bluuebunny/crossref_metadata_2025_split huggingface dataset:
Old Dog, New Trick: Efficacy of Self-Directed Procedural Training for Attending Critical Care Physicians
Authors: Reaven Matthew , Connor-Schuler Randi , Bender William , Daniels Lisa 
Published: April 2022

Background In teaching hospitals, the majority of central venous lines (CVL) are placed by trainees, resulting in little opportunity for attending critical care physicians to maintain this procedural skill. Additionally, not all attending critical care physicians have been trained in the most up-to-date method of dynamic ultrasound (US) guided CVL placement. Furthermore, there is no standardized method to assess procedural competency of attending critical care physicians or to train them in the evolving practice of CVL placement. Despite these limitations, attending critical care physicians are ultimately responsible for supervision of CVL placement by trainees. Objective To assess the utility of an instructional video to impact attending critical care physicians’ competency and confidence in dynamic US guided CVL placement. Methods A pre-post intervention study was conducted at an academic medical center. Attending critical care physicians were first asked to obtain CVL access on a gelatin model using US guidance. They then participated in the intervention, which consisted of watching a short instructional video demonstrating a method of dynamic US guided CVL placement. They were then asked to obtain access again, this time using the described method. All CVL placements were video recorded to assess competency in dynamic US guided CVL placement as well as the time required to obtain CVL access. Two blinded and independent reviewers evaluated each video with discrepancies resolved by a third reviewer. Participants were also surveyed pre and post intervention to assess their confidence in performing and supervising CVL placement. Results A total of 21 attending critical care physicians were included. Pre-intervention, four used dynamic US guidance compared to 16 post-intervention ( P < .001). Confidence in both CVL placement and supervision improved post-intervention ( P = .03 each). Time required to obtain CVL access did not differ significantly pre and post intervention. The majority (20/21) believed there should be required competency testing for CVL placement. Conclusions Pre-intervention dynamic US guided CVL competency was poor in this sample of attending critical care physicians but improved significantly with an instructional video intervention. This study suggests there is a role for procedural competency testing among attending critical care physicians, and that significant improvement is achievable with relatively minimal instruction.
Pornography—Is It Good for Sexual Health? A Systematic Review
Authors: Hakkim Saira , Parsa Ali Davod , Arafat S. M. Yasir , Mahmud Ilias , Sathian Brijesh , Sivasubramanian Madhini , Kabir Russell 
Published: April 2022

Aim: The topic of pornography use is controversial. It is important to understand how young people use pornography and determine whether pornography use has adverse effects on health and well-being. Methods: A comprehensive systematic literature search was conducted in 4 electronic databases (PubMed, Google Scholar, CINAHL plus, and Cochrane library) with appropriate MeSH terms “sexual health” and “pornography” and Boolean operators “AND” and “OR,” using SPIDER search strategy tools (sample, phenomenon of interest, design, evaluation, and research type). 11 articles were proceeded with systematic review after critical appraisal following PRISMA guidelines. Results: The major findings of the study imply that traditional and unimaginative activities depicted in some pornography and sexualized media are harmful because they impose restricted and circumscribed concepts of sex and sexuality. As a result, sexism, sexual objectification, neoliberal sexual consumerism, and sexual variety are reproduced and reinforced rather than promoted. FPU is linked to better levels of sexual comfort and self-acceptance and reduced levels of anxiety, shame, and guilt over sexual behavior. Pornography consumption has also been linked to increased arousal and orgasm responses, a greater interest in sex, acceptance of various sexual acts, and more sexual experimentation. Conclusion: Watching pornography may be a healthy phenomenon if it is occasional, not impairing the personal and social life; however, it can become pathological if watched excessively and impairs the individual’s functioning.
Recent advances for cancer detection and treatment by microfluidic technology, review and update
Authors: Bargahi Nasrin , Ghasemali Samaneh , Jahandar-Lashaki Samaneh , Nazari Atefeh 
Published: April 2022

AbstractNumerous cancer-associated deaths are owing to a lack of effective diagnostic and therapeutic approaches. Microfluidic systems for analyzing a low volume of samples offer a precise, quick, and user-friendly technique for cancer diagnosis and treatment. Microfluidic devices can detect many cancer-diagnostic factors from biological fluids and also generate appropriate nanoparticles for drug delivery. Thus, microfluidics may be valuable in the cancer field due to its high sensitivity, high throughput, and low cost. In the present article, we aim to review recent achievements in the application of microfluidic systems for the diagnosis and treatment of various cancers. Although microfluidic platforms are not yet used in the clinic, they are expected to become the main technology for cancer diagnosis and treatment. Microfluidic systems are proving to be more sensitive and accurate for the detection of cancer biomarkers and therapeutic strategies than common assays. Microfluidic lab-on-a-chip platforms have shown remarkable potential in the designing of novel procedures for cancer detection, therapy, and disease follow-up as well as the development of new drug delivery systems for cancer treatment.
Identifying pleiotropic variants and candidate genes for fertility and reproduction traits in Holstein cattle via association studies based on imputed whole-genome sequence genotypes
Authors: Chen Shi-Yi , Schenkel Flavio S. , Melo Ana L. P. , Oliveira Hinayah R. , Pedrosa Victor B. , Araujo Andre C. , Melka Melkaye G. , Brito Luiz F. 
Published: April 2022

Abstract
Background
Genetic progress for fertility and reproduction traits in dairy cattle has been limited due to the low heritability of most indicator traits. Moreover, most of the quantitative trait loci (QTL) and candidate genes associated with these traits remain unknown. In this study, we used 5.6 million imputed DNA sequence variants (single nucleotide polymorphisms, SNPs) for genome-wide association studies (GWAS) of 18 fertility and reproduction traits in Holstein cattle. Aiming to identify pleiotropic variants and increase detection power, multiple-trait analyses were performed using a method to efficiently combine the estimated SNP effects of single-trait GWAS based on a chi-square statistic.

Results
There were 87, 72, and 84 significant SNPs identified for heifer, cow, and sire traits, respectively, which showed a wide and distinct distribution across the genome, suggesting that they have relatively distinct polygenic nature. The biological functions of immune response and fatty acid metabolism were significantly enriched for the 184 and 124 positional candidate genes identified for heifer and cow traits, respectively. No known biological function was significantly enriched for the 147 positional candidate genes found for sire traits. The most important chromosomes that had three or more significant QTL identified are BTA22 and BTA23 for heifer traits, BTA8 and BTA17 for cow traits, and BTA4, BTA7, BTA17, BTA22, BTA25, and BTA28 for sire traits. Several novel and biologically important positional candidate genes were strongly suggested for heifer (SOD2, WTAP, DLEC1, PFKFB4, TRIM27, HECW1, DNAH17, and ADAM3A), cow (ANXA1, PCSK5, SPESP1, and JMJD1C), and sire (ELMO1, CFAP70, SOX30, DGCR8, SEPTIN14, PAPOLB, JMJD1C, and NELL2) traits.

Conclusions
These findings contribute to better understand the underlying biological mechanisms of fertility and reproduction traits measured in heifers, cows, and sires, which may contribute to improve genomic evaluation for these traits in dairy cattle.
Protective effect of the Impella on the left ventricular function after acute broad anterior wall ST elevation myocardial infarctions with cardiogenic shock: cardiovascular magnetic resonance imaging strain analysis
Authors: Fukamachi Daisuke , Yamada Akimasa , Ohgaku Akihito , Koyama Yutaka , Fujito Hidesato , Arai Riku , Ebuchi Yasunari , Migita Suguru , Morikawa Tomoyuki , Monden Masaki , Takei Norio , Tamaki Takehiro , Kojima Keisuke , Akutsu Naotaka , Murata Nobuhiro , Saito Yuki , Kitano Daisuke , Sudo Mitsumasa , Okumura Yasuo 
Published: April 2022

Abstract
Background
The clinical efficacy of the Impella for high-risk percutaneous coronary intervention (PCI) and cardiogenic shock remains under debate. We thus sought to investigate the protective effects on the heart with the Impella’s early use pre-PCI using cardiac magnetic resonance imaging (CMRI).

Methods
We retrospectively evaluated the difference in the subacute phase CMR imaging results (19 ± 9 days after admission) between patients undergoing an Impella (n = 7) or not (non-Impella group: n = 18 [12 intra-aortic balloon pumps (1 plus veno-arterial extracorporeal membrane oxygenation) and 6 no mechanical circulation systems]) in broad anterior ST-elevation myocardial infarction (STEMI) cases. A mechanical circulation system was implanted pre-PCI.

Results
No differences were found in the door-to-balloon time, peak creatine kinase, and hospital admission days between the Impella and non-Impella groups; however, the CMRI-derived left ventricular ejection fraction was significantly greater (45 ± 13% vs. 34 ± 7.6%, P = 0.034) and end-diastolic and systolic volumes smaller in the Impella group (149 ± 29 vs. 187 ± 41 mL, P = 0.006: 80 ± 29 vs. 121 ± 40 mL, P = 0.012). Although the global longitudinal peak strain did not differ, the global radial (GRS) and circumferential peak strain (GCS) were significantly higher in the IMPELLA than non-IMPELLA group. Greater systolic and diastolic strain rates (SRs) in the Impella than non-Impella group were observed in non-infarcted rather than infarcted areas.

Conclusions
Early implantation of an Impella before PCIs for STEMIs sub-acutely prevented cardiac dysfunction through preserving the GRS, GCS, and systolic and diastolic SRs in the remote myocardium. This study provided mechanistic insight into understanding the usefulness of the Impella to prevent future heart failure.
Does imbalance in chest X-ray datasets produce biased deep learning approaches for COVID-19 screening?
Authors: Álvarez-Rodríguez Lorena , Moura Joaquim de , Novo Jorge , Ortega Marcos 
Published: April 2022

Abstract
Background
The health crisis resulting from the global COVID-19 pandemic highlighted more than ever the need for rapid, reliable and safe methods of diagnosis and monitoring of respiratory diseases. To study pulmonary involvement in detail, one of the most common resources is the use of different lung imaging modalities (like chest radiography) to explore the possible affected areas.

Methods
The study of patient characteristics like sex and age in pathologies of this type is crucial for gaining knowledge of the disease and for avoiding biases due to the clear scarcity of data when developing representative systems. In this work, we performed an analysis of these factors in chest X-ray images to identify biases. Specifically, 11 imbalance scenarios were defined with female and male COVID-19 patients present in different proportions for the sex analysis, and 6 scenarios where only one specific age range was used for training for the age factor. In each study, 3 different approaches for automatic COVID-19 screening were used: Normal vs COVID-19, Pneumonia vs COVID-19 and Non-COVID-19 vs COVID-19. The study was validated using two public chest X-ray datasets, allowing a reliable analysis to support the clinical decision-making process.

Results
The results for the sex-related analysis indicate this factor slightly affects the system in the Normal VS COVID-19 and Pneumonia VS COVID-19 approaches, although the identified differences are not relevant enough to worsen considerably the system. Regarding the age-related analysis, this factor was observed to be influencing the system in a more consistent way than the sex factor, as it was present in all considered scenarios. However, this worsening does not represent a major factor, as it is not of great magnitude.

Conclusions
Multiple studies have been conducted in other fields in order to determine if certain patient characteristics such as sex or age influenced these deep learning systems. However, to the best of our knowledge, this study has not been done for COVID-19 despite the urgency and lack of COVID-19 chest x-ray images. The presented results evidenced that the proposed methodology and tested approaches allow a robust and reliable analysis to support the clinical decision-making process in this pandemic scenario.
Gut microbiota alterations in critically ill older patients: a multicenter study
Authors: Victoria Mesa , Elena Valdés-Duque Beatriz , Amparo Giraldo-Giraldo Nubia , María Jailler-R Ana , Adriana Giraldo-Villa , Irene Acevedo-Castaño , Alejandra Yepes-M Mónica , Janeth Barbosa-Barbosa , María Agudelo-Ochoa Gloria 
Published: April 2022

Abstract
Background
Aging generates changes in the gut microbiota, affecting its functionality. Little is known about gut microbiota in critically ill older adults. The objective of this study was to describe the profile of gut microbiota in a cohort of critically ill older adults.

Methods
This observational study was conducted in five health institutions. Over a 6-month study period, critically ill patients over 18 years old who were admitted to the intensive care unit were enrolled. Fecal microbiota profiles were determined from 155 individuals, over 60 years old (n = 72) and under 60 years old (n = 83). Gut microbiota was analyzed by sequencing the V3-V4 region of the 16S rRNA gene. Alpha and beta diversity, operational taxonomic units and the interaction of gut microbiota with variables under study were analyzed. Amplicon sequence variants (ASVs) specifically associated with age were recovered by including gender, discharge condition, BMI, ICU stay and antibiotics as covariates in a linear mixed model.

Results
In older adults, sepsis, malnutrition, antibiotic prescription and severity (APACHE and SOFA scores) were higher than in the group under 60 years of age. Alpha diversity showed lower gut microbiota diversity in those over 60 years of age (p < 0.05); beta diversity evidenced significant differences between the groups (PERMANOVA = 1.19, p = 0.038). The microbiota of the adults under 60 years old showed greater abundance of Murdochiella, Megasphaera, Peptoniphilus and Ezakiella, whereas those over 60 years old Escherichia-Shigella and Hungatella were more abundant.

Conclusion
The gut microbial community was altered by different factors; however, age significantly explained the variability in critically ill patients. A lower presence of beneficial genera and a higher abundance of pathogens was observed in adults over 60 years old.
Intrapartum versus postpartum insertion of intrauterine device in women delivering by cesarean section
Authors: Abdel-Ghany Ahmed , Khalifa Eissa , El-Din Mohamed Zeen , Ibrahim Emad , Abdallah Ameer , Abdel-Aziz Mahmoud , Abdel-Rasheed Mazen , Abdel-Azim Alaa 
Published: April 2022

Abstract
Background
The intrauterine device (IUD), being a reversible and effective contraception method, is the most widely used worldwide. This study aims to demonstrate the efficacy of IUD insertion during elective lower segment cesarean section (LSCS) versus its insertion six weeks postpartum.

Methods
A cohort study was conducted on 200 women planned for elective cesarean delivery and desired IUD as a contraceptive method. They were allocated into two groups; group I, in which IUD was inserted during LSCS, and group II, in which IUD was inserted six weeks or more after LSCS. Both groups were compared regarding failed insertion, post-insertion pain, and uterine perforation. They were followed for one year for the incidence of menorrhagia, vaginal infection, IUD displacement/expulsion, missed threads, or unintended pregnancy.

Results
Women in the second group showed a significantly higher incidence of failed insertion and uterine perforation than women in the first group. On the contrary, women in the first group showed a significantly higher incidence of missed threads than women in the second group. Regarding other consequences, there were no significant differences between both groups concerning menorrhagia, vaginal infection, IUD displacement/expulsion, or unintended pregnancy.

Conclusion
IUD insertion during elective LSCS showed a significantly lower incidence of failed insertion and uterine perforation than its insertion six weeks postoperative.
Prognostic biomarker SGSM1 and its correlation with immune infiltration in gliomas
Authors: Li Junsheng , Wang Jia , Ding Yaowei , Zhao Jizong , Wang Wen 
Published: April 2022

Abstract
Objective
Glioma was the most common type of intracranial malignant tumor. Even after standard treatment, the recurrence and malignant progression of lower-grade gliomas (LGGs) were almost inevitable. The overall survival (OS) of patients with LGG varied widely, making it critical for prognostic prediction. Small G Protein Signaling Modulator 1 (SGSM1) has hardly been studied in gliomas. Therefore, we aimed to investigate the prognostic role of SGSM1 and its relationship with immune infiltration in LGGs.

Methods
We obtained RNA sequencing data from The Cancer Genome Atlas (TCGA) to analyze SGSM1 expression. Functional enrichment analyses, immune infiltration analyses, immune checkpoint analyses, and clinicopathology analyses were performed. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors. And nomogram model has been developed. Kaplan–Meier survival analysis and log-rank test were used to estimate the relationship between OS and SGSM1 expression. The survival analyses and Cox regression were validated in datasets from the Chinese Glioma Genome Atlas (CGGA).

Results
SGSM1 was significantly down-regulated in LGGs. Functional enrichment analyses revealed SGSM1 was correlated with immune response. Most immune cells and immune checkpoints were negatively correlated with SGSM1 expression. The Kaplan–Meier analyses showed that low SGSM1 expression was associated with a poor outcome in LGG and its subtypes. The Cox regression showed SGSM1 was an independent prognostic factor in patients with LGG (HR = 0.494, 95%CI = 0.311–0.784, P = 0.003).

Conclusion
SGSM1 was considered to be a new prognostic biomarker for patients with LGG. And our study provided a potential therapeutic target for LGG treatment.
Endoscopic nodal staging in oligometastatic non-small cell lung cancer (NSCLC) being treated with stereotactic ablative radiotherapy (ENDO-SABR)
Authors: Dhaliwal Inderdeep , Kassirian Shayan , Mitchell Michael A. , Qiabi Mehdi , Warner Andrew , Louie Alexander V. , Wong Harvey H. , McDonald Christine M. , Rajchgot Jason , Palma David A. 
Published: April 2022

AbstractBackgroundResearch in treatment of non-small cell lung cancer (NSCLC) has shown promising results with stereotactic ablative radiotherapy (SABR) of oligometastatic disease, wherein distant disease may be limited to one or a few distant organs by host factors. Traditionally, PET/CT has been used in detecting metastatic disease and avoiding futile surgical intervention, however, sensitivity and specificity is limited to only 81 and 79%, respectively. Mediastinal staging still identifies occult nodal disease in up to 20% of NSCLC patients initially thought to be operative candidates. Endobronchial ultrasound and transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive tool for the staging and diagnosis of thoracic malignancy. When EBUS is combined with endoscopic ultrasound using the same bronchoscope (EUS-B), the diagnostic sensitivity and negative predictive value increase to 84 and 97%, respectively. Endoscopic staging in patients with advanced disease has never been studied, but may inform treatment if a curative SABR approach is being taken.MethodsThis is a multi-centre, prospective, cohort study with two-stage design. In the first stage, 10 patients with oligometastatic NSCLC (lung tumour ± hilar/mediastinal lymphadenopathy) with up to 5 synchronous metastases will be enrolled An additional 19 patients will be enrolled in the second stage if rate of treatment change is greater than 10% in the first stage. Patients will be subject to EBUS or combined modality EBUS/EUS-B to assess bilateral lymph node stations using a N3 to N2 to N1 progression. Primary endpoint is defined as the rate of change to treatment plan including change from SABR to conventional dose radiation, change in mediastinal radiation field, and change from curative to palliative intent treatment.DiscussionIf a curative approach with SABR for oligometastatic disease is being explored, invasive mediastinal staging may guide treatment and prognosis. This study will provide insight into the use of endoscopic mediastinal staging in determining changes in treatment plan of NSCLC. Results will inform the design of future phase II trials.Trial registrationClinicaltrials.gov identifier NCT04852588. Date of registration: April 19, 2021. Protocol version: 1.1 on December 9, 2021.