bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors and Prevalence of Limb Deficiencies Associated With Amniotic Band Sequence: A Population-based Case-control Study
Authors: Syvänen Johanna , Raitio Arimatias , Nietosvaara Yrjänä , Heiskanen Susanna , Lahesmaa-Korpinen Anna-Maria , Löyttyniemi Eliisa , Gissler Mika , Helenius Ilkka 
Published: September 2020

Background:
Limb deficiencies associated with amniotic bands comprise a wide range of congenital anomalies. The association of maternal medication and the risk of amniotic band sequence (ABS) has not yet been addressed.

Methods:
This nationwide population-based case-control study used national registers on congenital anomalies, births and induced abortions, cross-linked with information on maternal prescription medicine use obtained from the registers on Reimbursed Drug Purchases and Medical Special Reimbursements. All cases with congenital limb deficiency associated with amniotic bands born between 1996 and 2008 were included in the study. Five controls without limb deficiency matched for residency and time of conception were randomly selected from the Medical Birth Register.

Results:
In total, 106 children with limb deficiency associated with ABS were identified and compared with 530 matched controls. Young maternal age (less than 25 y) increased the risk of limb deficiencies [odds ratio=1.72; 95% confidence interval (CI): 1.06, 2.80]. Primiparity was also associated with increased risk [adjusted odds ratio (aOR)=2.42; 95% CI: 1.52, 3.88]. After adjusting for maternal age, pregestational diabetes, and parity, maternal use of beta-blockers (adjusted OR=24.2; 95% CI: 2.57, 228) and progestogens (adjusted OR=3.79; 95% CI: 1.38, 10.4) during the first trimester of pregnancy significantly increased the risk of limb deficiencies associated with amniotic bands.

Conclusions:
Primiparity significantly increased the risk of limb defects associated with amniotic bands. Also, a novel association on increased risk of ABS with maternal use of progestogens or beta-blockers during the first trimester of pregnancy was observed.

Level of Evidence:
Level III.
Modic Change and Clinical Assessment Scores in Patients Undergoing Lumbar Surgery for Disk Herniation
Authors: MacLean Mark A. , Kureshi Nelofar , Shankar Jai , Stewart Samuel A. , Christie Sean D. 
Published: September 2020

Study Design:
Retrospective cohort study.

Objective:
To examine the relationship between preoperative Modic change (MC) and postoperative clinical assessment scores for patients receiving lumbar discectomy or transforaminal lumbar interbody fusion for lumbar disk herniation.

Summary of Background Data:
Lumbar disk herniation is a risk factor for MC development. MC on spinal magnetic resonance imaging (MRI) has been associated with worse preoperative and postoperative clinical assessment scores.

Materials and Methods:
We reviewed data for 285 primary single-level surgeries. Preoperative and 12-month postoperative assessment scores were recorded using the visual analog scale leg pain, Oswestry Disability Index, and Short Form-36 Physical Component Summary. MC subgroup on preoperative MRI was recorded by a single neuroradiologist.

Results:
One hundred seventy-nine patients (female, 56%; age—53±13 y) with preoperative MRI were included. Age and sex were similar across MC subgroups. The sample prevalence of MC on preoperative MRI was 62%, and MC2 was the most common subgroup (35%). No differences in preoperative assessment scores were identified, regardless of presence or absence of MC. For the overall cohort, improvement in assessment scores were observed: Short Form-36 improved an average of 8.2 points [95% CI (95% CI), 5.8–10.7], Oswestry Disability Index by 11.3 points (95% CI, 8.7–14.0), and visual analog scale by 2.8 points (95% CI, 2.1–3.5). In nearly all cases, MCID values were met, even when stratifying by MC subgroup. Few differences in postoperative assessment scores were identified when comparing across MC1, MC2, or no MC groups.

Conclusions:
Statistically and clinically significant improvement in postoperative clinical assessment scores was observed for both lumbar discectomy and transforaminal lumbar interbody fusion groups. MC on preoperative MRI was not associated with worse preoperative or postoperative clinical assessment scores.

Level of Evidence:
Level III.
ICU Recovery Clinic Attendance, Attrition, and Patient Outcomes: The Impact of Severity of Illness, Gender, and Rurality
Authors: Mayer Kirby P. , Boustany Heba , Cassity Evan P. , Soper Melissa K. , Kalema Anna G. , Hatton Kolpek Jimmi , Montgomery-Yates Ashley A. 
Published: September 2020

Objectives:
The primary purpose is to characterize patients attending ICU recovery clinic and then describe their trajectory of cognitive and emotional health in 1 year.

Design:
Retrospective observational study to assess attendance, attrition, and patient outcomes.

Setting:
ICU Recovery Clinic.

Patients:
Adult patients recently admitted to ICU for sepsis or acute respiratory failure and who were referred to clinic.

Interventions:
None.

Measurements and Main Results:
Thirty-eight patients (63%) attended ICU recovery clinic with a mean age of 53.2 ± 16 years (range, 20–82 yr), 42% female and mean Sequential Organ Failure Assessment scores at an ICU admission of 9.4 ± 2.9 participated in outcomes. Twelve patients (32%) were lost to follow up and 12 patients (32%) were transferred to different providers before the end of 1 year. Sequential Organ Failure Assessment scores were negatively associated with health-related quality of life at baseline (r = –0.41; p = 0.033; n = 28) and short term (r = –0.40; p = 0.037; n = 27). Male patients had higher Sequential Organ Failure Assessment scores (mean difference = 2.4; t = 2.779; p = 0.008) and longer hospital length of stay (mean difference = 9.3; t = 2.27; p = 0.029). Female patients had higher scores on Hospital Anxiety and Depression Scale (mean difference = 7.2; t = 2.74; p = 0.01) and Impact of Events Scale-Revised (mean difference = 18.9; t = 2.74; p = 0.011) at the initial follow-up visit. Patients never attending clinic were more likely to live further away, have a tracheotomy, and spent longer time in the ICU.

Conclusions:
Attendance and attrition in ICU recovery clinic are related to patient factors (living in rural area) and ICU factors. Data suggest different recovery trajectories exist based on gender, severity of illness, and self-reported outcomes.
Doppler Interrogation of the Femoral Vein in the Critically Ill Patient: The Fastest Potential Acoustic Window to Diagnose Right Ventricular Dysfunction?
Authors: Denault André Y. , Aldred Matthew P. , Hammoud Ali , Zeng Yu Hao , Beaubien-Souligny William , Couture Etienne J. , Jarry Stéphanie , Gebhard Caroline E. , Langevin Stephane , Lamarche Yoan , Robillard Pierre 
Published: September 2020

Objectives:
To report the use of common femoral vein Doppler interrogation as a simple technique to diagnose right ventricular dysfunction.

Design:
Case report.

Setting:
Cardiac surgical ICU.

Patients:
Postoperative cardiac surgical patients.

Interventions:
Common femoral pulsed-wave and color Doppler examination associated with hepatic, portal, and renal venous Doppler measurement were obtained in both patients and before and after treatment in patient number 1. In addition, right ventricular pressure waveform examination was obtained in patient number 2.

Measurements and Main Results:
The technique to obtain common femoral venous Doppler is described. Two cases of patients presenting with right ventricular dysfunction and fluid overload with portal and renal venous congestion in the perioperative period undergoing complex multivalvular cardiac surgery are presented. Hemodynamic waveform monitoring was performed alongside echocardiographic, hepatic, and renal venous flow Doppler assessment, and spectral Doppler profiles of the common femoral veins were examined. Those findings were useful in confirming our diagnosis and guiding our response to treatment. An algorithm was developed and tested on two additional hemodynamically unstable patients.

Conclusions:
Doppler examination of the common femoral vein is a simple, fast, and noninvasive technique that could be useful to rule in the presence of right ventricular dysfunction with venous congestion and help guide the management of such patients.
Extracorporeal Membrane Oxygenation Retrieval in Coronavirus Disease 2019: A Case-Series of 19 Patients Supported at a High-Volume Extracorporeal Membrane Oxygenation Center
Authors: Riera Jordi , Argudo Eduard , Martínez-Martínez María , García Sandra , García-de-Acilu Marina , Santafé Manel , Díaz Cándido , Contreras Sofía , Cortina Alexandra , Bonilla Camilo , Pacheco Andrés , Resta Paula , Palmer Neiser , Castro Miguel Ángel , Ferrer Ricard 
Published: September 2020

Objective:
To evaluate the performance of the extracorporeal membrane oxygenation retrieval team at a high-volume extracorporeal membrane oxygenation center during the coronavirus disease 2019 pandemic.

Design:
Observational study including all adult patients with confirmed infection due to severe acute respiratory syndrome coronavirus-2 cannulated at other centers and transported on extracorporeal membrane oxygenation to the ICU of the Vall d’Hebron University Hospital between 15 March and 10 June 2020.

Setting:
The ICU (capacity expanded to 200 during the pandemic) of the Vall d’Hebron University Hospital (a 1,100-bed public university hospital in Barcelona), the referral center for extracorporeal respiratory support in Catalonia (7.5 million inhabitants).

Patients:
Extracorporeal membrane oxygenation was considered if the Pao
2/Fio
2 ratio less than 80 mm Hg (refractory to prone position) and/or Paco
2 greater than 80 mm Hg and pH less than 7.25 for more than 6 hours, and no contraindications for extracorporeal support were present.

Interventions:
Venovenous extracorporeal membrane oxygenation was initiated in the primary center. Then, patients were transferred to the ICU of the Vall d’Hebron University Hospital where they received support until respiratory improvement. After decannulation, patients were discharged for rehabilitation at the primary center.

Measurements and Main Results:
Nineteen patients with severe acute respiratory syndrome coronavirus-2 infection and with a mean Pao
2/Fio
2 ratio of 71 mm Hg (57–118 mm Hg) despite prone positioning and a mean Paco
2 of 70 mm Hg (47–110 mm Hg) were transferred to our center from their primary hospital after cannulation and received venovenous extracorporeal membrane oxygenation support. Prior to cannulation, six patients (31.5%) presented vascular thrombosis, and nine (47.4%) were already receiving anticoagulant therapy. Eighteen transfers were carried out with no significant complications. While on extracorporeal membrane oxygenation, thrombotic events were recorded in nine patients (47.4%) and hemorrhagic events in 13 (68.4%). Thirteen patients (68.4%) were successfully weaned, and 12 (63.1%) were discharged home.

Conclusions:
Extracorporeal membrane oxygenation retrieval can rescue young, previously healthy patients with severe coronavirus disease 2019 in whom all the conventional respiratory measures have failed. Thrombotic and hemorrhagic complications are frequent in this cohort.
A Novel Approach to ICU Survivor Care: A Population Health Quality Improvement Project
Authors: Snell Kenneth P. , Beiter Cynthia L. , Hall Erin L. , Junod Anthony S. , Wilson Bradley J. , Lepone Daniel K. , McIntyre Jeremy R. , Swartz Danielle Phelps , Berger Andrea L. , Kirchner H. Lester , Tomcavage Janet F. , Korzick Karen A. 
Published: September 2020

Objectives:
Deliver a novel interdisciplinary care process for ICU survivor care and their primary family caregivers, and assess mortality, readmission rates, and economic impact compared with usual care.

Design:
Population health quality improvement comparative study with retrospective data analysis.

Setting:
A single tertiary care rural hospital with medical/surgical, neuroscience, trauma, and cardiac ICUs.

Patients:
ICU survivors.

Interventions:
Reorganization of existing post discharge health care delivery resources to form an ICU survivor clinic care process and compare this new process to post discharge usual care process.

Measurements and Main Results:
Demographic data, Acute Physiology and Chronic Health Evaluation IV scores, and Charlson Comorbidity Index scores were extracted from the electronic health record. Additional data was extracted from the care manager database. Economic data were extracted from the Geisinger Health Plan database and analyzed by a health economist. During 13-month period analyzed, patients in the ICU survivor care had reduced mortality compared with usual care, as determined by the Kaplan-Meier method (ICU survivor care 0.89 vs usual care 0.71; log-rank p = 0.0108) and risk-adjusted stabilized inverse probability of treatment weighting (hazard ratio, 0.157; 95% CI, 0.058–0.427). Readmission for ICU survivor care versus usual care: at 30 days (10.4% vs 26.3%; stabilized inverse probability of treatment weighting hazard ratio, 0.539; 95% CI, 0.224–1.297) and at 60 days (16.7% vs 34.7%; stabilized inverse probability of treatment weighting hazard ratio, 0.525; 95% CI, 0.240–1.145). Financial data analysis indicates estimated annual cost savings to Geisinger Health Plan ranges from $247,052 to $424,846 during the time period analyzed.

Conclusions:
Our ICU survivor care process results in decreased mortality and a net annual cost savings to the insurer compared with usual care processes. There was no statistically significant difference in readmission rates.
Effect of sex hormones on coronavirus disease 2019: an analysis of 5,061 laboratory-confirmed cases in South Korea
Authors: Lee Jae Hoon , Kim Yong Chan , Cho Si Hyun , Lee Jinae , You Seng Chan , Song Young Goo , Won Young Bin , Choi Young Sik , Park Yun Soo 
Published: September 2020

Abstract

Objective:
To evaluate the effect of female sex hormones on the clinical outcomes of coronavirus disease 2019 patients using national claims data.

Methods:
This retrospective cohort study used the Health Insurance Review and Assessment data of 5,061 adult patients with laboratory-confirmed coronavirus disease 2019 in South Korea from January 20 to April 8, 2020. To evaluate the effect of hormone therapy on clinical outcomes among women, subgroup analyses using age-matched case-control data were performed.

Results:
Coronavirus disease 2019 was most prevalent in women in the 20-39 years age group (1,250 [44.14%]). Men were more likely to receive oxygen therapy (144 [6.46%] vs 131 [4.63%], P = 0.004), be admitted to the intensive care unit (60 [2.69%] vs 53 [1.87%], P = 0.049), and have a longer length of stay after admission to the intensive care unit (19.70 ± 11.80 vs 14.75 ± 9.23, P = 0.016). However, there was no significant difference in the mortality rate (men vs women: 42 [1.88%] vs 42 [1.48%], P = 0.267). In the multivariable Cox analysis, older age and underlying comorbidities, but not sex, were independent risk factors for mortality. Hormone therapy was not significantly associated with clinical outcomes.

Conclusions:
This study, using nationwide data, suggests that female sex hormones are not associated with the morbidity and clinical outcomes of coronavirus disease 2019 in South Korea.
Influence of Oxidative Stress-Related Genes on Susceptibility to Fibromyalgia
Authors: Rus Alma , Robles-Fernandez Inmaculada , Martinez-Gonzalez Luis Javier , Carmona Ramon , Alvarez-Cubero Maria Jesus 
Published: September 2020

Background
Fibromyalgia (FM) is a complex syndrome to diagnose and treat because of its unknown etiology. However, previous studies reported that patients with FM experience oxidative stress.

Objectives
In this study, we investigated single-nucleotide polymorphisms (SNPs) in genes encoding enzymes involved in oxidative stress (superoxide dismutase 1 [SOD1], catalase, and NADPH oxidase [CYBA]) in patients with FM and in healthy subjects, as well as the possible relation with demographic and clinical manifestations of FM.

Methods
A total of 141 patients with FM and 73 healthy subjects participated in this case–control study. For DNA extraction, buccal swabs were collected from patients with FM, and a peripheral blood sample was extracted from controls. We analyzed SNPs in genes related to oxidative stress (rs10432782 in SOD1, rs1001179 in catalase, and rs4673 in CYBA) using TaqMan probes. In patients with FM, severity of FM, fatigue, and pain were assessed by Fibromyalgia Impact Questionnaire, Multidimensional Fatigue Inventory, and Visual Analogue Scale (VAS), respectively. Physical (PCS-12) and mental (MCS-12) health statuses were evaluated by the 12-Item Short-Form Health Survey.

Results
The selected SNPs did not show significant differences between patients with FM and controls. The rs10432782 (SOD1) was associated with Fibromyalgia Impact Questionnaire scores in patients with FM, whereas the rs4673 (CYBA) was associated with the Multidimensional Fatigue Inventory score, MCS-12 score, and duration of the disease.

Discussion
We have identified significant correlations between SOD1 and CYBA variants with clinical manifestations of FM. These results provide new insights into the pathogenesis of FM that could be useful for guiding future studies along the way to find the cause(s) of this syndrome.
Optimizing Rapid Sequence Intubation for Medical and Trauma Patients in the Pediatric Emergency Department
Authors: Bennett Berkeley L. , Scherzer Daniel , Gold Delia , Buckingham Don , McClain Andrew , Hill Elaise , Andoh Adjoa , Christman Joseph , Shonk Andrew , Spencer Sandra P. 
Published: September 2020

Introduction:
Rapid sequence intubation (RSI) is a critical procedure for severely ill and injured patients presenting to the pediatric emergency department (PED). This procedure has a high risk of complications, and multiple attempts increase this risk. We aimed to increase successful intubation within two attempts, focusing on medical and trauma patients separately to identify improvement barriers for each group.

Methods:
A multifaceted intervention was implemented using quality improvement methods. The analysis included adherence to the standardized process, successful intubation within two attempts, and frequency of oxygen saturations <92% during laryngoscopy. Trauma and medical patients were analyzed separately as team composition differed for each.

Results:
This project began in February 2018, and we included 290 patients between April 2018 and December 2019. Adherence to the standardized process was sustained at 91% for medical patients and a baseline of 55% for trauma patients with a trend toward improvement. In May 2018, we observed and sustained special cause variations for medical patients’ successful intubations within two attempts (77–89%). In September 2018, special cause variation was observed and sustained for the successful intubation of trauma patients within two attempts (89–96%). The frequency of oxygen saturation of <92% was 21% for medical patients; only one trauma patient experienced oxygen desaturation.

Conclusion:
Implementation of a standardized process significantly improved successful intubations within two attempts for medical and trauma patients. Trauma teams had more gradual adherence to the standardized process, which may be related to the relative infrequency of intubations and variable team composition.
Quetiapine Relieved Pisa Syndrome in Patient With Parkinson Disease
Authors: Zhao Junwu , Wang Quan , Sun Hairong , Liu Xiaoxiao , Leng Bing , Wang Tong 
Published: September 2020

Objectives
The aim of the study was to report quetiapine-relieved Pisa syndrome in a patient with Parkinson disease and to discuss the pathogenesis and treatment of Pisa syndrome.

Methods
We report a 74-year-old female patient with a history of Parkinson disease for 7 years. Pisa syndrome, lateral deviation of the spine and leaning to one side, appeared more than a year ago; adjusting levodopa was ineffective. After treatment with quetiapine for visual hallucinations, the patient's right side tilt was completely relieved after taking the drug for 1 month.

Conclusions
Drug-related Pisa syndrome may be associated with the imbalance in dopamine-choline. Pisa syndrome may have similar mechanisms and treatment options to dystonia.
This is the first report of quetiapine relieving Pisa syndrome in a patient with Parkinson disease.
ACP-MHCNN: An Accurate Multi-Headed Deep-Convolutional Neural Network to Predict Anticancer peptides
Authors: Ahmed Sajid , Muhammod Rafsanjani , Adilina Sheikh , Khan Zahid Hossain , Shatabda Swakkhar , Dehzangi Abdollah 
Published: September 2020

AbstractAlthough advancing the therapeutic alternatives for treating deadly cancers has gained much attention globally, still the primary methods such as chemotherapy have significant downsides and low specificity. Most recently, Anticancer peptides (ACPs) have emerged as a potential alternative to therapeutic alternatives with much fewer negative side-effects. However, the identification of ACPs through wet-lab experiments is expensive and time-consuming. Hence, computational methods have emerged as viable alternatives. During the past few years, several computational ACP identification techniques using hand-engineered features have been proposed to solve this problem. In this study, we propose a new multi headed deep convolutional neural network model called ACP-MHCNN, for extracting and combining discriminative features from different information sources in an interactive way. Our model extracts sequence, physicochemical, and evolutionary based features for ACP identification through simultaneous interaction with different numerical peptide representations while restraining parameter overhead. It is evident through rigorous experiments using cross-validation and independent-dataset that ACP-MHCNN outperforms other models for anticancer peptide identification by a substantial margin. ACP-MHCNN outperforms state-of-the-art model by 6.3%, 8.6%, 3.7%, 4.0%, and 0.20 in terms of accuracy, sensitivity, specificity, precision, and MCC respectively. ACP-MHCNN and its relevant codes and datasets are publicly available at:https://github.com/mrzResearchArena/Anticancer-Peptides-CNN.