bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid sparing effect of ketamine in military prehospital pain management—A retrospective study
Authors: Cohen Bar , Talmy Tomer , Gelikas Shaul , Radomislensky Irina , Kontorovich-Chen Diana , Cohen Barak , Benov Avi , Avital Guy 
Published: May 2022

BACKGROUND
Opioids are the most commonly used analgesics in acute trauma, but are limited by slow onset and significant adverse effects. Ketamine is an effective and widely used analgesic. This study was aimed to evaluate the effectiveness and opioid-sparing effects of ketamine when used in prehospital military trauma setting.

METHODS
A retrospective analysis of a prehospital military trauma registry between 2014 and 2020. Inclusion criteria were 16 years or older, two or more documented pain assessments, at least one indicating severe pain, and administration of opioids and/or low-dose ketamine. Joint hypothesis testing was used to compare casualties who received opioids only to those who received ketamine on outcomes of pain score reduction and opioid consumption.

RESULTS
Overall, 382 casualties were included. Ninety-one (24%) received ketamine (21 as a single analgesic), with a mean dose of 29 mg (standard deviation, 11). Mean reduction in pain scores (on an 11-point scale) was not significantly different; 4.3-point (2.8) reduction in the ketamine group and 3.7 points (2.4) in the opioid-only group (p = 0.095). Casualties in the ketamine group received a median of 10 mg (interquartile range, 3.5–25) of morphine equivalents (MEs) compared with a median of 20 ME (10, 20) in the opioid-only group. In a multivariable multinomial logistic regression, casualties in the ketamine group were significantly more likely to receive a low (1–10 ME) rather than a medium (11–20 ME) dose of opioids compared with the opioid-only group (odds ratio, 0.032; 95% confidence interval, 0.14–0.75).

CONCLUSION
The use of ketamine in the prehospital military setting as part of a pain management protocol was associated with a low rather than medium dose of opioids in a multivariable analysis, while the mean reduction in pain scores was not significantly different between groups. Using ketamine as a first-line agent may further reduce opioid consumption with a similar analgesic effect.

LEVEL OF EVIDENCE
Therapeutic/care management; Level IV.
Measuring Real-Time Medication Effects From Electroencephalography
Authors: Sathyanarayana Aarti , El Atrache Rima , Jackson Michele , Cantley Sarah , Reece Latania , Ufongene Claire , Loddenkemper Tobias , Mandl Kenneth D. , Bosl William J. 
Published: May 2022

Purpose:
Evaluating the effects of antiseizure medication (ASM) on patients with epilepsy remains a slow and challenging process. Quantifiable noninvasive markers that are measurable in real-time and provide objective and useful information could guide clinical decision-making. We examined whether the effect of ASM on patients with epilepsy can be quantitatively measured in real-time from EEGs.

Methods:
This retrospective analysis was conducted on 67 patients in the long-term monitoring unit at Boston Children's Hospital. Two 30-second EEG segments were selected from each patient premedication and postmedication weaning for analysis. Nonlinear measures including entropy and recurrence quantitative analysis values were computed for each segment and compared before and after medication weaning.

Results:
Our study found that ASM effects on the brain were measurable by nonlinear recurrence quantitative analysis on EEGs. Highly significant differences (P < 1e-11) were found in several nonlinear measures within the seizure zone in response to antiseizure medication. Moreover, the size of the medication effect correlated with a patient's seizure frequency, seizure localization, number of medications, and reported seizure frequency reduction on medication.

Conclusions:
Our findings show the promise of digital biomarkers to measure medication effects and epileptogenicity.
ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia
Authors: Lowit Anja , Cox Jessica , Loucas Melissa , Grassly Jennifer , Egan Aisling , van Brenk Frits , Hadjivassiliou Marios 
Published: May 2022

AbstractBackgroundProgressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach.A new model of care – ClearSpeechTogether – is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias.MethodThe study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over two weeks followed by 20 patient-led group sessions over four weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation.ResultsNine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved intelligibility for reading, and increased participation and confidence. Participant interviews highlighted the value of group support, from psychosocial perspectives and in supporting speech strategy internalisation and generalisation.DiscussionClearSpeechTogether presented an effective intervention in a small group of people with progressive ataxia. It matched or exceeded the outcomes previously reported for intensive, individual therapy while minimising clinician time demands. Furthermore, its unique peer led group intervention design appeared effective in addressing intractable psychosocial issues. ClearSpeechTogether is potentially cost-effective, providing intensive delivery with few clinician sessions, thus maximising the input available from health care providers.
Rasch Validation of the Revised Body Awareness Rating Questionnaire (BARQ-R) in Adults with Musculoskeletal Pain, Adults with Spinal Cord Injury, and Community-Dwelling Adults in the US
Authors: Carpentier Sydney , Deng Wei , Blackwood Jena , Van de Winckel Ann 
Published: May 2022

ABSTRACTBackgroundTo establish Rasch validation of the Revised Body Awareness Rating Questionnaire (BARQ-R) in adults with musculoskeletal pain, community-dwelling adults without pain, and adults with spinal cord injury (SCI) who have neuropathic pain.Materials and MethodThe BARQ-R has 12 items with scores ranging from 0 (completely disagree) to 3 (completely agree). Through Rasch analysis, we evaluated unidimensionality through item and person fit, targeting of the population, person separation reliability (PSR), local item dependence (LID), and principal components analysis of residuals (PCAR).ResultsThe BARQ-R in adults with musculoskeletal pain (n=152; average age = 52.26±16.13 years) showed good targeting (person mean location: -0.36±0.88 logits), minimal floor effect (0.01%), and no ceiling effect (0.00%) and had good reliability (PSR=0.75). The BARQ-R in community-dwelling adults (n=471; average age = 49.63±17.57 years) had a person mean location of -0.62±1.09 logits, minimal floor (2.63%), and minimal ceiling effect (0.43%) after rescoring 2 items and deleting 3 items and had good reliability (PSR=0.74). The BARQ-R in adults with SCI-related neuropathic pain (n=44; average age = 55.45±13.47 years) showed good targeting after rescoring 7 items (person mean location: -0.33±0.71 logits), no floor effect (0.00%) or ceiling effect (0.00%) but had poor reliability (PSR=0.65).ConclusionsThe BARQ-R shows sufficient fit to be used in clinical settings for group decision-making for both adults with musculoskeletal pain and community-dwelling adults. However, in adults with SCI-related neuropathic pain, preliminary Rasch analysis of the BARQ-R showed low reliability and therefore the BARQ-R is not recommended for clinical use in that population. Validation in larger groups of adults with SCI as well as more diverse samples are needed.
Exploring biomarkers of processing speed and executive function: the role of the anterior thalamic radiations
Authors: Ferris Jennifer , Greeley Brian , Yeganeh Negin Motamed , Rinat Shie , Ramirez Joel , Black Sandra , Boyd Lara 
Published: May 2022

AbstractIntroductionProcessing speed and executive functioning are often impaired after stroke and in typical aging. However, there are no reliable neurological markers of these cognitive impairments. The trail making test (TMT) is a common index of processing speed and executive function. Here, we tested candidate MRI markers of TMT performance in a cohort of older adults and individuals with chronic stroke.MethodsIn 61 older adults and 32 individuals with chronic stroke, we indexed white matter structure with region-specific lesion load (WMH and stroke lesions) and diffusion tensor imaging (DTI) from four regions related to TMT performance: the anterior thalamic radiations (ATR), superior longitudinal fasciculus (SLF), forceps minor, and cholinergic pathways. Regression modelling was used to identify the marker(s) that best predicted TMT performance.ResultsDTI metrics of the ATR predicted processing speed in both the older adult (TMT A: β=-3.431, p<0.001) and chronic stroke (TMT A: β=11.282, p<0.001) groups. In the stroke group executive function was best predicted by a combination of ATR and forceps minor DTI metrics in the chronic stroke group (TMT B: adjustedR2=0.438, p<0.001); no significant predictors of executive function (TMT B) emerged in the older adult group. No imaging metrics related to set shifting (TMT B-A). For all TMT outcome measures with significant imaging predictors, regional DTI metrics predicted TMT performance above and beyond whole-brain stroke and WMH volumes and removing whole-brain lesion volumes improved model fits.ConclusionsIn this comprehensive assessment of candidate imaging markers, we demonstrate an association between ATR microstructure and processing speed and executive function performance. Regional DTI metrics provided better predictors of cognitive performance than whole-brain lesion volumes or regional lesion load, emphasizing the importance of lesion location in understanding cognition. We propose ATR DTI metrics as novel candidate imaging biomarker of post-stroke cognitive impairment.
Compellingly high SARS-CoV-2 susceptibility of Golden Syrian hamsters suggests multiple zoonotic infections of pet hamsters during the COVID-19 pandemic
Authors: Blaurock Claudia , Breithaupt Angele , Weber Saskia , Wylezich Claudia , Keller Markus , Mohl Björn-Patrick , Görlich Dirk , Groschup Martin H. , Sadeghi Balal , Höper Dirk , Mettenleiter Thomas C. , Balkema-Buschmann Anne 
Published: May 2022

AbstractGolden Syrian hamsters (Mesocricetus auratus) are used as a research model for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Millions of Golden Syrian hamsters are also kept as pets in close contact to humans. To determine the minimum infective dose (MID) for assessing the zoonotic transmission risk, and to define the optimal infection dose for experimental studies, we orotracheally inoculated hamsters with SARS-CoV-2 doses from 1*105 to 1*10−4 tissue culture infectious dose 50 (TCID50). Body weight and virus shedding were monitored daily. 1*10−3 TCID50 was defined as the MID, and this was still sufficient to induce virus shedding at levels up to 102.75 TCID50/ml, equaling the estimated MID for humans. Virological and histological data revealed 1*102 TCID50 as the optimal dose for experimental infections. This compellingly high susceptibility resulting in productive infections in Golden Syrian hamsters needs to be considered also as a source of SARS-CoV-2 infections in humans.
Spinal cord damage in Friedreich’s ataxia: Results from the ENIGMA-Ataxia
Authors: Rezende Thiago JR , Adanyeguh Isaac M , Arrigoni Filippo , Bender Benjamin , Cendes Fernando , Corben Louise A , Deistung Andreas , Delatycki Martin , Dogan Imis , Egan Gary F , Göricke Sophia L , Georgiou-Karistianis Nellie , Henry Pierre-Gilles , Hutter Diane , Jahanshad Neda , Joers James M , Lenglet Christophe , Lindig Tobias , Martinez Alberto RM , Martinuzzi Andrea , Paparella Gabriella , Peruzzo Denis , Reetz Kathrin , Romanzetti Sandro , Schöls Ludger , Schulz Jörg B , Synofzik Matthis , Thomopoulos Sophia I , Thompson Paul M , Timmann Dagmar , Harding Ian H , França Marcondes C. 
Published: May 2022

AbstractObjectiveSpinal cord damage is a hallmark of Friedreich ataxia (FRDA), but its progression and clinical correlates remain unclear. Here we performed a characterization of cervical spinal cord structural abnormalities in a large multisite FRDA cohort.MethodsWe performed a cross-sectional analysis of cervical spinal cord (C1 to C4) cross-sectional area (CSA) and eccentricity using MRI data from eight sites within the ENIGMA-Ataxia initiative, including 256 individuals with FRDA and 223 age- and sex-matched controls. Correlations and subgroup analyses within the FRDA cohort were undertaken based on disease duration, ataxia severity, and onset age.ResultsIndividuals with FRDA, relative to controls, had significantly reduced CSA at all examined levels, with large effect sizes (d>2.1) and significant correlations with disease severity (r<-0.4). Similarly, we found significantly increased eccentricity (d>1.2), but without significant clinical correlations. Subgroup analyses showed that CSA and eccentricity are abnormal at all disease stages. However, while CSA appears to decrease progressively, eccentricity remains stable over time.InterpretationPrevious research has shown that increased eccentricity reflects dorsal column (DC) damage, while decreased CSA reflects either DC or corticospinal tract (CST) damage or both. Hence, our data support the hypothesis that damage to DC and CST follow distinct courses in FRDA: developmental abnormalities likely define the DC, whereas CST alterations may be both developmental and degenerative. These results provide new insights about FRDA pathogenesis and indicate that CSA of the cervical spinal cord should be investigated further as a potential biomarker of disease progression.
Weakly supervised and transfer learning for adenocarcinoma classification in transurethral resection of the prostate whole slide images
Authors: Tsuneki Masayuki , Abe Makoto , Kanavati Fahdi 
Published: May 2022

AbstractThe transurethral resection of the prostate (TUR-P) is generally considered an option for benign prostatic diseases especially nodular hyperplasia patients who have moderate to severe urinary problems that have not responded to medication. Importantly, incidental prostate cancer are diagnosed at the time of TUR-P for benign prostatic disease. Since diagnosing a large number of cases containing TUR-P specimens which are characterized by a very large volume of tissue fragments by pathologists using a conventional microscope is time-consuming and limited in terms of human resources. Thus, it is necessary to develop new techniques which can rapidly and accurately screen large numbers of TUR-P specimens. Computational pathology applications which can assist pathologists in detecting prostate adenocarcinoma from TUR-P whole slide images (WSIs) would be of great benefit for routine histopathological workflow. In this study, we trained deep learning models to classify TUR-P WSIs into prostate adenocarcinoma and benign (non-neoplastic) lesions using transfer and weakly supervised learning. We evaluated the models on TUR-P, needle biopsy, and The Cancer Genome Atlas (TCGA) public dataset test sets, achieving an ROC-AUC up to 0.984 in TUR-P test sets for adenocarcinoma. The results demonstrate the high promising potential of deployment in a practical TUR-P histopathological diagnostic workflow system.
Geospatial distribution of Hepatitis B prevention services in Wakiso District, Central Uganda
Authors: Ssekamatte Tonny , Isunju John Bosco , Nalugya Aisha , Wafula Solomon Tsebeni , Nuwematsiko Rebecca , Doreen Nakalembe , Kansiime Winnifred K. , Naume Muyanga , Nakiggala Joana , Bukenya Justine N. , Mugambe Richard K. 
Published: May 2022

AbstractIntroductionDespite global and national efforts in place for the prevention and control of Hepatitis B, there remains a gap in access to hepatitis B prevention services such as testing and vaccination. Nonetheless, there is limited evidence of the geospatial distribution of Hepatitis B services. This study established the geospatial distribution of HBV vaccination services in Wakiso District, Uganda.Materials and methodsA cross-sectional quantitative descriptive study was conducted among 55 healthcare facilities including 6 hospitals, and 49 primary care facilities in Wakiso district. Data were collected using the KoboCollect application. Quantitative data were analysed using STATA 14.0. A chi-square test was performed to establish the relationship between healthcare facility characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used for analysis of geospatial data.ResultsThe hepatitis B vaccine was available in only 27.3 % (15) of the facilities, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level of healthcare facility (p=≤0.001) and location (p=0.030). Availability of the Hepatitis B vaccines at the time of the survey was associated with the level of healthcare facility (p=0.002) and location (p=0.010). Availability of hepatitis B testing services was associated with level of healthcare facility (p=0.031), ownership (p≤0.001) and location (p=0.010). Healthcare facilities offering vaccination and testing services were mostly in urban healthcare facilities, and close to Kampala, Uganda’s capital.ConclusionHepatitis B services were sub-optimal across all healthcare facility levels, locations, and ownership. The majority of the hepatitis B prevention services were provided in urban settings, close to major towns, municipalities, and the city. This calls a extension of hepatitis B prevention services to rural, public and PNFP healthcare facilities.
Association of Sedentary and Physical Activity Behaviors with Body Composition: a Genome-Wide Association and Mendelian Randomization Study
Authors: Ramadan Ferris , Bea Jennifer W. , Garcia David O. , Ellingson Katherine , Canales Robert A. , Raichlen David A. , Klimentidis Yann C. 
Published: May 2022

ABSTRACTObjectivesStudies suggest that body composition can be independently improved through physical activity (PA). We performed a Mendelian randomization (MR) study to test the incremental benefits of sedentary behavior and various physical activity (PA) exposures on body composition outcomes as assessed by anthropometric indices, lean body mass (LBM) (kg), body fat (%), and visceral adipose tissue (VAT) (kg).MethodsGenetic instruments were identified for both self-reported and accelerometer-measured sedentary behavior and PA. Outcomes included anthropometric and dual-energy X-ray absorptiometry measures of adiposity, extracted from the UK Biobank and the largest available consortia. Multivariable MR (MVMR) included educational attainment as a covariate to address potential confounding. Sensitivity analyses were evaluated for weak instrument bias and pleiotropic effects.ResultsWe did not identify consistent associations between genetically-predicted self-reported and accelerometer-measured sedentary behavior and body composition outcomes. All analyses for self-reported moderate PA were null for body composition outcomes. Genetically-predicted PA at higher intensities was protective against VAT in MR and MVMR analyses of both accelerometer-measured vigorous PA (MVMR β = -0.15, 95% Confidence Interval (CI): -0.24, -0.07, p<0.001) and self-reported participation in strenuous sports or other exercises (MVMR β = -0.27, 95%CI: -0.52, -0.01, p=0.034) was robust across several sensitivity analyses.ConclusionsWe did not identify evidence of a causal relationship between genetically-predicted PA and body composition, with the exception of a putatively protective effect of higher-intensity PA on VAT. Protective effects of PA against VAT may support prior evidence of biological pathways through which PA decreases risk of downstream cardiometabolic diseases.
Heterozygous and homozygous variants in STX1A cause a neurodevelopmental disorder with or without epilepsy
Authors: Luppe Johannes , Sticht Heinrich , Lecoquierre François , Goldenberg Alice , Gorman Kathleen , Molloy Ben , Agolini Emanuele , Novelli Antonio , Briuglia Silvana , Kuismin Outi , Marcelis Carlo , Vitobello Antonio , Denommé-Pichon Anne-Sophie , Julia Sophie , Lemke Johannes R. , Jamra Rami Abou , Platzer Konrad 
Published: May 2022

AbstractThe neuronal SNARE complex drive synaptic vesicle exocytosis. Therefore, one of its core proteins syntaxin 1A (STX1A) has long been suspected to play a role in neurodevelopmental disorders. We assembled eight individuals harboring rare variants in STX1A who present with a spectrum of intellectual, autism and epilepsy. Causative variants comprise a homozygous splice variant, three de novo missense variants and two inframe deletions of a single amino acid. We observed a phenotype mainly driven by epilepsy in the individuals with missense variants in contrast to intellectual disability and autistic behavior in individuals with single amino acid deletions and the splicing variant. In silico modeling of missense variants and single amino acid deletions show different impaired protein-protein interactions. We hypothesize the two phenotypic courses of affected individuals to be dependent on two different pathogenic mechanisms: (1) a weakened inhibitory STX1A-STXBP1 interaction due to missense variants results in an STX1A-related developmental epileptic encephalopathy and (2) a hampered SNARE complex formation due to inframe deletions causes an STX1A-related intellectual disability and autism phenotype.
Genetic diversity and spatiotemporal distribution of SARS-CoV-2 alpha variant in India
Authors: Parasar Jahnavi , Pandey Rudra Kumar , Patel Yashvant , Singh Prajjval Pratap , Srivastava Anshika , Mishra Rahul , Kumar Bhupendra , Rai Niraj , Mishra Vijay Nath , Shrivastava Pankaj , Suravajhala Prashanth , Chaubey Gyaneshwer 
Published: May 2022

AbstractAfter the spill to humans, in the timeline of SARS-CoV-2, several positively selected variants have emerged. A phylogeographic study on these variants can reveal their spatial and temporal distribution. In December 2020, the alpha variant of the severe acute respiratory syndrome coronavirus (SARS-CoV-2), which has been designated as a variant of concern (VOC) by WHO, was discovered in the southeastern United Kingdom (UK). Slowly, it expanded across India, with a considerable number of cases, particularly in North India. The study focuses on determining the prevalence and expansion of the alpha variants in various parts of India. The genetic diversity estimation helped us understand various evolutionary forces that have shaped the spatial distribution of this variant during the peak. Overall, our study paves the way to understand the evolution and expansion of a virus variant.