bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is magnetic resonance imaging becoming the new computed tomography for cervical spine clearance? Trends in magnetic resonance imaging utilization at a Level I trauma center
Authors: Huang Raymond , Ryu Robert C. , Kim Terrence T. , Alban Rodrigo F. , Margulies Daniel R. , Ley Eric J. , Barmparas Galinos 
Published: April 2020

BACKGROUND
Increasing evidence supports the limited use of magnetic resonance imaging (MRI) for cervical spine (C-spine) clearance following blunt trauma. We sought to characterize the utilization of MRI of the C-spine at a Level I trauma center.

METHODS
All blunt trauma patients undergoing a computed tomography (CT) of the C-spine between January 2009 and December 2018 were reviewed. The CT and MRI results, demographics, clinical presentation, subspecialty consultations, and interventions were recorded. The MRI results were considered clinically significant if they resulted in cervical thoracic orthosis/halo placement or surgical intervention. Linear regression models were utilized to identify trends.

RESULTS
There were 9,101 patients that underwent a CT of the C-spine, with 513 (5.6%) being positive for an acute injury. MRI was obtained for 375 (4.1%) of patients. A linear increase in the proportion of patients undergoing an MRI was noted, from 0.9% in 2009 to 5.6% in 2018 (p < 0.01). Of the 513 patients with a positive CT, 290 (56.5%) had an MRI. In 40 (13.8%) of them, the CT demonstrated a minor injury. Clinically significant MRI findings were noted only in two (5.0%) of the 40 patients, and both had a neurologic deficit on initial examination. Of the 8,588 patients with a negative CT, 85 (1.0%) underwent an MRI. Of those, 9 (10.6%) had a clinically significant MRI with all but one presenting with a neurological deficit.

CONCLUSION
MRI is increasingly utilized for C-spine clearance following blunt trauma. MRI was exceedingly unlikely to demonstrate a clinically significant finding in the absence of a neurological deficit, when the CT was negative or included minor injuries. Trauma centers are encouraged to constantly evaluate their own practices and intervene with education and collaboration to limit the excessive use of unnecessary resources.

LEVEL OF EVIDENCE
Therapeutic/Care Management Study, Level III or IV. Diagnostic test, level IV.
Reperfusion repercussions: A review of the metabolic derangements following resuscitative endovascular balloon occlusion of the aorta
Authors: Abid Mustafa , Neff Lucas P. , Russo Rachel M. , Hoareau Guillaume , Williams Timothy K. , Grayson J. Kevin , DuBose Joseph J. , Lendrum Robbie , Johnson M. Austin 
Published: April 2020

BACKGROUND
Current resuscitative endovascular balloon occlusion of the aorta (REBOA) literature focuses on improving outcomes through careful patient selection, diligent catheter placement, and expeditious definitive hemorrhage control. However, the detection and treatment of post-REBOA ischemia-reperfusion injury (IRI) remains an area for potential improvement. Herein, we provide a review of the metabolic derangements that we have encountered while managing post-REBOA IRI in past swine experiments. We also provide data-driven clinical recommendations to facilitate resuscitation post-REBOA deflation that may be translatable to humans.

METHODS
We retrospectively reviewed the laboratory data from 25 swine across three varying hemorrhagic shock models that were subjected to complete REBOA of either 45 minutes, 60 minutes, or 90 minutes. In each model the balloon was deflated gradually following definitive hemorrhage control. Animals were then subjected to whole blood transfusion and critical care with frequent electrolyte monitoring and treatment of derangements as necessary.

RESULTS
Plasma lactate peaked and pH nadired long after balloon deflation in all swine in the 45-minute, 60-minute, and 90-minute occlusion models (onset of peak lactate, 32.9 ± 6.35 minutes, 38.8 ± 10.55 minutes, and 49.5 ± 6.5 minutes; pH nadir, 4.3 ± 0.72 minutes, 26.9 ± 12.32 minutes, and 42 ± 7.45 minutes after balloon deflation in the 45-, 60-, and 90-minute occlusion models, respectively). All models displayed persistent hypoglycemia for more than an hour following reperfusion (92.1 ± 105.5 minutes, 125 ± 114.9 minutes, and 96 ± 97.8 minutes after balloon deflation in the 45-, 60-, and 90-minute occlusion groups, respectively). Hypocalcemia and hyperkalemia occurred in all three groups, with some animals requiring treatment more than an hour after reperfusion.

CONCLUSION
Metabolic derangements resulting from REBOA use are common and may worsen long after reperfusion despite resuscitation. Vigilance is required to detect and proactively manage REBOA-associated IRI. Maintaining a readily available “deflation kit” of pharmacological agents needed to treat common post-REBOA electrolyte abnormalities may facilitate management.

LEVEL OF EVIDENCE
Level V.
The Influence of Body Mass Index on Characteristics of Falls in the Malaysian Elders Longitudinal Research Study
Authors: Kioh Sheng Hui , Mat Sumaiyah , Myint Phyo Kyaw , Ai-Vyrn Chin , Kamaruzzaman Shahrul Bahyah , Hairi Noran N. , Cumming Robert , Tan Maw Pin 
Published: April 2020

Aim:
To compare and contrast falls characteristics between older adults with body mass index of 25.0 kg/m2 or greater and less than 25.0 kg/m2 and to further identify potential underlying mechanisms if differences existed.

Subjects and Methods:
This was a cross-sectional study using data from fallers identified during the first wave of the Malaysian Elders Longitudinal Research study. Basic demographics, falls characteristics, fear of falling, medical comorbidities, and lifestyle factors were obtained during a home-based computer-assisted interview, while anthropometric measurements, body composition, and physical performance were collected during the hospital-based health check.

Results:
Of the 302 individuals with 1 or more falls in the previous 12 months, mean age (SD) = 69.6 (7.7) years, 152 individuals (50.3%) were in the body mass index of 25.0 group or greater. Fallers with body mass index of 25.0 or greater were more likely to have fallen in the bedroom and on the stairs (adjusted odds ratio = 2.50; 95% confidence interval, 1.10-5.73) and less likely to fall in the afternoon (adjusted odds ratio = 0.47; 95% confidence interval, 0.26-0.83) after adjustment for potential confounders.

Conclusions:
Our study suggests that mechanisms of falls may differ in those with excess body weight, who may benefit from specific targeted fall prevention programmes.
Investigation of the Relationship Between Activity Performance, Frequency of Fall, and Pain in Elderly People Living at Home
Authors: Cetin Sebahat Yaprak , Calik Bilge Basakci 
Published: April 2020

Objective:
The aim of this study was to determine the occupational performance of the elderly individuals living at home and to investigate the relationship between this performance and the frequency of fall and pain.

Methods:
A total of 120 elderly individuals with a mean age of 71.86 ± 5.69 years were included in the study. The Canadian Occupational Performance Measure was used to determine occupational performance. The frequency of falls has been recorded as none, 1, and more than 1 over the last 1 year. Visual analog scale (resting-activity) was used to evaluate the pain.

Results:
There was a moderately significant relationship between the performance and satisfaction scores of the elderly individuals and VAS values and the frequency of fall (P < .05).

Conclusion:
According to the results of our study, it is thought that the participation of the elderly individuals will be increased by relieving the pain in the home-based rehabilitation program to be prepared for the elderly individuals and reducing or preventing the falls.
Multi-omic modelling of inflammatory bowel disease with regularized canonical correlation analysis
Authors: Revilla Lluís , Mayorgas Aida , Corraliza Ana Maria , Masamunt Maria C. , Metwaly Amira , Haller Dirk , Tristán Eva , Carrasco Anna , Esteve Maria , Panés Julian , Ricart Elena , Lozano Juan J. , Salas Azucena 
Published: April 2020

AbstractBackgroundPersonalized medicine requires finding relationships between variables that influence a patient’s phenotype and predicting an outcome. Sparse generalized canonical correlation analysis identifies relationships between different groups of variables. This method requires establishing a model of the expected interaction between those variables. Describing these interactions is challenging when the relationship is unknown or when there is no pre-established hypothesis.AimTo develop a method to find the relationships between microbiome and transcriptome data and the relevant clinical variables in a complex disease, such as Crohn’s disease.ResultsWe present here a method to identify interactions based on canonical correlation analysis. Our main contribution is to show that the model is the most important factor to identify relationships between blocks. Analysis were conducted on three independent datasets: a glioma, Crohn’s disease and a pouchitis data set. We describe how to select the optimum hyperparameters on the glioma dataset. Using such hyperparameters on the Crohn’s disease data set, our analysis revealed the best model for identifying relationships between transcriptome, gut microbiome and clinically relevant variables. With the pouchitis data set our analysis revealed that adding the clinically relevant variables improves the average variance explained by the model.ConclusionsThe methodology described herein provides a framework for identifying interactions between sets of (omic) data and clinically relevant variables. Following this method, we found genes and microorganisms that were related to each other independently of the model, while others were specific to the model used. Thus, model selection proved crucial to finding the existing relationships in multi-omics datasets.
Impact of blood analysis and immune function on the prognosis of patients with COVID-19
Authors: Fu Yue-qiang , Sun Yue-lin , Lu Si-wei , Yang Yang , Wang Yi , Xu Feng 
Published: April 2020

ABSTRACTIntroductionThis retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with 2019-coronavirus infected disease (COVID-19).MethodsRecords were reviewed of 85 patients with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital mortality at 28 days.ResultsFourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO2/FiO2, CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×109/L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts.ConclusionsFor patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. A high neutrophil count is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.
Evidence for probable aerosol transmission of SARS-CoV-2 in a poorly ventilated restaurant
Authors: Li Yuguo , Qian Hua , Hang Jian , Chen Xuguang , Hong Ling , Liang Peng , Li Jiansen , Xiao Shenglan , Wei Jianjian , Liu Li , Kang Min 
Published: April 2020

AbstractBackgroundThe role of aerosols in the transmission of SARS-CoV-2 remains debated. We analysed an outbreak involving three non-associated families in Restaurant X in Guangzhou, China, and assessed the possibility of aerosol transmission of SARS-CoV-2 and characterize the associated environmental conditions.MethodsWe collected epidemiological data, obtained a video record and a patron seating-arrangement from the restaurant, and measured the dispersion of a warm tracer gas as a surrogate for exhaled droplets from the suspected index patient. Computer simulations were performed to simulate the spread of fine exhaled droplets. We compared the in-room location of subsequently infected cases and spread of the simulated virus-laden aerosol tracer. The ventilation rate was measured using the tracer decay method.ResultsThree families (A, B, C), 10 members of which were subsequently found to have been infected with SARS-CoV-2 at this time, or previously, ate lunch at Restaurant X on Chinese New Year’s Eve (January 24, 2020) at three neighboring tables. Subsequently, three members of family B and two members of family C became infected with SARS-CoV-2, whereas none of the waiters or 68 patrons at the remaining 15 tables became infected. During this occasion, the ventilation rate was 0.75–1.04 L/s per person. No close contact or fomite contact was observed, aside from back-to-back sitting by some patrons. Our results show that the infection distribution is consistent with a spread pattern representative of exhaled virus-laden aerosols.ConclusionsAerosol transmission of SARS-CoV-2 due to poor ventilation may explain the community spread of COVID-19.
Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs
Authors: Wyllie Anne L. , Fournier John , Casanovas-Massana Arnau , Campbell Melissa , Tokuyama Maria , Vijayakumar Pavithra , Geng Bertie , Muenker M. Catherine , Moore Adam J. , Vogels Chantal B.F. , Petrone Mary E. , Ott Isabel M. , Lu Peiwen , Venkataraman Arvind , Lu-Culligan Alice , Klein Jonathan , Earnest Rebecca , Simonov Michael , Datta Rupak , Handoko Ryan , Naushad Nida , Sewanan Lorenzo R. , Valdez Jordan , White Elizabeth B. , Lapidus Sarah , Kalinich Chaney C. , Jiang Xiaodong , Kim Daniel J. , Kudo Eriko , Linehan Melissa , Mao Tianyang , Moriyama Miyu , Oh Ji Eun , Park Annsea , Silva Julio , Song Eric , Takahashi Takehiro , Taura Manabu , Weizman Orr-El , Wong Patrick , Yang Yexin , Bermejo Santos , Odio Camila , Omer Saad B. , Dela Cruz Charles S. , Farhadian Shelli , Martinello Richard A. , Iwasaki Akiko , Grubaugh Nathan D. , Ko Albert I. 
Published: April 2020

AbstractRapid and accurate SARS-CoV-2 diagnostic testing is essential for controlling the ongoing COVID-19 pandemic. The current gold standard for COVID-19 diagnosis is real-time RT-PCR detection of SARS-CoV-2 from nasopharyngeal swabs. Low sensitivity, exposure risks to healthcare workers, and global shortages of swabs and personal protective equipment, however, necessitate the validation of new diagnostic approaches. Saliva is a promising candidate for SARS-CoV-2 diagnostics because (1) collection is minimally invasive and can reliably be self-administered and (2) saliva has exhibited comparable sensitivity to nasopharyngeal swabs in detection of other respiratory pathogens, including endemic human coronaviruses, in previous studies. To validate the use of saliva for SARS-CoV-2 detection, we tested nasopharyngeal and saliva samples from confirmed COVID-19 patients and self-collected samples from healthcare workers on COVID-19 wards. When we compared SARS-CoV-2 detection from patient-matched nasopharyngeal and saliva samples, we found that saliva yielded greater detection sensitivity and consistency throughout the course of infection. Furthermore, we report less variability in self-sample collection of saliva. Taken together, our findings demonstrate that saliva is a viable and more sensitive alternative to nasopharyngeal swabs and could enable at-home self-administered sample collection for accurate large-scale SARS-CoV-2 testing.
Psychological impact of infectious disease outbreaks on pregnant women: Rapid evidence review
Authors: Brooks Samantha K. , Weston Dale , Greenberg Neil 
Published: April 2020

AbstractInfectious disease outbreaks can be distressing for everyone, especially so for those deemed to be particularly vulnerable, such as pregnant women who have been named a high-risk group in the current COVID-19 pandemic. This rapid review aimed to summarise existing literature on the psychological impact of infectious disease outbreaks on women who were pregnant at the time of the outbreak. In April 2020 five databases were searched for relevant literature and main findings were extracted. Thirteen papers were included in the review. The following themes were identified: negative emotional states; living with uncertainty; concerns about infection; concerns about and uptake of prophylaxis or treatment; disrupted routines; non-pharmaceutical protective behaviours; social support; demands from others; financial and occupational concerns; disrupted expectations of birth, prenatal care and postnatal care, and; sources of information. Results showed that pregnant women have unique needs during infectious disease outbreaks and could benefit from: up-to-date, consistent information and guidance; appropriate support and advice from healthcare professionals, particularly with regards to the risks and benefits of prophylaxis and treatment; virtual support groups, and; designating locations or staff specifically for pregnant women.
Diffusion tensor imaging of white matter microstructure in chronic pain: a tract-based spatial statistics study and a systematic review
Authors: Gronemann Dominique Christopher , Koch Katharina , Bantel Carsten , Sörös Peter 
Published: April 2020

AbstractThe pathophysiology of many chronic pain disorders is far from evident. MR imaging studies provided initial data indicating chronic pain might lead to changes in brain structure and function. These changes may contribute to cognitive and emotional impairment and maybe even to the chronification of pain. However, the evidence for pain-related changes in gray and white matter is inconclusive so far. Hence we investigated potential changes of white matter microstructure in 34 adults with chronic noncancer pain (> 1 year) and 34 sex- and age-matched healthy individuals using diffusion tensor imaging (DTI). Whole-brain tract-based spatial statistics (TBSS) analyses of fractional anisotropy, mode of diffusivity, mean diffusivity, axial diffusivity, and radial diffusivity did not show significant differences after correction for multiple comparisons. The volumes of subdivisons of the corpus callosum were not significantly different either. We also performed a systematic review of the existing literature on white matter microstructure in patients with chronic pain following PRISMA guidelines. We identified 53 eligible studies on DTI in chronic pain. These studies demonstrated conflicting results regarding the direction and location of white matter changes across all diagnoses and within major diagnostic subcategories. We propose that two factors primarily contribute to this low reproducibility, small sample size and the use of potentially unreliable DTI parameters derived from the single-tensor model.
Coronavirus Disease (COVID-19) Pandemic: An Overview of Systematic Reviews
Authors: do Nascimento Israel Júnior Borges , O’Mathúna Dónal P. , von Groote Thilo Caspar , Abdulazeem Hebatullah Mohamed , Weerasekara Ishanka , Marusic Ana , Puljak Livia , Civile Vinicius Tassoni , Zakarija-Grkovic Irena , Pericic Tina Poklepovic , Atallah Alvaro Nagib , Filoso Santino , Bragazzi Nicola Luigi , Marcolino Milena Soriano 
Published: April 2020

AbstractBackgroundNavigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging and ongoing critical appraisal of this output is essential. We aimed to collate and summarize all published systematic reviews on the coronavirus disease (COVID-19).MethodsNine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS and Epistemonikos) were searched from December 1, 2019 to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory and radiological findings) and quality assessment (AMSTAR 2). Meta-analysis on prevalence of clinical outcomes was performed.ResultsEighteen systematic reviews were included; one was empty. Using AMSTAR 2, confidence in the results of 13 reviews was rated as “critically low”, one as “low”, one as “moderate” and two as “high”. Symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8– 12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein (associated with lymphocytopenia) and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. Chest imaging described a frequent pattern of uni- or bilateral multilobar ground-glass opacity. Only one review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3% to 14%.ConclusionsConfidence in the results of most reviews was “critically low”. Future studies and systematic reviews should adhere to established methodologies. The majority of included systematic reviews were hampered by imprecise search strategy and no previous protocol submission.Protocol registrationThis is an extension of a PROSPERO protocol (CRD42020170623); protocol available on Open Science Framework (https://osf.io/6xtyw).