bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital diaphragmatic hernia repair in patients requiring extracorporeal membrane oxygenation: are outcomes better with repair on ECMO or after decannulation?
Authors: Low Zhao Kai , Tan Amelia Su May , Nakao Masakazu , Yap Kok Hooi 
Published: November 2020

Summary
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether congenital diaphragmatic hernia repair outcomes are better before or after decannulation in infants requiring extracorporeal membrane oxygenation (ECMO). A total of 884 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that infants with congenital diaphragmatic hernia requiring ECMO should undergo a trial of weaning and aim for post-decannulation repair, as this has been associated with improved survival, shorter ECMO duration and fewer bleeding complications. However, if weaning of ECMO is unsuccessful, the patient should ideally undergo early on-ECMO repair (within 72 h of cannulation), which has been associated with improved survival, less bleeding, shorter ECMO duration and fewer circuit changes compared to late on-ECMO repair. Anticoagulation protocols including perioperative administration of aminocaproic acid or tranexamic acid, as well as close perioperative monitoring of coagulation parameters have been associated with reduced bleeding risk with on-ECMO repairs.
Evolution from mitral annular dysfunction to severe mitral regurgitation in Barlow’s disease
Authors: Hiemstra Yasmine L , Tomsic Anton , Gripari Paola , van Wijngaarden Aniek L , van der Pas Stéphanie L , Palmen Meindert , Klautz Robert J M , Pepi Mauro , Bax Jeroen J , Delgado Victoria , Marsan Nina Ajmone 
Published: November 2020

Abstract

OBJECTIVES
Barlow’s disease (BD) is characterized by thick, redundant mitral valve (MV) leaflets, which can lead to prolapse and significant mitral regurgitation (MR). MV annular abnormalities are also commonly observed and increasingly recognized as possible primary pathology, with leaflet thickening being secondary to increased stress on the MV apparatus. To provide more insights into this hypothesis, the evolution of MV abnormalities over time in patients with BD was assessed.

METHODS
A total of 64 patients (54 ± 12 years, 72% male) with BD who underwent MV surgery and had multiple transthoracic echocardiograms (TTE) before surgery were included. In total, 186 TTE were analysed (median time interval 4.2, interquartile range 2.2–6.5 years) including specific MV characteristics.

RESULTS
At baseline, MV leaflet length, thickness, billowing height and annular diameter were larger in patients with BD compared to 59 healthy subjects. Systolic outward motion (curling) of the annulus was observed in 77% and severe mitral annular disjunction (≥5 mm) in 38% of patients with BD. Forty (63%) patients had MR grade I–II and 24 (37%) MR grade III–IV; at baseline, the 2 groups only differed in left atrial volume and in thickness and billowing height of the posterior leaflet, showing comparable MV annular abnormalities and dilatation despite different grades of MR. Over time, MV annulus diameter, leaflet length and billowing height increased significantly along with MR grade.

CONCLUSIONS
In patients with BD, MV annulus abnormalities are present at an early stage and precede the development of significant MR, suggesting their substantial role in the pathophysiology of this disease and as an important target for surgical treatment.
Algorithmic prediction of failure modes in healthcare
Authors: Kobo-Greenhut Ayala , Sharlin Ortal , Adler Yael , Peer Nitza , Eisenberg Vered H , Barbi Merav , Levy Talia , Shlomo Izhar Ben , Eyal Zimlichman 
Published: November 2020

Abstract

Background
Preventing medical errors is crucial, especially during crises like the COVID-19 pandemic. Failure Modes and Effects Analysis (FMEA) is the most widely used prospective hazard analysis in healthcare. FMEA relies on brainstorming by multi-disciplinary teams to identify hazards. This approach has two major weaknesses: significant time and human resource investments, and lack of complete and error-free results.

Objectives
To introduce the algorithmic prediction of failure modes in healthcare (APFMH) and to examine whether APFMH is leaner in resource allocation in comparison to the traditional FMEA and whether it ensures the complete identification of hazards.

Methods
The patient identification during imaging process at the emergency department of Sheba Medical Center was analyzed by FMEA and APFMH, independently and separately. We compared between the hazards predicted by APFMH method and the hazards predicted by FMEA method; the total participants’ working hours invested in each process and the adverse events, categorized as ‘patient identification’, before and after the recommendations resulted from the above processes were implemented.

Results
APFMH is more effective in identifying hazards (P &lt; 0.0001) and is leaner in resources than the traditional FMEA: the former used 21 h whereas the latter required 63 h. Following the implementation of the recommendations, the adverse events decreased by 44% annually (P = 0.0026). Most adverse events were preventable, had all recommendations been fully implemented.

Conclusion
In light of our initial and limited-size study, APFMH is more effective in identifying hazards (P &lt; 0.0001) and is leaner in resources than the traditional FMEA. APFMH is suggested as an alternative to FMEA since it is leaner in time and human resources, ensures more complete hazard identification and is especially valuable during crisis time, when new protocols are often adopted, such as in the current days of the COVID-19 pandemic.
The emergence of azithromycin-resistant Salmonella Typhi in Nepal
Authors: Duy Pham Thanh , Dongol Sabina , Giri Abhishek , Nguyen To Nguyen Thi , Dan Thanh Ho Ngoc , Nhu Quynh Nguyen Pham , Duc Trung Pham , Thwaites Guy E , Basnyat Buddha , Baker Stephen , Rabaa Maia A , Karkey Abhilasha 
Published: November 2020

Abstract

Background
Typhoid fever remains a significant cause of morbidity and mortality in Asia and Africa. The emergence of azithromycin resistance in South Asia is concerning, as azithromycin is one of the last effective oral drugs for treating typhoid.

Objectives
To describe the molecular mechanism and phylogenetics of azithromycin-resistant (AzithR) Salmonella Typhi isolates from Patan Hospital, Kathmandu, Nepal.

Methods
Whole-genome sequences of three AzithR S. Typhi isolates (MIC &gt;256 mg/L) were analysed and compared with a global collection to investigate the azithromycin resistance mechanism and phylogenetic structure. Clinical information is reported for one of the three patients infected with AzithR S. Typhi.

Results
The three AzithR isolates belonged to the H58 lineage and were genetically identical; they were distantly related to contemporaneous S. Typhi from Nepal and AzithR S. Typhi recently described in Bangladesh. Azithromycin resistance was mediated by a non-synonymous mutation in the acrB gene (R717L). The three AzithR isolates showed reduced susceptibility to ciprofloxacin (double mutation in the gyrA: S83F and D87G), and were susceptible to ampicillin, chloramphenicol and co-trimoxazole. Clinical information from one patient suggested non-response to azithromycin treatment.

Conclusions
This is the first molecular description of AzithR S. Typhi in Nepal. These organisms showed no phylogenetic link to AzithR S. Typhi in Bangladesh. Our data suggest that increasing use of azithromycin may pose a strong selective pressure driving the emergence of AzithR S. Typhi in South Asia. Further investigations are needed to evaluate treatment responses to azithromycin, predict evolutionary trajectories, and track the transmission of these organisms.
The volume effect in cartel cases—a special challenge for damage quantification?
Authors: Weber Franziska 
Published: November 2020

Abstract
Cartel damage occurs in many different shapes. Actors that are beyond doubt heavily affected by a cartel agreement are the purchasers of the cartel—the direct same as the indirect ones. Economic insights teach us that they do not only suffer damage in the form of the overcharge they paid or of shares of this overcharge that are passed-on to lower levels in the supply chain, but also in the form of the volume effect: a price increase as induced by a cartel agreement leads to a reduction in quantities sold, the consequence of which is typically lost profit—ie the volume effect. Whereas this effect is firmly established in economics, on the legal side it is so far discussed only on a superficial level with legal practice lacking behind in its recognition altogether. This is particularly surprising in the German and Spanish legal order where the highest courts many years ago did recognize the relevance of this damage component in pass-on situations. This article thoroughly analyses the economic and legal perspectives in respect of volume effects.
Ensuring full participation of people with disabilities in an era of telehealth
Authors: Valdez Rupa S , Rogers Courtney C , Claypool Henry , Trieshmann Lucy , Frye Olivia , Wellbeloved-Stone Claire , Kushalnagar Poorna 
Published: November 2020

Abstract
The widespread use of telehealth resulting from the COVID-19 pandemic has the potential to further exacerbate inequities faced by people with disabilities. Although, for some members of the disability community, the option to engage with telehealth may result in reduced barriers to care, for others, inadequate attention to the design, implementation, and policy dimensions may be detrimental. Addressing such considerations is imperative to mitigate health inequities faced by the disability community.
Long-run analysis of regional inequalities in the US
Authors: Logan Trevon , Hardy Bradley , Parman John 
Published: November 2020

AbstractWe consider the regional differences in economic development across the United States, which have been a unique feature of American economic history. The paths of both convergence and divergence by region have been driven by a complex mix of differences in resource endowments, demographic differences, international and internal migration patterns, and variation in the scope and impact of government policies at the local, state, and federal level. We show that the development of a national and fully integrated economy have accelerated and decelerated over time, and these features are driven by unique sets of historical circumstances and policy choices.
Regional growth and inequality in the long-run: Europe, 1900–2015
Authors: Rosés Joan R , Wolf Nikolaus 
Published: November 2020

AbstractIn this paper we discuss regional income growth and inequality based on a new set of long-run data. The data cover 173 European regions in 16 countries, from 1900 to 2015. These data allow us to compare regions over time, among each other, and to other parts of the world. After some brief notes on methodology, we describe the basic patterns in the data in terms of some key dimensions: variation in the density of population and economic activity, structural change with a declining role of agriculture, the rise and fall of industry, and the long rise of services. We show how ‘fundamentals’ of institutions and geography affected income levels over the twentieth century, and describe how regional growth after 1945 turned from convergence and adjustment to shocks to divergence. In the long run we observe a U-shaped pattern of regional convergence followed by divergence, not unlike recent observations on personal income and wealth distributions.
Increased risk of rheumatoid arthritis among patients with endometriosis: a nationwide population-based cohort study
Authors: Xue Yu-Hao , You Liang-Tian , Ting Hsin-Fu , Chen Yu-Wen , Sheng Zi-Yun , Xie Yi-Dong , Wang Yu-Hsun , Chiou Jeng-Yuan , Wei James Cheng-Chung 
Published: November 2020

AbstractObjectivesAutoimmunity may play a role in endometriosis. The association between endometriosis and RA remains unknown. This study was conducted to identify any evidence for this relationship.MethodsThis 13-year, nationwide, population-based, retrospective cohort study analysed the risk of RA in a cohort of individuals with endometriosis. We investigated the incidence of RA among patients with endometriosis using data from the Longitudinal Health Insurance Database 2000, which is maintained by the Taiwan National Health Research Institutes. We used propensity scores to match comorbidities in the two cohorts. Kaplan–Meier analysis and Cox proportional hazard model were employed to analyse the association between endometriosis and RA among patients with different potential risks.ResultsPatients with endometriosis [adjusted hazard ratio (HR) 1.75, 95% CI 1.27, 2.41], aged ≥45 years (adjusted HR 1.50, 95% CI 1.06–2.13) and with autoimmune disease (adjusted HR 6.99, 95% CI 2.84–17.21) had a significantly higher risk of RA. The analyses also showed that when stratified by age, comorbidities and medication use, the risk of RA in patients with endometriosis was also higher than in those without endometriosis.ConclusionsThis 14-year, nationwide, population-based retrospective cohort study revealed that patients with endometriosis have a higher risk of RA. In the clinical management of patients with RA, rheumatologists should be especially mindful of the possibility of underlying endometriosis.
Collision of Solid Pseudopapillary Tumor and Neuroendocrine Tumor of the Pancreas on 18F-FDG PET/CT
Authors: Yin Hongyan , Lv Jing , Chen Lingli , Xiu Yan , Shi Hongcheng 
Published: November 2020

Abstract
We report a rare case of pancreatic collision tumor of solid pseudopapillary tumor and neuroendocrine tumor in a 43-year-old woman. A pancreatic mass was found by abdominal ultrasound. A mainly cystic mass with solid component progressive enhancement was revealed using abdominal enhanced CT. Staging 18F-FDG PET/CT demonstrated a pancreatic tail mass with an increased uneven 18F-FDG uptake. Distal pancreatectomy was performed. Postoperatively, the mass was diagnosed as pancreatic collision tumor of solid pseudopapillary tumor and neuroendocrine tumor.
Calcified Adrenal Metastasis of High-Grade Osteosarcoma on FDG PET/CT
Authors: Filizoglu Nuh , Engur Ceren Ozge , Turkoz Huseyin Kemal , Ones Tunc , Erdil Tanju Yusuf 
Published: November 2020

Abstract
Classic type of high-grade osteosarcoma is the most common type of skeletal malignancy in children and adolescents. Metastasis of osteosarcoma frequently occurs in the lung. Adrenal metastasis of osteosarcoma is extremely rare, with only few reported case in the literature. Herein, we present the case of a 13-year-old boy with adrenal metastasis of high-grade osteosarcoma, which was seen as a solitary calcified hypermetabolic adrenal lesion on FDG PET/CT.
Sinus Tarsi Syndrome on Bone Scintigraphy With SPECT/CT
Authors: Martineau Patrick , Pelletier-Galarneau Matthieu 
Published: November 2020

Abstract
Sinus tarsi syndrome is a common cause of hindfoot pain in adults; however, diagnosis on planar bone scintigraphy can be challenging. We present 3 cases of sinus tarsi syndrome, review the spectrum of imaging findings associated with sinus tarsi syndrome, and show the key role that SPECT/CT can play in its diagnosis.
Brain Connectomics and Severity of Internalizing Symptoms in Early Adolescence Predict Severity of Suicidal Ideation in Later Adolescence
Authors: Kirshenbaum Jaclyn S. , Chahal Rajpreet , Ho Tiffany C. , King Lucy S. , Gifuni Anthony J. , Mastrovito Dana , Coury Saché M. , Weisenburger Rachel L. , Gotlib Ian H. 
Published: November 2020

AbstractBackgroundSuicidal ideation (SI) typically emerges during adolescence but is challenging to predict. Given the consequences of SI, it is important to identify neurobiological and psychological predictors of SI in adolescents in order to improve strategies to prevent suicide.MethodsIn 109 participants (61 female), we assessed psychological characteristics and obtained resting-state fMRI data in early adolescence (ages 9-13). Using graph theoretical methods, we assessed local network properties across 250 brain regions by computing measures of nodal interconnectedness: local efficiency, eigenvector centrality, nodal degree, within-module z-score, and participation coefficient. Four years later (ages 13-17), participants self-reported their SI severity. We used LASSO regression to identify a linear combination of the most important psychological, environmental, and brain-based predictors of future SI severity.ResultsThe LASSO analysis identified a combination of 10 predictors of future SI severity (R2=0.23). Severity of internalizing symptoms at baseline was the strongest predictor; the remaining 9 predictors were brain-based, including nodal degree of the inferior frontal gyrus, precentral gyrus, fusiform gyrus, and inferior temporal gyrus; within-module degree of the substantia nigra and inferior parietal lobe; eigenvector centrality of the subgenual cingulate gyrus; participation coefficient of the caudal cingulate gyrus and medial amygdala.ConclusionsOur findings suggest that combining network properties and earlier internalizing symptoms may improve prediction of later SI, compared to prior symptoms and other sociodemographic variables alone. Research should validate the clinical utility of these markers as predictors of suicidal thoughts.
Altered cerebellar white matter in sensory processing dysfunction is associated with impaired multisensory integration and attention
Authors: Narayan Anisha , Rowe Mikaela A. , Palacios Eva M. , Wren-Jarvis Jamie , Bourla Ioanna , Gerdes Molly , Brandes-Aitken Annie , Desai Shivani , Marco Elysa J. , Mukherjee Pratik 
Published: November 2020

AbstractSensory processing dysfunction (SPD) is characterized by a behaviorally observed difference in the response to sensory information from the environment. While the cerebellum is involved in normal sensory processing, it has not yet been examined in SPD. Diffusion tensor imaging scans of children with SPD (n=42) and typically developing controls (TDC; n=39) were compared for fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) across the following cerebellar tracts: the middle cerebellar peduncles (MCP), superior cerebellar peduncles (SCP), and cerebral peduncles (CP). Compared to TDC, children with SPD show reduced microstructural integrity of the SCP and MCP, which correlates with abnormal auditory behavior, multisensory integration, and attention, but not tactile behavior or direct measures of auditory discrimination. In contradistinction, decreased CP microstructural integrity in SPD correlates with abnormal tactile and auditory behavior and direct measures of auditory discrimination, but not multisensory integration or attention. Hence, altered cerebellar white matter organization is associated with complex sensory behavior and attention in SPD, which prompts further consideration of diagnostic measures and treatments to better serve affected individuals.
COVID-19 COGNITIVE DEFICITS AFTER RESPIRATORY ASSISTANCE IN THE SUBACUTE PHASE: A COVID-REHABILITATION UNIT EXPERIENCE
Authors: Alemanno Federica , Houdayer Elise , Parma Anna , Spina Alfio , Forno Alessandra Del , Scatolini Alessandra , Angelone Sara , Brugliera Luigia , Tettamanti Andrea , Beretta Luigi , Iannaccone Sandro 
Published: November 2020

AbstractIntroductionCOVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy).Material and Methods87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge.ResultsOut of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p=0.016), naming (p=0.024), short- and long-term memory (p=0.010, p=0.005), abstraction (p=0.024), and orientation (p=0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients’ age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder.ConclusionPatients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for decision-making in respiratory and neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term support and psychological treatment of post-COVID-19 patients.
The implementation of remote home monitoring models during the COVID-19 pandemic in England
Authors: Vindrola-Padros Cecilia , Sidhu Manbinder S , Georghiou Theo , Sherlaw-Johnson Chris , Singh Kelly E , Tomini Sonila M , Ellins Jo , Morris Steve , Fulop Naomi J 
Published: November 2020

ABSTRACTBackgroundThere is a paucity of evidence for the implementation of remote home monitoring for COVID-19 infection. The aims of this study were to identify the key characteristics of remote home monitoring models for COVID-19 infection, explore the experiences of staff implementing these models, understand the use of data for monitoring progress against outcomes, and document variability in staffing and resource allocation.MethodsThis was a multi-site mixed methods study that combined qualitative and quantitative approaches to analyse the implementation and impact of remote home monitoring models during the first wave of the COVID-19 pandemic (July to September 2020) in England. The study combined interviews (n=22) with staff delivering these models across eight sites in England with the collection and analysis of data on staffing models and resource allocation.FindingsThe models varied in relation to the healthcare settings and mechanisms used for patient triage, monitoring and escalation. Implementation was embedded in existing staff workloads and budgets. Good communication within clinical teams, culturally-appropriate information for patients/carers and the combination of multiple approaches for patient monitoring (app and paper-based) were considered facilitators in implementation. The mean cost per monitored patient varied from £400 to £553, depending on the model.InterpretationIt is necessary to provide the means for evaluating the effectiveness of these models, for example, by establishing comparator data. Future research should also focus on the sustainability of the models and patient experience (considering the extent to which some of the models exacerbate existing inequalities in access to care).FundingThe study was funded by the National Institute for Health Research-NIHR (Health Services and Delivery Research, 16/138/17 – Rapid Service Evaluation Research Team; or The Birmingham, RAND and Cambridge Evaluation (BRACE) Centre Team (HSDR16/138/31).