bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain Scores and Activity Tolerance in the Early Postoperative Period After Hip Arthroscopy
Authors: Ramos Laylaa , Kraeutler Matthew J. , Marty Eric , Welton K. Linnea , Garabekyan Tigran , Mei-Dan Omer 
Published: October 2020

Background: Despite the rapid growth in the use of hip arthroscopy, standardized data on postoperative pain scores and activity level are lacking. Purpose: To quantify narcotic consumption and use of the stationary bicycle in the early postoperative period after hip arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: In this prospective case series, patients undergoing a primary hip arthroscopy procedure by a single surgeon were asked to fill out a daily survey for 9 days postoperatively. Patients were asked to report their pain level each day on a visual analog scale from 1 to 10, along with the amount of narcotic pain pills they used during those postoperative days (PODs). Narcotic usage was converted to a morphine-equivalent dosage (MED) for each patient. Patients were also instructed to cycle daily starting on the night of surgery for a minimum of 3 minutes twice per day and were asked to rate their pain as a percentage of their preoperative pain level and the number of minutes spent cycling on a stationary bicycle per day. Results: A total of 212 patients were enrolled in this study. Pain levels (POD1, 5.5; POD4, 3.8; POD9, 2.9; P < .0001) and the percentage of preoperative pain (POD1, 51.6%; POD4, 31.8%; POD9, 29.5%; P < .01) significantly decreased over the study period. The amount of narcotics used per day (reported in MED) also significantly decreased (POD1, 27.3; POD4, 22.3; POD9, 8.5; P < .0001). By POD4, 41% of patients had discontinued all narcotics, and by POD9, 65% of patients were completely off narcotic medication. Patients were able to significantly increase the number of minutes spent cycling each day (POD1, 7.6 minutes; POD4, 13.8 minutes; POD9, 19.0 minutes; P < .0001). Patients who received a preoperative narcotic prescription for the affected hip were significantly more likely to require an additional postoperative narcotic prescription ( P < .001). Conclusion: Patients can expect a rapid decrease in narcotic consumption along with a high degree of activity tolerance in the early postoperative period after hip arthroscopy.
Anterior Knee Pain After Anterior Cruciate Ligament Reconstruction
Authors: Marques Fabiano da Silva , Barbosa Pedro Henrique Borges , Alves Pedro Rodrigues , Zelada Sandro , Nunes Rodrigo Pereira da Silva , de Souza Marcio Régis , Pedro Márcio do Amaral Camargo , Nunes José Francisco , Alves Wilson Mello , de Campos Gustavo Constantino 
Published: October 2020

Background: Anterior knee pain is a frequent condition after anterior cruciate ligament reconstruction (ACLR), but its origin remains uncertain. Studies have suggested that donor site morbidity in autologous bone–patellar tendon–bone reconstructions may contribute to patellofemoral pain, but this does not explain why hamstring tendon reconstructions may also present with anterior pain. Purpose: To evaluate the prevalence of anterior knee pain after ACLR and its predisposing factors. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated the records of all patients who underwent ACLR between 2000 and 2016 at a private facility. The prevalence of anterior knee pain after surgery was assessed, and possible risk factors (graft type, patient sex, surgical technique, range of motion) were evaluated. Results: The records of 438 patients (mean age, 30 years) who underwent ACLR were analyzed. Anterior knee pain was found in 6.2% of the patients. We found an increased prevalence of anterior knee pain with patellar tendon graft, with an odds ratio of 3.4 ( P = .011). Patients who experienced extension deficit in the postoperative period had an odds ratio of 5.3 of having anterior pain ( P < .001). Anterior knee pain was not correlated with patient sex or surgical technique. Conclusion: The chance of having anterior knee pain after ACLR was higher when patellar tendon autograft was used compared with hamstring tendon graft, as well as in patients who experienced extension deficit in the postoperative period.
Low investment non-pharmacological approaches implemented for older people experiencing responsive behaviours of dementia
Authors: Yous Marie-Lee , Martin Lori Schindel , Kaasalainen Sharon , Ploeg Jenny 
Published: October 2020

Introduction The acute care setting is not ideal for older people with dementia; responsive behaviours may be triggered when care is delivered within a strange environment by staff with limited knowledge of life history and personal preferences. Responsive behaviours (e.g., yelling, hitting, restlessness) are used by older people with dementia to communicate their needs and concerns. It is unknown whether non-pharmacological approaches used by nurses support the development of a meaningful interpersonal relationship between nurses and older people with dementia. Aims: The aims of this study were to explore: (a) the types of low investment non-pharmacological approaches (e.g., music, social activities) used by nurses caring for older people experiencing responsive behaviours of dementia in acute medical settings and (b) the factors that influence the decisions of these nurses to implement these approaches. Methods We present a qualitative secondary analysis of data from a primary study using Thorne’s interpretive description approach. Interviews were conducted with 11 nurses and four allied health professionals from acute medical settings in Canada. A qualitative secondary data analytic approach was used, specifically analytic expansion, and experiential thematic analysis. Findings: egardless of the educational preparation of nurses, the decision to use specific types of low investment non-pharmacological approaches were influenced by the perfunctory development of the interpersonal relationships in acute care hospitals. The factors that led nurses to use limited approaches (e.g., turning on the TV and providing a newspaper) were lack of dementia care education and attending to other acutely ill clients. Conclusions: This study revealed that nurses in acute medical settings require greater practice growth to deliver relational care which is crucial to supporting older people with dementia. Nurses need education and knowledge translation support to use creative low investment non-pharmacological approaches with the intent on upholding the quality of life older people with dementia.
Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients
Authors: Vijenthira Abi , Gong Inna Y. , Fox Thomas A. , Booth Stephen , Cook Gordon , Fattizzo Bruno , Martín-Moro Fernando , Razanamahery Jerome , Riches John C. , Zwicker Jeff , Patell Rushad , Vekemans Marie Christiane , Scarfò Lydia , Chatzikonstantinou Thomas , Yildiz Halil , Lattenist Raphaël , Mantzaris Ioannis , Wood William A. , Hicks Lisa K. 
Published: October 2020

AbstractOutcomes for patients with hematologic malignancy infected with COVID-19 have not been aggregated. The objective of this study was to perform a systematic review and meta-analysis to estimate the risk of death and other important outcomes for these patients. We searched PubMed and EMBASE up to 20 August 2020 to identify reports of patients with hematologic malignancy and COVID-19. The primary outcome was a pooled mortality estimate, considering all patients and only hospitalized patients. Secondary outcomes included risk of intensive care unit admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-four adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14 of 34 adult studies included only hospitalized patients). Risk of death among adult patients was 34% (95% CI, 28-39; N = 3240) in this sample of predominantly hospitalized patients. Patients aged ≥60 years had a significantly higher risk of death than patients &lt;60 years (RR, 1.82; 95% CI, 1.45-2.27; N = 1169). The risk of death in pediatric patients was 4% (95% CI, 1-9; N = 102). RR of death comparing patients with recent systemic anticancer therapy to no treatment was 1.17 (95% CI, 0.83-1.64; N = 736). Adult patients with hematologic malignancy and COVID-19, especially hospitalized patients, have a high risk of dying. Patients ≥60 years have significantly higher mortality; pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.
Inbreeding depression across the genome of Dutch Holstein Friesian dairy cattle
Authors: Doekes Harmen P. , Bijma Piter , Veerkamp Roel F. , de Jong Gerben , Wientjes Yvonne C. J. , Windig Jack J. 
Published: October 2020

AbstractBackgroundInbreeding depression refers to the decrease in mean performance due to inbreeding. Inbreeding depression is caused by an increase in homozygosity and reduced expression of (on average) favourable dominance effects. Dominance effects and allele frequencies differ across loci, and consequently inbreeding depression is expected to differ along the genome. In this study, we investigated differences in inbreeding depression across the genome of Dutch Holstein Friesian cattle, by estimating dominance effects and effects of regions of homozygosity (ROH).MethodsGenotype (75 k) and phenotype data of 38,792 cows were used. For nine yield, fertility and udder health traits, GREML models were run to estimate genome-wide inbreeding depression and estimate additive, dominance and ROH variance components. For this purpose, we introduced a ROH-based relationship matrix. Additive, dominance and ROH effects per SNP were obtained through back-solving. In addition, a single SNP GWAS was performed to identify significant additive, dominance or ROH associations.ResultsGenome-wide inbreeding depression was observed for all yield, fertility and udder health traits. For example, a 1% increase in genome-wide homozygosity was associated with a decrease in 305-d milk yield of approximately 99 kg. For yield traits only, including dominance and ROH effects in the GREML model resulted in a better fit (P < 0.05) than a model with only additive effects. After correcting for the effect of genome-wide homozygosity, dominance and ROH variance explained less than 1% of the phenotypic variance for all traits. Furthermore, dominance and ROH effects were distributed evenly along the genome. The most notable region with a favourable dominance effect for yield traits was on chromosome 5, but overall few regions with large favourable dominance effects and significant dominance associations were detected. No significant ROH-associations were found.ConclusionsInbreeding depression was distributed quite equally along the genome and was well captured by genome-wide homozygosity. These findings suggest that, based on 75 k SNP data, there is little benefit of accounting for region-specific inbreeding depression in selection schemes.
Experimental determination of evolutionary barriers to horizontal gene transfer
Authors: Acar Kirit Hande , Lagator Mato , Bollback Jonathan P. 
Published: October 2020

AbstractBackgroundHorizontal gene transfer, the acquisition of genes across species boundaries, is a major source of novel phenotypes that enables microbes to rapidly adapt to new environments. How the transferred gene alters the growth – fitness – of the new host affects the success of the horizontal gene transfer event and how rapidly the gene spreads in the population. Several selective barriers – factors that impact the fitness effect of the transferred gene – have been suggested to impede the likelihood of horizontal transmission, however experimental evidence is scarce. The objective of this study was to determine the fitness effects of orthologous genes transferred fromSalmonella entericaserovar Typhimurium toEscherichia colito identify the selective barriers using highly precise experimental measurements.ResultsWe found that most gene transfers result in strong fitness costs. Previously identified evolutionary barriers — gene function and the number of protein-protein interactions — did not predict the fitness effects of transferred genes. In contrast, dosage sensitivity, gene length, and the intrinsic protein disorder significantly impact the likelihood of a successful horizontal transfer.ConclusionWhile computational approaches have been successful in describing long-term barriers to horizontal gene transfer, our experimental results identified previously underappreciated barriers that determine the fitness effects of newly transferred genes, and hence their short-term eco-evolutionary dynamics.
The impact of growth differentiation factor 15 on the risk of cardiovascular diseases: two-sample Mendelian randomization study
Authors: Wang Zhuo , Yang Fangkun , Ma Menghuai , Bao Qinyi , Shen Jinlian , Ye Feiming , Xie Xiaojie 
Published: October 2020

Abstract

Background
Growth differentiation factor 15 (GDF-15), a stress responsive cytokine, belongs to transforming growth factor β cytokine superfamily. Some evidence support that it’s involved in inflammation, coagulation, oxidative stress, endothelial dysfunction, and hemostasis. However, it’s still controversial whether GDF-15 directly contributes to the morbidity and mortality of patients suffered with cardiovascular disease (CVD). Besides prospective cohort study and randomized controlled trial, Mendelian randomization (MR) is a genetic epidemiological method that exploits genetic variants as unbiased proxies for modifiable to determine the causal relationships between exposures and health outcomes. Herein, we introduced a two-sample MR approach to evaluate the causal relationships of circulating GDF-15 levels with major CVDs incidence.

Methods
Genetic instruments and summary statistics for two-sample MR analysis were obtained from 5 independent large genome-wide association studies (GWAS) to investigate the causal correlation between circulating GDF-15 levels and 9 CVDs, respectively. Conventional inverse variance weighted method was adopted to evaluate the causality of GDF-15 with different outcomes; weighted median and MR egger were used for sensitivity analyses.

Results
Among 9 SNPs identified from 5 GWASs in 2.6 million individuals, 5 SNPs (rs1227731, rs3195944, rs17725099, rs888663, rs749451) coming from chromosome 19 and containing the PGPEP1 and GDF-15 genes were employed. Based on the instruments, circulating GDF-15 levels significantly linked to the increased risk of cardioembolic stroke, atrial fibrillation, coronary artery disease and myocardial infarction. However, no significant causal association was observed for circulating GDF-15 levels with the incidence of any ischemic stroke, large-artery atherosclerotic stroke, small vessel stroke, heart failure and nonischemic cardiomyopathy.

Conclusions
The MR study provides with genetic evidence for the causal relationship of circulating GDF-15 levels with the increased risk of cardioembolic stroke, atrial fibrillation, coronary artery disease and myocardial infarction, but not any ischemic stroke, large-artery atherosclerotic stroke, small vessel stroke, heart failure and nonischemic cardiomyopathy. It indicates that GDF-15 might be a promising biomarker or potential therapeutic target for some CVDs.
National Early Warning Score 2 (NEWS2) and 3-level triage scale as risk predictors in frail older adults in the emergency department
Authors: Kemp Kirsi , Alakare Janne , Harjola Veli-Pekka , Strandberg Timo , Tolonen Jukka , Lehtonen Lasse , Castrén Maaret 
Published: October 2020

AbstractBackgroundThe aim of the emergency department (ED) triage is to recognize critically ill patients and to allocate resources. No strong evidence for accuracy of the current triage instruments, especially for the older adults, exists. We evaluated the National Early Warning Score 2 (NEWS2) and a 3-level triage assessment as risk predictors for frail older adults visiting the ED.MethodsThis prospective, observational study was performed in a Finnish ED. The data were collected in a six-month period and included were ≥ 75-year-old residents with Clinical Frailty Scale score of at least four. We analyzed the predictive values of NEWS2 and the three-level triage scale for 30-day mortality, hospital admission, high dependency unit (HDU) and intensive care unit (ICU) admissions, a count of 72-h and 30-day revisits, and ED length-of-stay (LOS).ResultsA total of 1711 ED visits were included. Median for age, CFS, LOS and NEWS2 were 85 years, 6 points, 6.2 h and 1 point, respectively. 30-day mortality was 96/1711. At triage, 69, 356 and 1278 of patients were assessed as red, yellow and green, respectively. There were 1103 admissions, of them 31 to an HDU facility, none to ICU.With NEWS2 and triage score, AUCs for 30-day mortality prediction were 0.70 (0.64–0.76) and 0.62 (0.56–0.68); for hospital admission prediction 0.62 (0.60–0.65) and 0.55 (0.52–0.56), and for HDU admission 0.72 (0.61–0.83) and 0.80 (0.70–0.90), respectively.The NEWS2 divided into risk groups of low, medium and high did not predict the ED LOS (p = 0.095). There was a difference in ED LOS between the red/yellow and as red/green patient groups (p < 0.001) but not between the yellow/green groups (p = 0.59).There were 48 and 351 revisits within 72 h and 30 days, respectively. With NEWS2 AUCs for 72-h and 30-day revisit prediction were 0.48 (95% CI 0.40–0.56) and 0.47 (0.44–0.51), respectively; with triage score 0.48 (0.40–0.56) and 0.49 (0.46–0.52), respectively.ConclusionsThe NEWS2 and a local 3-level triage scale are statistically significant, but poor in accuracy, in predicting 30-day mortality, and HDU admission but not ED LOS or revisit rates for frail older adults. NEWS2 also seems to predict hospital admission.
Impacts of reopening strategies for COVID-19 epidemic: a modeling study in Piedmont region
Authors: Pernice Simone , Castagno Paolo , Marcotulli Linda , Maule Milena Maria , Richiardi Lorenzo , Moirano Giovenale , Sereno Matteo , Cordero Francesca , Beccuti Marco 
Published: October 2020

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), the causative agent of the coronavirus disease 19 (COVID-19), is a highly transmittable virus. Since the first person-to-person transmission of SARS-CoV-2 was reported in Italy on February 21st, 2020, the number of people infected with SARS-COV-2 increased rapidly, mainly in northern Italian regions, including Piedmont. A strict lockdown was imposed on March 21st until May 4th when a gradual relaxation of the restrictions started. In this context, computational models and computer simulations are one of the available research tools that epidemiologists can exploit to understand the spread of the diseases and to evaluate social measures to counteract, mitigate or delay the spread of the epidemic.

Methods
This study presents an extended version of the Susceptible-Exposed-Infected-Removed-Susceptible (SEIRS) model accounting for population age structure. The infectious population is divided into three sub-groups: (i) undetected infected individuals, (ii) quarantined infected individuals and (iii) hospitalized infected individuals. Moreover, the strength of the government restriction measures and the related population response to these are explicitly represented in the model.

Results
The proposed model allows us to investigate different scenarios of the COVID-19 spread in Piedmont and the implementation of different infection-control measures and testing approaches. The results show that the implemented control measures have proven effective in containing the epidemic, mitigating the potential dangerous impact of a large proportion of undetected cases. We also forecast the optimal combination of individual-level measures and community surveillance to contain the new wave of COVID-19 spread after the re-opening work and social activities.

Conclusions
Our model is an effective tool useful to investigate different scenarios and to inform policy makers about the potential impact of different control strategies. This will be crucial in the upcoming months, when very critical decisions about easing control measures will need to be taken.
Early life household intactness and timing of pubertal onset in girls: a prospective cohort study
Authors: Aghaee Sara , Deardorff Julianna , Greenspan Louise C. , Quesenberry Charles P. , Kushi Lawrence H. , Kubo Ai 
Published: October 2020

AbstractBackgroundGirls who experience early-life familial stress may have heightened risk of early puberty, which has adverse implications for adolescent and adult health. We assessed the association between household intactness and pubertal onset using a racially/ethnically diverse cohort of girls from Northern California.MethodsA prospective cohort study of 26,044 girls born in 2003-10. Girls living with both parents from birth up to 6 years were considered to come from “intact” households while others constituted “non-intact” households. Pubertal development was measured using pediatrician-assessed Tanner staging for breast and pubic hair. Pubertal onset was defined as the transition from Tanner Stage 1 to 2+ for breast (thelarche) and pubic hair (pubarche). Menarche data was collected from routine well-child questionnaires. Weibull regression models accommodating left, right, and interval censoring were used to determine risk of earlier thelarche and pubarche, and logistic regressions were used to assess the risk of early menarche (age < 12).ResultsGirls exposed to non-intact households before age 2 years were at increased risk for earlier thelarche and pubarche with significant effect modification by race/ethnicity, compared with girls from intact households. The associations were strongest among Black girls (adjusted hazard ratio [HR]: 1.60, 95% confidence interval [CI]: 1.29,1.98; HR: 1.42, 95%CI: 1.15,1.77 for thelarche and pubarche, respectively). There were no significant associations among Asian/Pacific Islanders. Girls who lived in non-intact households before age 2 years were also at increased risk for earlier menarche, but without race/ethnic interaction. Adjustment for prepubertal obesity did not change these associations. Associations between living in non-intact households after age 2 years and early puberty were weaker but still significant.ConclusionsExposure to a non-intact household early in life may increase the risk of early puberty in girls. Future psychosocial interventions focused on improving family cohesiveness and efforts to reduce childhood stress among families that are non-intact may mitigate these negative associations, thereby preventing future adverse health effects of early puberty and health disparities.