bluuebunny/crossref_metadata_2025_split huggingface dataset:
Affective brain patterns as multivariate neural correlates of cardiovascular disease risk
Authors: Gianaros Peter J , Kraynak Thomas E , Kuan Dora C-H , Gross James J , McRae Kateri , Hariri Ahmad R , Manuck Stephen B , Rasero Javier , Verstynen Timothy D 
Published: April 2020

AbstractThis study tested whether brain activity patterns evoked by affective stimuli relate to individual differences in an indicator of pre-clinical atherosclerosis: carotid artery intima-media thickness (CA-IMT). Adults (aged 30–54 years) completed functional magnetic resonance imaging (fMRI) tasks that involved viewing three sets of affective stimuli. Two sets included facial expressions of emotion, and one set included neutral and unpleasant images from the International Affective Picture System (IAPS). Cross-validated, multivariate and machine learning models showed that individual differences in CA-IMT were partially predicted by brain activity patterns evoked by unpleasant IAPS images, even after accounting for age, sex and known cardiovascular disease risk factors. CA-IMT was also predicted by brain activity patterns evoked by angry and fearful faces from one of the two stimulus sets of facial expressions, but this predictive association did not persist after accounting for known cardiovascular risk factors. The reliability (internal consistency) of brain activity patterns evoked by affective stimuli may have constrained their prediction of CA-IMT. Distributed brain activity patterns could comprise affective neural correlates of pre-clinical atherosclerosis; however, the interpretation of such correlates may depend on their psychometric properties, as well as the influence of other cardiovascular risk factors and specific affective cues.
Accuracy of Bilistick (a Point-of-Care Device) to Detect Neonatal Hyperbilirubinemia
Authors: Kamineni Bhargavi , Tanniru Anusha , Vardhelli Venkateshwarlu , Sharma Deepak , Pawale Dinesh , Kulkarni Dattatray , Muppidi Pranitha Reddy , Deshabhotla Saikiran , Murki Srinivas 
Published: April 2020

AbstractIntroductionEarly diagnosis and appropriate management of neonatal jaundice is crucial in avoiding severe hyperbilirubinemia and brain injury. A low-cost, minimally invasive, point-of-care (PoC) tool for total bilirubin (TB) estimation which can be useful across all ranges of bilirubin values and all settings is the need of the hour.ObjectiveTo assess the accuracy of Bilistick system, a PoC device, for measurement of TB in comparison with estimation by spectrophotometry.Design/methodsIn this cross-sectional clinical study, in infants who required TB estimation, blood samples in 25-µl sample transfer pipettes were collected at the same time from venous blood obtained for laboratory bilirubin estimation. The accuracy of Bilistick in estimating TB within ±2 mg/dl of bilirubin estimation by spectrophotometry was the primary outcome.ResultsAmong the enrolled infants, 198 infants were eligible for study analysis with the mean gestation of 36 ± 2.3 weeks and the mean birth weight of 2368 ± 623 g. The median age at enrollment was 68.5 h (interquartile range: 48–92). Bilistick was accurate only in 54.5% infants in measuring TB within ±2 mg/dl difference of TB measured by spectrophotometry. There was a moderate degree of correlation between the two methods (r = 0.457; 95% CI: 0.339–0.561, p value &lt; 0.001). Bland–Altman analysis showed a mean difference of 0.5 mg/dl (SD ± 4.4) with limits of agreement between −8.2 and +9.1 mg/dl.ConclusionBilistick as a PoC device is not accurate to estimate TB within the clinically acceptable difference (±2 mg/dl) of TB estimation by spectrophotometry and needs further improvement to make it more accurate.
Tracking echovirus eleven outbreaks in Guangdong, China: a metatranscriptomic, phylogenetic, and epidemiological study
Authors: Lu Jing , Kang Min , Zeng Hanri , Zhong Yuwen , Fang Ling , Zheng Xiaoling , Liu Leng , Yi Lina , Lin Huifang , Peng Jingju , Li Caixia , Zhang Yingtao , Sun Limei , Luo Shuhua , Xiao Jianpeng , Munnink Bas B Oude , Koopmans Marion P G , Wu Jie , Zhang Yong , Zhang Yonghui , Song Tie , Li Hui , Zheng Huanying 
Published: April 2020

Abstract
In April 2019, a suspect cluster of enterovirus cases was reported in a neonatology department in Guangdong, China, resulting in five deaths. We aimed to investigate the pathogen profiles in fatal cases, the circulation and transmission pattern of the viruses by combining metatranscriptomic, phylogenetic, and epidemiological analyses. Metatranscriptomic sequencing was used to characterize the enteroviruses. Clinical and environmental surveillance in the local population was performed to understand the prevalence and genetic diversity of the viruses in the local population. The possible source(s), evolution, transmission, and recombination of the viruses were investigated by incorporating genomes from the current outbreak, from local retrospective surveillance, and from public databases. Metatranscriptomic analysis identified Echovirus 11 (E11) in three fatal cases. Seroprevalence of neutralization antibody to E11 was 35 to 44 per cent in 3–15 age groups of general population, and the viruses were associated with various clinical symptoms. From the viral phylogeny, nosocomial transmissions were identified and all E11 2019 outbreak strains were closely related with E11 strains circulating in local population 2017–19. Frequent recombination occurred among the 2019 Guangdong E11 outbreak strains and various genotypes in enterovirus B species. This study provides an example of combining advanced genetic technology and epidemiological surveillance in pathogen diagnosis, source(s), and transmission tracing during an infectious disease outbreak. The result highlights the hidden E11 circulation and the risk of viral transmission and infection in the young age population in China. Frequent recombination between Guangdong-like strains and other enterovirus genotypes also implies the prevalence of these emerging E11 strains.
Recognizing and managing upper extremity compartment syndrome
Authors: Miranda-Klein Jacqueline , Howell Christopher M. , Davis-Cheshire Michael 
Published: April 2020

ABSTRACT
Compartment syndrome is an acute limb-threatening condition typically treated with emergency fasciotomy. Although limbs often are saved, ischemia can cause irreversible neurologic damage to the extremity. Patients with upper extremity compartment syndrome may lose fine motor function, which can result in long-term impairment of perceived quality of life. This article reviews the anatomy, physiology, presentation, diagnosis, and treatment of upper extremity compartment syndrome, including rehabilitation, which can reduce complications that occur even in patients who were promptly and properly treated.
Fetal Sex Results of Noninvasive Prenatal Testing and Differences With Ultrasonography
Authors: Dhamankar Rupin , DiNonno Wendy , Martin Kimberly A. , Demko Zachary P. , Gomez-Lobo Veronica 
Published: April 2020

OBJECTIVE:
To assess the causes of reported discordance between noninvasive prenatal testing (NIPT) and ultrasound or other clinical information.

METHODS:
In this retrospective, observational study, all cases in which single-nucleotide polymorphism (SNP)–based NIPT reported normal sex chromosomes and the laboratory was notified by the patient or health care provider of discordance between NIPT and observed or expected fetal sex from clinical information were reviewed. When discordances were unresolved after internal and external laboratory clerical data review or repeat ultrasound imaging, additional clinical records, genetic testing results and pregnancy outcomes were reviewed.

RESULTS:
Of the 1,301,117 eligible NIPT cases, fetal sex discordances were reported in 91 (0.007%; 1:14,300; 95% CI 1:11,600–1:17,800); partial or complete outcome information was available for 83 of 91 cases. In 30 of 83 (36%) cases, karyotyping was performed, and sufficient clinical information was provided to establish the diagnosis of disorders of sexual development. The disorders of sexual development were classified into three categories: 46,XY disorders of sexual development (n=19), 46,XX disorders of sexual development (n=4), and sex chromosome disorders of sexual development (n=7). In 28 of 83 (34%) cases, the cause of the apparent discrepancy was attributable to human error, predominantly phlebotomy labeling or ultrasound misassignment. In 25 of 83 cases, a diagnosis was not possible; the outcome reported was either abnormal (18/83, 22%) or no abnormalities were reported (7/83, 8%). When normal sex chromosomes were predicted by SNP-based NIPT and clinical information was discordant, disorders of sexual development were common. Internal laboratory clerical data review and re-imaging confirmed the NIPT fetal sex reports in 34% cases, providing reassurance that no further evaluation was necessary.

CONCLUSION:
Identification of apparent fetal sex discordances with NIPT results, and reporting this suspicion to the laboratory, provides an opportunity for further evaluation to identify the cause of apparent discordances and the involvement of a multi-disciplinary team, as necessary to prepare for postnatal care. We propose a protocol for evaluation of these cases.

FUNDING SOURCE:
This study was funded by Natera, Inc.
Internal Iliac Artery Balloon Occlusion for Placenta Previa and Suspected Placenta Accreta
Authors: Chen Meng , Liu Xinghui , You Yong , Wang Xiaodong , Li Tao , Luo Hong , Qu Haibo , Xu Lian 
Published: April 2020

OBJECTIVE:
To investigate the effect of intraoperative balloon occlusion of the internal iliac arteries in women with placenta previa and antenatally diagnosed placenta accreta.

METHODS:
In this single-center, randomized controlled trial, women with placenta previa and antenatally suspected placenta accreta were randomly assigned to either the balloon occlusion group or to the control group. The perioperative management approach was similar for both groups, other than preoperative balloon catheter placement and intraoperative occlusion of bilateral internal iliac arteries. The primary outcome was the number of packed red blood cell (RBC) units transfused. With a two-sided α of 0.05 and a power of 0.8, a sample size of 48 women per group was calculated to detect a mean reduction of 2 units packed RBCs transfused with an expected SD of 3.5.

RESULTS:
From August 2017 to July 2018, we randomized 50 eligible women to the balloon group and 50 to the control group. Demographic, obstetric, and placental imaging characteristics were similar between groups. The number of packed RBC units transfused was not significantly different between groups (5.3±5.3 in the occlusion group vs 4.7±5.4 in the control group, P=.54). Hospitalization costs and incidence of postoperative fever were significantly higher in the balloon group. No significant differences were found in other outcomes.

CONCLUSION:
Intraoperative balloon occlusion of the internal iliac arteries did not reduce the number of packed RBC units transfused in women with placenta previa and antenatally suspected placenta accreta.

CLINICAL TRIAL REGISTRATION:
Chinese Clinical Trial Registry, ChiCTR-IOR-17012244.
Double-Balloon Device for 6 Compared With 12 Hours for Cervical Ripening
Authors: Bleicher Inna , Dikopoltsev Elena , Kadour-Ferro Einav , Sammour Rami , Gonen Ron , Sagi Shlomi , Eshel Aya , Nussam Liraz , Vitner Dana 
Published: April 2020

OBJECTIVE:
To evaluate whether removal of a double-balloon device for cervical ripening for 6 compared with 12 hours in women with an unfavorable cervix will result in a shorter time to delivery, similar cervical ripening, and without affecting cesarean delivery rate.

METHODS:
In a prospective randomized trial, cervical ripening was performed using a double-balloon device. Women were randomized to removal of the device after 6 compared with 12 hours. Primary outcome was time to delivery. Secondary outcomes included mode of delivery, Bishop score, and maternal and neonatal adverse outcomes. A sample size of 100 nulliparous and 100 parous women was required assuming a 95% CI, power of 80%, and mean decrease of 6 hours to delivery between the groups.

RESULTS:
From March 2017 through February 2019, 688 women were screened, 243 were found eligible, and 197 were randomized as follows: nulliparous cohort (n=101): removal after 6 hours (n=48) compared with removal after 12 hours (n=53); parous cohort (n=96): removal after 6 hours (n=49) compared with removal after 12 hours (n=47). Insertion-to-delivery interval was significantly shorter in the 6-hour group for both nulliparous (25.6±12.8 hours vs 31.4±15.2 hours, P<.04; mean difference 5.8, 95% CI 0.2–11.3), and parous cohorts (18.0±6.8 hours vs 22.6±8.2 hours, P=.003; mean difference 4.7, 95% CI 1.6–7.7). Bishop score change and cesarean delivery rate were similar between groups regardless of parity. The 12-hour group in the combined cohort was associated with higher rates of maternal intrapartum fever (2% vs 10%, P=.02; odds ratio 5.3, 95% CI 1.1–24.8).

CONCLUSION:
Insertion-to-delivery interval is shorter after 6 compared with 12 hours for both nulliparous and parous women. Cervical ripening with a double-balloon device may be achieved in 6 hours. The longer time was associated with a higher rate of intrapartum fever. Six hours should be considered as standard placement time for double-balloon catheters.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03045939.
Role of Prenatal Ultrasonography and Amniocentesis in the Diagnosis of Congenital Zika Syndrome
Authors: Viens Laura J. , Fleck-Derderian Shannon , Baez-Santiago Madelyn A. , Oduyebo Titilope , Broussard Cheryl S. , Khan Sumaiya , Jones Abbey M. , Meaney-Delman Dana 
Published: April 2020

OBJECTIVE:
To examine the relationship between prenatal diagnostics (ultrasound examination and amniotic fluid Zika virus testing) and postnatal congenital Zika syndrome abnormalities.

DATA SOURCES:
Systematic searches were performed in 27 databases, including ClinicalTrials.gov, from inception to July 1, 2019, for articles with the keywords “Zika,” “prenatal,” “ultrasound,” and “amniocentesis.”

METHODS OF STUDY SELECTION:
A total of 3,049 unique records were identified. Two reviewers independently assessed titles, abstracts, and full texts for relevance; 84 articles met the inclusion criteria. These articles describe 402 mother–fetus or mother–neonate dyads; 385 were included in the review of prenatal ultrasound examination, and 56 in the review of amniocentesis (39 in both).

TABULATION, INTEGRATION, AND RESULTS:
Among 195 fetuses with congenital Zika syndrome findings on prenatal ultrasound examination, postnatal congenital Zika syndrome abnormalities were reported for 153 (78%; 95% CI 7–84%). High proportions of microcephaly (76%; 95% CI 69–82%) and brain abnormalities (78%; 95% CI 69–86%) were confirmed postnatally. Among 190 fetuses without congenital Zika syndrome findings on prenatal ultrasound examination, 17% (95% CI 12–24%) had congenital Zika syndrome abnormalities identified postnatally. Structural congenital Zika syndrome abnormalities were identified postnatally in approximately equal proportions among dyads with and without Zika virus RNA detected in an amniotic fluid specimen (68% and 67%; 95% CI 52–82% and 95% CI 38–88%). In six pregnancies, Zika virus RNA was detected in amniotic fluid but not in a subsequent amniocentesis specimen.

CONCLUSION:
Prenatal ultrasound examination frequently detects structural findings associated with Zika virus infection; however, not all abnormalities are detected, and some may represent transient findings. As with other congenital infections, prenatal detection may vary with timing of infection, timing of ultrasound examination, technical expertise, and severity of abnormalities. The detection of Zika virus RNA in amniotic fluid in the included studies did not predict the risk for congenital Zika syndrome abnormalities in these cases, and clearance of Zika virus RNA from amniotic fluid appears possible after maternal infection. Diagnostic testing for Zika virus infection remains a shared decision between patients and clinicians, and more data are needed to define clinical predictors that will inform these decisions.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42018080959.
The Efficacy, Safety, and Optimal Regimen of Corticosteroids in Sepsis: A Bayesian Network Meta-Analysis
Authors: Zhang Shi , Chang Wei , Xie Jianfeng , Wu Zongsheng , Yang Yi , Qiu Haibo 
Published: April 2020

Objectives:Conventional systematic reviews have indicated that corticosteroids might result in a slight reduction in mortality in sepsis. However, the efficacy, safety, and optimal regimen of different corticosteroids partly remain unknown. In this study, we conducted a Bayesian network meta-analysis for a head-to-head comparison of the therapeutic efficacy and safety of currently used corticosteroids in sepsis.Design:A Bayesian network meta-analysis for a head-to-head comparison of the therapeutic efficacy and safety of currently used corticosteroids in sepsis.Setting:A total of 35 eligible randomized controlled trials of corticosteroid use in sepsis.Patients:The present Bayesian network meta-analysis included 8,859 patients with sepsis.Interventions:Randomized controlled trials were screened from PubMed, Embase, and the Cochrane Library up to December 28, 2019. A head-to-head comparison of the therapeutic efficacy and safety between the different categories of corticosteroids from the trials was conducted by Bayesian network meta-analysis. An empirical Bayesian meta-regression and a post hoc Bayesian network meta-analysis were performed to explore the appropriate dose and therapeutic duration of steroids for sepsis.Measurements and Main Results:A total of 35 randomized controlled trials including 8,859 patients with sepsis were enrolled in the final analysis. Bayesian network meta-analysis revealed that methylprednisolone and dexamethasone might be more effective in reducing short-term mortality in sepsis than placebo: methylprednisolone versus placebo (relative risk, 0.65, 95% credible interval 0.40–0.93), dexamethasone versus placebo (relative risk, 0.42, 95% credible interval, 0.24–0.84). Hydrocortisone and hydrocortisone plus fludrocortisone were superior to placebo in days to shock resolution (e-Table 5, Supplemental Digital Content 1, http://links.lww.com/CCX/A150): hydrocortisone versus placebo (mean difference, –1.70, 95% credible interval, –2.83 to –0.92), hydrocortisone plus fludrocortisone versus placebo (mean difference, –2.54, 95% credible interval, –4.19 to –0.84). Hydrocortisone was superior to placebo in reducing the length of stay in the ICU (mean difference, –1.43, 95% credible interval, –3.36 to –0.15). Methylprednisolone was superior to placebo in improving ventilation-free days (mean difference, 7.71, 95% credible interval, 1.15–14.42). In addition, further analysis indicated that the optimal therapeutic dosage was 200–400 mg per day of hydrocortisones or equivalents (relative risk, 0.83, 95% credible interval, 0.64–0.98), and the appropriate therapeutic duration was 4–7 days (relative risk, 0.78; 95% credible interval, 0.57–0.96).Conclusions:This study provided moderate evidence that the dosage of 200–400 mg per day of hydrocortisone or equivalent for 4–7 days was most likely to benefit septic patients.
SUB-RETINAL PIGMENT EPITHELIUM MULTILAMINAR HYPERREFLECTIVITY AT THE ONSET OF TYPE 3 MACULAR NEOVASCULARIZATION
Authors: Miere Alexandra , Sacconi Riccardo , Amoroso Francesca , Capuano Vittorio , Jung Camille , Bandello Francesco , Souied Eric H. , Querques Giuseppe 
Published: April 2020

Purpose:
To report the prevalence and treatment outcomes of eyes with sub-retinal pigment epithelium (sub-RPE) multilaminar hyperreflectivity at the onset/clinical detection of Type 3 macular neovascularization (MNV) secondary to exudative age-related macular degeneration.

Methods:
Retrospective analysis of consecutive patients diagnosed with Type 3 MNV secondary to age-related macular degeneration was performed. Eyes presenting with sub-RPE multilaminar hyperreflectivity on structural optical coherence tomography at the onset of Type 3 MNV were included in this study. An age-, sex-, and stage-matched control group was composed of eyes affected by Type 3 MNV without sub-RPE multilaminar hyperreflectivity. Prevalence and treatment outcomes after anti–vascular endothelial growth factor injections at 1-year follow-up were analyzed in both groups.

Results:
Nineteen treatment-naïve eyes of 19 patients (8 men/11 women, mean age 83 ± 8 years old) presenting with sub-RPE multilaminar hyperreflectivity before or at the onset/clinical detection of Type 3 MNV were included from a cohort of 162 eyes with treatment-naïve Type 3 MNV. This accounts for an estimated prevalence of 11.7% (5.8–15.2, 95% confidence intervals). No significant differences were disclosed between cases studied and the control group (143 eyes of 143 patients) in age, sex, best-corrected visual acuity at baseline, and number of injections. Best-corrected visual acuity did not improve during the 1-year follow-up in patients showing sub-RPE multilaminar hyperreflectivity (P = 0.45), whereas best-corrected visual acuity significantly increased in the control group (P < 0.001). The presence of sub-RPE multilaminar hyperreflectivity in the context of Type 3 MNV was significantly associated with regressive calcific drusen (P < 0.001) and multiple Type 3 lesions/eye (P < 0.001).

Conclusion:
The detection of multilaminar hyperreflectivity at the onset/clinical detection of Type 3 MNV suggests that chronic exudation (i.e., the “onion-sign”) in the sub-RPE space (i.e., focal sub-RPE neovascularization) may precede the onset/clinical detection of Type 3 MNV. Sub-retinal pigment epithelium multilaminar hyperreflectivity at the onset of Type 3 MNV may be an important predictor of poor visual outcome in these eyes.