bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variability of Prognostic Communication in Critically Ill Neurologic Patients: A Pilot Multicenter Mixed-Methods Study
Authors: Ge Connie , Goss Adeline L. , Crawford Sybil , Goostrey Kelsey , Buddadhumaruk Praewpannarai , Shields Anne-Marie , Hough Catherine L. , Lo Bernard , Carson Shannon S. , Steingrub Jay , White Douglas B. , Muehlschlegel Susanne 
Published: February 2022

IMPORTANCE:
Withdrawal-of-life-sustaining treatments (WOLST) rates vary widely among critically ill neurologic patients (CINPs) and cannot be solely attributed to patient and family characteristics. Research in general critical care has shown that clinicians prognosticate to families with high variability. Little is known about how clinicians disclose prognosis to families of CINPs, and whether any associations exist with WOLST.

OBJECTIVES:
Primary: to demonstrate feasibility of audio-recording clinician-family meetings for CINPs at multiple centers and characterize how clinicians communicate prognosis during these meetings. Secondary: to explore associations of 1) clinician, family, or patient characteristics with clinicians’ prognostication approaches and 2) prognostication approach and WOLST.

DESIGN, SETTING, AND PARTICIPANTS:
Forty-three audio-recorded clinician-family meetings during which prognosis was discussed from seven U.S. centers for 39 CINPs with 88 family members and 27 clinicians.

MAIN OUTCOMES AND MEASURES:
Two investigators qualitatively coded transcripts using inductive methods (inter-rater reliability > 80%) to characterize how clinicians prognosticate. We then applied univariate and multivariable multinomial and binomial logistic regression.

RESULTS:
Clinicians used four distinct prognostication approaches: Authoritative (21%; recommending treatments without discussing values and preferences); Informational (23%; disclosing just the prognosis without further discussions); advisory (42%; disclosing prognosis followed by discussion of values and preferences); and responsive (14%; eliciting values and preferences, then disclosing prognosis). Before adjustment, prognostication approach was associated with center (p < 0.001), clinician specialty (neurointensivists vs non-neurointensivists; p = 0.001), patient age (p = 0.08), diagnosis (p = 0.059), and meeting length (p = 0.03). After adjustment, only clinician specialty independently predicted prognostication approach (p = 0.027). WOLST decisions occurred in 41% of patients and were most common under the advisory approach (56%). WOLST was more likely in older patients (p = 0.059) and with more experienced clinicians (p = 0.07). Prognostication approach was not independently associated with WOLST (p = 0.198).

CONCLUSIONS AND RELEVANCE:
It is feasible to audio-record sensitive clinician-family meetings about CINPs in multiple ICUs. We found that clinicians prognosticate with high variability. Our data suggest that larger studies are warranted in CINPs to examine the role of clinicians’ variable prognostication in WOLST decisions.
Excessive gestational weight gain in early pregnancy and insufficient gestational weight gain in middle pregnancy increased risk of gestational diabetes mellitus
Authors: Yin Aiqi , Tian Fuying , Wu Xiaoxia , Chen Yixuan , Liu Kan , Tong Jianing , Guan Xiaonian , Zhang Huafan , Wu Linlin , Niu Jianmin 
Published: February 2022

Abstract

Background:
Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters.

Methods:
A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.

Results:
In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found (P = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) (F = 1.268; P = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%.

Conclusions:
eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy.
A Case of Probable Multifocal Motor Neuropathy With Clinical Stability for Ten Years After a Single Treatment of Rituximab
Authors: Gonzalez Natalia L. , Juel Vern C. , Živković Saša A. 
Published: February 2022

Abstract
Multifocal motor neuropathy is a rare, immune-mediated motor neuropathy with asymmetric, often debilitating progressive weakness. The efficacy of intravenous immunoglobulin in this disease is well established; however, the response typically wanes over time. No other agent has shown similar therapeutic efficacy. We describe a case of anti-ganglioside GM1 IgM-positive multifocal motor neuropathy with typical incomplete and diminishing response to intravenous immunoglobulin over time. Sixteen years after symptom onset, rituximab was administered at 2 g/m2 over 2 weeks. No significant progression of disease has occurred over the following 10 years despite no additional treatments, including intravenous immunoglobulin, being given. Only case reports and small, mostly uncontrolled studies have reported the use of rituximab in multifocal motor neuropathy with mixed results. However, given its potential benefits and lack of an established second-line agent, treatment with rituximab may be considered in select patients with refractory multifocal motor neuropathy.
Multiple Cranial Nerve Enhancement in Guillain–Barre Syndrome With Clinicoradiological Dissociation
Authors: Kesav Praveen , John Seby , Dogar Mohammad A. , Al-Sharif Khalid , Hussain Zulfiqar 
Published: February 2022

Abstract
Guillain-Barre Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy which can lead to rapid neuromuscular respiratory failure, with an estimated annual incidence of 1-2 per 100,000 person-years. Even though cranial nerve involvement is known to occur in GBS, radiological correlation on neuroimaging studies are less frequently reported in pediatric population. We hereby report the case of a 14-year-old boy with acute motor axonal neuropathy variant of GBS, who had extensive contrast enhancement of multiple cranial nerves on Magnetic Resonance Imaging brain, associated with clinicoradiological dissociation on presentation.
The P value plot does not provide evidence against air pollution hazards
Authors: Hicks Daniel J. 
Published: February 2022

Background:
A number of papers by Young and collaborators have criticized epidemiological studies and meta-analyses of air pollution hazards using a graphical method that the authors call a P value plot, claiming to find zero effects, heterogeneity, and P hacking. However, the P value plot method has not been validated in a peer-reviewed publication. The aim of this study was to investigate the statistical and evidentiary properties of this method.

Methods:
A simulation was developed to create studies and meta-analyses with known real effects

, integrating two quantifiable conceptions of evidence from the philosophy of science literature. The simulation and analysis is publicly available and automatically reproduced.

Results:
In this simulation, the plot did not provide evidence for heterogeneity or P hacking with respect to any condition. Under the right conditions, the plot can provide evidence of zero effects; but these conditions are not satisfied in any actual use by Young and collaborators.

Conclusion:
The P value plot does not provide evidence to support the skeptical claims about air pollution hazards made by Young and collaborators.
Discovery of Third Possible Ion Generating Source in 4π Plasma Focus Device Space
Authors: Sohrabi Mehdi 
Published: February 2022

Abstract
Discovery of a possible third source of ion generation in 4π Plasma Focus Device (PFD) space is reported. Unexpected observation of dense ion tracks, called “On Shadow Ion Tracks” (OSIT), on the “ion cathode shadows” (ICS) was discovered. These ions were formed on panorama mega-size cylindrical polycarbonate ion image detectors placed behind the cathodes in the PFD space on PFD wall, where no ion tracks are expected to exist. Such unexpected ion tracks were observed when different gases were used, in particular hydrogen, deuterium, and helium. An ICS is formed on the detector when each cathode shadows and removes all ions bombarding it from the “anode top” and “anode cathodes assembly.” Such ion tracks forming the OSITs seem to be generated not from the “anode top” and “a node cathodes assembly” but also from a third possible ion source in PFD space bombarding the detector.
SAFETY AND THERAPEUTIC EFFECTS OF ORALLY ADMINISTERED AKST4290 IN NEWLY DIAGNOSED NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Stewart Michael W. , Garg Seema , Newman Erin M. , Jeffords Elizabeth , Konopińska Joanna , Jackson Sam , Sikorski Bartosz L. , Rawner Esther S. 
Published: February 2022

Purpose:
To evaluate the safety and therapeutic effects of orally administered AKST4290 (formerly BI 144807 and ALK4290) in treatment-naive patients with neovascular age-related macular degeneration.

Methods:
In this prospective, multicenter, open-label Phase 2a pilot clinical study, 30 patients with newly diagnosed neovascular age-related macular degeneration self-administered AKST4290 (400 mg) orally twice daily for 6 weeks. Patients were examined weekly for safety, to measure best-corrected visual acuity (BCVA), and to perform exploratory morphologic assessments. The primary endpoint was the mean change in BCVA from baseline to end of treatment, and the secondary endpoint was safety. Exploratory endpoints investigated potential changes in macular morphology.

Results:
Mean BCVA improved by +7.0 letters (95% CI, 2.2–11.7); 24 patients (82.8%) had stable or improved BCVA, with 6 (20.7%) gaining ≥15 letters. No patients experienced severe or serious adverse events.

Conclusion:
In this 6-week study, AKST4290 treatment was associated with improved BCVA scores in patients with treatment-naive neovascular age-related macular degeneration. All adverse events were mild or moderate in severity and no safety issues were identified. Treatment of neovascular age-related macular degeneration with AKST4290 warrants further investigation in randomized, placebo-controlled trials.
Sapovirus, Norovirus and Rotavirus Detections in Stool Samples of Hospitalized Finnish Children With and Without Acute Gastroenteritis
Authors: Pitkänen Oskari , Markkula Jukka , Hemming-Harlo Maria 
Published: February 2022

Background:
Sapovirus, norovirus and rotavirus are major causes of childhood acute gastroenteritis (AGE) globally. Asymptomatic infections of these viruses have not been extensively studied.

Aim:
To examine the prevalence and the genetic variations of sapovirus, norovirus and rotavirus in children with and without symptoms of AGE.

Methods:
We collected 999 stool samples from children under 16 years old from September 2009 to August 2011 at Tampere University Hospital, Finland. In total 442 children (44%) had symptoms of AGE and 557 patients (56%) had acute respiratory tract infection (ARTI) only. Samples were examined for sapovirus, norovirus and rotavirus using reverse transcription-polymerase chain reaction and the positive amplicons were sequenced.

Results:
Totally 54% and 14% of the patients in AGE and ARTI groups, respectively, tested positive. All viruses were more frequently detected in AGE patients than in ARTI patients (norovirus, 25% vs. 7.2%, respectively; rotavirus, 24% vs. 6.1%; sapovirus, 5.2% vs. 1.4%). In ARTI patients, the cases were seen most frequently during the first two years of life. Norovirus was the most detected pathogen in both groups with genogroup GII covering ≥97% of norovirus strains. Sapovirus was mostly detected in children under 18 months old without predominating genotype. Rotavirus was often detected after recent rotavirus vaccination and 18% and 88% of the strains were rotavirus vaccine-derived in AGE and ARTI groups, respectively.

Conclusions:
We showed that the most common viruses causing gastroenteritis in children may be found in the stools of an asymptomatic carrier which may function as a potential reservoir for AGE.
Psychometric Testing of the Newly Developed Competence Scale for Clinical Nurses
Authors: KAO Chia-Chan , CHAO Hsiu-Ling , LIU Yi-Hui , PAN I-Ju , YANG Li-Hui , CHEN Wan-I 
Published: February 2022

ABSTRACT

Background
Nursing competence is an essential element in ensuring high-quality nursing care and positive patient outcomes. Valid and reliable assessment tools for assessing nurse competence are needed to help nurse supervisors measure whether nurses are performing their job well and to provide a baseline for improving the competences of nurses.

Purpose
This study was designed to develop and psychometrically validate the Competence Scale for Clinical Nurses (CSCN).

Methods
The CSCN was developed in three steps: (a) generalize assessment items from nursing competence-related scales and a review of the relevant literature, (b) determine the content validity of the developed scale, and (c) psychometrically test the developed scale. Five hundred nurses were recruited from a medical center in southern Taiwan. Exploratory and confirmatory factor analyses were executed to analyze construct validity and internal consistency reliability.

Results
The scale-content validity index was .87, as determined by five experts. Two thirds (63.29%) of the variance was explained by three factors: basic care skills (nine items), being dedicated to work (five items), and patient-centered and ethical considerations (four items). A second-order confirmatory factor analysis indicated that the data fit the model well. The Cronbach's alpha coefficients for each of the three factors and the total scale were .84–.91.

Conclusions/Implications for Practice
The 18-item CSCN is a feasible and time-efficient tool for assessing competence in clinical nurses. Nursing supervisors may use this tool to explore nurses' competency and routinely track the effect of continuing education on competence. Continuous evaluation of nurses' clinical-based competence using the CSCN is recommended.
Role of ATP-dependent chromatin remodelers in hematopoietic stem and progenitor cell maintenance
Authors: Tu Zhaowei , Zheng Yi 
Published: February 2022

Purpose of review
ATP-dependent chromatin remodeling factors utilize energy from ATP hydrolysis to modulate DNA-histone structures and regulate gene transcription. They are essential during hematopoiesis and for hematopoietic stem and progenitor cell (HSPC) function. This review discusses the recently unveiled roles of these chromatin remodelers in HSPC regulation, with an emphasis on the mechanism of chromodomain helicase DNA-binding (CHD) family members.

Recent findings
Recent studies of ATP-dependent chromatin remodelers have revealed that individual CHD family members engage in distinct mechanisms in regulating HSPC cell fate. For example, CHD8 is required for HSPC survival by restricting both P53 transcriptional activity and protein stability in steady state hematopoiesis while the related CHD7 physically interacts with RUNX family transcription factor 1 (RUNX1) and suppresses RUNX1-induced expansion of HSPCs during blood development. Moreover, other CHD subfamily members such as CHD1/CHD2 and CHD3/CHD4, as well as the switch/sucrose non-fermentable, imitation SWI, and SWI2/SNF2 related (SWR) families of chromatin modulators, have also been found important for HSPC maintenance by distinct mechanisms.

Summary
The expanding knowledge of ATP-dependent chromatin remodelers in hematopoiesis illustrates their respective critical roles in HSPC maintenance including the regulation of HSPC differentiation, survival, and self-renewal. Further studies are warranted to elucidate how different chromatin remodeling complexes are integrated in various HSPC cell fate decisions during steady-state and stress hematopoiesis.
Meningeal Lymphatic vasculature in health and disease
Authors: Busch Nisha , O’Reilly Liam , Louveau Antoine 
Published: February 2022

Purpose of review
The recent (re)discovery of the meningeal lymphatic has brought a new player in brain neurophysiology. This review highlights the state of the current research on the meningeal lymphatic vasculature, from its specific physiology to its increasing implication in normal and pathological brain function.

Recent findings
Growing evidence are emerging about the uniqueness of the meningeal lymphatic vasculature and its implication in multiple neurological and neurotraumatic disorders.

Summary
These studies are highlighting a new and unexpected role for the lymphatic vasculature in brain function and a potential new therapeutic target for neurological disorders.
Clinical and pathologic characteristics to select patients for focal therapy or partial gland ablation of nonmetastatic prostate cancer
Authors: Jaipuria Jiten , Ahmed Hashim U. 
Published: February 2022

Purpose of review
Focal therapy or partial gland ablation for nonmetastatic prostate cancer is gaining popularity not just as an alternative to active surveillance, but as an acceptable alternative to whole gland therapy in appropriate cases. This review summarizes recent evidence to help select patients for optimal outcomes.

Recent findings
Recommendations by expert panels have become less conservative with each meeting. As experience with older modalities for focal therapy grows, newer modalities continue to be introduced. We are now in a position to offer personalized treatment pathway considering nuances of each focal therapy modality.

Summary
The ideal case for focal therapy should be an MRI visible significant lesion (PIRADS score ≥ 3), with a positive biopsy for significant cancer (Gleason grade group 2–3) in the corresponding targeted biopsy area, and insignificant or absent disease in the nontarget random biopsy areas. Multifocal disease can also be selectively treated. Salvage focal ablation is an attractive treatment option for radio-recurrent or index focal therapy failure cases.
Diagnostic Value of the Electroencephalogram and Cerebrospinal Fluid in Viral Encephalitis
Authors: Chen Jian-Hua , Wu Jie , Yang Xiao-Yan , Li Jing , Huang Nan-Qu , Shi Shang-Peng , Feng Fei , Li Qin , Yu Chang-Yin , Luo Yong 
Published: February 2022

Background:
Electroencephalogram (EEG) and cerebrospinal fluid (CSF) are widely used in the clinical diagnosis of viral encephalitis (VE), but their value in the diagnosis of VE and the detection rate of abnormal indicators need to be further supported by more clinical data.

Methods:
In this study, routine laboratory testing, biochemical examinations of cerebrospinal fluid (CSF) and EEG characteristics were performed in patients with VE to guide the diagnosis and treatment of VE in clinical settings. A total of 330 patients with VE were enrolled in the Department of Neurology of the Third Affiliated Hospital of Zunyi Medical University from January 1, 2015 to January 30, 2020. EEG, routine testing and assessment of biochemical indicators of CSF were performed within 10 days after admission, and the results were analyzed by paired χ2 test to compare the diagnostic value of EEG and CSF for VE.

Results:
In 330 cases of VE, 283 cases (85.76%) had abnormal EEG, and 189 cases (57.27%) had abnormal CSF indicators. The incidence of EEG abnormalities was higher than that of CSF indicators, and the difference was statistically significant (P<0.05).

Conclusions:
Both the EEG and CSF analysis are valuable indicators in the diagnosis of VE patients. Compared with the CSF examination, the EEG examination had a better diagnostic efficacy for the diagnosis of VE. In addition, a normal EEG or a normal CSF level cannot exclude VE, and it is still necessary to develop new diagnostic indicators to cover all viral encephalitides.
Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation as Treatment of Poststroke Depression
Authors: Shen Yiting , Cai Zhengyun , Liu Furong , Zhang Zhihui , Ni Guangxia 
Published: February 2022

Background:
Previous studies showed that the application of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) during stroke rehabilitation improve the depression symptoms in poststroke depression (PSD). However, some studies showed inconsistent results. The study was designed to make a meta-analysis to evaluate the effect of noninvasive brain stimulation (tDCS and rTMS) on PSD.

Methods:
Articles published before July 2021 were searched in databases: PubMed, Web of Science, and Google Scholar. STATA 12.0 software was utilized to make meta-analysis. We extracted or calculated mean values and SD of reduction or increase rate of depression-related scales. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated as effect size.

Results:
The study showed increased immediate and long-term improvement in depression in rTMS group compared with sham rTMS group after treatment with random-effects models (immediate: SMD=4.92, 95% CI=2.69-7.15, I
2=95.2%, P-value for Q test <0.001; long term: SMD=7.21, 95% CI=3.50-10.92, I
2=93.9%, P-value for Q test <0.001). Meta-analysis showed increased substantially immediate improvement in depression in tDCS group compared with sham tDCS group with a random effect model (SMD=5.30, 95% CI=1.30-9.30, I
2=97.3%, P-value for Q test <0.001).

Conclusions:
rTMS and tDCS were demonstrated to be effective and safe treatment techniques for PSD. More large-scale studies were essential to explore the effect of rTMS with different frequencies and tDCS on PSD.