bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evolution of a national, advanced airway management simulation-based course for anaesthesia trainees
Authors: Rewers Mikael , Østergaard Doris 
Published: July 2020

BACKGROUND
Needs analyses involving patient complaints and anaesthesiologists’ confidence levels in difficult airway management procedures in Denmark have shown a need for training in both technical and non-technical skills.

OBJECTIVE
To provide an example of how to design, implement and evaluate a national simulation-based course in advanced airway management for trainees within a compulsory, national specialist training programme.

DESIGN AND RESULTS
A national working group, established by the Danish Society for Anaesthesiology and Intensive Care Medicine, designed a standardised simulation course in advanced airway management for anaesthesiology trainees based on the six-step approach. Learning objectives are grounded in the curriculum and analyses-of-needs (in terms of knowledge, skills and attitudes, including non-technical skills, which encompass the cognitive skills and social skills, necessary for safe and effective performance). A total of 28 courses for 800 trainees have been conducted. Evaluation has been positive and pre and posttests have indicated a positive effect on learning.

CONCLUSION
The course was successfully designed and implemented within the national training programme for trainees. Important factors for success were involvement of all stakeholders, thorough planning, selection of the most important learning objectives, the use of interactive educational methods and training of the facilitators.
Precision pulse capsulotomy: performance metrics and utility in routine and complex cases
Authors: Ifantides Cristos , Lee Junhun , Rouweyha Rajy , Vital Mark , Sretavan David 
Published: July 2020

Purpose:
To evaluate precision pulse capsulotomy (PPC) performance.

Setting:
University and private practice in the United States and South Korea.

Design:
Multicenter retrospective analysis.

Methods:
The surgical videos of 337 cataract surgeries with PPC capsulotomy performed by 4 surgeons at 4 centers were used to assess capsulotomy outcomes including completion rate, diameter, roundness (ovality), and quality of capsular overlap.

Results:
PPC use resulted in 99.4% free-floating capsulotomies from 337 cases. Video image analysis in a subset (n = 52) yielded a mean capsulotomy diameter of 5.0 mm ± 0.16 mm SD (95% CI, 4.96-5.04 mm). Capsulotomies were round to slightly oval at the end of the case with a mean ovality of 3.0% ± 2.86% (95% CI, 2.22%-3.78%; 360 degrees capsular overlap was obtained in 98% of cases. The offset of the capsulotomy center with the intraocular lens (IOL) optic center was 197 μm ± 122 μm (SD) (95% CI, 148-246 μm). PPC was used successfully in traumatic cataracts with compromised anterior and posterior capsule, phacodonesis, intumescent cataract with constricted pupil, and zonular dialysis and in penetrating keratoplasty with open-sky extracapsular cataract extraction.

Conclusions:
Surgeons obtained good PPC capsulotomy outcomes in routine and challenging cases. Little variation was observed in achieving free-floating capsulotomies with approximately 5.0 mm diameter and complete capsular overlap. Variation was observed in the amount of offset between the capsulotomy center and the center of the IOL optic. PPC was useful in cases with multiple comorbidities that challenge capsulotomy performance.
Validation of the Globalcare GCE603 automated blood pressure monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010
Authors: Song Cheng , Yu Yang , Lu Bao-Chuan , Yan Xi-Ling 
Published: July 2020

Objective
To evaluate the accuracy of the automated oscillometric upper-arm blood pressure (BP) monitor Globalcare GCE603 for home BP monitoring according to the International Protocol of the European Society of Hypertension (ESH) revision 2010.

Methods
BP was sequentially measured in 33 adult participants and compared with a standard mercury sphygmomanometer. A total of 99 comparison pairs were obtained and analyzed according to the ESH international protocol.

Results
For the 33 eligible participants, the device achieved 80/99, 98/99 and 99/99 measurements of absolute differences between device and observers within 5, 10 and 15 mmHg for systolic BP (SBP) and 87/99, 98/99 and 99/99 for diastolic BP (DBP), respectively. The average device-observer difference was 1.01 ± 4.11 mmHg for SBP and −0.69 ± 3.56 mmHg for DBP, respectively. The number of participants with two or three of the device-observer difference within 5 mmHg was 28 for SBP and 30 for DBP, and there was no subject with none of the device-observer difference within 5 mmHg.

Conclusion
According to the validation results on the basis of the ESH international protocol revision 2010, the Globalcare GCE603 automated upper-arm BP monitor can be recommended for home measurement in general population.
Postural blood pressure changes in the elderly: orthostatic hypotension and hypertension
Authors: Kocyigit Suleyman Emre , Erken Neziha , Dokuzlar Ozge , Dost Gunay Fatma Sena , Ates Bulut Esra , Aydin Ali Ekrem , Soysal Pinar , Isik Ahmet Turan 
Published: July 2020

Objectives
Orthostatic hypotension is a well-known disorder, but orthostatic hypertension (OHT) still remains unclear in older adults. The aim of this study was to determine the comparison orthostatic hypotension with OHT according to fall risk and geriatric assessment parameters.

Methods
A total of 741 patients who were admitted to the geriatric clinic and underwent comprehensive geriatric assessment were reviewed. Orthostatic blood pressure changes were measured by head-up-tilt Table test within the first three minutes. Orthostatic hypotension was defined as 20 or 10-mmHg drop in systolic and/or diastolic blood pressure from supine to standing position. OHT was defined as an increase in systolic blood pressure of 10 mmHg or more while the patient was standing up from the supine position.

Results
The mean age was 75 ± 8 and 65. About 65% of all participants were female. The rate of orthostatic hypotension and OHT was 17.3 and 7.2%, respectively. The falls and dementia were more frequent, and the Instrumental Activities of Daily Living (IADL) score was lower in orthostatic hypotension group than in OHT and control groups (P < 0.05). These variables were similar between OHT and control groups (P > 0.05). The rates of falls [odds ratio (OR) = 2.02; 95% confidence interval (CI), (0.94–4.33); P = 0.044] and dementia [OR = 2.65; 95% CI, (1.08–6.48); P = 0.032] in orthostatic hypotension group were still higher than in OHT group, even after adjusting for age, sex, estimated glomerular filtration rate and drugs.

Conclusion
Orthostatic hypotension may be more significant in terms of falls, dementia and impaired IADLs scores in older adults than in OHT and control groups. It seems that OHT may be of no clinical importance in geriatric practice.
A Systematic Review With Meta-Analysis of the Efficacy of Cannabis and Cannabinoids for Inflammatory Bowel Disease
Authors: Doeve Benthe H. , van de Meeberg Maartje M. , van Schaik Fiona D.M. , Fidder Herma H. 
Published: July 2020

Goal and Background:A number of studies have investigated the effectiveness of cannabis or cannabinoids for treatment of inflammatory bowel diseases (IBD). We aimed to systematically analyze their effect in in the treatment of IBD patients.Study:We included randomized controlled trials and nonrandomized studies analyzing IBD patients of any age using cannabi(noid)s. Two reviewers searched 3 databases until August 13, 2019. Primary outcome was clinical remission and secondary outcomes included inflammatory biomarkers, symptom improvement, quality of life (QoL) scores, and hospital outcomes. Risk of bias was assessed according to study type. The meta-analyses were performed using a random-effects model with subgroup analyses based on study type.Results:The search identified 682 records of which 15 nonrandomized studies and 5 randomized controlled trials were eligible for inclusion. The meta-analysis of the primary outcome included 146 randomized participants, all 18 years of age or older. Risk of bias was moderate. Cannabi(noid)s were not effective at inducing remission (risk ratio=1.56, 95% confidence interval=0.99-2.46). No effect on inflammatory biomarkers was observed. However, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) all improved with cannabi(noid)s on Likert-scales. Baseline QoL scores were lower in patients using cannabis among cohort studies but improved significantly with cannabi(noid)s. Although length of hospital stay was shorter and risk of parenteral nutrition was lower in patients using cannabis, there was no effect on other IBD complications.Conclusions:Cannabi(noid)s do not induce clinical remission or affect inflammation in IBD patients. However, cannabi(noid)s significantly improve patient-reported symptoms and QoL.
Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn’s disease
Authors: Steell Lewis , Johnston Blair A. , Dewantoro Dickson , Foster John E. , Gaya Daniel R. , Macdonald Jonathan , McMillan Martin , Russell Richard K. , Seenan John Paul , Ahmed S. Faisal , Gray Stuart R. , Wong Sze Choong 
Published: July 2020

Background
Muscle–bone deficits are common in pediatric Crohn’s disease; however, few studies have assessed long-term musculoskeletal outcomes in adults with childhood-onset Crohn’s disease. This study assessed the prevalence of musculoskeletal deficits in young adults with childhood-onset Crohn’s disease compared with healthy controls.

Methods
High-resolution MRI and MR spectroscopy were used to assess bone microarchitecture, cortical geometry and muscle area, and adiposity at distal femur and bone marrow adiposity (BMA) at lumbar spine. Muscle function and biomarkers of the muscle-bone unit were also assessed.

Results
Twenty-seven adults with Crohn’s disease with median (range) age 23.2 years (18.0, 36.1) and 27 age and sex-matched controls were recruited. Trabecular microarchitecture, cortical geometry and BMA were not different between Crohn’s disease and controls (P > 0.05 for all). Muscle area was lower (P = 0.01) and muscle fat fraction was higher (P = 0.04) at the distal femur in Crohn’s disease compared to controls. Crohn’s disease participants had lower grip strength [-4.3 kg (95% confidence interval (CI), -6.8 to -1.8), P = 0.001] and relative muscle power [-5.0 W/kg (95% CI, -8.8 to -1.2), P = 0.01]. Crohn’s disease activity scores negatively associated with trabecular bone volume (r = -0.40, P = 0.04) and muscle area (r = -0.41, P = 0.03).

Conclusion
Young adults with well-controlled Crohn’s disease managed with contemporary therapies did not display abnormal bone microarchitecture or geometry at the distal femur but exhibited muscle deficits. The observed muscle deficits may predispose to musculoskeletal morbidity in future and interventions to improve muscle mass and function warrant investigation.
Seroprevalence of hepatitis E virus in Argentinean blood donors
Authors: Di Lello Federico A. , Blejer Jorgelina , Alter Adriana , Bartoli Sonia , Vargas Fabiana , Ruiz Rosángela , Galli Claudio , Blanco Sebastián , Carrizo Luis Horacio , Gallego Sandra , Fernández Roberto , Martínez Alfredo P. , Flichman Diego M. 
Published: July 2020

Background
Hepatitis E virus (HEV) is the main cause of enteric acute viral hepatitis worldwide. In this epidemiological framework, it has become a threat to blood safety and a relevant issue for blood transfusions. However, there is a paucity of data regarding prevalence of HEV infection. The aim of this study was to determine HEV seroprevalence in blood donors from different regions from Argentina.

Material and methods
Serum samples from 391 individuals attending five blood donor centers located in different regions from Argentina were analyzed for anti-HEV IgG and anti-HEV IgM.

Results
Overall, anti-HEV IgG was detected in 44 out of 391 (11.3%) samples. HEV prevalence ranged from 5.1 to 20.0% among different country regions. A significant difference in blood donors’ age was observed between anti-HEV IgG positive and negative individuals [44 (37–51) vs. 35 (27–43), P < 0.001, respectively]. Anti-HEV IgM was detected in 8 out of 44 (18.2%) anti-HEV IgG positive cases.

Conclusion
Anti-HEV IgG was detected in blood donor samples from five analyzed Argentinean regions, highlighting the wide distribution of the virus in the country. HEV prevalence was variable among different regions and significantly higher in older donors. Given the evidence of anti-HEV IgM presence in blood donors, suggesting a potential risk of transfusion-transmitted HEV, screening for HEV in blood units to be used in vulnerable population would be desirable. Molecular studies for detection of viremic donors and donor–recipients follow-up are necessary to certainly determine the risk of transfusion-transmitted HEV in Argentina.
COVID-19 Ischemic Strokes as an Emerging Rehabilitation Population
Authors: Diaz-Segarra Nicole , Edmond Arline , Kunac Anastasia , Yonclas Peter 
Published: July 2020

Abstract
There is emerging literature that coronavirus disease 2019 infections result in an increased incidence of thrombosis secondary to a prothrombotic state. Initial studies reported ischemic strokes primarily occurring in the critically ill coronavirus disease 2019 population. However, there have been reports of ischemic strokes as the presenting symptom in young noncritically ill coronavirus disease 2019 patients without significant risk factors. Further characterization of the coronavirus disease 2019 stroke population is needed. We present four cases of coronavirus disease 2019 ischemic strokes occurring in patients aged 37–68 yrs with varying coronavirus disease 2019 infection severities, premorbid risk factors, clinical presentations (eg, focal and nonfocal), and vascular distributions. These cases highlight the heterogeneity of coronavirus disease 2019 ischemic strokes. The duration of the coronavirus disease 2019–related prothrombotic state is unknown, and it is unclear whether patients are at risk for recurrent strokes. With more coronavirus disease 2019 patients recovering and being discharged to rehabilitation, physiatric awareness of this prothrombotic state and increased incidence of ischemic strokes is essential. Because of the variable presentation of coronavirus disease 2019 ischemic strokes, clinicians can consider neuroimaging as part of the evaluation in coronavirus disease 2019 patients with either acute focal or nonfocal neurologic symptoms. Additional studies are needed to clarify prothrombotic state duration, determine prognosis for recovery, and establish the physiatrist’s role in long-term disease management.
Ex Vivo Analysis of Kidney Graft Viability Using 31P Magnetic Resonance Imaging Spectroscopy
Authors: Longchamp Alban , Klauser Antoine , Songeon Julien , Agius Thomas , Nastasi Antonio , Ruttiman Raphael , Moll Solange , Meier Raphael P. H. , Buhler Leo , Corpataux Jean-Marc , Lazeyras Francois 
Published: July 2020

Background.
The lack of organs for kidney transplantation is a growing concern. Expansion in organ supply has been proposed through the use of organs after circulatory death (donation after circulatory death [DCD]). However, many DCD grafts are discarded because of long warm ischemia times, and the absence of reliable measure of kidney viability. 31P magnetic resonance imaging (pMRI) spectroscopy is a noninvasive method to detect high-energy phosphate metabolites, such as ATP. Thus, pMRI could predict kidney energy state, and its viability before transplantation.

Methods.
To mimic DCD, pig kidneys underwent 0, 30, or 60 min of warm ischemia, before hypothermic machine perfusion. During the ex vivo perfusion, we assessed energy metabolites using pMRI. In addition, we performed Gadolinium perfusion sequences. Each sample underwent histopathological analyzing and scoring. Energy status and kidney perfusion were correlated with kidney injury.

Results.
Using pMRI, we found that in pig kidney, ATP was rapidly generated in presence of oxygen (100 kPa), which remained stable up to 22 h. Warm ischemia (30 and 60 min) induced significant histological damages, delayed cortical and medullary Gadolinium elimination (perfusion), and reduced ATP levels, but not its precursors (AMP). Finally, ATP levels and kidney perfusion both inversely correlated with the severity of kidney histological injury.

Conclusions.
ATP levels, and kidney perfusion measurements using pMRI, are biomarkers of kidney injury after warm ischemia. Future work will define the role of pMRI in predicting kidney graft and patient’s survival.
Early Impact of COVID-19 on Solid Organ Transplantation in the United States
Authors: Cholankeril George , Podboy Alexander , Alshuwaykh Omar S. , Kim Donghee , Kanwal Fasiha , Esquivel Carlos O. , Ahmed Aijaz 
Published: July 2020

Background.
The regional impact of coronavirus disease 2019 on solid organ transplantation in the United States has not been fully evaluated.

Methods.
A retrospective analysis of month-to-month trends on waitlist additions, waitlist deaths, and transplant surgeries between all United Network for Organ Sharing (UNOS) regions was performed. A linear regression model trained on historical data was used to estimate anticipated transplantation volume.

Results.
All UNOS regions reported a decrease in total waitlist additions and transplant surgeries. The largest decreases in total transplants were identified in regions 1, 2, 6, and 9, with regions 2, 7, 8, and 9 noting the largest decrease in waitlist additions. Six of the 11 regions noted increases in waitlist deaths, with UNOS regions 9, 1, and 2, all located within the Northeast, noting the highest percent increase in waitlist deaths at 170%, 89%, and 54%, respectively. The largest reductions in solid organ transplantation and waitlist deaths were seen in kidney and lung transplantation. Current transplantation volume is significantly lower than the low range of the 95% confidence interval derived from the linear regression model (2182 versus 3110; P < 0.05).

Conclusions.
Significant decreases in total waitlist additions and transplant surgeries with increases in waitlist deaths were noted in the majority of US transplant domains. The impact was especially prevalent in areas with high burden of coronavirus disease 2019 infection. National and regional strategies aimed at minimizing disruptions in transplantation are needed.
EEG Beta-Band Spectral Entropy Can Predict the Effect of Drug Treatment on Pain in Patients With Herpes Zoster
Authors: Wei Mengying , Liao Yuliang , Liu Jia , Li Linling , Huang Gan , Huang Jiabin , Li Disen , Xiao Lizu , Zhang Zhiguo 
Published: July 2020

Background:
Medication is the main approach for early treatment of herpes zoster, but it could be ineffective in some patients. It is highly desired to predict the medication responses to control the degree of pain for herpes zoster patients. The present study is aimed to elucidate the relationship between medication outcome and neural activity using EEG and to establish a machine learning model for early prediction of the medication responses from EEG.

Methods:
The authors acquired and analyzed eye-closed resting-state EEG data 1 to 2 days after medication from 70 herpes zoster patients with different drug treatment outcomes (measured 5–6 days after medication): 45 medication-sensitive pain patients and 25 medication-resistant pain patients. EEG power spectral entropy of each frequency band was compared at each channel between medication-sensitive pain and medication-resistant pain patients, and those features showing significant difference between two groups were used to predict medication outcome with different machine learning methods.

Results:
Medication-sensitive pain patients showed significantly weaker beta-band power spectral entropy in the central–parietal regions than medication-resistant pain patients. Based on these EEG power spectral entropy features and a k-nearest neighbors classifier, the medication outcome can be predicted with 80% ± 11.7% accuracy, 82.5% ± 14.7% sensitivity, 77.7% ± 27.3% specificity, and an area under the receiver operating characteristic curve of 0.85.

Conclusions:
EEG beta-band power spectral entropy in the central–parietal region is predictive of the effectiveness of drug treatment on herpes zoster patients, and it could potentially be used for early pain management and therapeutic prognosis.
Non-additive polygenic models improve predictions of fitness traits in three eukaryote model species
Authors: Exposito-Alonso Moises , Wilton Peter , Nielsen Rasmus 
Published: July 2020

ABSTRACTTo describe a living organism it is often said that “the whole is greater than the sum of its parts”. In genetics, we may also think that the effect of multiple mutations on an organism is greater than their additive individual effect, a phenomenon called epistasis or multiplicity. Despite the last decade’s discovery that many disease- and fitness-related traits are polygenic, or controlled by many genetic variants, it is still debated whether the effects of individual genes combine additively or not. Here we develop a flexible likelihood framework for genome-wide associations to fit complex traits such as fitness under both additive and non-additive polygenic architectures. Analyses of simulated datasets under different true additive, multiplicative, or other epistatic models, confirm that our method can identify global non-additive selection. Applying the model to experimental datasets of wild type lines ofArabidopsis thaliana, Drosophila melanogaster, andSaccharomyces cerevisiae, we find that fitness is often best explained with non-additive polygenic models. Instead, a multiplicative polygenic model appears to better explain fitness in some experimental environments. The statistical models presented here have the potential to improve prediction of phenotypes, such as disease susceptibility, over the standard methods for calculating polygenic scores which assume additivity.
A parsimonious model for spatial transmission and heterogeneity in the COVID-19 propagation
Authors: Roques Lionel , Bonnefon Olivier , Baudrot Virgile , Soubeyrand Samuel , Berestycki Henri 
Published: July 2020

AbstractRaw data on the cumulative number of deaths at a country level generally indicate a spatially variable distribution of the incidence of COVID-19 disease. An important issue is to determine whether this spatial pattern is a consequence of environmental heterogeneities, such as the climatic conditions, during the course of the outbreak. Another fundamental issue is to understand the spatial spreading of COVID-19. To address these questions, we consider four candidate epidemiological models with varying complexity in terms of initial conditions, contact rates and non-local transmissions, and we fit them to French mortality data with a mixed probabilistic-ODE approach. Using standard statistical criteria, we select the model with non-local transmission corresponding to a diffusion on the graph of counties that depends on the geographic proximity, with time-dependent contact rate and spatially constant parameters. This original spatially parsimonious model suggests that in a geographically middle size centralized country such as France, once the epidemic is established, the effect of global processes such as restriction policies, sanitary measures and social distancing overwhelms the effect of local factors. Additionally, this modeling approach reveals the latent epidemiological dynamics including the local level of immunity, and allows us to evaluate the role of non-local interactions on the future spread of the disease. In view of its theoretical and numerical simplicity and its ability to accurately track the COVID-19 epidemic curves, the framework we develop here, in particular the non-local model and the associated estimation procedure, is of general interest in studying spatial dynamics of epidemics.