bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a long-acting substitute in detoxification from benzodiazepines: safety (accumulation) problems and proposed mitigation procedure
Authors: Basińska-Szafrańska Anna 
Published: September 2022

Abstract
Objective
In the majority of approaches, detoxification of patients with benzodiazepine (BZD) addiction is preceded by conversion to long-acting BZDs. Resulting BZD accumulation, however, is neither monitored nor prevented. An unrecognized shift of the key low-concentration phase beyond the nominal treatment period may underlie delayed unassisted crises and treatment failures. This open, single-arm, semi-naturalistic study examines the anti-accumulation paradigm to minimize the high-concentration treatment phase and to regain time for medical assistance during the low-concentration phase.

Methods
In 133 of 165 patients with BZD dependency, after conversion to diazepam by titration up to the satiation state, the loading dose and satiating concentration were recorded. The subsequent anti-accumulation procedure consisted of aggressive daily dose reductions under laboratory feedback (serum BZD concentration, radioimmunoassay) until accumulation stopped. The final overaccumulation ratio (OA) and maintenance-dose/loading-dose ratio (MTN) were estimated. The post-conversion peak-concentration/loading-dose ratio was illustratively compared with the concentration/dose ratio in 32 long-term diazepam users demonstrating the natural plateau.

Results
Despite gender- and age-related differences in loading and maintenance doses and in satiating and peak concentrations (higher in younger and male patients), their quotients remained similar. The MTN ratio had an average value of 0.29 and a median value of 0.25, with OA ratios of 1.54 and 1.39, respectively. The concentration/dose ratio was approximately 3 times lower than that in regular diazepam users. With effective elimination starting (on average) from the 6th day, the treatment, including post-elimination recovery, lasted on average 52 days.

Conclusions
The MTN values show how harmfully popular tapering schedules intensify and extend the high-concentration stage during alleged detoxification, leading to unrecognized delays in elimination, and delayed withdrawal crises. The common errors are discussed. An individual MTN, estimated from laboratory feedback (the anti-accumulation paradigm), expeditiously moves patients to the onset of actual detoxification. This action regains time to maintain medical assistance until treatment is properly completed.
Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group
Authors: Salem Riad , Padia Siddharth A. , Lam Marnix , Chiesa Carlo , Haste Paul , Sangro Bruno , Toskich Beau , Fowers Kirk , Herman Joseph M. , Kappadath S. Cheenu , Leung Thomas , Sze Daniel Y. , Kim Edward , Garin Etienne 
Published: September 2022

Abstract

Purpose
In light of recently published clinical reports and trials, the TheraSphere Global Dosimetry Steering Committee (DSC) reconvened to review new data and to update previously published clinical and dosimetric recommendations for the treatment of hepatocellular carcinoma (HCC).

Methods
The TheraSphere Global DSC is comprised of health care providers across multiple disciplines involved in the treatment of HCC with yttrium-90 (Y-90) glass microsphere–based transarterial radioembolization (TARE). Literature published between January 2019 and September 2021 was reviewed, discussed, and adjudicated by the Delphi method. Recommendations included in this updated document incorporate both the results of the literature review and the expert opinion and experience of members of the committee.

Results
Committee discussion and consensus led to the expansion of recommendations to apply to five common clinical scenarios in patients with HCC to support more individualized efficacious treatment with Y-90 glass microspheres. Existing clinical scenarios were updated to reflect recent developments in dosimetry approaches and broader treatment paradigms evolving for patients presenting with HCC.

Conclusion
Updated consensus recommendations are provided to guide clinical and dosimetric approaches for the use of Y-90 glass microsphere TARE in HCC, accounting for disease presentation, tumor biology, and treatment intent.
Anaerobic work capacity in cycling: the effect of computational method
Authors: Andersson Erik P. , Bachl Philipp , Schmuttermair Anna , Staunton Craig A. , Stöggl Thomas L. 
Published: September 2022

Abstract
Purpose
To compare the anaerobic work capacity (AnWC, i.e., attributable anaerobic mechanical work) assessed using four different approaches/models applied to time-trial (TT) cycle-ergometry exercise.

Methods
Fifteen male cyclists completed a 7 × 4-min submaximal protocol and a 3-min all-out TT (TTAO). Linear relationships between power output (PO) and submaximal metabolic rate were constructed to estimate TT-specific gross efficiency (GE) and AnWC, using either a measured resting metabolic rate as a Y-intercept (7 + YLIN) or no measured Y-intercept (7-YLIN). In addition, GE of the last submaximal bout (GELAST) was used to estimate AnWC, and critical power (CP) from TTAO (CP3´AO) was used to estimate mechanical work above CP (W’, i.e., “AnWC”).

Results
Average PO during TTAO was 5.43 ± 0.30 and CP was 4.48 ± 0.23 W∙kg−1. The TT-associated GE values were ~ 22.0% for both 7 + YLIN and 7-YLIN and ~ 21.1% for GELAST (both P < 0.001). The AnWC were 269 ± 60, 272 ± 55, 299 ± 61, and 196 ± 52 J∙kg−1 for the 7 + YLIN, 7-YLIN, GELAST, and CP3´AO models, respectively (7 + YLIN and 7-YLIN versus GELAST, both P < 0.001; 7 + YLIN, 7-YLIN, and GELAST versus CP3´AO, all P < 0.01). For the three pair-wise comparisons between 7 + YLIN, 7-YLIN, and GELAST, typical errors in AnWC values ranged from 7 to 11 J∙kg−1, whereas 7 + YLIN, 7-YLIN, and GELAST versus CP3´AO revealed typical errors of 55–59 J∙kg−1.

Conclusion
These findings demonstrate a substantial disagreement in AnWC between CP3´AO and the other models. The 7 + YLIN and 7-YLIN generated 10% lower AnWC values than the GELAST model, whereas 7 + YLIN and 7-YLIN generated similar values of AnWC.
A comparative study of the superior longitudinal fasciculus subdivisions between neonates and young adults
Authors: Liang Wenjia , Yu Qiaowen , Wang Wenjun , Dhollander Thijs , Suluba Emmanuel , Li Zhuoran , Xu Feifei , Hu Yang , Tang Yuchun , Liu Shuwei 
Published: September 2022

AbstractThe superior longitudinal fasciculus (SLF) is a complex associative tract comprising three distinct subdivisions in the frontoparietal cortex, each of which has its own anatomical connectivity and functional roles. However, many studies on white matter development, hampered by limitations of data quality and tractography methods, treated the SLF as a single entity. The exact anatomical trajectory and developmental status of each sub-bundle of the human SLF in neonates remain poorly understood. Here, we compared the morphological and microstructural characteristics of each branch of the SLF at two ages using diffusion MRI data from 40 healthy neonates and 40 adults. A multi-shell multi-tissue constrained spherical deconvolution (MSMT-CSD) algorithm was used to ensure the successful separation of the three SLF branches (SLF I, SLF II and SLF III). Then, between-group differences in the diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) metrics were investigated in all the SLF branches. Meanwhile, Mahalanobis distances based on all the diffusion metrics were computed to quantify the maturation of neonatal SLF branches, considering the adult brain as the reference. The SLF branches, excluding SLF II, had similar fibre morphology and connectivity between the neonatal and adult groups. The Mahalanobis distance values further supported the notion of heterogeneous maturation among SLF branches. The greatest Mahalanobis distance was observed in SLF II, possibly indicating that it was the least mature. Our findings provide a new anatomical basis for the early diagnosis and treatment of diseases caused by abnormal neonatal SLF development.
Morphology, biochemistry and connectivity of Cluster N and the hippocampal formation in a migratory bird
Authors: Heyers Dominik , Musielak Isabelle , Haase Katrin , Herold Christina , Bolte Petra , Güntürkün Onur , Mouritsen Henrik 
Published: September 2022

AbstractThe exceptional navigational capabilities of migrating birds are based on the perception and integration of a variety of natural orientation cues. The “Wulst” in the forebrain of night-migratory songbirds contains a brain area named “Cluster N”, which is involved in processing directional navigational information derived from the Earth´s magnetic field. Cluster N is medially joined by the hippocampal formation, known to retrieve and utilise navigational information. To investigate the connectivity and neurochemical characteristics of Cluster N and the hippocampal formation of migratory birds, we performed morphological and histochemical analyses based on the expression of calbindin, calretinin, parvalbumin, glutamate receptor type 1 and early growth response protein-1 in the night-migratory Garden warbler (Sylvia borin) and mapped their mutual connections using neuronal tract tracing. The resulting expression patterns revealed regionally restricted neurochemical features, which mapped well onto the hippocampal and hyperpallial substructures known from other avian species. Magnetic field-induced neuronal activation covered caudal parts of the hyperpallium and the medially adjacent hippocampal dorsomedial/dorsolateral subdivisions. Neuronal tract tracings revealed connections between Cluster N and the hippocampal formation with the vast majority originating from the densocellular hyperpallium, either directly or indirectly via the area corticoidea dorsolateralis. Our data indicate that the densocellular hyperpallium could represent a central relay for the transmission of magnetic compass information to the hippocampal formation where it might be integrated with other navigational cues in night-migratory songbirds.
A novel retraining strategy of chest compression skills for infant CPR results in high skill retention for longer
Authors: Gugelmin-Almeida Debora , Jones Michael , Clark Carol , Rolfe Ursula , Williams Jonathan 
Published: September 2022

AbstractInfant cardiopulmonary resuscitation (iCPR) is often poorly performed, predominantly because of ineffective learning, poor retention and decay of skills over time. The aim of this study was to investigate whether an individualized, competence-based approach to simulated iCPR retraining could result in high skill retention of infant chest compressions (iCC) at follow-up. An observational study with 118 healthcare students was conducted over 12 months from November 2019. Participants completed pediatric resuscitation training and a 2-min assessment on an infant mannequin. Participants returned for monthly assessment until iCC competence was achieved. Competence was determined by passing assessments in two consecutive months. After achieving competence, participants returned just at follow-up. For each ‘FAIL’ during assessment, up to six minutes of practice using real-time feedback was completed and the participant returned the following month. This continued until two consecutive monthly ‘PASSES’ were achieved, following which, the participant was deemed competent and returned just at follow-up. Primary outcome was retention of competence at follow-up. Descriptive statistics were used to analyze demographic data. Independent t-test or Mann–Whitney U test were used to analyze the baseline characteristics of those who dropped out compared to those remaining in the study. Differences between groups retaining competence at follow-up were determined using the Fisher exact test. On completion of training, 32 of 118 participants passed the assessment. Of those achieving iCC competence at month 1, 96% retained competence at 9–10 months; of those achieving competence at month 2, 86% demonstrated competence at 8–9 months; of those participants achieving competence at month 3, 67% retained competence at 7–8 months; for those achieving competence at month 4, 80% demonstrated retention at 6–7 months. Conclusion: Becoming iCC competent after initial training results in high levels of skill retention at follow-up, regardless of how long it takes to achieve competence.

What is Known:• Infant cardiopulmonary resuscitation (iCPR) is often poorly performed and skills decay within months after training.• Regular iCPR skills updates are important, but the optimal retraining interval considering individual training needs has yet to be established.

What is New:• Infant chest compression (iCC) competence can be achieved within one to four months after training and once achieved, it can be retained for many months.• With skill reinforcement of up to 28 minutes after initial training, 90% of individuals were able to achieve competence in iCC and 86% retained this competence at follow-up.
A novel decellularized nerve graft for repairing peripheral nerve long gap injury in the rat
Authors: Contreras Estefanía , Bolívar Sara , Nieto-Nicolau Núria , Fariñas Oscar , López-Chicón Patrícia , Navarro Xavier , Udina Esther 
Published: September 2022

AbstractDecellularized nerve allografts are an alternative to autograft for repairing severe nerve injuries, since they have higher availability and do not induce rejection. In this study, we have assessed the regenerative potential of a novel decellularization protocol for human and rat nerves for repairing nerve resections, compared to the gold standard autograft. A 15-mm gap in the sciatic nerve was repaired with decellularized rat allograft (DC-RA), decellularized human xenograft (DC-HX), or fresh autograft (AG). Electrophysiology tests were performed monthly to evaluate muscle reinnervation, whereas histological and immunohistochemical analyses of the grafts were evaluated at 4 months. A short-term study was also performed to compare the differences between the two decellularized grafts (DC-RA and DC-HX) in early phases of regeneration. The decellularization process eliminated cellularity while preserving the ECM and endoneurial tubules of both rat and human nerves. Higher amount of reinnervation was observed in the AG group compared to the DC-RA group, while only half of the animals of the DC-HX showed distal muscle reinnervation. The density of myelinated axons was significantly higher in AG compared to both DC grafts, being this density significantly higher in DC-RA than in DC-HX. At short term, fibroblasts repopulated the DC-RA graft, supporting regenerated axons, whereas an important fibrotic reaction was observed around DC-HX grafts. In conclusion, the decellularized allograft sustained regeneration through a long gap in the rat although at a slower rate compared to the ideal autograft, whereas regeneration was limited or even failed when using a decellularized xenograft.
Species accumulation in small–large vs large–small order: more species but not all species?
Authors: Deane David C. 
Published: September 2022

AbstractAlthough groups of small habitat patches often support more species than large patches of equal total area, their biodiversity value remains controversial. An important line of evidence in this debate compares species accumulation curves, where patches are ordered from small–large and large–small (aka ‘SLOSS analysis’). However, this method counts species equally and is unable to distinguish patch size dependence in species’ occupancies. Moreover, because of the species–area relationship, richness differences typically only contribute to accumulation in small–large order, maximizing the probability of adding species in this direction. Using a null model to control for this, I tested 202 published datasets from archipelagos, habitat islands and fragments for patch size dependence in species accumulation and compared conclusions regarding relative species accumulation with SLOSS analysis. Relative to null model expectations, species accumulation was on average 2.7% higher in large–small than small–large order. The effect was strongest in archipelagos (5%), intermediate for fragments (1.5%) and smallest for habitat islands (1.1%). There was no difference in effect size among taxonomic groups, but each shared this same trend. Results suggest most meta-communities include species that either prefer, or depend upon, larger habitat patches. Relative to SLOSS analysis, null models found lower frequency of greater small-patch importance for species representation (e.g., for fragments: 69 vs 16% respectively) and increased frequency for large patches (fragments: 3 vs 25%). I suggest SLOSS analysis provides unreliable inference on species accumulation and the outcome largely depends on island species–area relationships, not the relative diversity value of small vs large patches.
Three-dimensional maxillary virtual patient creation by convolutional neural network-based segmentation on cone-beam computed tomography images
Authors: Nogueira-Reis Fernanda , Morgan Nermin , Nomidis Stefanos , Van Gerven Adriaan , Oliveira-Santos Nicolly , Jacobs Reinhilde , Tabchoury Cinthia Pereira Machado 
Published: September 2022

Abstract
Objective
To qualitatively and quantitatively assess integrated segmentation of three convolutional neural network (CNN) models for the creation of a maxillary virtual patient (MVP) from cone-beam computed tomography (CBCT) images.

Materials and methods
A dataset of 40 CBCT scans acquired with different scanning parameters was selected. Three previously validated individual CNN models were integrated to achieve a combined segmentation of maxillary complex, maxillary sinuses, and upper dentition. Two experts performed a qualitative assessment, scoring-integrated segmentations from 0 to 10 based on the number of required refinements. Furthermore, experts executed refinements, allowing performance comparison between integrated automated segmentation (AS) and refined segmentation (RS) models. Inter-observer consistency of the refinements and the time needed to create a full-resolution automatic segmentation were calculated.

Results
From the dataset, 85% scored 7–10, and 15% were within 3–6. The average time required for automated segmentation was 1.7 min. Performance metrics indicated an excellent overlap between automatic and refined segmentation with a dice similarity coefficient (DSC) of 99.3%. High inter-observer consistency of refinements was observed, with a 95% Hausdorff distance (HD) of 0.045 mm.

Conclusion
The integrated CNN models proved to be fast, accurate, and consistent along with a strong interobserver consistency in creating the MVP.

Clinical relevance
The automated segmentation of these structures simultaneously could act as a valuable tool in clinical orthodontics, implant rehabilitation, and any oral or maxillofacial surgical procedures, where visualization of MVP and its relationship with surrounding structures is a necessity for reaching an accurate diagnosis and patient-specific treatment planning.
The use of dual antiplatelet therapy for ischemic cerebrovascular events
Authors: Mele Francesco , Gendarini Claudia , Pantoni Leonardo 
Published: September 2022

AbstractIn the last 10 years, the use of dual antiplatelet therapy (DAPT) in the neurological ambit has been explored in patients with non-cardioembolic ischemic stroke, transient ischemic attack (TIA), and intracranial atherosclerotic disease. Two clinical trials (CHANCE and POINT) showed that in patients with minor non-cardioembolic ischemic stroke or high-risk TIA, the addition of clopidogrel to aspirin reduces the risk of stroke recurrence. Another trial (THALES) evaluated the association of ticagrelor and aspirin in mild-to-moderate non-cardioembolic ischemic stroke or high-risk TIA, showing a reduced risk of subsequent stroke compared to aspirin alone. Finally, the use of DAPT has been assessed in the treatment of stroke associated with atherosclerotic intracranial stenosis in the SAMMPRIS trial, showing a favorable profile compared to percutaneous angioplasty and stenting. The aim of this article is, after a review the major trials evaluating DAPT in patients with ischemic cerebrovascular events and the ways they have been implemented in Italian, European, and USA guidelines, to provide a practical algorithm to help clinicians in their everyday clinical practice and to outline possible caveats in the practical implementation of guidelines. Possible limitations and gaps in knowledge regarding specific conditions (e.g., the use of DAPT after acute phase therapies) are also underlined.
Effects of bolus injection duration on perfusion estimates in dynamic CT and dynamic susceptibility contrast MRI
Authors: Arvidsson Jonathan , Starck Göran , Lagerstrand Kerstin , Ziegelitz Doerthe , Jalnefjord Oscar 
Published: September 2022

AbstractEstimates of cerebral blood flow (CBF) and tissue mean transit time (MTT) have been shown to differ between dynamic CT perfusion (CTP) and dynamic susceptibility contrast MRI (DSC-MRI). This study investigates whether these discrepancies regarding CBF and MTT between CTP and DSC-MRI can be attributed to the different injection durations of these techniques. Five subjects were scanned using CTP and DSC-MRI. Region-wise estimates of CBF, MTT, and cerebral blood volume (CBV) were derived based on oscillatory index regularized singular value decomposition. A parametric model that reproduced the shape of measured time curves and characteristics of resulting perfusion parameter estimates was developed and used to simulate data with injection durations typical for CTP and DSC-MRI for a clinically relevant set of perfusion scenarios and noise levels. In simulations, estimates of CBF/MTT showed larger negative/positive bias and increasing variability for CTP when compared to DSC-MRI, especially for high CBF levels. While noise also affected estimates, at clinically relevant levels, the injection duration effect was larger. There are several methodological differences between CTP and DSC-MRI. The results of this study suggest that the injection duration is among those that can explain differences in estimates of CBF and MTT between these bolus tracking techniques.
The gay gene(s)? Rethinking the concept of sexual orientation in the context of science
Authors: Vázquez Iz González 
Published: September 2022

AbstractI argue that scientists should adopt a sexual orientation view that includes ‘internal’ sexual orientation markers such as desire, fantasies, and attraction, plus self-identification, and that these two markers should line up. By ‘internal’ markers, I mean inner states or processes of the agent. This can be contrasted with ‘external markers’, by which I mean, behaviours of the agent. I begin by critically reviewing four genetic studies of sexual orientation that are representative of the literature. I look at how each of these studies deploy the concept of ‘sexual orientation’, and show a) that they are each using different notions, and b) that none of the notions are satisfactory. I argue that these accounts have a very limited amount of predictive and explanatory power. Following this, I outline what an account of sexual orientation that has more predictive and explanatory power might look like. I argue that this account will be one that includes internal markers and self-identification.