bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Dysphagia and Dysphonia in Patients With Prior Thyroidectomy Undergoing Anterior Cervical Discectomy and Fusion
Authors: Alsoof Daniel , Perry Justin , Yang Daniel S. , Zhang Andrew S. , McDonald Christopher L. , Kuris Eren O. , Daniels Alan H. 
Published: July 2022

Study Design Retrospective cohort study using PearlDiver database. Objectives To evaluate the effect of prior thyroidectomy on complications of Anterior Cervical Discectomy and Fusion (ACDF) surgery. Methods PearlDiver was used to identify patients without prior dysphagia or dysphonia undergoing ACDF between the years 2010-2020Q1. Patients with and without prior thyroidectomy were matched by levels of fusion, alcohol use, and gastroesophageal reflux disease in a 1:5 ratio. Postoperative outcomes were assessed for each cohort with multivariable logistic regression, controlling for age, sex, and Elixhauser Comorbidity Index. Results Between 2010 and 2019, matched cohorts of 792 ACDF patients with prior thyroidectomy and 3960 ACDF only patients were included in the study. Of patients with previous thyroidectomy undergoing ACDF, 16.3% experienced dysphagia at 1-year compared with 10.6% for patients undergoing ACDF only (aOR=1.39, P=.004). Patients with previous thyroidectomy also had higher odds of dysphonia at 1-year following ACDF, as compared to patients with ACDF alone (2.7% vs 1.2%, aOR=1.74, P= .048). Patients undergoing ACDF with prior thyroidectomy did not have increased risk of revision at 1 year (aOR=1.10, P=.698), 2 years (aOR=1.16, P=.457), or 5 years (aOR=1.20, P=.255) following surgery. There were no differences in postoperative opioid utilization rates at 1 month (aOR=2.07, P=.138), 3 months (aOR=2.45, P=.095), 6 months (aOR=1.34, P=.520), and 12 months (aOR=1.69, P=.202). Prior thyroidectomy was not associated with reintubation following ACDF (P=.995). Conclusions Patients with prior thyroidectomy undergoing ACDF surgery experience increased odds of dysphagia and dysphonia at 1-year follow-up compared to those without prior thyroidectomy.
Impact of COVID-19 on Intensive Care Unit Nurse Duty of Care and Professional Roles: A Qualitative Content Analysis
Authors: Christianson Jacqueline , Guttormson Jill , McAndrew Natalie Susan , Calkins Kelly 
Published: July 2022

Background Nurse duty of care, the balance between nursing occupational obligations to provide care, the personal costs for providing such care, and the reward for providing care, has been significantly altered by the COVID-19 pandemic. ICU nurses are increasingly burdened with higher personal costs to fulfill their jobs, but little additional reward for continuing to provide care. Objectives The purpose of this study was to examine the impact of the COVID-19 pandemic on the duty of care balance among ICU nurses who manage COVID-19 patients. Design This was a descriptive qualitative study using semi-structured interviews. Methods Nurses were recruited for a parent study on ICU nursing during COVID-19; this is a secondary analysis of the interviews that took place during the parent study. Content analysis was utilized to identify themes from interview transcripts. Results Thirteen nurses participated in interviews. Nurses reported betrayal at perceived breeches in their duty of care agreement by their employers, the general public, and national health authorities. They described alterations to previous standards of care such as significantly increased workloads, worsening understaffing, and changes to patient care expectations that were implemented for reasons other than betterment of patient care. Nurses reported they felt a moral obligation to provide care, however they experienced disempowerment and burnout that affected them both in and out of the workplace. Conclusion The COVID-19 pandemic has affected several aspects of the duty of care balance, resulting in a duty of care balance that is inequitable to nurses. Imbalance in the effort, risks, and rewards for nursing professionals may contribute to nurse burnout. Relevance to Clinical Practice This research highlights the need for healthcare administrators to consider resource allocation, nurse appreciation, and commensurate compensation for professional nurses.
Gamma-aminobutyric acid and glutamate/glutamine levels in the dentate nucleus and periaqueductal gray with episodic and chronic migraine: a proton magnetic resonance spectroscopy study
Authors: Wang Wei , Zhang Xueyan , Bai Xiaoyan , Zhang Yingkui , Yuan Ziyu , Tang Hefei , Li Zhiye , Hu Zhangxuan , Zhang Yaqing , Yu Xueying , Sui Binbin , Wang Yonggang 
Published: July 2022

AbstractBackgroundThe pathogenesis of migraine chronification remains unclear. Functional and structural magnetic resonance imaging studies have shown impaired functional and structural alterations in the brains of patients with chronic migraine. The cerebellum and periaqueductal gray (PAG) play pivotal roles in the neural circuits of pain conduction and analgesia in migraine. However, few neurotransmitter metabolism studies of these migraine-associated regions have been performed. To explore the pathogenesis of migraine chronification, we measured gamma-aminobutyric acid (GABA) and glutamate/glutamine (Glx) levels in the dentate nucleus (DN) and PAG of patients with episodic and chronic migraine and healthy subjects.MethodsUsing the MEGA-PRESS sequence and a 3-Tesla magnetic resonance scanner (Signa Premier; GE Healthcare, Chicago, IL, USA), we obtained DN and PAG metabolite concentrations from patients with episodic migraine (n = 25), those with chronic migraine (n = 24), and age-matched and sex-matched healthy subjects (n = 16). Patients with chronic migraine were further divided into those with (n = 12) and without (n = 12) medication overuse headache. All scans were performed at the Beijing Tiantan Hospital, Capital Medical University.ResultsWe found that patients with chronic migraine had significantly lower levels of GABA/water (p = 0.011) and GABA/creatine (Cr) (p = 0.026) in the DN and higher levels of Glx/water (p = 0.049) in the PAG than healthy controls. In all patients with migraine, higher GABA levels in the PAG were significantly associated with poorer sleep quality (GABA/water:r = 0.515,p = 0.017,n = 21; GABA/Cr:r = 0.522,p = 0.015,n = 21). Additionally, a lower Glx/Cr ratio in the DN may be associated with more severe migraine disability (r = -0.425,p = 0.055,n = 20), and lower GABA/water (r = -0.424,p = 0.062,n = 20) and Glx/Water (r = -0.452,p = 0.045,n = 20) may be associated with poorer sleep quality.ConclusionsNeurochemical levels in the DN and PAG may provide evidence of the pathological mechanisms of migraine chronification. Correlations between migraine characteristics and neurochemical levels revealed the pathological mechanisms of the relevant characteristics.
Controversies in ACL revision surgery: Italian expert group consensus and state of the art
Authors: Matassi Fabrizio , Giabbani Niccolò , Arnaldi Enrico , Tripodo Alessandro , Bonaspetti Giovanni , Bait Corrado , Ronga Mario , Di Benedetto Paolo , Zaffagnini Stefano , Jannelli Eugenio , Schiavone Panni Alfredo , Berruto Massimo 
Published: July 2022

Abstract
Background
Revision ACL reconstruction is a complex topic with many controversies and not-easy-to-make decisions. The authors’ aim is to provide some feasible advice that can be applied in daily clinical practice with the goal of facilitating the decision-making process and improving the outcomes of patients subjected to revision ACL reconstruction.

Methods
A national survey with seven questions about the most controversial topics in revision ACL reconstruction was emailed to members of two societies: SIOT and SIAGASCOT. The participants’ answers were collected, the most recent literature was analyzed, and a consensus was created by the authors, according to their long-term surgical experience.

Conclusions
The decision-making process in revision ACL reconstruction starts with a standardized imaging protocol (weight-bearing radiographs, CT scan, and MRI). One-stage surgery is indicated in almost all cases (exceptions are severe tunnel enlargement and infection), while the choice of graft depends on the previously used graft and the dimensions of the tunnels, with better clinical outcomes obtained for autografts. Additional procedures such as lateral extra-articular tenodesis in high-grade pivot-shift knees, biplanar HTO in the case of severe coronal malalignment, and meniscal suture improve the clinical outcome and should be considered case by case.

Level of evidence
V (Expert opinion).
Barriers to change in urban freight systems: a systematic literature review
Authors: Kervall Mikael , Pålsson Henrik 
Published: July 2022

Abstract
Purpose
The purpose of this systematic literature review is to contribute to the knowledge about barriers to change in urban freight systems and to support managed changes toward more sustainable urban freight systems.

Method
This paper is based on a systematic review covering 93 peer-reviewed journal articles. The study was designed to advance earlier research in this area by providing a system perspective on barriers to development in urban freight systems. The theoretical knowledge about these barriers was analyzed and synthesized, the relationships between barriers explored, and the insights developed into a model of understanding of managed change processes in urban freight systems.

Findings
From a system perspective 11 categories of barriers to change in urban freight systems were identified and characterized. The barriers are, in different ways, related both to each other and to a managed change process for sustainable development of urban freight systems. A model for understanding categories of barriers and their connection to managed change processes in urban freight systems is proposed in this paper. The model consists of three groups of barriers within the process, and two groups in the system context, which should be addressed with different priorities in a managed change process. The study identifies several future research options. Future research could support the development of sustainable urban freight systems by providing insights into change process governance, potentially by combining theory from areas like organization, systems, and networks with the system perspective on urban freight systems. Research on non-European urban freight systems could increase the scholarly insights about contextual impact on barriers and change processes. Future studies could also explore methods to mitigate identified barriers, especially in the areas of cooperation, organization, politics, knowledge, and the first mover disadvantage. Finally, future research should continue to develop the model of the managed change process for urban freight systems and its use in supporting sustainable development of these systems.
Accurate classification of white blood cells by coupling pre-trained ResNet and DenseNet with SCAM mechanism
Authors: Chen Hua , Liu Juan , Hua Chunbing , Feng Jing , Pang Baochuan , Cao Dehua , Li Cheng 
Published: July 2022

Abstract
Background
Via counting the different kinds of white blood cells (WBCs), a good quantitative description of a person’s health status is obtained, thus forming the critical aspects for the early treatment of several diseases. Thereby, correct classification of WBCs is crucial. Unfortunately, the manual microscopic evaluation is complicated, time-consuming, and subjective, so its statistical reliability becomes limited. Hence, the automatic and accurate identification of WBCs is of great benefit. However, the similarity between WBC samples and the imbalance and insufficiency of samples in the field of medical computer vision bring challenges to intelligent and accurate classification of WBCs. To tackle these challenges, this study proposes a deep learning framework by coupling the pre-trained ResNet and DenseNet with SCAM (spatial and channel attention module) for accurately classifying WBCs.

Results
In the proposed network, ResNet and DenseNet enables information reusage and new information exploration, respectively, which are both important and compatible for learning good representations. Meanwhile, the SCAM module sequentially infers attention maps from two separate dimensions of space and channel to emphasize important information or suppress unnecessary information, further enhancing the representation power of our model for WBCs to overcome the limitation of sample similarity. Moreover, the data augmentation and transfer learning techniques are used to handle the data of imbalance and insufficiency. In addition, the mixup approach is adopted for modeling the vicinity relation across training samples of different categories to increase the generalizability of the model. By comparing with five representative networks on our developed LDWBC dataset and the publicly available LISC, BCCD, and Raabin WBC datasets, our model achieves the best overall performance. We also implement the occlusion testing by the gradient-weighted class activation mapping (Grad-CAM) algorithm to improve the interpretability of our model.

Conclusion
The proposed method has great potential for application in intelligent and accurate classification of WBCs.
Genome-wide identification of resistance genes and transcriptome regulation in yeast to accommodate ammonium toxicity
Authors: Fu Wenhao , Cao Xiuling , An Tingting , Zhao Huihui , Zhang Jie , Li Danqi , Jin Xuejiao , Liu Beidong 
Published: July 2022

Abstract
Background
Ammonium is an important raw material for biomolecules and life activities, and the toxicity of ammonium is also an important ecological and agricultural issue. Ammonium toxicity in yeast has only recently been discovered, and information on its mechanism is limited. In recent years, environmental pollution caused by nitrogen-containing wastewater has been increasing. In addition, the use of yeast in bioreactors to produce nitrogen-containing compounds has been developed. Therefore, research on resistance mechanisms that allow yeast to grow under conditions of high concentrations of ammonium has become more and more important.

Results
To further understand the resistance mechanism of yeast to grow under high concentration of ammonium, we used NH4Cl to screen a yeast non-essential gene-deletion library. We identified 61 NH4Cl-sensitive deletion mutants from approximately 4200 mutants in the library, then 34 of them were confirmed by drop test analysis. Enrichment analysis of these 34 genes showed that biosynthesis metabolism, mitophagy, MAPK signaling, and other pathways may play important roles in NH4Cl resistance. Transcriptome analysis under NH4Cl stress revealed 451 significantly upregulated genes and 835 significantly downregulated genes. The genes are mainly enriched in: nitrogen compound metabolic process, cell wall, MAPK signaling pathway, mitophagy, and glycine, serine and threonine metabolism.

Conclusions
Our results present a broad view of biological pathways involved in the response to NH4Cl stress, and thereby advance our understanding of the resistance genes and cellular transcriptional regulation under high concentration of ammonium.
Genomic surveillance of SARS-CoV-2 in US military compounds in Afghanistan reveals multiple introductions and outbreaks of Alpha and Delta variants
Authors: Maljkovic Berry Irina , Hang Jun , Fung Christian , Yang Yu , Chibucos Marcus , Pollio Adam , Gandhi Jay , Li Tao , Conte Matthew A. , Lidl Grace M. , Johannigman Jay A. , Friberg Heather 
Published: July 2022

Abstract
Background
With the emergence and spread of SARS-CoV-2 variants, genomic epidemiology and surveillance have proven invaluable tools for variant tracking. Here, we analyzed SARS-CoV-2 samples collected from personnel located at the US/NATO bases across Afghanistan.

Results
Sequencing and phylogenetic analyses revealed at least 16 independent introductions of SARS-CoV-2 into four of these relatively isolated compounds during April and May 2021, including multiple introductions of Alpha and Delta variants. Four of the introductions resulted in sustained spread of the virus within, and in two cases between, the compounds. Three of these outbreaks, one Delta and two Alpha, occurred simultaneously.

Conclusions
Even in rigorously controlled and segregated environments, SARS-CoV-2 introduction and spread may occur frequently.
Strategies to rare primary cardiac lipomas in the left ventricle in a patient: case report
Authors: Liu Wei , Bu Haisong 
Published: July 2022

Abstract
Background
Primary cardiac tumors are rare in all age groups and are usually benign. Symptoms are usually related to tumor size, location, invasiveness, number, and growth rate. While histologically benign, cardiac arrest may be caused by blocked inflow or outflow or malignant ventricular arrhythmia. Surgical resection of left ventricular tumors, especially those involving the outflow tract, is challenging.

Case presentation
Herein, we present a rare case of an asymptomatic, 39-year-old woman who was referred to our cardiovascular department for a huge left ventricular cardiac mass incidentally discovered during the physical examination. Images showed a huge mass that quasi-circular low-density focus with a clear boundary and regular shape in the left ventricular cavity and fortunately had no significant effect on the peripheral valves and hemodynamics.

Conclusions
This illustrative report highlights the exact surgical management of a cardiac tumor depends largely on the site and extent of the mass. Mechanical compromise and not the neoplastic potential should be considered. A conservative approach and follow-up regularly are advocated to ensure that the patient gets the best diagnosis and treatment, however, surgery is indicated only for severely symptomatic patients with hemodynamic compromise.
Therapy options for those affected by a long lie after a fall: a scoping review
Authors: Kubitza Jenny , Haas Margit , Keppeler Lena , Reuschenbach Bernd 
Published: July 2022

Abstract
Background
After a fall, more than half of older people living alone are unable to get up or get help independently. Fall-related recumbency makes affected individuals aware of functional status limitations and increased vulnerability. Patient-centered therapy is needed to manage physical, psychological, and social needs. This review summarizes the current evidence on care options for the special patient population.

Methods
The scoping review used the six-step framework proposed by Arksey and O´Malley and was conducted in accordance with the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews. The literature searches were conducted in five databases and ten online archives. Articles were screened, assessed and selected using defined inclusion and exclusion criteria. Articles were included if they were published in either German or English and related to the care of long lies. Thematic synthesis was based on the literature review.

Results
The search yielded 1047 hits, of which 19 research papers were included. Two themes were identified: (1) acute therapy, focused on prolonged recumbency and pronounced physical effects; and (2) preventive therapy, which examined standing up training, technical aids, and social control systems in the context of fall management.

Conclusions
There are a limited number of interventions that relate to the patient population. The interventions are predominantly presented independently, so there is a lack of structuring of the interventions in the form of a treatment pathway. In addition to pooling professional expertise and an interprofessional approach, it is important to continue inpatient treatment in the home setting, even though the effectiveness of interventions in a home setting has hardly been verified thus far. The solution for a missing treatment process is first of all a planned, interprofessional and intersectoral approach in therapy.
Influence of intergenerational relationships on depressive symptoms in ageing Chinese adults in Hong Kong: Mediating effects of sense of loneliness
Authors: Zhou Jia-Jia , Bai Xue 
Published: July 2022

Abstract
Background
Mental health of older adults could be positively predicted by harmonious parent–adult children relationships, although the mechanism has not been sufficiently demonstrated. This study employed sense of loneliness as mediator to examine the influence of multiple domains of intergenerational relationships on depressive symptoms in ageing Chinese adults.

Methods
Data was extracted from a representative survey in Hong Kong among Chinese adults aged over 50 with at least one adult child (n = 801). Four key domains (structural–associational, consensual–normative, affectual closeness, and intergenerational conflict) were adopted to measure the intergenerational relationship quality. Depressive symptoms were assessed using the five-item Geriatric Depression Scale. The mediating role of sense of loneliness in the association between intergenerational relationships and depressive symptoms were tested by the PROCESS macro in SPSS.

Results
The influence of overall intergenerational relationship quality and its four subdomains on depressive symptoms were significantly mediated by sense of loneliness. Among the four domains, affectual closeness presented the strongest association with older people’s depressive symptoms. The effect of intergenerational conflict on depressive symptoms was completely mediated by sense of loneliness, and the effects of remaining three domains were partially mediated. The domain of consensual–normative solidarity received the lowest rating by Chinese older adults.

Conclusion
The psychological pathway that loneliness links intergenerational relationships and depressive symptoms was supported in this study. With respect to improving intergenerational relationships, enhancing affectual connection between older parents and adult children was essential to prevent mental problems. This study calls for more attention to the protective role of diverse social relationships in improving mental health through multiple pathways.