bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity, Specificity, and Predictive Values of Laryngopharyngeal Reflux Symptoms and Signs in Clinical Practice
Authors: Lechien Jérôme R. 
Published: August 2022

AbstractObjectiveTo investigate the sensitivity (SE), specificity (SP), and positive and negative predictive value (PPV and NPV) of symptoms and signs of laryngopharyngeal reflux (LPR).Study DesignProspective controlled.SettingUniversity medical center.MethodsPatients presenting with LPR symptoms and signs were consecutively included after diagnosis confirmation through 24‐hour hypopharyngeal‐esophageal multichannel intraluminal impedance–pH monitoring. Healthy individuals were recruited to compose a control group. Symptoms and signs were evaluated with the reflux symptom score and reflux sign assessment. The SE, SP, PPV, and NPV of symptoms and signs were assessed.ResultsThe study included 403 patients with LPR and 144 healthy individuals. Throat clearing, globus sensation, heartburn, and excess throat mucus were symptoms with the highest SE (67.5%‐69.7%), SP (12.5%‐20.8%), and NPV (48.3%‐49.2%). The combination of throat clearing, heartburn, globus sensation, and excess throat mucus led to a high SE (96.0%) and NPV (85.2%). Anterior pillar erythema, tongue tonsil hypertrophy, and posterior commissure hypertrophy resulted in the highest SE (75.5%‐83.5%). The highest SP was found for uvula erythema/edema, epiglottis erythema, and interarytenoid granulatory tissue (97.1%‐97.2%). The association of nonendoscopic signs (anterior pillar erythema, uvula erythema/edema, and coated tongue) had an SE and SP of 80.1% and 47.2%, respectively. The association of throat clearing, heartburn, globus, anterior pillar erythema, and uvula erythema/edema had the highest SE (98.8%), SP (33.3%), PPV (94.3%), and NPV (70.6%).ConclusionLPR symptoms and signs reported low SP and NPV. The SE, SP, PPV, and NPV may be maximized with the association of throat clearing, heartburn, globus sensation, anterior pillar erythema, and uvula erythema/edema.
Social Structures of Accumulation in a Semiperiphery Country
Authors: Kılıç Sadık 
Published: August 2022

This article claims that the world-system approach can serve as a mediating force in understanding the social structure(s) of accumulation (SSA) dynamics in Turkey. The argument for using the world-system approach has two complementary supports. First, the Turkish SSAs are driven by the capitalist world economy. As such, the author focuses on Turkey’s Westernization efforts and dependency on core countries and international organizations under their control. Second, domestic struggles and political decisions related to the Turkish SSAs are not limited to the main variables of the SSA theory, such as labor-capital conflict, profit rate, and economic crises. Thus, the author shows that phenomena such as the religion-secularity conflict, the struggle between anti-imperialism and anticommunism, and military interventions are crucial in SSA formations. In support of this argumentation, the author discusses the regulationist and neoliberal SSAs in Turkey. JEL Classification: J50, J08, B51, P16
Probabilistic review of wheel profiles based on hollow tread in the U.S. heavy haul rail network
Authors: Lee Jaeik , Dersch Marcus S , Lima Arthur de Oliveira , Edwards J Riley 
Published: August 2022

Wheel profile is one of the most critical factors that governs the dynamic interaction between railcar wheels and the rail. This paper quantifies and analyzes 15,000 wheel profiles that were randomly selected from a dataset obtained from wayside wheel profile measurement systems from railcars that are in unrestricted interchange in the North American Class I railroad network. Mean dimensions for each of the four critical wheel tread parameters were as follows; 30.5 mm (1.202 in.) for flange height, 35.4 mm (1.395 in.) for flange thickness, 0.483 mm (0.019 in.) for hollow tread, and 37.8 mm (1.488 in.) for rim thickness. Further evaluation focused on the magnitude of hollow tread, one of the important factors that determines wheel rail contact location, contact patch size, and dynamic interaction of the railcar and track. Correlative analysis revealed that hollow tread is linearly related to flange height, flange thickness, and rim thickness. Given this relationship, we categorized wheel profile data into characteristic bins of wheel profiles, and a new classification system based on hollow tread was proposed that should be considered when designing track infrastructure components (e.g., turnout frogs). Combinations of parameters were derived and organized into five wheel-profile classification ranges, based on “most likely” to “least likely” profiles that might be encountered. For the five classifications (Type A to Type E), a range of hollow tread from 0 mm to 5 mm (interval of 1 mm) and corresponding mean values for the three other parameters were applied. This probabilistic analysis and classification of wheel profiles into categories enables better understanding of current North American wheel conditions. Additionally, these data and the proposed analysis method can be leveraged to further optimize wheel profiles and track components, identify relationships with rates of rail surface defects and track degradation, and prioritize maintenance.
Performance analysis of Luminex and ELISA to profile serum IP-10 as a biomarker in systemic lupus erythematosus
Authors: Espinosa-Bautista Fernanda , Coronel Dania , Ramos-Rosillo Varna , Amezcua-Guerra Luis M 
Published: August 2022

Objective Interferon-γ inducible protein-10 (IP-10) is a promising biomarker in systemic lupus erythematosus (SLE). The optimal quantification platform has not yet been identified. We compared the performance of bead-based multiplex assay (Luminex) and high-sensitivity enzyme-linked immunosorbent assay (hs-ELISA) for profiling serum IP-10 as a biomarker of lupus activity. Methods A cross-sectional study was conducted on outpatients with SLE. Serum IP-10 was measured simultaneously on Luminex and hs-ELISA, and correlation between platforms was assessed. Additionally, IP-10 levels were tested against disease activity and organ involvement. Results One-hundred and forty-one patients (88% women; 38 years old) were studied. Median IP-10 levels were 100.9 (125.2) pg/mL by Luminex and 156.5 (191.7) pg/mL by hs-ELISA. Correlation analysis showed Spearman’s ρ = 0.621 ( p < 0.0001) between Luminex and hs-ELISA. Quantification of IP-10 by Luminex showed a significant correlation (ρ = 0.198; p = 0.021) with disease activity, while this was not observed (ρ = 0.036; p = 0.683) when measured using hs-ELISA. Serum IP-10 levels were lower in quiescent patients than in those with active disease (70.8 [68.4] versus 114.3 [123.9] pg/mL; p = 0.024), with an AUC-ROC = 0.62 ( p = 0.029), sensitivity = 47.9%, specificity = 77.5%, and positive likelihood ratio = 2.1. Patients with active arthritis had higher IP-10 levels than non-arthritis patients (158.1 [505.4] versus 94.1 [114.0] pg/mL; p = 0.008), with an AUC-ROC = 0.73 ( p = 0.0009), sensitivity = 72.7%, specificity = 66.4%, and positive likelihood ratio = 2.1. No other type of organ involvement was identified by serum IP-10. Conclusions Luminex performs better than hs-ELISA as a quantification platform for IP-10 as it correlates with disease activity and identifies active arthritis in SLE.
Magnetic Resonance Imaging for Assessing Velopharyngeal Function: Current Applications, Barriers, and Potential for Future Clinical Translation in the United States
Authors: Mason Kazlin N. 
Published: August 2022

Objective The use of magnetic resonance imaging (MRI) in the assessment process for children with cleft/craniofacial conditions remains uncommon, particularly for velopharyngeal assessments. The purpose of this study was to analyze the perceived clinical utility of MRI for cleft/craniofacial providers and identify barriers that exist for clinical translation of this imaging modality to this population of patients. Methods A 38-item survey was disseminated to craniofacial team providers. Workplace context and demographics, MRI as a research and clinical tool, access and barriers for use of MRI, and needs for successfully establishing MRI protocols at clinical sites were investigated. Descriptive statistics were used to identify differences in the clinical use of MRI across disciplines. Chi-square analyses were conducted to determine how different specialties perceived potential barriers. Results Respondents reported that MRI is likely to be beneficial for clinical assessments (93.5%) and that this imaging modality is available for use (83.8%). However, only 11.8% of providers indicated the use of MRI in their clinical assessments. This discrepancy highlights a potential disconnect between perceived use and implementation of this imaging methodology on cleft and craniofacial teams. A number of barriers were identified by providers. Challenges and opportunities for clinical translation of MRI protocols were highlighted. Conclusion Results may guide the development for improved clinical feasibility and implementation of MRI for clinical planning in this population of patients. Reported barriers highlight additional areas for translational research and the potential for the development of clinical tools related to MRI assessment and protocol implementation.
Effectiveness, Safety, and Predictors of Response to 5% Lidocaine-Medicated Plaster for the Treatment of Patients With Trigeminal Neuralgia: A Retrospective Study
Authors: Yu Bin , Zhang Wei , Zhao Chunmei , Xing Yan , Meng Lan , Luo Fang 
Published: August 2022

Background: Whether 5% lidocaine-medicated plaster (LMP) is a valuable therapeutic option for the treatment of trigeminal neuralgia (TN) is worth exploring. If LMP is proven effective for TN, positive predictors of the analgesic effects of LMP warrant further investigation. Objective: To evaluate the efficacy and safety of LMP for the treatment of TN, and to explore the predictive factors for the treatment efficacy of LMP. Methods: This is a retrospective and observational study. We analyzed the efficacy of LMP for the treatment of TN between March 2019 and January 2022. The follow-up time was approximately 2 weeks, 1 month, 2 months, and 3 months after LMP treatment. The LMP response was considered the Barrow Neurological Institute (BNI) score of I to III and an improvement in BNI of at least I grade from pretreatment baseline. Univariable and multivariable logistic analyses were performed to identify the predictive factors for LMP response. Results: A total of 103 patients were included and analyzed in this study. LMP was effective in some TN patients, with an efficacy rate of 21.4%, 21.4%, 18.4%, and 16.5% after 2 weeks, 1 month, 2 months, and 3 months of LMP treatment, respectively. The overall adverse event rate associated with LMP was 5.8%, and the reported adverse events were all skin reactions. Facial trigger points (odds ratio [OR] = 0.25, 95% confidence interval [CI] = 0.07-0.86, P = 0.03) and a lower BNI score (OR = 0.37, 95% CI = 0.07-0.87, P = 0.01) were identified as potential predictors for initial efficacy (2-week follow-up) of LMP treatment. Conclusions and Relevance: LMP has been shown to provide effective and sustained analgesia in some TN patients with minimal risk of systemic adverse reactions. Patients with facial trigger points and mild to moderate pain are more likely to benefit from LMP treatment. Our data suggest that LMP may be an effective treatment option for patients with the aforementioned characteristics of TN.
Haemodialysis access profile in failed kidney transplant patients: Analysis of data from the Catalan Renal Registry (1998–2016)
Authors: Roca-Tey Ramon , Arcos Emma , Comas Jordi , Tort Jaume 
Published: August 2022

Background: Data about vascular access (VA) use in failed kidney transplant (KT) patients returning to haemodialysis (HD) are limited. We analysed the VA profile of these patients, the factors associated with the likelihood of HD re-initiation through fistula (AVF) and the effect of VA in use at the time of KT on kidney graft (KTx) outcome. Method: Data from the Catalan Registry on failed KT patients restarting HD and incident HD patients with native kidney failure were examined over an 18-year period. Results: The VA profile of 675 failed KT patients at HD re-initiation compared with that before KT and with 16,731 incident patients starting HD was (%): AVF 79.3 versus 88.6 and 46.2 ( p = 0.001 and p < 0.001), graft AVG 4.4 versus 2.6 and 1.1 ( p = 0.08 and p < 0.001), tunnelled catheter TCC 12.4 versus 5.5 and 18.0 ( p = 0.001 and p < 0.001) and non-tunnelled catheter 3.9 versus 3.3 and 34.7 ( p = 0.56 and p < 0.001). The likelihood of HD re-initiation by AVF was significantly lower in patients with cardiovascular disease, KT duration >5 years, dialysed through AVG or TCC before KT, and females. The analysis of Kaplan-Meier curves showed a greater KTx survival in patients dialysed through arteriovenous access than in patients using catheter just before KT (λ2 = 5.59, p = 0.0181, log-rank test). Cox regression analysis showed that patients on HD through arteriovenous access at the time of KT had lower probability of KTx loss compared to those with catheter (hazard ratio 0.71, 95% CI 0.55–0.90, p = 0.005). Conclusions: The VA profile of failed KT patients returning to HD and incident patients starting HD was different. Compared to before KT, the proportion of failed KT patients restarting HD with AVF decreased significantly at the expense of TCC. Patients on HD through arteriovenous access at the time of KT showed greater KTx survival compared with those using catheter.
State-level heterogeneity in associations between structural stigma and individual health care access: A multilevel analysis of transgender adults in the United States
Authors: Tran Nguyen K , Baker Kellan E , Lett Elle , Scheim Ayden I 
Published: August 2022

Objective State-level variation in how restrictive policies affect health care access for transgender populations has not been widely studied. Therefore, we assessed the association between structural stigma and four measures of individual health care access among transgender people in the United States, and the extent to which structural stigma explains state-level variability. Methods Data were drawn from the 2015–2019 Behavioral Risk Factor Surveillance System and the Human Rights Campaign’s State Equality Index. We calculated weighted proportions and conducted multilevel logistic regression of individual heterogeneity and discriminatory accuracy. Results An increase in the structural stigma score by one standard deviation was associated with lower odds of health care coverage (OR = 0.80; 95% CI: 0.66, 0.96) after adjusting for individual-level confounders. Approximately 11% of the total variance for insurance coverage was attributable to the state level; however, only 18% of state-level variability was explained by structural stigma. Adding Medicaid expansion attenuated the structural stigma-insurance association and explained 22% of state-level variation in health insurance. For the remaining outcomes (usual source of care, routine medical check-up, and cost-related barriers), we found neither meaningful associations nor considerable between-state variability. Conclusions Our findings support the importance of Medicaid expansion and transgender-inclusive antidiscrimination protections to enhance health care insurance coverage. From a measurement perspective, however, additional research is needed to develop and validate measures of transgender-specific structural stigma to guide future policy interventions.
Discordance in tests used to detect inhibition of the P2Y12 receptor in patients undergoing interventional neuroradiology procedures
Authors: Gegri Mansour , Cheves Tracey A , Anderson Matthew N , McTaggart Ryan , Sweeney Joseph D 
Published: August 2022

Background Clopidogrel is an inhibitor of the P2Y12 platelet receptor but testing to demonstrate a drug effect is controversial since there are often discordant results between different tests methods. Methods Samples from patients taking clopidogrel prior to intracranial flow-diversion procedures were tested using light transmission aggregometry (LTA), whole blood impedance aggregometry (WBIA) and the VerifyNow device (VND). Samples were classified as concordant if all test results were either responsive (inhibition) or resistant. Discordant results were separated using the VND into those with a responsive versus a resistant test result. Results Samples from 96 patients were studied. Concordance for all three tests was seen in 53/96 (55%) of samples, of which 41 (43%) were responsive and 12 (12%) were resistant. Discordance was observed in 43 samples (45%), 37 (28%) of which were caused by responsive VND and either a resistant WBIA or LTA and 6 (7%) of which were caused by a resistant VND but a responsive test result using either WBIA or LTA. These two discordant groups differed in both platelet count and hematocrit, but no such difference was present between the two concordant groups. Conclusion Discordance in P2Y12 inhibition testing may be partly explained by sample platelet count and hematocrit.
Psychological sequelae of hand injuries: an integrative review
Authors: Maddison Kay , Perry Lin , Debono Deborah 
Published: August 2022

This integrative review investigated reports of psychological impact and sequelae of traumatic hand injuries. A systematic search using Medline, PsychINFO, PubMed, EMBASE, CINAHL and hand-searching methods was conducted from 2008 to 2020. Nine included articles with a total of 503 participants were reported in prospective cross-sectional or longitudinal cohort studies. Depression and anxiety were common, affecting between 7% and 71% and between 23% and 71% of patients, respectively. Post-traumatic stress disorder affected between 3% and 95% of patients. Factors reported predicting psychological sequelae of hand injuries included injury severity, pain, limb dysfunction, negative perceptions of injured limbs, suboptimal coping mechanisms and limited social support. Symptoms persisted for protracted periods of follow-up but broadly attenuated after 3 months. We conclude that the high prevalence and enduring nature of psychological symptoms demonstrate an urgent need for further research to optimize treatment. Level of evidence: III
Investigating Accessibility of Hospitals in Cold Regions: A Case Study of Harbin in China
Authors: Wu Yue , Xia Lei , He Jun , Meng Qi , Yang Da , Liu Fangfang , Liu Nan 
Published: August 2022

Objective: The objective of this study is to explore healthcare resource accessibility in Harbin, a typical city in a cold region in China. Background: Recently, investments in the construction of medical resources have been increasing annually in China, and consequently, the allocation of these resources has improved. Snow and ice on surfaces in China’s cold regions have certain effects on the traffic capacity of urban roads, leading to a great difference in the accessibility of medical resources in winter and summer. Methods: The basic spatial data, including spatial road data, medical facility data, and population distribution data, are analyzed using geographic information system. Then, a spatial barrier model is used to measure healthcare accessibility based on geographic and population weighting; we explore the accessibility of hospitals under the influence of weather by defining a novel distance attenuation function. Finally, the accessibility of medical institutions in the study area is explored by analyzing data about the related separation factors. Results: It was found that the spatial distribution of medical resources was not equal, and the dominant resources were concentrated in the city center. Some regions are always in an advantageous position regardless of traffic conditions. In contrast, in areas far from the city center, the accessibility of medical resources significantly decreases in winter. Conclusions: These results will help optimize the layout of medical institutions and improve medical equality and propose strategies for the optimization of the accessibility of urban medical institutions in cold regions of China.
Early Outcomes of Combined Total Ankle Total Talus Replacement Using a 3D-Printed Talus Component With Hindfoot Arthrodesis
Authors: Madi Naji S. , Fletcher Amanda N. , Pereira Gregory F. , Balu Abhinav , DeOrio James K. , Parekh Selene G. 
Published: August 2022

Late-stage talar avascular necrosis (AVN) results in devascularization of the talus with osteonecrosis and subchondral collapse. A combined total ankle and total talus replacement (TATTR) with hindfoot arthrodesis may be utilized for end-stage talar AVN with tibiotalar and hindfoot joint arthritis. The purpose of this study is to evaluate the short-term outcomes of combined TATTR with hindfoot arthrodesis. Patients who underwent a combined TATTR or TTR with a hindfoot arthrodesis (subtalar with or without talonavicular arthrodesis) from 2016 to 2020 were retrospectively reviewed. Patient demographics, comorbidities, and surgical data were collected. Outcomes included the Visual Analog Scale (VAS) scores, range of motion, radiographic parameters, union rates, and complications. A total of 18 patients were reviewed. Nine patients were included with an average of 19.4 months follow-up. Significant postoperative improvements were observed in VAS scores (P < .001), ankle plantarflexion (P = .04), talocalcaneal height (P = .03), and tibiotalar alignment (P = .02). All patients achieved a successful union of their subtalar and talonavicular joints arthrodesis. There was one reoperation for a persistent varus ankle deformity. This is the first study to evaluate the clinical outcomes, radiographic outcomes, and union rate in combined TATTR with hindfoot arthrodesis. The early results demonstrated significant clinical improvement with 100% hindfoot union rate and no prosthetic failure. Level of Evidence: IV
Approaches to reducing fragmented care in systemic lupus erythematosus (SLE) and other multimorbid conditions: A realist review
Authors: Sumpter IJ , Phillips SM , Magwood GS 
Published: August 2022

Introduction Fragmented care overwhelmingly affects populations with multimorbid chronic conditions, like systemic lupus erythematosus (SLE). However, strategies to mitigate care fragmentation typically focus on singular disease frameworks with insufficient evidence regarding approaches for individuals with two or more concurrent chronic conditions (multimorbidity). This review explores the literature to identify the (C)ontextual influences, underlying (M)echanisms, and associated (O)utcomes of fragmented care prevention in SLE and other multimorbid conditions. Methods A realist review was applied to systematically examine literature, including the search of >1300 published articles focused on SLE and multimorbidity, continuity of care, and approaches to mitigate fragmented care. The analysis was guided by care continuity elements and organized by fragmented care concepts explicated by the MacColl Institute for Healthcare Innovations Care Coordination Model and further grouped for context–mechanism–outcome (CMO) configurations. Results Fourteen articles met inclusion/exclusion criteria and were included in the sample to illustrate the relationship between C-M-O for approaches focused on fragmented care prevention. Favorable outcomes in mechanisms that produced positive responses to resources relevant to fragmented care prevention included 1) opportunities for exposure and negotiation within professional teams, 2) structured health education, role clarity, and access to adherence services for patients, and 3) awareness of workflow waste and use of clinical algorithms. Discussion Review findings suggest using a multidimensional approach to mitigate fragmented care in SLE and other multimorbid conditions. Multidimensional approaches should focus on shared decision-making, social support, social–cultural–economic factors, patient engagement, and technological infrastructure to support the complex care needs of the multimorbid patient.