bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Medical Serious Adverse Events in Hip Fracture Patients Treated With Arthroplasty
Authors: Neilly David , MacDonald David R. W. , Sprague Sheila , Bzovsky Sofia , Axelrod Daniel , Poolman Rudolf W. , Frihagen Frede , Heels-Ansdell Diane , Bhandari Mohit , Schemitsch Emil H. , Stevenson Iain M. ,   on behalf of the HEALTH Investigators
Published: October 2020

Aim:
Patients with hip fractures are often frail with multiple comorbidities and at risk of medical serious adverse events (SAEs). We investigated the HEALTH trial patient population to ascertain predictors of SAEs.

Methods:
We performed a multivariable Cox regression analysis. Occurrence of SAEs was included as the dependent variable with 31 potential prognostic factors being included as independent variables.

Results:
One thousand four hundred forty-one patients were included in this analysis. Three hundred seventy (25.6%) patients suffered from an SAE. The most common events were cardiac (38.4%, n = 105), respiratory (20.8%, n = 77), and neurological (14.1%, n = 77). The majority of SAEs (50.8%, n = 188) occurred in the first 90 days after hip fracture with 35.4% occurring in the first 30 days (n = 131). Body mass index (BMI) between 18.5 and 24.9 compared with BMI between 25 and 29.9 [hazard ratio (HR) 1.32, P = 0.03] and receiving a total hip arthroplasty compared with a bipolar hemiarthroplasty (HR 1.36, P = 0.03) were associated with a higher risk of a medical SAE within 24 months of femoral neck fracture. Age (P = 0.09), use of femoral cement (P = 0.59), and use of canal pressurization (P = 0.37) were not associated with a medical SAE.

Conclusion:
Total hip arthroplasty is associated with more SAEs in the immediate postoperative period, and care should be taken in selecting patients for this treatment compared with a hemiarthroplasty. A higher BMI may be protective in hip fracture patients while age alone does not predict SAEs and neither does the use of femoral cement and/or pressurization.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Factors Associated With Mortality After Surgical Management of Femoral Neck Fractures
Authors: Bzovsky Sofia , Comeau-Gauthier Marianne , Schemitsch Emil H. , Swiontkowski Marc , Heels-Ansdell Diane , Frihagen Frede , Bhandari Mohit , Sprague Sheila ,   on behalf of the FAITH and HEALTH Investigators
Published: October 2020

Background:
Hip fractures are recognized as one of the most devastating injuries impacting older adults because of the complications that follow. Mortality rates postsurgery can range from 14% to 58% within one year of fracture. We aimed to identify factors associated with increased risk of mortality within 24 months of a femoral neck fracture in patients aged ≥50 years enrolled in the FAITH and HEALTH trials.

Methods:
Two multivariable Cox proportional hazards regressions were used to investigate potential prognostic factors that may be associated with mortality within 90 days and 24 months of hip fracture.

Results:
Ninety-one (4.1%) and 304 (13.5%) of 2247 participants died within 90 days and 24 months of suffering a femoral neck fracture, respectively. Older age (P < 0.001), lower body mass index (P = 0.002), American Society of Anesthesiologists (ASA) class III/IV/V (P = 0.004), use of an ambulatory aid before femoral neck fracture (P < 0.001), and kidney disease (P < 0.001) were associated with a higher risk of mortality within 24 months of femoral neck fracture. Older age (P = 0.03), lower body mass index (P = 0.02), use of an ambulatory aid before femoral neck fracture (P < 0.001), and having a comorbidity (P = 0.04) were associated with a higher risk of mortality within 90 days of femoral neck fracture.

Conclusions:
Our analysis found that factors that are indicative of a poorer health status were associated with a higher risk of mortality within 24 months of femoral neck fracture. We did not find a difference in treatment methods (internal fixation vs. joint arthroplasty) on the risk of mortality.

Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Secondary prevention after CABG: do new agents change the paradigm?
Authors: Paquin Amélie , Poirier Paul , Beaudoin Jonathan , Piché Marie-Eve 
Published: October 2020

Purpose of review
Coronary artery bypass graft (CABG) surgery remains the gold-standard treatment for multivessel and left main coronary artery disease. Despite significant improvement in cardiovascular outcomes, patients undergoing CABG remain at risk for recurrent adverse ischemic events and other cardiovascular outcomes (coronary revascularisation, stroke, cardiac death, etc.). The purpose of this review is to summarize the most recent evidence in pharmacological preventive therapies addressing the residual cardiovascular risk in patients who have undergone CABG.

Recent findings
Novel cardiovascular pharmacological preventive strategies targeting inflammatory, metabolic and prothrombotic (antiplatelet and anticoagulation) pathways have been recently assessed, with promising results for secondary prevention after CABG.

Summary
Secondary prevention is an essential part of postoperative care after CABG. Novel lipid-lowering and glucose-controlling agents suggest a strong and consistent benefit on native coronary artery disease and overall cardiovascular outcomes. The role and the choice of enhanced antiplatelet/anticoagulation/lipid/glucose-modulating therapies following CABG should be better defined and deserves further investigation. Additional studies are required to identify new therapeutic target addressing the specific multifactorial nature of the graft CV disease and identifying the best preventive strategies for long-term graft patency.
Psychiatric Disabilities and Other Long-term Consequences of Childhood Bacterial Meningitis
Authors: Johansson Kostenniemi Urban , Bazan Aleksander , Karlsson Linda , Silfverdal Sven-Arne 
Published: October 2020

Background:
Bacterial meningitis is known to cause hearing impairments and neurologic deficits; however, less is known regarding psychiatric disabilities. In this study, we assessed psychiatric disabilities and other long-term consequences of childhood bacterial meningitis.

Methods:
From a previously validated dataset, we selected children having had bacterial meningitis. We then reviewed medical records and child health records from discharge onwards to identify disabilities. We calculated the occurrence of disabilities with a 95% confidence interval (CI), and we used a χ2 test to assess possible individual risk factors associated with occurrence of disabilities.

Results:
Of the 80 children included in this study, permanent disabilities not attributed to preexisting diseases were noted in 56% (CI: 45–67) during the mean observation period of 19 years and 2 months. Psychiatric disease was diagnosed in 30% (CI: 21–41), and another 5% (CI: 2–13) were under ongoing investigations for symptoms of psychiatric disease. Hearing impairments affected at least 30% (CI: 20–40), and neurologic deficits affected at least 23% (CI: 15–34). While other disabilities were often detected within the first year, psychiatric disabilities were detected after a mean time period of 14 years (CI: 11:1–16:11). Although some associations were noted, no individual risk factor was able to predict the occurrence of disabilities.

Conclusions:
Psychiatric disabilities affect more than one-third of survivors and are among the most common long-term consequence of childhood bacterial meningitis. Late discovery and predictive difficulties call for a revision of current guidelines to include a specific long-term strategy for detecting psychiatric disabilities.
Effect of Macrolides and β-lactams on Clearance of Bordetella pertussis in the Nasopharynx in Children With Whooping Cough
Authors: Mi Yu-Mei , Hua Chun-Zhen , Fang Chao , Liu Juan-Juan , Xie Yong-Ping , Lin Luo-Na , Wang Gao-Liang 
Published: October 2020

Objective:
The purpose of the current study is to investigate the bactericidal effect of macrolides and β-lactams on Bordetella pertussis (B. pertussis) in the nasopharynx and provide guidance for treating macrolides-resistant B. pertussis infections.

Methods:
Patients with whooping cough was diagnosed by culture of nasopharynx swabs between January 2016 to December 2018. B. pertussis was identified using specific antisera against pertussis and parapertussis. Drug susceptibility test was carried out using the E-test method. The clearance of B. pertussis in nasopharynx at 7 and 14 days into and posttreatment with macrolides, and β-lactams was compared.

Results:
A total of 125 B. pertussis samples were collected from patients who received single antibiotic treatment. Among those isolates, 62.4% (78/125) had high resistance with minimum inhibitory concentrations greater than 256 mg/L for erythromycin and azithromycin. The MIC90 of piperacillin, cefoperazone-sulbactam, meropenem, ampicillin, ceftriaxone, ceftazidime and trimethoprim-sulfamethoxazole for these isolates was <0.016, 0.094, 0.094, 0.19, 0.19, 0.25 and 0.75 mg/L, respectively. The clearance rate with β-lactams treatment (68.8%, 44/64) was significantly higher than that with macrolides treatment at 14 days posttreatment (50.8%, 31/61) (χ2 = 4.18, P = 0.04). Macrolides had a better clearance rate at 7 days posttreatment than β-lactams (χ2 = 4.49, P = 0.03) for macrolides-sensitive isolates and a worse clearance rate for macrolides-resistant isolates.

Conclusion:

B. pertussis isolates had a high-resistant rate for macrolides in our study. Macrolides are the first choice for treating pertussis caused by macrolides-sensitive strains, and some β-lactams such as piperacillin should be considered as alternative antibiotics for treatment of macrolides-resistant B. pertussis infection.
Liver Fibrosis Evaluated With Transient Elastography in 35 Children With Chronic Hepatitis C Virus Infection
Authors: Pokorska-Śpiewak Maria , Dobrzeniecka Anna , Lipińska Marta , Tomasik Anna , Aniszewska Małgorzata , Marczyńska Magdalena 
Published: October 2020

Background:
The aim of this prospective study was to analyze liver fibrosis in teenagers with chronic hepatitis C (CHC) using noninvasive methods.

Methods:
Thirty-five patients with CHC, 12–17 years of age (mean 14.2 ± 1.8 years; 22/35, 63% male) were included. Most of them (29/35, 83%) were infected vertically, 21/35 (60%) were treatment-naive, 30/35 (86%) were infected with genotype 1 and 5/35 (14%) were infected with genotype 4 HCV. In all patients, evaluation of liver fibrosis was performed using transient elastography (TE) and measurement of the following serum biomarkers: aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4). Using liver stiffness measurement (LSM) results as a reference, the diagnostic performance of APRI and FIB-4 was assessed by calculating area under the receiver operating characteristics curve.

Results:
Transient elastography results revealed no or mild fibrosis (F0/1 in METAVIR scale) in 31/35 (89%) patients. In 4/35 (11%) patients, significant fibrosis was observed (F ≥ 2), including 3/35 (9%) with cirrhosis (F4). The median APRI was 0.32, and the median FIB-4 was 0.32. LSM was associated with both APRI and FIB-4 [r = 0.61, 95% confidence interval (CI) 0.35–0.79, P = 0.0001; and r = 0.60, 95% CI 0.32–0.78, P = 0.0002, respectively]. For the diagnosis of significant fibrosis, the area under the receiver operating characteristics (95% CI) for both APRI and FIB-4 was 0.855 (0.695–0.951). APRI, with a cutoff >0.374, predicted significant fibrosis, with 100% sensitivity and 67.7% specificity, whereas FIB-4, with a cutoff >0.402, predicted significant fibrosis, with 75.0% sensitivity and 90.3% specificity.

Conclusions:
Significant fibrosis, including cirrhosis, may occur in teenagers with CHC. Serum biomarkers (APRI, FIB-4) correlate positively with LSM.
Changes in the Etiology and Clinical Characteristics of Pediatric Infective Endocarditis in South Korea
Authors: Song Seung Ha , Bang Ji Seok , Han Mi Seon , Yun Ki Wook , Lee Sang Yun , Song Mi Kyoung , Kim Gi Beom , Bae Eun Jung , Kim Woong Han , Choi Eun Hwa 
Published: October 2020

Objective:
Changes in the epidemiology, clinical manifestations, and outcomes of infective endocarditis (IE) have been reported in recent years. This study was performed to analyze changing trends in the etiology of IE in children in South Korea.

Study design:
A retrospective study of children with IE was conducted from 2 hospitals in Korea from 2004 to 2019. IE was defined according to the Modified Duke criteria. We analyzed the etiology and clinical outcome of 96 cases and compared the etiology with that during 1987–1997, as described in a previous study.

Results:
A total of 96 cases in 89 children satisfied the modified Duke criteria. The median age was 9.5 years. Preexisting structural heart diseases were identified in 81 cases (84.4%). Ten of the 15 cases with normal heart anatomy had a history of indwelling central venous catheters and underlying noncardiac conditions. Of the 72 identified organisms, common pathogens included Staphylococcus aureus, 24 (32.9%); viridans streptococci, 22 (30.2%); coagulase-negative staphylococci, 14 (19.2%); and Candida species, 7 (9.6). Sixty-three cases (66.7%) required surgical intervention, and the overall fatality rate was 7.9%. Compared with the period of 1987–1997, an increasing trend in the proportion of staphylococci as the etiology of IE in 2004–2019 was observed (26.7% vs. 51.8%, P = 0.029). In addition, S. aureus was associated with the high rate of developing complications (P < 0.05).

Conclusion:
In South Korea, Gram-positive cocci represent 85% of all etiologic agents of IE in children with an increasing trend in the proportion of staphylococci.
MRI of the Wrist Ligaments
Authors: Leake Richard L. , Mills Megan K. , Allen Hailey , Crawford Amanda M. , Kobes Patrick H. , Soltanolkotabi Maryam 
Published: October 2020

Abstract
Technological advances in magnetic resonance imaging (MRI) have improved radiologists’ ability to evaluate wrist ligaments. MRI interpretation often guides clinical management. This article aims to review the normal and pathologic appearance of intrinsic and extrinsic wrist ligaments with a focus on MRI. Variant anatomy, imaging pearls, and clinical significance are also discussed. Special attention is paid to key wrist ligaments that play a role in carpal stability.
3T Magnetic Resonance Imaging of the Wrist Tendons
Authors: Rehwald Christine , Joyce Ryan P. , Pezeshk Parham , Del Grande Filippo , Khoshpouri Parisa , Chew Felix , Chalian Majid 
Published: October 2020

Abstract
Magnetic resonance imaging (MRI) is frequently used in the imaging evaluation of wrist pain. The complex anatomy of the wrist can be demonstrated by MRI. Three tesla (3 T) MRI offers increased signal-to-noise ratio relative to 1.5 T MRI allowing for higher soft tissue contrast and better spatial resolution. The resulting increase in conspicuity of fine anatomic detail may improve the detection and characterization of wrist pathology. In this article, we will review the anatomy, normal variants, and common pathologies of the wrist tendons as evaluated on 3 T MRI.
Osseous Pathology on Wrist Magnetic Resonance Imaging
Authors: Gimarc David C. 
Published: October 2020

Abstract
Advanced imaging of the osseous structures of the wrist by magnetic resonance imaging (MRI) yields powerful information regarding marrow composition and overall bone structure. Various forms of pathology, both benign and malignant, have unique marrow signal abnormalities that can be easily detected by MRI given its high sensitivity to radiographically occult processes. In particular, osseous pathology can be seen in the setting of traumatic, degenerative, congenital, infectious, and neoplastic conditions. The acuity or chronicity of these conditions can often be determined by imaging to aid in appropriate therapy. A thorough understanding of the breadth of pathology and corresponding MRI appearances can allow the interpreting radiologist to formulate a concise and accurate assessment of an examination.
Using a crowdsourcing open call, hackathon and a modified Delphi method to develop a consensus statement and sexual health survey instrument
Authors: Kpokiri Eneyi E. , Wu Dan , Srinivas Megan L. , Anderson Juliana , Say Lale , Kontula Osmo , Ahmad Noor Ani , Morroni Chelsea , Izugbara Chimaraoke , de Visser Richard , Yaa-Oduro Georgina , Gitau Evelyn , Welbourn Alice , Andrasik Michele , Norman Wendy V. , Clifton Soazig , Gabster Amanda , Gesselman Amanda , Smith Chantal , Prause Nicole , Olumide Adesola , Erausquin Jennifer T. , Muriuki Peter , van der Straten Ariane , Nicholson Martha , O’Connell Kathryn A. , Mwoka Meggie , Bajos Nathalie , Mercer Catherine H , Gonsalves Lianne Marie , Tucker Joseph D. 
Published: October 2020

AbstractPopulation health surveys are rarely comprehensive in addressing sexual health, and population-representative surveys often lack standardized measures for collecting comparable data across countries. We present a sexual health survey instrument and implementation considerations for population-level sexual health research. The brief, comprehensive sexual health survey and consensus statement was developed via a multi-step process (an open call, a hackathon, and a modified Delphi process). The survey items, domains, entire instruments, and implementation considerations to develop a sexual health survey were solicited via a global crowdsourcing open call. The open call received 175 contributions from 49 countries. Following review of submissions from the open call, 18 finalists and eight facilitators with expertise in sexual health research, especially in low and middle-income countries (LMICs), were invited to a 3-day hackathon to harmonize a survey instrument. Consensus was achieved through an iterative, modified Delphi process that included three rounds of online surveys. The entire process resulted in a 19-item consensus statement and a 10-minute sexual health survey instrument. This is the first global consensus on a sexual and reproductive health survey instrument that can be used to generate cross-national comparative data in both high-income and LMICs. The inclusive process identified priority domains for improvement and can inform the design of sexual and reproductive health programs and contextually relevant data for comparable research across countries.Key points–National population-representative surveys assessing sexual practices, behaviours and health-related outcomes focus on high-income countries and different sexual health measures are often used.–There is a lack of population-level representative sexual health research in low- and middle-income countries.–Existing comparable data on sexual practices and behaviours across countries are limited due to the absence of a standardized global sexual health survey instrument.–We report the global consensus on a set of core sexual health items within a 10-minute survey instrument that accommodates the needs and priorities of people from LMICs and various legal and cultural contexts across countries.–The consensus process breaks new ground in terms of incorporating feedback from diverse individuals using a crowdsourcing open call and hackathon process.
A machine learning-based holistic approach for diagnoses within the Alzheimer’s disease spectrum
Authors: Massetti Noemi , Granzotto Alberto , Bomba Manuela , Pizzi Stefano Delli , Mosca Alessandra , Scherer Reinhold , Onofrj Marco , Sensi Stefano L. ,   for the Alzheimer’s Disease Neuroimaging Initiative (ADNI)
Published: October 2020

AbstractAlzheimer’s disease (AD) is a neurodegenerative condition driven by a multifactorial etiology. We employed a machine learning (ML) based algorithm and the wealth of information offered by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database to investigate the relative contribution of clinically relevant factors for identifying subjects affected by Mild Cognitive Impairment (MCI), a transitional status between healthy aging and dementia. Our ML-based Random Forest (RF) algorithm did not help predict clinical outcomes and the AD conversion of MCI subjects. On the other hand, non-converting (ncMCI) subjects were correctly classified and predicted. Two neuropsychological tests, the FAQ and ADAS13, were the most relevant features used for the classification and prediction of younger, under 70, ncMCI subjects. Structural MRI data combined with systemic parameters and the cardiovascular status were instead the most critical factors for the classification of over 70 ncMCI subjects. Our results support the notion that AD is not an organ-specific condition and results from pathological processes inside and outside the Central Nervous System.
Comparing biomarkers for COVID-19 disease with commonly associated preexisting conditions and complications
Authors: Huang Jesse 
Published: October 2020

AbstractSevere coronavirus disease 2019 (COVID-19) has been associated with certain preexisting health conditions and can cause respiratory failure along with other multi-organ injuries. However, the mechanism of these relationships is unclear, and prognostic biomarkers for the disease and its systemic complications are lacking. This study aims to examine the plasma protein profile of COVID-19 patients and evaluate overlapping protein modules with biomarkers of common comorbidities.Blood samples were collected from COVID-19 cases (n=307) and negative controls (n=78) among patients with acute respiratory distress. Proteins were measured by proximity extension assay utilizing next-generation sequencing technology. Its associations to COVID-19 disease characteristics were compared to that of preexisting conditions and established biomarkers for myocardial infarction (MI), stroke, hypertension, diabetes, smoking, and chronic kidney disease.Several proteins were differentially expressed in COVID-19, including multiple pro-inflammatory cytokines such as IFN-γ, CXCL10, and CCL7/MCP-3. Elevated IL-6 was associated with increased severity, while baseline IL1RL1/ST2 levels were associated with a worse prognosis. Network analysis identified several protein modules associated with COVID-19 disease characteristics overlapping with processes of preexisting hypertension and impaired kidney function. BNP and NTpro-BNP, markers for MI and stroke, increased with disease progression and were positively associated with severity. MMP12 was similarly elevated and has been previously linked to smoking and inflammation in emphysema, along with increased cardiovascular disease risk.In conclusion, this study provides an overview of the systemic effects of COVID-19 and candidate biomarkers for clinical assessment of disease progression and the risk of systemic complications.