bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparisons on perinatal depression between the first-child women and the second-child women in West China under the universal 2-child policy
Authors: Guo Xiu-Jing , Chen Jing , Ren Jian-Hua , Deng Xue , Xu Liang-Zhi 
Published: June 2020

Abstract

Background:
Universal 2-child policy was proposed in 2015 in China, but it was still uncertain whether having a second child would have any impacts on maternal health, especially mental health. So, the aim of this study was to compare the incidence of perinatal depression between the first-child women and the second-child women and to describe the patterns of perinatal depression from the first and third trimesters to 6 weeks postpartum.

Methods:
A prospective cohort study was conducted in a university hospital, 969 first-child women and 492 second-child women registered in this hospital from Dec 2017 to Mar 2018 were involved in the study. The Mainland Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was applied to screen perinatal depressive symptoms, while socio-demographic and obstetric data were obtained by self-administered questionnaires. Multiple logistic regression analyses were used to compare the risk of depression between 2 groups, and repeated measures of analysis of variances (ANOVAs) were used to determine the EPDS scores of 2 groups across 3 stages.

Results:
The incidence of perinatal depression was 21.78% to 24.87% and 18.29% to 22.15% in the first-child group and the second-child group, respectively. The second-child women were less likely to exhibit depressive symptoms than the first-child women in the first trimester (Adjusted OR = 0.630, 95%CI = 0.457–0.868, P = .005), but no significant difference was found between the 2 groups in the third trimester and at postpartum period. During the whole perinatal period, no significant difference was found in EPDS scores of the first-child group among the three stages. However, the EPDS scores of the second-child group were higher in the first trimester than that at the postpartum period.

Conclusion:
The risk of perinatal depression for the second-child women was no higher than for the first-child women, and the EPDS scores of the second-child women were decreasing during the perinatal period. So couples in West China are recommended to consider having a second child without much worry about its negative effects on mental health under the universal 2-child policy.
A simple new scoring system for predicting the mortality of severe acute pancreatitis
Authors: Wang Lei , Zeng Yan-Bo , Chen Jia-Yun , Luo Qian , Wang Rowan , Zhang Ruijie , Zheng Daniel , Dong Yuan-Hang , Zou Wen-Bin , Xie Xiaoqing , Du Yi-Qi , Li Zhao-Shen 
Published: June 2020

Abstract
It is critical to accurately identify patients with severe acute pancreatitis (SAP) in a timely manner. This study aimed to develop a new simplified AP scoring system based on data from Chinese population.
We retrospectively analyzed a consecutive series of 585 patients diagnosed with SAP at the Changhai hospital between 2009 and 2017. The new Chinese simple scoring system (CSSS) was derived using logistic regression analysis and was validated in comparison to 4 existing systems using receiver operating characteristic curves.
Six variables were selected for incorporation into CSSS, including serum creatinine, blood glucose, lactate dehydrogenase, heart rate, C-reactive protein, and extent of pancreatic necrosis. The new CSSS yields a maximum total score of 9 points. The cut-offs for predicting mortality and severity (discriminating moderately SAP from SAP) were set as 6 points and 4 points respectively. Compared with 4 existing scoring systems, the area under the receiver operating characteristic of CSSS for prediction of mortality was 0.838, similar to acute physiology and chronic health evaluation II (0.844) and higher than Ranson's score (0.702, P < .001), bedside index of severity in acute pancreatitis (0.615), and modified computed tomography severity index (MCTSI) (0.736). For predicting SAP severity, CSSS was the most accurate (0.834), followed by acute physiology and chronic health evaluation II (0.800), Ranson's score (0.702), MCTSI (0.660), and bedside index of severity in acute pancreatitis (0.570). Further, the accuracy of predicting pancreatic infection with CSSS was the highest (0.634), similar to that of MCTSI (0.641).
A new prognostic scoring system for SAP was derived and validated in a Chinese sample. This scoring system is a simple and accurate method for prediction of mortality.
A 3-month-old child with COVID-19
Authors: Li Chenxi , Luo Fan , Wu Bing 
Published: June 2020

Abstract

Introduction:
Coronavirus disease 2019 (COVID-19) is pandemic and is a medical issue. However, children account for a small portion of those with the disease, and there are few published reports of COVID-19 in children. The patient reported in this case report is the youngest case reported in Chengdu, China to date.

Patient concerns:
A 3-month-old male infant presented with cough and rhinorrhea.

Diagnosis:
Family members from Wuhan, the epicenter of the epidemic came to stay in the patient's home 16 days before the onset of his disease, and his mother had been diagnosed with COVID-19. He was diagnosed with COVID-19 based on a history of exposure and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected using reverse transcription polymerase chain reaction (RT-PCR).

Interventions:
The patient was admitted to hospital and treated symptomatically with oral medication.

Outcomes:
The patient recovered completely and was discharged after one month of hospitalization. He tested negative for SARS-CoV-2 using RT-PCR and a chest CT performed 4 weeks after admission showed marked improvement prior to discharge.

Conclusion:
Clinicians must be aware of the presentation of COVID-19 in children because it differs from that in adults.
Successful sirolimus therapy of an aplastic anemia patient with chronic kidney disease
Authors: Niu Haiyue , Qi Weiwei , Wang Yihao , Xing Limin , Fu Rong , Shao Zonghong , Wang Huaquan 
Published: June 2020

Abstract

Rationale:
It is very difficult to treat patients with aplastic anemia accompanied by chronic kidney disease. The nephrotoxicity of cyclosporine limits its use in these patients. Most of these patients also lack suitable sibling donors. Sirolimus, as a new type of immunosuppressive agent, has good therapeutic effect, lower toxicity, especially lower nephrotoxicity, thus attracting the attention of hematologists.

Patient concerns:
This 55-year-old Chinese male patient suffered from pancytopenia and renal insufficiency and has a poor quality of life.

Diagnosis:
The patient was diagnosed as severe aplastic anemia with chronic kidney disease-G3a.

Interventions:
We started the sirolimus therapy with the initial dose of 1 mg per day. Based on the good tolerability and clinical effect, we increased the dose of sirolimus to 2 mg per day after 2 weeks.

Outcomes:
By taking sirolimus, the patient's peripheral blood cell count gradually increased, and he achieved blood transfusion independent, and eventually the blood cell count was completely normal.

Lessons:
We consider that sirolimus is a safe, effective, and well-tolerated oral drug that can be used as a treatment for aplastic anemia patients with chronic kidney disease.
In Vivo Quantification of Water Diffusion, Stiffness, and Tissue Fluidity in Benign Prostatic Hyperplasia and Prostate Cancer
Authors: Asbach Patrick , Ro Sa-Ra , Aldoj Nader , Snellings Joachim , Reiter Rolf , Lenk Julian , Köhlitz Torsten , Haas Matthias , Guo Jing , Hamm Bernd , Braun Jürgen , Sack Ingolf 
Published: June 2020

ObjectivesWater diffusion, tissue stiffness, and viscosity characterize the biophysical behavior of tumors. However, little is known about how these parameters correlate in prostate cancer (PCa). Therefore, we paired tomoelastography of the prostate with diffusion-sensitive magnetic resonance imaging for the quantitative mapping of biophysical parameters in benign prostatic hyperplasia (BPH) and PCa.Materials and MethodsMultifrequency magnetic resonance imaging elastography with tomoelastography processing was performed at 60, 70, and 80 Hz using externally placed compressed-air drivers. Shear-wave speed (SWS) and loss angle (φ) were analyzed as surrogate markers of stiffness and viscosity-related fluidity in the normal peripheral zone (PZ), hyperplastic transition zone (TZ), which is consistent with BPH, and PCa lesions. The SWS and φ were correlated with the normalized apparent diffusion coefficient (nADC).ResultsThirty-nine men (median age/range, 67/49–88 years), 25 with BPH and 14 with biopsy-proven PCa, were prospectively enrolled in this institutional review board–approved study. The SWS in PCa (3.1 ± 0.6 m/s) was higher than in TZ (2.8 ± 0.3 m/s,P= 0.004) or tended to be higher than in PZ (2.8 ± 0.4 m/s,P= 0.025). Similarly, φ in PCa (1.1 ± 0.1 rad) was higher than in TZ (0.9 ± 0.2 m/s,P< 0.001) and PZ (0.9 ± 0.1 rad,P< 0.001), whereas nADC in PCa (1.3 ± 0.3) was lower than in TZ (2.2 ± 0.4,P< 0.001) and PZ (3.1 ± 0.7,P< 0.001). Pooled nADC was inversely correlated with φ (R= −0.6,P< 0.001) but not with SWS. TZ and PZ only differed in nADC (P< 0.001) but not in viscoelastic properties. Diagnostic differentiation of PCa from normal prostate tissues, as assessed by area under the curve greater than 0.9, was feasible using nADC and φ but not SWS.ConclusionsTomoelastography provides quantitative maps of tissue mechanical parameters of the prostate. Prostate cancer is characterized by stiff tissue properties and reduced water diffusion, whereas, at the same time, tissue fluidity is increased, suggesting greater mechanical friction inside the lesion. This biophysical signature correlates with known histopathological features including increased cell density and fibrous protein accumulation.
Automated Segmentation of the Craniofacial Skeleton With “Black Bone” Magnetic Resonance Imaging
Authors: Eley Karen A. , Delso Gaspar 
Published: June 2020

Abstract
Three-dimensional (3D) imaging of the craniofacial skeleton is integral in managing a wide range of bony pathologies. The authors have previously demonstrated the potential of “Black Bone” MRI (BB) as a non-ionizing alternative to CT. However, even in experienced hands 3D rendering of BB datasets can be challenging and time consuming. The objectives of this study were to develop and test a semi- and fully-automated segmentation algorithm for the craniofacial skeleton.
Previously acquired adult volunteer (n = 15) BB datasets of the head were utilized. Imaging was initially 3D rendered with our conventional manual technique. An algorithm to remove the outer soft-tissue envelope was developed and 3D rendering completed with the processed datasets (semi-automated). Finally, a fully automated 3D-rendering method was developed and applied to the datasets. All 3D rendering was completed with Fovia High Definition Volume Rendering (Fovia Inc, Palo Alto, CA). Analysis was undertaken of the 3D visual results and the time taken for data processing and interactive manipulation.
The mean time for manual segmentation was 12.8 minutes, 3.1 minutes for the semi-automated algorithm, and 0 minutes for the fully automated algorithm. Further fine adjustment was undertaken to enhance the automated segmentation results, taking a mean time of 1.4 minutes.
Automated segmentation demonstrates considerable potential, offering significant time saving in the production of 3D BB imaging in adult volunteers. the authors continue to undertake further development of our segmentation algorithms to permit adaption to the pediatric population in whom non-ionizing imaging confers the most potential benefit.
Aminoglycosides in Immunocompromised Critically Ill Patients With Bacterial Pneumonia and Septic Shock: A Post-Hoc Analysis of a Prospective Multicenter Multinational Cohort
Authors: Lopez René , Rello Jordi , Taccone Fabio Silvio , Salem Omar Ben Hadj , Bauer Philippe R. , Séguin Amélie , van de Louw Andry , Metaxa Victoria , Klouche Kada , Martin Loeches Ignacio , Montini Luca , Mehta Sangeeta , Bruneel Fabrice , Lisboa T. , Viana William , Pickkers Peter , Russell Lene , Rusinova Katerina , Kouatchet Achille , Barbier François , Mokart Djamel , Azoulay Elie , Darmon Michael 
Published: June 2020

ABSTRACT

Background:
The routine use of empiric combination therapy with aminoglycosides during critical illness is associated with uncertain benefit and increased risk of acute kidney injury. This study aimed to assess the benefits of aminoglycosides in immunocompromised patients with suspected bacterial pneumonia and sepsis.

Methods:
Secondary analysis of a prospective multicenter study. Adult immunocompromised patients with suspected bacterial pneumonia and sepsis or septic shock were included. Primary outcome was hospital mortality. Secondary outcomes were needed for renal replacement therapy (RRT). Mortality was also assessed in neutropenic patients and in those with confirmed bacterial pneumonia. Results were further analyzed in a cohort matched on risk of receiving aminoglycosides combination.

Results:
Five hundred thirty-five patients were included in this analysis, of whom 187 (35%) received aminoglycosides in addition to another antibiotic effective against gram-negative bacteria. Overall hospital mortality was 59.6% (58.3% vs. 60.3% in patients receiving and not receiving combination therapy; P = 0.71). Lack of association between mortality and aminoglycosides was confirmed after adjustment for confounders and center effect (adjusted OR 1.14 [0.69–1.89]) and in a propensity matched cohort (adjusted OR = 0.89 [0.49–1.61]). No association was found between aminoglycosides and need for RRT (adjusted OR = 0.83 [0.49–1.39], P = 0.477), nor between aminoglycoside use and outcome in neutropenic patients or in patients with confirmed bacterial pneumonia (adjusted OR 0.66 [0.23–1.85] and 1.25 [0.61–2.57], respectively).

Conclusion:
Aminoglycoside combination therapy was not associated with hospital mortality or need for renal replacement therapy in immunocompromised patients with pulmonary sepsis.
Effects of Corticosteroid Treatment for Non-Severe COVID-19 Pneumonia: A Propensity Score-Based Analysis
Authors: Yuan Mingli , Xu Xiaoxiao , Xia Dongping , Tao Zhaowu , Yin Wen , Tan Weijun , Hu Yi , Song Cheng 
Published: June 2020

ABSTRACT

Background and objective:
The effects of corticosteroid treatment on non-severe COVID-19 pneumonia patients are unknown. To determine the impacts of adjuvant corticosteroid administrated to patients with non-severe COVID-19 pneumonia.

Method:
A retrospective cohort study based on propensity score analysis was designed to explore the effects of corticosteroid on several clinical outcomes.

Results:
One hundred thirty-two patients satisfied the inclusion criteria and 35 pairs were generated according to propensity score matching. Compared to non-corticosteroid group, the CT score on day 7 was significantly higher in corticosteroid group (8.6 (interquartile range [IQR], 2.8–11.5) versus 12.0 (IQR, 5.0–19.3), P = 0.046). In corticosteroid group, more patients progressed to severe cases (11.4% versus 2.9%, P = 0.353), hospital stay (23.5 days (IQR, 19–29 d) versus 20.2 days (IQR, 14–25.3 d), P = 0.079) and duration of viral shedding (20.3 days (IQR, 15.2–24.8 d) versus 19.4 days (IQR, 11.5–28.3 d), P = 0.669) were prolonged, while fever time (9.5 days (IQR, 6.5–12.2 d) versus 10.2 days (IQR, 6.8–14 d), P = 0.28) was shortened; however, all these data revealed no statistically significant differences.

Conclusion:
Corticosteroid might have a negative effect on lung injury recovery in non-severe COVID-19 pneumonia patients; however, the results of this study must be interpreted with caution because of confounding factors.
Indirect, Non-Thermal Atmospheric Plasma Promotes Bacterial Killing in vitro and Wound Disinfection in vivo Using Monogenic and Polygenic Models of Type 2 Diabetes (Without Adverse Metabolic Complications)
Authors: Cooley Chris R. , McLain John Mark , Dupuy Samuel D. , Eder Adrianna E. , Wintenberg Molly , Kelly-Wintenberg Kimberly , Wintenberg Alan , Collier J. Jason , Burke Susan J. , Karlstad Michael D. 
Published: June 2020

ABSTRACT
A novel atmospheric plasma device that uses indirect, non-thermal plasma generated from room air is being studied for its effects on wound disinfection in animal wounds of monogenic and polygenic murine models of type 2 diabetes. As a proof-of-concept report, the goal of this study was to demonstrate the efficacy and safety of the indirect non-thermal plasma (INTP) device in disinfecting polycarbonate filters established with Pseudomonas aeruginosa (PAO1) biofilms as well as wound disinfection in diabetic murine wounds. Dorsal excisional wounds in BALB/c, polygenic TALLYHO, and monogenic db/db mice established with PAO1 infection all demonstrated a 3-log colony-forming unit (CFU) reduction when subjected to a course of 20-min INTP treatments. Importantly, blood glucose and body weights in these animals were not significantly impacted by plasma treatment over the study period. Plasma safety was also analyzed via complete blood count and comprehensive metabolic panels, showing no deleterious systemic effects after 3 consecutive days of 20-min plasma applications. Therefore, the results obtained demonstrated the Pseudomonas aeruginosa isolates were highly sensitive to INTP in vitro, CFU reduction of infectious Pseudomonas in wounds of diabetic mice after INTP treatment is far superior to that of non-treated infected wounds, and the application of INTP shows no indication of toxic effects. Our results are consistent with indirect non-thermal atmospheric plasma as a promising adjunct to disinfecting wounds.
Impact of Belatacept Conversion on Renal Function, Histology, and Gene Expression in Kidney Transplant Patients With Chronic Active Antibody-mediated Rejection
Authors: Kumar Dhiren , Raynaud Marc , Chang Jessica , Reeve Jeff , Yakubu Idris , Kamal Layla , Levy Marlon , Bhati Chandra , Kimball Pamela , King Anne , Massey Davis , Halloran Philip , Gupta Gaurav 
Published: June 2020

Background.
Here, we present our initial experience with a prospective protocol of belatacept conversion in patients with chronic active antibody-mediated rejection (caAMR) and a high degree of chronicity at the time of diagnosis.

Methods.
We converted 19 patients (mean age, 45 ± 12 y) with biopsy-proven caAMR from tacrolimus to belatacept at a median of 44 months post–kidney transplant.

Results.
At a median of 29 months (interquartile range, 16–46 mo) postconversion, death-censored graft and patient survivals were 89% and 95%, respectively. When compared to a 1:2 propensity-matched control cohort from the INSERM U970 registry maintained on calcineurin inhibitor, the belatacept group had progressive improvement (P = 0.02) in estimated glomerular filtration rate from a mean of 33.9 ± 10 at baseline to 37.8 ± 13 at 6 months and 38.5 ± 12 mL/min/1.73 m2 at 12 months postconversion, as compared to a steady decline noted in the controls (36.2 [baseline] → 33.1 [6 mo] → 32.7 mL/min/1.73 m2 [12 mo] of follow-up). A paired histologic comparison of preconversion and postconversion (performed at median 9.5 mo postconversion) biopsies showed no worsening in microvascular inflammation or chronicity. The paired tissue gene expression analysis showed improved mean total rejection score (0.68 ± 0.26–0.56 ± 0.33; P = 0.02) and a trend toward improved antibody-mediated rejection score (0.64 ± 0.34–0.56 ± 0.39; P = 0.06).

Conclusions.
Here, we report that in patients diagnosed with caAMR who were not subjected to intensive salvage immunosuppressive therapies, isolated belatacept conversion alone was associated with stabilization in renal function. These results are bolstered by molecular evidence of improved inflammation.
Effects of Deep Brain Stimulation and Dopaminergic Medication on Excitatory and Inhibitory Spinal Pathways in Parkinson Disease
Authors: Andrews Jennifer C. , Roy François D. , Stein Richard B. , Ba Fang , Sankar Tejas 
Published: June 2020

Purpose:
Abnormal activity within the corticospinal system is believed to contribute to the motor dysfunction associated with Parkinson disease. However, the effect of treatment for parkinsonian motor symptoms on dysfunctional descending input to the motor neuron pool remains unclear.

Methods:
We recruited nine patients with PD treated with deep brain stimulation and examined the time course of interaction between a conditioning pulse from transcranial magnetic stimulation and the soleus H-reflex. Patients with Parkinson disease were examined under four treatment conditions and compared with 10 age-matched control subjects.

Results:
In healthy controls, transcranial magnetic stimulation conditioning led to early inhibition of the H-reflex (76.2% ± 6.3%) at a condition-test interval of −2 ms. This early inhibition was absent when patients were OFF medication/OFF stimulation (132.5% ± 20.4%; P > 0.05) but was maximally restored toward control levels ON medication/ON stimulation (80.3% ± 7.0%). Of note, early inhibition ON medication/ON stimulation tended to be stronger than when medication (85.4% ± 5.9%) or deep brain stimulation (95.7% ± 9.4%) were applied separately. Late facilitation was observed in controls at condition-test intervals ≥5 ms but was significantly reduced (by 50% to 80% of controls) in Parkinson disease OFF stimulation at condition-test intervals ≥15 ms. The late facilitation was akin to control subjects when patients were ON stimulation.

Conclusions:
The present pilot study demonstrates that the recruitment of early inhibition and late facilitation is disrupted in untreated Parkinson disease and that medication and deep brain stimulation may act together to normalize supraspinal drive to the motor neuron pool.
Resident Use of EEG Cap System to Rule Out Nonconvulsive Status Epilepticus
Authors: Kyriakopoulos Paulina , Ding Joy Z. , Niznick Naomi , Lee Jong Woo , Sarkis Rani , Carpentier Josee , Fantaneanu Tadeu A. 
Published: June 2020

Background:
Nonconvulsive status epilepticus (NCSE) requires an EEG for diagnosis and in many centers access may be limited. The authors aimed to test whether neurology residents can be trained to use and interpret full-montage EEGs using an EEG cap electrode system to detect NCSE while on-call.

Methods:
Neurology residents were trained to interpret EEG recordings using the American Clinical Neurophysiology Society critical care EEG terminology. Residents who achieved a score of 70% or higher in the American Clinical Neurophysiology Society certification test and attended a training session were eligible to use the EEG cap on-call with patients suspected of having NCSE. Residents' experience and interpretation of observed EEG patterns were evaluated using a questionnaire. Each EEG recording was independently reviewed by three epilepsy specialists to determine the interpretability of each study and whether the residents correctly identified the EEG patterns.

Results:
Sixteen residents undertook the training and 12 (75%) achieved a score of 70% or higher on the certification test. Seven of these residents performed 14 EEG cap studies between August 2017 and May 2018. The percent agreement between residents and electroencephalographers was 78.6% for EEG interpretability and 57.1% for description of EEG pattern. Residents did not miss any malignant patterns concerning for NCSE, which accounted for 1 of 14 EEGs but “overcalled” patterns as malignant in 3 of 14 recordings.

Conclusions:
This study suggests that neurology residents can be taught to perform and interpret EEGs using a cap system to monitor for NCSE. Additional training will help improve EEG interpretation and sensitivity.