bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fructose Malabsorption in Chilean Children Undergoing Fructose Breath Test at a Tertiary Hospital
Authors: Alliende Francisco , Lucero Yalda , Jaime Francisca , Ríos Gloria , Arancibia María E. , Rodriguez Lorena 
Published: August 2020

ABSTRACTFructose is a highly abundant carbohydrate in western diet and may induce bowel symptoms in children as in adults. The main objective of this study is to describe the frequency of fructose malabsorption (FM) in symptomatic patients 18 years or younger undergoing fructose breath test in a single tertiary center between 2013 and 2018, and to evaluate whether certain symptoms are related to positivity of the test. Out of 273 tests 183 (67%) were compatible with FM. The most frequent pretest symptom in the overall study population was bloating (83%), followed by abdominal pain (73%). Patients with positive test were younger than those with a negative test (median 5 vs 8 years, P < 0.001). In multivariate analysis, which included age, sex, and symptoms (diarrhea, abdominal pain, bloating, nausea), only age <6 years (odds ratio 2.93, 95% confidence interval 1.64–5.23) and absence of nausea (odds ratio = 3.32, 95% confidence interval 1.56–7.05) were associated with FM.
Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine
Authors: Tenforde Adam S. , Borgstrom Haylee , Polich Ginger , Steere Hannah , Davis Irene S. , Cotton Kester , O’Donnell Mary , Silver Julie K. 
Published: August 2020

Abstract
The COVID-19 pandemic transformed health care delivery, including rapid expansion of telehealth. Telerehabilitation, defined as therapy provided by physical therapy, occupational therapy, and speech and language pathology, was rapidly adopted with goals to provide access to care and limit contagion. The purpose of this brief report was to describe the feasibility of and satisfaction with telerehabilitation. A total of 205 participants completed online surveys after a telerehabilitation visit. Most commonly, participants were women (53.7%), 35–64 yrs old, and completed physical therapy (53.7%) for established visits of 30–44 mins in duration for primary impairments in sports, lower limb injuries, and pediatric neurology. Overall, high ratings (“excellent” or “very good” responses) were observed for all patient-centered outcome metrics (range, 93.7%–99%) and value in future telehealth visit (86.8%) across telerehabilitation visits. Women participated more frequently and provided higher ratings than male participants did. Other benefits included eliminating travel time, incorporating other health care advocates, and convenience delivering care in familiar environment to pediatric patients. Technology and elements of hands-on aspects of care were observed limitations. Recognizing reduced indirect costs of care that telerehabilitation may provide along with high patient satisfaction are reasons policy makers should adopt these services into future health care delivery models.
The Effect of Opioid Stewardship Interventions on Key Outcomes: A Systematic Review
Authors: Shoemaker-Hunt Sarah J. , Wyant Brandy E. 
Published: August 2020

Objectives
We sought to identify potential patient safety practices to reduce high-risk opioid prescribing.

Methods
We conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. Included studies evaluated an OS strategy or a multicomponent OS initiative to address potential harms of opioids and used experimental or quasi-experimental designs.

Results
We identified 14 studies and 1 systematic review that met inclusion criteria. Most studies examined multicomponent OS interventions, which often consisted of guideline-recommended clinical interventions or care processes (e.g., use urine drug screening, check Prescription Drug Monitoring Program), as well as implementation strategies (e.g., dashboards, audit and feedback). Most studies examined the effect of OS interventions on reducing the potential risks of opioids with judicious prescribing and guideline-concordant care (e.g., reduce inappropriate high opioid dosages, avoid co-prescribing opioids and benzodiazepines, use urine drug screening, treatment agreements).

Conclusions
The strength of the evidence is low to moderate that OS efforts decrease numbers of opioid prescriptions, proportion of patients on long-term opioids, or days’ supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate. Future research is needed on the effectiveness of OS interventions, particularly studies with experimental designs and in diverse settings within the health care system.
System-Level Patient Safety Practices That Aim to Reduce Medication Errors Associated With Infusion Pumps: An Evidence Review
Authors: Bacon Olivia , Hoffman Lynn 
Published: August 2020

Objectives
In this literature review, we discuss 2 system-level, nurse-targeted patient safety practices (PSPs) that aim to reduce medication errors associated with infusion pumps, including smart pumps. One practice focuses on implementing structured process changes and redesigning workflows to improve efficiencies with pump use. The other focuses on investing in initial and ongoing staff training on the correct use, maintenance, and monitoring of infusion pumps.

Methods
Two databases were searched for “infusion pumps” and related synonyms, along with relevant terms for each PSP. Articles were excluded if outcomes were not directly relevant to the PSP addressed in this review, the article was out of scope, or study design was insufficiently described.

Results
Limited research was found on best practices for reducing errors and improving infusion pump use through workflow and process changes, as well as education and training. Four studies reported medication administration errors, procedural errors, or deviations from hospital policy as clinical outcomes of workflow or process changes. Mixed results were found examining process outcomes related to pump handling. Education on the correct use of smart pumps was found to decrease medication errors and adverse drug events, and 2 studies found an increase in nurses’ adherence to using the medication safety software library as a result of education.

Conclusions
Standardization of process and integration of technology and workflows were found as facilitators. Type and content of education provided were identified as facilitators, whereas time and energy constraints on nurse educators can be barriers to implementing large hospital-wide education programs.
Squamous Cell Carcinoma Arising in Breast Implant Capsules
Authors: Goldberg Mytien Thi , Llaneras Jason , Willson Thomas D. , Boyd John Brain , Venegas Rose J. , Dauphine Christine , Kalantari Babak N. 
Published: August 2020

Abstract
Breast augmentation and reconstruction utilizing implants are among the most common plastic surgery procedures performed in the United States. A small proportion of these implants are removed each year. We report 2 cases where routine pathologic evaluation of capsulectomy specimens revealed squamous cell carcinoma associated with the breast implant capsule and discuss the possible pathogenesis of this unusual entity. Both patients had long-standing implants (>10 years) and presented with acute unilateral breast erythema and swelling. Intraoperatively, the capsules for both cases appeared thickened and calcified, containing extensive granulomatosis and keratinaceous debris invading into the chest wall. Extensive workup failed to find an occult primary. One patient died from a malignant pleural effusion secondary to tumor invasion during chemotherapy, and the second patient obtained stabilization of the mass after 5 weeks of chemotherapy but subsequently declined further surgical intervention. A thorough literature review was performed, and 5 similar reports were identified, involving 6 patients. All patients presented with similar clinical presentations as ours and had poor outcomes. The mean reporting age at diagnosis was 60 years, and the average time from initial implant to diagnosis was 25 years. Due to the small numbers of squamous cell carcinomas associated with breast implant capsules, the true association between the 2 is unknown. It is postulated that chronic inflammation/irritation from the breast implant and epithelialization of the capsule play a significant role in the disease process. This may represent a new entity of “chronic inflammatory capsular malignancies.” Increased awareness of this entity may allow for earlier suspicion, diagnosis, and management.
Anterolateral Thigh Flap With Vascularized Fascia Lata Associated With Thigh Flaps
Authors: Guiotto Martino , Watfa William , Raffoul Wassim , di Summa Pietro Giovanni 
Published: August 2020

Abstract
Radical surgical debridement after Fournier gangrene (FG) can totally change anatomical balance between structures and compromise urogenital function. This is particularly true when the suspensory ligament and the lower abdominal wall are involved, leading to erection and sexual intercourse dysfunction.
We present the case of a 48-year-old man, who underwent emergency debridement and split-thickness skin graft (STSG) of inferior abdominal wall, pubis, scrotal bag and penile shaft after Fournier gangrene.
Five months after the emergency procedure, bilateral medial thigh flaps recreated the scrotal compartment, whereas a pedicled composite anterolateral thigh flap including fascia lata could cover the lower abdominal wall and rebuilt the penile suspensory ligament (PSL).
Healing was uneventful and the patient returned to a normal sexual life with satisfactory erection and intercourse.
Composite and/or chimeric anterolateral thigh fascia lata flaps have been previously used as a reliable option for complex defects, including tendon and ligaments. We describe here, the first case in the literature of a penile suspensory ligament reconstruction.
Reversed Palmaris Longus Muscle With Median Nerve Compression Symptoms
Authors: Demir Can İlker , Yaşar Emrah Kağan , Dursun Buket , Alagöz Murat Şahin 
Published: August 2020

Background
The palmaris longus (PL) is one of the most anatomically variable muscles in the body. Although these variations are often asymptomatic, symptoms related to nerve compression can sometimes be encountered. If treatment is indicated, correct diagnosis is important for successful management. In cases of upper extremity nerve compression, variations of the PL should be included in the differential diagnosis. We report a case of reversed PL (RPL) with symptoms of median nerve compression and review the literature, emphasizing the rare and challenging character of these lesions.

Methods
The literature review was performed using Google Scholar and PubMed databases. Keywords were “reversed palmaris longus,” “reversed palmaris longus median nerve compression,” “anomolous palmaris longus muscle,” and “symptomatic palmaris longus.” Only clinical RPL muscle cases with at least one of the symptoms of paresthesia and pain in the median nerve sensory area or swelling on the wrist were included.

Results
In the literature review, 21 publications including 30 patients, matched the search criteria between 1973 and 2018 and were evaluated.

Conclusion
In carpal tunnel syndrome, in cases with atypical presentation, RPL should be considered in the differential diagnosis.
MIMIC in the OMOP Common Data Model
Authors: Paris Nicolas , Parrot Adrien 
Published: August 2020

ObjectivesIn the era of big data, the intensive care unit (ICU) is very likely to benefit from real-time computer analysis and modeling based on close patient monitoring and Electronic Health Record data. MIMIC is the first open access database in the ICU domain. Many studies have shown that common data models (CDMs) improve database searching by allowing code, tools and experience to be shared. OMOP-CDM is spreading all over the world. The objective was to evaluate the difficulty to transform MIMIC into an OMOP (MIMIC-OMOP) database and the benefits of this transformation for analysts.Material & MethodA documented, tested, versioned, exemplified and open repository has been set up to support the transformation and improvement of the MIMIC community’s source code. The resulting data set was evaluated over a 48-hour datathon.ResultWith an investment of 2 people for 500 hours, 64% of the data items of the 26 MIMIC tables have been standardized into the OMOP CDM and 78% of the source concepts mapped to reference terminologies. The model proved its ability to support community contributions and was well received during the datathon with 160 participants and 15,000 requests executed with a maximum duration of one minute.ConclusionThe resulting MIMIC-OMOP dataset is the first MIMIC-OMOP dataset available free of charge with real disidentified data ready for replicable intensive care research. This approach can be generalized to any medical field.
The effect of smoking on COVID-19 symptom severity: Systematic review and meta-analysis
Authors: Gülsen Askin , Yigitbas Burcu Arpinar , Uslu Berat , Drömann Daniel , Kilinc Oguz 
Published: August 2020

AbstractBackgroundCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR2-COV-2), and was first identified in Wuhan, China in December of 2019, but quickly spread to the rest of the world, causing a pandemic. While some studies have found no link between smoking status and severe COVID-19, others demonstrated a significant one. The present study aimed to determine the relationship between smoking and clinical COVID-19 severity via a systematic meta-analysis approach.MethodsWe searched the Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting smoking status and comparing non-severe and severe patients were included. Non-severe cases were described as mild, common type, non-intensive care unit (ICU) treatment, survivors, and severe cases as critical, need for ICU, refractory, and non-survivors.ResultsA total of 16 articles detailing 11322 COVID-19 patients were included. Our meta-analysis revealed a relationship between a history of smoking and severe COVID-19 cases (OR=2.17; 95% CI: 1.37–3.46; P <.001). Additionally, we found an association between the current smoking status and severe COVID-19 (OR=1.51; 95% CI: 1.12–2.05; P <.008). In 10.7% (978/9067) of non-smokers, COVID-19 was severe, while in active smokers, severe COVID-19 occurred in 21.2% (65/305) of cases.ConclusionActive smoking and a history of smoking are clearly associated with severe COVID-19. The SARS-COV-2 epidemic should serve as an impetus for patients and those at risk to maintain good health practices and discontinue smoking.
Evaluation of commercially available immuno-magnetic agglutination and enzyme-linked immunosorbent assays for rapid point-of-care diagnostics of COVID-19
Authors: Moeller Maria Engel , Fock Jeppe , Pah Pearlyn , Veras Antia De La Campa , Bade Melanie , Donolato Marco , Israelsen Simone Bastrup , Eugen-Olsen Jesper , Benfield Thomas , Engsig Frederik Neess 
Published: August 2020

ABSTRACTIntroductionCoronavirus Disease 2019 (COVID-19) is caused bysevere acute respiratory coronavirus-2(SARS-CoV-2). Fast, accurate and simple blood-based assays for quantification of anti-SARS-CoV-2 antibodies are urgently needed to identify infected individuals and keep track of the spread of disease.MethodsThe study included 35 plasma samples from 22 individuals with confirmed COVID-19 by real time reverse-transcriptase-polymerase-chain-reaction and 40 non-COVID-19 plasma samples. Anti-SARS-CoV-2 IgM/lgA or IgG antibodies were detected by a microfluidic quantitative immunomagnetic assay (IMA) (ViroTrack Sero COVID IgM+lgA /IgG Ab, Blusense Diagnostics, Denmark) and by enzyme-linked immunosorbent assay ((ELISA) (Eurolmmun Medizinische Labordiagnostika, Germany).ResultsOf the 35 plasma samples from the COVID-19 patients, 29 (82.9%) were positive for IgA/IgM or IgG by IMA and 29 samples (82.9%) were positive by ELISA. Sensitivity for only one sample per patient was 68% for IgA+IgM and 73% IgG by IMA and 73% by ELISA. For samples collected 14 days after symptom onset, the sensitivity of both IMA and ELISA was around 90%. Specificity of the IMA reached 100% compared to 95% for ELISA IgA and 97.5% for ELISA IgG.ConclusionIMA for COVID-19 is a rapid simple-to-use point of care test with sensitivity and specificity similar to a commercial ELISA.
A pilot study to see any Change of the Nasal and Oropharyngeal Microbiota with Prolonged Use of Medical Masks during the COVID-19 Outbreak
Authors: Roy Sayak , Majumder Pampi , Bhattacharya Kingshuk 
Published: August 2020

AbstractBackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has played havoc on the healthcare system and society. Many international guidelines have put forward various measures to control the spread and, using various quality masks seems to be the most important amongst them. This was a cross-sectional pilot study to see any alterations in the bacterial flora of the nasal and the oropharyngeal (OP) microbiota with the use of medical masks over prolonged periods during this COVID-19 outbreak.MethodsNasal and oropharyngeal swabs were collected using proper international guidelines from 30 healthy healthcare workers matching pre-set inclusion criteria, who gave written informed consent. The swabs were used for gram stain as well as culture and sensitivity analysis using standard methods.ResultsIn general, we found that the oropharyngeal microflora harboured a more diverse population of bacteria (n=13) than the nasal microflora (n=5). The predominant bacterial flora was found to Staphylococcus epidermidis in the nasal cavity and Streptococcus viridans in the oropharyngeal cavity. There was no growth in 8 (26.68%) samples of oropharynx and 3 (10%) of nasal samples, with one patient having no growth in both the samples. The commonest resistant antibiotic from both the cavity cultures was benzylpenicillin (nasal flora 80% and OP flora 47.37%).ConclusionThis small pilot study has shown a reassuring aspect of no change in the typical bacterial microflora species of the nasal and OP cavity with prolonged use of medical masks. This is the first study to show this convincing evidence during the COVID-19 outbreak and also in healthy healthcare workers who have to wear masks over long durations.
IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression
Authors: Dhar Sujan K , Vishnupriyan K , Damodar Sharat , Gujar Shashi , Das Manjula 
Published: August 2020

AbstractAimsSARS-CoV-2, an infectious agent behind the ongoing COVID-19 pandemic, induces high levels of cytokines such as IL-1, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ etc in infected individuals which contribute towards the underlying disease patho-physiology. Nonetheless, exact association and contribution of every cytokine towards COVID-19 pathology remains poorly understood. Delineation of the role of the cytokines during COVID-19 holds the key of efficient patient management in clinics. This study performed a comprehensive meta-analysis to establish association between induced cytokines and COVID-19 disease severity to help in prognosis and clinical care.Main methodsScientific literature was searched to identify 13 cytokines (IL-1β, IL-2, IL-2R, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-17, TNF-α and IFN-γ) from 18 clinical studies. Standardized mean difference (SMD) for selected 6 cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ between severe and non-severe COVID-19 patient groups were summarized using random effects model. A classifier was built using logistic regression model with cytokines having significant SMD as covariates.Key findingsOut of 13 cytokines, IL-6 and IL-10 showed statistically significant SMD across the studies synthesized. Classifier with mean values of both IL-6 and IL-10 as covariates performed well with accuracy of ~ 92% that was significantly higher than accuracy reported in literature with IL-6 and IL-10 as individual covariates.SignificanceSimple panel proposed by us with only two cytokine markers can be used as predictors for fast diagnosis of patients with higher risk of COVID-19 disease deterioration and thus can be managed well for a favourable prognosis.
Effects of SARS-CoV-2 Mutations on Protein Structures and Intraviral Protein-Protein Interactions
Authors: Wu Siqi , Tian Chang , Liu Panpan , Guo Dongjie , Zheng Wei , Huang Xiaoqiang , Zhang Yang , Liu Lijun 
Published: August 2020

AbstractSince 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has infected ten millions of people across the globe, and massive mutations in virus genome have occurred during the rapid spread of this novel coronavirus. Variance in protein sequence might lead to change in protein structure and interaction, then further affect the viral physiological characteristics, which could bring tremendous influence on the pandemic. In this study, we investigated 18 non-synonymous mutations in SARS-CoV-2 genome which incidence rates were all ≥1% as of July 15th, 2020, then modeled the mutated protein structures and compared them with the reference ones. The results showed that four types of mutations could cause dramatic changes in protein structures (RMSD ≥5.0 Å), which were Q57H and G251V in open reading frames 3a (ORF3a), S194L and R203K/G204R in nucleocapsid (N). Next, we found that these mutations could affect the binding affinity of intraviral protein interactions. In addition, the hot spots within these docking complexes were altered, among which the mutation Q57H was involved in both Orf3a-Orf8 and Orf3a-S protein interactions. Besides, these mutations were widely distributed all over the world, and their occurrences fluctuated as time went on. Notably, the incidences of R203K/G204R in N and Q57H in Orf3a were both over 50% in some countries. Overall, our findings suggest that SARS-CoV-2 mutations can change viral protein structure, binding affinity and hot spots of the interface, thereby may have impacts on SARS-CoV-2 transmission, diagnosis and treatment of COVID-19.
High titers of multiple antibody isotypes against the SARS-CoV-2 spike receptor-binding domain and nucleoprotein associate with better neutralization
Authors: Noval Maria G. , Kaczmarek Maria E. , Koide Akiko , Rodriguez-Rodriguez Bruno A. , Louie Ping , Tada Takuya , Hattori Takamitsu , Panchenko Tatyana , Romero Larizbeth A. , Teng Kai Wen , Bazley Andrew , Vries Maren de , Samanovic Marie I. , Weiser Jeffrey N. , Aifantis Ioannis , Cangiarella Joan , Mulligan Mark J. , Desvignes Ludovic , Dittmann Meike , Landau Nathaniel R. , Aguero-Rosenfeld Maria , Koide Shohei , Stapleford Kenneth A. 
Published: August 2020

AbstractUnderstanding antibody responses to SARS-CoV-2 is indispensable for the development of containment measures to overcome the current COVID-19 pandemic. Here, we determine the ability of sera from 101 recovered healthcare workers to neutralize both authentic SARS-CoV-2 and SARS-CoV-2 pseudotyped virus and address their antibody titers against SARS-CoV-2 nucleoprotein and spike receptor-binding domain. Interestingly, the majority of individuals have low neutralization capacity and only 6% of the healthcare workers showed high neutralizing titers against both authentic SARS-CoV-2 virus and the pseudotyped virus. We found the antibody response to SARS-CoV-2 infection generates antigen-specific isotypes as well as a diverse combination of antibody isotypes, with high titers of IgG, IgM and IgA against both antigens correlating with neutralization capacity. Importantly, we found that neutralization correlated with antibody titers as quantified by ELISA. This suggests that an ELISA assay can be used to determine seroneutralization potential. Altogether, our work provides a snapshot of the SARS-CoV-2 neutralizing antibody response in recovered healthcare workers and provides evidence that possessing multiple antibody isotypes may play an important role in SARS-CoV-2 neutralization.