant to a given trial, thus reducing the measurement burden.

Conclusion
Using a rapid response approach, a COS for COVID-19 prevention interventions in care homes has been developed. Future work should focus on identifying instruments for measuring these outcomes, and the interpretation and application of the COS across different trial contexts. Beyond COVID-19, the outcomes identified in this COS may have relevance to other infectious diseases in care homes, and the rapid response approach may be useful as preparation for future pandemics.
An evaluation of a community-based vision care programme for the elderly
Authors: Yang She Chiu , Law Tsz Kin , Leung Yan Lok Lucas , Tam Yim Ying , Sum Rita , Lian Jinxiao , Yap Maurice 
Published: August 2022

Abstract
Background
This study evaluated the real-world effectiveness and potential cost-effectiveness of a community-based vision care programme for the elderly population aged 60 years or above.

Methods
Data from a total of 8899 subjects participating in a community-based comprehensive vision care programme from 2015 to 2019 were analysed to evaluate the effectiveness of the programme in terms of the prevalence of distance visual impairment (VI), the change in the prevalence of distance VI after refractive error correction, and the types of ocular disorders suspected. Distance VI was defined as a) visual acuity (VA) worse than 6/18 in any eye (worse eye) and b) VA worse than 6/18 in the better eye. The cost-effectiveness from the funder’s perspective was also estimated in terms of cost per distance VI avoided.

Results
Based on the presenting vision of the worse eye, the prevalence of distance VI was 39.1% (3482/8899, 95% CI: 38.1%-40.1%) and reduced to 13.8% (1227/8899, 95% CI: 13.1%-14.5%) based on best-corrected VA. Referenced to the presenting vision of the better eye, the prevalence of distance VI was 17.3% (1539/8899, 95% CI: 16.5%-18.1%) and decreased to 4.2% (373/8899, 95% CI: 3.8%-4.6%) with best optical correction. Uncorrected refractive error was the major cause of presenting distance VI. From the funder’s perspective, the cost per distance VI case prevented was HK$1921 based on VA in the worse eye and HK$3715 based on the better eye.

Conclusion
This community-based programme identified distance VI in the best eye of 17 out of every 100 subjects. With appropriate new or updated distance optical corrections, distance VI was reduced to about 4 in 100 subjects. Visual impairment in the elderly is common even in a relatively affluent city. A model of care which could minimise avoidable distance VI would bring benefits at individual and societal levels.