bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetics of renovascular hypertension in children
Authors: Viering Daan H.H.M. , Chan Melanie M.Y. , Hoogenboom Lieke , Iancu Daniela , de Baaij Jeroen H.F. , Tullus Kjell , Kleta Robert , Bockenhauer Detlef 
Published: June 2020

Objective:
In most cases of renovascular hypertension in children, the cause is unclear. The aim of this study was to investigate genetic variation as a factor in the development of renovascular hypertension in children.

Methods:
In a cohort of 37 unrelated children from a single tertiary referral center, exome sequencing was performed. We assessed variants in recognized and suspected disease genes and searched for novel ones with a gene-based variant-burden analysis.

Results:
In the majority of patients, exome sequencing could not identify causative variants. We found a pathogenic variant in a recognized associated disease gene in five patients (three pathogenic variants in NF1, one in ELN and a deletion of chromosome 7q11.23, consistent with Williams syndrome). In two other patients, (likely) pathogenic variants were found in putative renovascular hypertension genes (SMAD6 and GLA), with clinical implications for both. Ten additional patients carried variants of uncertain significance (VUS) in known (n = 4) or putative (n = 6) renovascular hypertension disease genes. Rare variant burden analysis yielded no further candidate genes.

Conclusion:
Genetic contributors, such as germline mutations in NF1, ELN, 7q11.23del were present in only 5 out of 37 (14%) children with renovascular hypertension. Twelve other children (32%) had potentially causal variants identified, including a pathogenic variant in SMAD6; a vasculopathy gene hitherto unknown to link with renovascular hypertension. Most importantly, our data show that exome sequencing can rarely identify the cause of renovascular hypertension in nonsyndromic children. We suggest that nongenetic factors or somatic genetic variation will play a more important role.
COVID-19 epidemic in the Seine-Saint-Denis Department of Greater Paris: one month and three waves for a tsunami
Authors: Lapostolle Frédéric , Goix Laurent , Vianu Isabelle , Chanzy Erick , De Stefano Carla , Gorlicki Judith , Petrovic Tomislav , Adnet Frédéric 
Published: June 2020

Introduction
Worldwide, the COVID-19 epidemic has put health systems to the test. The excess mortality is partly due to the influx of patients requiring hospitalization and intensive care. We propose that the chronology of epidemic spread gives a window of time in which hospitals can act to prevent reaching capacity.

Methods
The out-of-hospital SAMU Emergency Medical System in an entry point into the French health care system. We recorded the number of patients managed, of patients transferred to emergency departments (ED), and of mobile intensive care units (MICUs) dispatched. Each criterion was compared to the mean of the same criterion over the previous 5 years. The alert threshold which indicated a public health crisis was defined as a 20% increase compared to the 5-year mean.

Results
The reference period, from January 2015 to December 2019, included 3 381 611 calls, and 1 137 856 patients. The study period, from 17 February to 28 March 2020, included 166 888 calls, and 56 708 patients. The daily numbers of patients managed crossed the threshold on February 25, and increased until the end of the study period. The daily number of patients transferred to ED crossed the threshold on March 16, and increased until the end of the period. The daily number of MICUs dispatched crossed the threshold on March 15, and increased until the end of the period.

Conclusion
The COVID-19 epidemic reached our department in three consecutive waves which overwhelmed the health care system. The first wave preceded by 30 days the massive arrival of critical patients. Health care systems must take advantage of this delay to prepare for the third wave.
Discussing Drug Use With Health Care Providers Is Associated With Perceived Need and Receipt of Drug Treatment Among Adults in the United States
Authors: Mauro Pia M. , Samples Hillary , Klein Kathryn S. , Martins Silvia S. 
Published: June 2020

Background:
Drug treatment utilization is low despite a high public health burden of drug use disorders (DUDs). Engaging people at risk for DUDs across a broader range of health care settings may improve uptake of drug treatment.

Objectives:
To estimate the prevalence of drug use screening/discussions between health care providers and individuals with past-year drug use, and to assess the associations between drug use screening/discussions and perceived need and use of drug treatment.

Methods:
We analyzed representative cross-sectional data from the 2015 to 2017 National Surveys on Drug Use and Health. The sample included adults aged 18 years and above reporting past-year drug use and ≥1 health care visit. We measured correlates of drug use screening/discussions using multinomial logistic regression. Overall and among adults meeting DUD criteria, we used logistic regression to estimate associations between drug use screening/discussions and (1) past-year drug treatment and (2) perceived need for treatment.

Results:
In the full sample (n=21,505), 34.50% reported no screening/discussions, 44.50% reported screening only, and 21.00% reported discussions with providers. Discussions were associated with significantly higher odds of receiving any drug treatment [adjusted odds ratio (aOR)=3.52 (2.66–4.65)], specialty drug treatment [aOR=4.13 (2.92–5.82)], and perceived treatment need [aOR=2.08 (1.21–3.59)]. Among people with DUD (n=3,834; 15.69%), discussions were associated with treatment use, but not with perceived need.

Conclusions:
Discussing drug use with providers may impact people’s perceptions of drug treatment need and use, indicating potential opportunities to engage people in addiction treatment. Addressing barriers to discussing drug use across care settings could increase treatment use, particularly among people with DUD.
Adverse Events and Burnout
Authors: Vogus Timothy J. , Ramanujam Rangaraj , Novikov Zhanna , Venkataramani Vijaya , Tangirala Subrahmaniam 
Published: June 2020

Background:
Prior research has found that adverse events have significant negative consequences for the patients (first victim) and caregivers (second victim) involved such as burnout. However, research has yet to examine the consequences of adverse events on members of caregiving units. We also lack research on the effects of the personal and job resources that shape the context of how adverse events are experienced.

Objectives:
We test the relationship between job demands (the number of adverse events on a hospital nursing unit) and nurses’ experience of burnout. We further explore the ways in which personal (workgroup identification) and job (safety climate) resources amplify or dampen this relationship. Specifically, we examine whether, and the conditions under which, adverse events affect nurse burnout.

Research Design:
Cross-sectional analyses of survey data on nurse burnout linked to hospital incident reporting system data on adverse event rates for the year before survey administration and survey data on workgroup identification and safety climate.

Subjects:
Six hundred three registered nurses from 30 nursing units in a large, urban hospital in the Midwest completed questionnaires.

Results:
Multilevel regression analysis indicated that adverse events were positively associated with nurse burnout. The effects of adverse events on nurse burnout were amplified when nurses exhibited high levels of workgroup identification and attenuated when safety climate perceptions were higher.

Conclusions:
Adverse events have broader negative consequences than previously thought, widely affecting nurse burnout on caregiving units, especially when nurses strongly identify with their workgroup. These effects are mitigated when leaders cultivate safety climate.
Enhancing capacity and synthesis of [68Ga]68-Ga-PSMA-HBED-CC with the lyophilized ready-to-use kit for nuclear pharmacy applications
Authors: Golan Haim , Esa Moad , Moshkoviz Keren , Feldhaim Asher , Hoch Baruch , Shalom Eli 
Published: June 2020

Introduction
The authors describe the newly proposed synthesis technique for the gallium-68 (Ga-68)-labeled tracer ([68Ga]Ga-PSMA-HBED-CC) for imaging expression of the prostate-specific membrane antigen (PSMA). An effort was applied to design the lyophilized cold kit (isoPROtrace-11) as a time-saving technique resulting in increased radiochemical yields.

Procedures
The initial material for labeling was obtained from a 68Ge/68Ga-generator. For labeling with the lyophilized cold kit isoPROtrace-11, 2.5 ml 0.1 M HCl of the middle Ga-68 elution fraction were added to the kit, shook for dissolving the vial’s contents and kept for 5 minutes at room temperature. A systematic comparison was carried out between results obtained with the cold kit technique and with previously used Modular-Lab module concerning the radiochemical yield, purity, and the time of producing.

Results
Automated module-involved synthesis of [68Ga]Ga-PSMA-HBED- CC resulted in a radiochemical yield of 84.2 ± 6.3% and purity of >95% after 25 minutes. The room temperature cold kit gave a radiochemical yield of >98% and purity of >95% after 5 minutes.

Conclusion
Using the kit method reduced the labeling time. The cold kit method increased production efficiency because less of the eluted Ga-68 was wasted.
Prediction of Acute Kidney Injury on Admission to Pediatric Intensive Care
Authors: Raman Sainath , Tai Chian Wern , Le Marsney Renate , Schibler Andreas , Gibbons Kristen , Schlapbach Luregn J. 
Published: June 2020

Objectives:
Up to 37% of children admitted to the PICU develop acute kidney injury as defined by Kidney Disease: Improving Global Outcomes criteria. We describe the prevalence of acute kidney injury in a mixed pediatric intensive care cohort using this criteria. As tools to stratify patients at risk of acute kidney injury on PICU admission are lacking, we explored the variables at admission and day 1 that might predict the development of acute kidney injury.

Design:
Single-center retrospective observational study.

Setting:
Thirty-six–bed surgical/medical tertiary PICU.

Patients:
Children from birth to less than or equal to 16 years old admitted between 2015 and 2018.

Interventions:
None.

Measurements and Main Results:
Clinical data were extracted from the PICU clinical information system. Patients with baseline creatinine at admission greater than 20 micromol/L above the calculated normal creatinine level were classified as “high risk of acute kidney injury.” Models were created to predict acute kidney injury at admission and on day 1. Out of the 7,505 children admitted during the study period, 738 patients (9.8%) were classified as high risk of acute kidney injury at admission and 690 (9.2%) developed acute kidney injury during PICU admission. Compared to Kidney Disease: Improving Global Outcomes criteria as the reference standard, high risk of acute kidney injury had a lower sensitivity and higher specificity compared with renal angina index greater than or equal to 8 on day 1. For the admission model, the adjusted odds ratio of developing acute kidney injury for high risk of acute kidney injury was 4.2 (95% CI, 3.3–5.2). The adjusted odds ratio in the noncardiac cohort for high risk of acute kidney injury was 7.3 (95% CI, 5.5–9.7). For the day 1 model, odds ratios for high risk of acute kidney injury and renal angina index greater than or equal to 8 were 3.3 (95% CI, 2.6–4.2) and 3.1 (95% CI, 2.4–3.8), respectively.

Conclusions:
The relationship between high risk of acute kidney injury and acute kidney injury needs further evaluation. High risk of acute kidney injury performed better in the noncardiac cohort.
First-line HIV treatment outcomes following the introduction of integrase inhibitors in UK guidelines
Authors: El Bouzidi Kate , Jose Sophie , Phillips Andrew N. , Pozniak Anton , Ustianowski Andrew , Gompels Mark , Winston Alan , Schaap Ab , Dunn David T. , Sabin Caroline A. 
Published: June 2020

Objective:
To investigate the characteristics and outcomes of people who initiated different antiretroviral therapy (ART) regimens during the era of integrase strand transfer inhibitors (INSTIs).

Design:
UK-based observational cohort study.

Methods:
UK Collaborative HIV Cohort study participants were included if they had started ART between 1 January 2012 and 30 June 2017. Virological failure was defined as the first of two consecutive plasma HIV RNA more than 50 copies/ml, at least 6 months after starting ART. Follow-up was censored at ART discontinuation, class switch or death. The risk of virological failure among those on INSTI, protease inhibitor or nonnucleoside reverse transcriptase inhibitor (NNRTI) regimens was compared using Kaplan–Meier and Cox regression methods.

Results:
Of 12 585 participants, 45.6% started a NNRTI, 29.0% a protease inhibitor and 25.4% an INSTI regimen. Over a median follow-up of 20.3 months (interquartile range 7.9–38.9), 7.5% of participants experienced virological failure. Compared with those starting an NNRTI regimen, people receiving INSTIs or protease inhibitors were more likely to experience virological failure: INSTI group adjusted hazard ratio 1.52, 95% confidence interval 1.19–1.95, P = 0.0009; protease inhibitor group adjusted hazard ratio 2.70, 95% confidence interval 2.27–3.21, P less than 0.0001, likelihood ratio test P less than 0.0001.

Conclusion:
First-line INSTI regimens were associated with a lower risk of virological failure than protease inhibitor regimens but both groups were more likely to experience virological failure than those initiating treatment with a NNRTI. There is likely to be residual channelling bias resulting from selected use of INSTIs and protease inhibitors in specific clinical contexts, including in those with a perceived risk of poor adherence.
Use of Point-of-Care Nucleic Acid Tests Beyond Early Infant Diagnosis of HIV: A Retrospective Case Review in Lesotho
Authors: Macneal Kenneth , Tukei Vincent , Sacks Emma , Mokone Mafusi , Makoti Lehlohonolo , Tumbare Esther , Samosamo Tebello , Mots'oane Tsietso , Lemaire Jean-Francois , Cohn Jennifer 
Published: June 2020

Background:
Rapid diagnostic tests (RDTs) for HIV antibodies remain the primary method of diagnosis of HIV in individuals over age 18 months in Lesotho. Although antibody tests have high sensitivity and specificity, up to 2.3% of serial two-test algorithms can have discrepant results between RDTs. In the case of inconclusive RDT results, Lesotho guidelines at the time of this study recommended either repeat testing with the same RDT algorithm after 14 days or immediately collect a blood sample to be sent for laboratory-based polymerase chain reaction testing. Point-of-care qualitative nucleic acid tests (POC qual NAT) may have benefits in rapidly resolving these inconclusive results, particularly when compared with repeating RDTs later or conventional polymerase chain reaction testing at the National Reference Laboratory.

Setting:
Hospitals and clinics at 29 locations throughout Lesotho that had access to point-of-care nucleic acid testing.

Methods:
Retrospective case review.

Results:
We identified 100 testing records where POC qual NAT was used to resolve inconclusive RDTs per Lesotho guidelines. Eighty-nine percent of patients received their results in a median of one day from their inconclusive RDT result (interquartile range 0–7 days). Sixty-eight patients (68%) were determined to be HIV positive based on POC nucleic acid tests (NATs), of which 54 (79%) were started on antiretroviral therapy (ART). Median time from inconclusive RDT result to initiation of ART therapy was 2 days (interquartile range 0–14 days). Three patients in this review were pregnant at the time of testing; one was HIV positive by POC qual NAT and was started on ART therapy the same day.

Conclusion:
As the availability of POC qual NAT platforms increases, they may serve as feasible options for rapid resolution of inconclusive results and initiation of ART, particularly in populations with high risk of imminent transmission.
Orbital Decompression for Exorbitism and Exophthalmos in a Patient With Thyroid Eye Disease
Authors: Kakutani Satoshi , Ito Makoto , Kakizaki Hirohiko , Takahashi Yasuhiro 
Published: June 2020

Abstract
A 34-year-old man with Basedow disease consulted us to treat disfiguring proptosis. On examination, the patient showed right lower eyelid retraction and right inferior rectus muscle enlargement, which were consistent with thyroid eye disease. Hertel's exophthalmometric examination demonstrated proptosis of 25.5 and 24.0 mm on the right and left sides, respectively. Computed tomography (CT) images revealed absence of the sphenoid door jamb. To correct both exorbitism and exophthalmos, the patient underwent bilateral “shallow” decompression of the lateral and medial orbital walls with orbital fat removal under general anesthesia. The authors removed 2.5 and 1.0 mL of orbital fat from the inferolateral quadrant of the right and left orbits, respectively. At 3 months postoperatively, based on the measurements of the axial globe position on sagittal CT images, postoperative proptosis reductions of 7.5 and 6.5 mm were observed on the right and left sides, respectively.
Effectiveness of Blepharoptosis Surgery in Patients With Deepening of the Upper Eyelid Sulcus
Authors: Yamazaki Hitoshi , Yunoki Tatsuya , Tojo Naoki , Hayashi Atsushi 
Published: June 2020

Abstract
The purpose of this retrospective study was to evaluate the effectiveness of blepharoptosis surgery in patients with deepening of the upper eyelid sulcus (DUES). This case series included 10 consecutive patients (19 eyes) with DUES associated with use of a prostaglandin analog for glaucoma. Patients who had used bimatoprost and developed DUES were changed to an alternative prostaglandin analog and observed for ≥3 months. If there was no improvement, they underwent levator resection for blepharoptosis and were followed up for ≥6 months postoperatively. Improvement in margin reflex distance-1 and surgical complications was evaluated. After discontinuation of bimatoprost in 3 cases (6 eyes), mild subjective and objective improvement in DUES was seen in 2 cases (4 eyes) but without improvement in blepharoptosis. The prostaglandin analog used before surgery was travoprost in 4 eyes (21.0%), tafluprost in 7 eyes (36.9%; including 4 eyes switched from bimatoprost), and latanoprost in 8 eyes (42.1%; including 2 eyes switched from bimatoprost). The mean margin reflex distance-1 value was 1.11 ± 0.96 mm before surgery and 3.72 ± 0.81 mm at the final postoperative follow-up; the difference was significant (P = 3.32 × −10). There were no intraoperative or postoperative complications. Levator resection is a useful and safe procedure for blepharoptosis with DUES.
Histological Aspects of a Novel Technique Used for the Management of Infections Secondary to Sinus Bone Grafting
Authors: Ayna Mustafa , Açil Yahya , Wiltfang Jörg , Gülses Aydin 
Published: June 2020

Abstract
Recently, a technical note describing a promising method for the management of infections after sinus bone grafting by irrigating the corresponding area with hydrogen peroxide based solution with an aid of a drain has been published. The aim of this paper was to present the histological and radiological results of the above mentioned technique. A total of 17 patients who have presented with infections secondary to sinus bone grafting enrolled in the study. During implant placement, bone was collected from the originally grafted site with a trephine burr for radiological examination via micro-computed tomography and histological examination. According to the results of the current study, Bio-Oss acted as a scaffold, and mature fibrous bone formed trabeculae, which assembled to an interlinked trabecular structure. Average results obtained from the microradiography confirmed the higher percentage of Bio-Oss (27.21% ± 3.31%) at the corresponding area; whereas the amount of newly formed bone was slightly lower (6.79% ± 1.13%) As a conclusion, this simple and minimally invasive technique might be beneficial in avoiding removal of bone graft material and could help in rescuing the former laborious procedure.
Convolutional Neural Networks for Immediate Surgical Needle Automatic Detection in Craniofacial X-Ray Images
Authors: Liang Zhuangzhuang , Liao Qian , Chen Sheng , Qian Qingyu , Zhu Lin , Yang Hui , Gui Haijun 
Published: June 2020

Purpose:
Immediate X-ray examination is necessary while the surgical needle falls off during operation. In this study, one convolutional neural network (CNN) model was introduced for automatically surgical needle detection in craniofacial X-ray images.

Materials and Methods:
The craniofacial surgical needle (5–0, ETHICON, USA) was localized in 8 different anatomic regions of 2 pig heads for bilateral X-ray examination separately. Thirty-two images were obtained finally which were cropped into fragmented images and divided into the training dataset and the test dataset. Then, one immediate needle detection CNN model was developed and trained. Its performance was quantitatively evaluated using the precision rate, the recall rate, and the f2-score. One 8-fold cross-validation experiment was performed. The detection rate and the time it took were calculated to quantify the degree of difference between the automatic detection and the manual detection by 3 experienced clinicians.

Results:
The precision rate, the recall rate, and the f2-score of the CNN model on fragmented images were 98.99%, 92.67%, and 93.85% respectively. For the 8-fold cross-validation experiments, 26 cases of all the 32 X-ray images were automatically marked the right position of the needle (detection rate of 81.25%). The average time of automatically detecting one image was 5.8 seconds. For the 3 clinicians, 65 images of all the 32× 3 images were checked right (detection rate of 67.7%) with the average time-consuming of 33 seconds.

Conclusion:
In summary, after training with a large dataset, the CNN model showed potential for immediate surgical needle automatic detection in craniofacial X-ray images with better detection accuracy and efficiency than the conventional manual method.