bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood pressure control in patients with chronic kidney disease according to office and home blood pressures
Authors: Chantrel François , Ott Julien , Dimitrov Yves , Babici Daniela , Fourcade Jacques , Hanon Olivier , Achard Jean-Michel , Jabourek Olivier , Ducher Michel , Fauvel Jean-Pierre 
Published: August 2020

Objectives
The aim of this study was to assess blood pressure (BP) control in patients with chronic kidney disease (CKD) according to office and home BP and to assess the prevalence of normal BP, white-coat uncontrolled hypertension (WUCH), masked uncontrolled hypertension (MUCH) and elevated BP.

Methods
Patients with renal failure with or without proteinuria were included in this multicenter observational study. Office BP was first measured by the physician using a self-monitoring BP device (three automatic readings), then by the patient at home (morning and evening) over 3 consecutive days. WUCH was defined as a systolic BP (SBP)/diastolic BP (DBP) ≥140/90 mmHg in the clinic and SBP/DBP<135/85 mmHg at home. MUCH was defined as SBP/DBP <140/90 mmHg in the clinic and SBP/DBP ≥135/85 mmHg at home.

Results
Among the 243 included subjects, data of 225 patients were analyzed. Mean estimated glomerular filtration rate was 37.7 ± 15.7 mL/min/1.73 m2 and mean office SBP/DBP was 154 ± 19/83 ± 13 mmHg. Mean office SBP/DBP was significantly higher than home SBP/DBP (+9.0 ± 15.1/+7.0 ± 10.0 mmHg, P < 0.01). Normal BP (office and home BP), WUCH, MUCH and elevated BP (office and home BP) rates were 12.0, 14.2, 6.7 and 67.1%, respectively. The patients were taking, on average, 2.8 ± 1.5 antihypertensive drugs/day.

Conclusion
BP control in patients with CKD was poor. Routine use of ‘out-of-office’ BP measurement, in addition to office BP by which we can identify patients with WUCH or MUCH, should be recommended based on the current findings.
Effect of written and video discharge instructions on parental recall of information about analgesics in children: a pre/post-implementation study
Authors: Hoek Amber E. , Bouwhuis Marna G. , Haagsma Juanita A. , Keyzer – Dekker Claudia M.G. , Bakker Berdine , Bokhorst Eric F. , Oostenbrink Rianne , Rood Pleunie P.M. 
Published: August 2020

Objective
The aim of this study was to determine whether written and video instructions improved the recall of how to use analgesics correctly in parents of children discharged following assessment in the emergency department (ED).

Methods
This was a prospective pre- and post-implementation study set in the EDs of a tertiary teaching hospital and an urban general hospital in the Netherlands. The participants were parents/carers of children under 12-years-old who had been assessed in and subsequently discharged from the ED. The pre-implementation phase involved 165 participants; the post-phase involved 174 participants. In the post-implementation phase, written instructions about correct analgesic use in children and a link to an online video were provided at discharge. Endpoints were measured using a questionnaire designed to ascertain participants’ recall of how to use analgesics correctly and their patterns of use, completed 3–5 days following discharge of their child from the ED. Additionally, participants were asked about re-attending healthcare services and their satisfaction with and preferences for information about analgesic use.

Results
Recall of the correct use of analgesics was significantly higher in participants in the post-implementation phase compared to the pre-implementation phase [difference 29%; 95% confidence interval (CI) 19–39%]. In the post-implementation phase, participants represented to healthcare services less frequently (difference –6%; 95% CI –13–0%). Patterns of use of analgesics varied between the pre- and post-phases, with significantly more participants giving analgesics at home (difference 11%; 95% CI 1–20%). Participants in the post-implementation phase were significantly more (highly) satisfied about the analgesic advice they received compared to parents in the pre-implementation phase (difference –13; 95% CI –23% to –3%). Verbal (93%) or written instructions (83%) were the most popular choices for discharge instructions.

Conclusion
In our study, we observed that the recall of the correct use of analgesics was increased in participants who had been given written instructions at discharge.
Surgical Treatment for Capsular Contracture: A New Paradigm and Algorithm
Authors: Hidalgo David A. , Weinstein Andrew L. 
Published: August 2020

Background:
Capsular contracture following breast augmentation is prone to recurrence with conventional surgical therapy. Adding acellular dermal matrix improves results but significantly increases operating time and cost. This study tested a new treatment algorithm that uses acellular dermal matrix selectively to optimize success rates while minimizing its drawbacks.

Methods:
All patients surgically treated by the authors for Baker grade III/IV capsular contracture between 2007 and 2018 were included in this retrospective cohort study. Data were collected on patient, breast augmentation, capsular contracture, and surgical treatment characteristics, in addition to follow-up findings. Treatment success was defined as Baker grade II or better.

Results:
One hundred eighty patients underwent 217 surgical treatments for capsular contracture. Conventional treatment was used in 185 cases and acellular dermal matrix in 32. Twenty-six patients were treated for a second occurrence and four were treated for a third. The average follow-up was 2.4 years. Conventional treatment was successful in 72.5 percent of first occurrences, 62.5 percent of second occurrences, and 50.0 percent of third occurrences. Acellular dermal matrix was successful in 96.9 percent of cases. The odds of failure were increased by bilateral capsular contracture (3.9 times) and previous treatment failure (3.5 times). When acellular dermal matrix was used selectively for bilateral capsular contracture or in unilateral cases with a previous treatment failure, the overall treatment success rate improved to 85.6 percent compared with 64.2 percent when this algorithm was not followed (p < 0.001).

Conclusion:
This study demonstrates that selective acellular dermal matrix use can increase success rate to over 85 percent in the overall treatment of capsular contracture, and to nearly 100 percent in individual cases.
High Prevalence of HIV-1 Drug Resistance and Dynamics of Transmission Among High-Risk Populations in Port-au-Prince, Haiti
Authors: Jean Louis Frantz , Domercant Jean Wysler , Ignacio Caroline , Gianella Sara , Galbaud Guethina , Leonard Maureen , Smith Davey M. , Chaillon Antoine 
Published: August 2020

Background:
In low HIV prevalence settings, understanding the transmission dynamics and the impact of drug resistance is critical to curb down the epidemic. This study aims to explore the prevalence and dynamics of transmission of HIV drug-resistance mutations (DRMs) among key populations in Haiti.

Settings:
Eligible participants (naive, treated) were selected from 7 key population friendly health care centers in Port-au-Prince, Haiti, from September 2018 to July 2019.

Methods:
A total of 119 HIV-1 pol sequences were analyzed from men having sex with men (MSM), female sex workers (FSWs), and their sexual partners. Screening for HIV DRMs was performed using the Stanford University Drug Resistance Database. Phylogenetic and network analyses using HIV-TRACE software were performed to infer putative relationships and shared DRMs.

Results:
Of the 119 participants, 62.2% were men (74/119), and 75.7% of them (56/74) reported MSM as a main risk factor. The overall DRM prevalence was 58.8% (70/119). A DRM was observed in 37.5% of MSM (21/56), 82.2% of FSWs (37/45), and 66.7% (12/18) among FSWs' clients. In a multivariate model, age and FSWs were significant predictors for DRMs (P = 0.001). Transmission network analysis found 24 of the 119 (20.2%) genetically linked individuals forming 8 clusters. Clustering participants were mostly MSM (15/24; 62.5%). Five clusters (62.5%) had shared DRMs, and K103N and M184V were the main shared mutations.

Conclusions:
High prevalence of HIV DRMs was observed among MSM, FSWs, and their clients in Port-au-Prince, Haiti. Network analysis revealed frequent DRM transmission among genetically linked individuals, highlighting the need for appropriate interventions to limit HIV transmission in these high-risk populations.
Model-Based Predictions of HIV Incidence Among African Women Using HIV Risk Behaviors and Community-Level Data on Male HIV Prevalence and Viral Suppression
Authors: Moore James R. , Donnell Deborah J. , Boily Marie-Claude , Mitchell Kate M. , Delany-Moretlwe Sinead , Bekker Linda-Gail , Mgodi Nyaradzo M. , El-Sadr Wafaa , Cohen Myron S. , Celum Connie L. , Dimitrov Dobromir 
Published: August 2020

Background:
Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine has proven highly effective in preventing HIV acquisition and is therefore offered to all participants in the control group as part of the standard of care package in many new HIV prevention studies. We propose a methodology for predicting HIV incidence in a hypothetical “placebo arm” for open-label studies or clinical trials with active control among African women. We apply the method to an open-label PrEP study, HIV Prevention Trials Network 082, which tested strategies to improve PrEP adherence in young African women all of whom were offered PrEP.

Methods:
Our model predicted HIV infection risk for female study cohorts in sub-Saharan Africa using baseline behavioral risk factors and contemporary HIV prevalence and viral suppression in the local male population. The model was calibrated to HIV incidence in the Vaginal and Oral Interventions to Control the Epidemic study.

Results:
Our model reproduced the annual HIV incidence of 3.2%–4.8% observed over 1 year of follow-up in the placebo groups of 4 completed clinical studies. We predicted an annual HIV incidence of 3.7% (95% confidence interval: 3.2 to 4.2) among HIV Prevention Trials Network 082 participants in the absence of PrEP and other risk reduction interventions.

Conclusions:
We demonstrated the potential of the proposed methodology to provide HIV incidence predictions based on assessment of individual risk behaviors and community and time-specific HIV exposure risk using HIV treatment and viral suppression data. These estimates may serve as comparators in HIV prevention trials without a placebo group.
Cardiothoracic Complications of Immune Checkpoint Inhibitor Therapy: An Imaging Review
Authors: Agarwal Saurabh , Healey Terrance T. 
Published: August 2020

Abstract
Immune checkpoint inhibitor therapy has revolutionized the treatment of many different types of cancer. However, despite dramatic improvements in tumor oncologic response and patient outcomes, immune checkpoint blockade has been associated with multiple distinctive side-effects termed immune-related adverse events. These often have important clinical implications because these can vary in severity, sometimes even resulting in death. Therefore, it is important for both radiologists and clinicians to recognize and be aware of these reactions to help appropriately guide patient management. This article specifically highlights imaging manifestations of the most common cardiothoracic toxicities of these agents, including pneumonitis, sarcoid-like granulomatosis and lymphadenopathy, and myocarditis.
Renal Cell Carcinoma: Predicting DNA Methylation Subtyping and Its Consequences on Overall Survival With Computed Tomography Imaging Characteristics
Authors: Yu Taihen , Lin Chunmiao , Li Xinming , Quan Xianyue 
Published: August 2020

Purpose
The aim of the study was to investigate associations between computed tomography (CT) imaging characteristics, DNA methylation subtyping, and overall survival in renal cell carcinomas.

Methods
Survival curves were calculated using the Kaplan-Meier analysis. The CT data from 212 patients generated with The Cancer Imaging Archive (TCIA) were reviewed. Identified were 70 (33.0%) M1 subtype, 17 (8.0%) M2 subtype, and 125 (59.0%) M3 subtype. Univariate and multivariate analyses were performed using the logistic regression model.

Results
Patients with M1 subtype had the shortest median overall survival (P < 0.001). On univariate analysis, long axis of 70 mm, intratumoral calcifications, enhancement, long axis > median, short axis > median, and intratumoral vascularity were associated with a significantly higher incidence of M1 subtype (P < 0.05). Short axis ≤ median, absence of necrosis, absence of intratumoral vascularity, and nodular enhancement were associated with M2 subtype (P < 0.05). Short axis ≤ median, long axis ≤ median, long axis of less than 70 mm, and necrosis were associated with a significantly higher incidence of M3 subtype (P < 0.05). On multivariate logistic regression analysis, long axis of greater than 70 mm (odds ratio [OR] = 2.452, P = 0.004; 95% confidence interval [CI] = 1.332–4.514) and necrosis (OR = 4.758, P = 0.041, 95% CI = 1.065–21.250) were associated with M1 subtype (area under the curve [AUC] = 0. 664). Necrosis (OR = 0.047, P < 0.001, 95% CI = 0.012–0.178) and enhancement (OR = 0.083, P = 0.024, 95% CI = 0.010–0.716) were associated with M2 subtype (AUC = 0.909). Long axis > median (OR = 0.303, P < 0.001, 95% CI = 0.164–0.561) and necrosis (OR = 3.256, P = 0.003, 95% CI = 1.617–10.303) were associated with M3 subtype (AUC = 0. 664).

Conclusions
The shortest survival was observed in patients with M1 subtype. This preliminary radiogenomics analysis of renal cell carcinoma demonstrated associations between CT imaging characteristic and DNA methylation subtyping.
Computed Tomography Findings in Vernix Caseosa Peritonitis
Authors: Becker-Weidman David , Chung Celina M.C. , Nadeem Muhammad , Virk Jas , Chung Charles 
Published: August 2020

Introduction
Vernix caseosa peritonitis (VCP) is a rare peripartum complication secondary to the introduction of fetal vernix into the maternal peritoneal cavity. Vernix caseosa peritonitis typically manifests a few hours to days after a cesarian section and is often initially misdiagnosed as a more common disease process resulting in delayed diagnosis. We report the computed tomography (CT) findings in 2 patients with VCP and reviewed the previously reported CT findings of VCP.

Cases
Two patients, aged 17 and 24 years, presented with signs and symptoms of peritonitis within days of undergoing a cesarian section. In both cases, CT scans of the abdomen and pelvis demonstrated ascites and multiple small, well-defined, peripherally enhancing, cystic peritoneal nodules which were most prominent around the liver and became larger and more numerous over time. Antibiotic therapy was not effective, subsequent laparoscopic peritoneal biopsy demonstrated VCP, and patients were successfully treated with lavage and the addition of intravenous steroids.

Conclusions
Vernix caseosa peritonitis is an underrecognized disorder that is most often mistaken for other more common causes of peritonitis. In the setting of peripartum peritonitis, the CT findings of ascites with multiple small, well-defined, peripherally enhancing, cystic peritoneal nodules, especially adjacent to the liver, which grow in size and number strongly suggests VCP.
The Effect of Rectal Distention on the Intravoxel Incoherent Motion Parameters: Using Sonography Transmission Gel
Authors: Song Gesheng , Sun Hongjun , Chen Xu , Li Houying , Li Panpan , Li Jinye , Li Aiyin 
Published: August 2020

Objective
To compare the intravoxel incoherent motion (IVIM) parameters of rectal tumors before and after lumen distension obtained with sonography transmission gel.

Methods
Twenty-five patients were enrolled. The multiple b values of IVIM including 0, 20, 50, 100, 150, 200, 400, 600, 800, 1000, 1500, and 2000 s/mm2. Two blinded readers have drawn the region of interests and calculated the D, D*, and f values. Interobserver variability between the 2 readers was measured by intraclass correlation coefficients and Altman-Bland plots. The intergroup differences of the average values were compared with the paired sample t test.

Results
After distention, the interrater agreement of the D* value increased obviously (from 0.547 to 0.692) and that of the D and f values increased slightly (from 0.731 and 0.618 to 0.807 and 0.666). The difference in the D value had statistical significance (P = 0.0043).

Conclusions
Intraluminal distension can increase the repeatability of IVIM parameters and the value of IVIM.
Primary Pharyngeal Flap With Palate Repair Improves Speech Outcome in Older Children and Adults
Authors: Gill Nauman Ahmad , Fayyaz Ghulam Qadir , Bashir Muhammad Mustehsan , Ganatra Muhammad Ashraf , Sohail Muhammad , Jan Saadia Nosheen , ElShazly Mohamed , Aazam Muhammad , Siddique Kashif , Daiem Muhammad 
Published: August 2020

Background
Repair of cleft palate after 6 years of age is controversial in regard to the surgical procedure and the speech outcome. Primary repair alone may not be considered sufficient to achieve intelligible speech. The authors consider addition of pharyngeal flap at the time of primary repair to be a significant factor in improving speech.

Methods
Prospectively maintained data of all cleft palate patients operated from 2013 to 2017 (5 years) was analyzed to identify patients older than 6 years. Complete cleft palate, incomplete cleft palate, and cleft of the soft palate were further stratified according to different Randall types. They were divided into 2 main types: primary palate repair only and primary palate repair with pharyngeal flap. Speech was assessed preoperatively and 12 months postoperatively by Pittsburgh weighted speech scale.

Results
A total of 139 patients were analyzed. There were 78 males and 61 females. Their ages ranged from 6 to 60 years (mean age, 12.5 years). The overall preoperative speech score in palate repair–only group was 12.15, whereas the postoperative score was 7.32. In patients who underwent primary pharyngeal flap along with palate repair, the preoperative speech score was 11.3, and the postoperative score was 3.76.

Conclusions
In select group of patients who report late for palate repair, addition of pharyngeal flap along with the primary palate repair improves the speech outcome in all Randall groups.
Abrupt Discontinuation Versus Down-Titration of Vasopressin in Patients Recovering from Septic Shock
Authors: Lam Simon W. , Sacha Gretchen L. , Duggal Abhijit , Reddy Anita J. , Bauer Seth R. 
Published: August 2020

ABSTRACT

Purpose:
To compare patient outcomes based on management of arginine vasopressin (AVP) during the recovery phase of septic shock (abrupt vs. tapering discontinuation).

Patients and Methods:
Multicenter, retrospective cohort study of patients receiving AVP with concomitant norepinephrine for septic shock. Primary outcome measure was time to intensive care unit (ICU) discharge (from decision to titrate or stop AVP). Secondary outcomes included ICU and hospital mortality, and incidence of hypotension.

Results:
A total of 958 (73%) abrupt discontinuation and 360 (27%) down-titration patients were included. Patient characteristics and septic shock treatment courses were similar between groups. Median time to ICU discharge was similar between abrupt discontinuation (7.9 days, 95% CI 7.2–8.7 days) and tapered patients (7.3 days, 95% CI 6.3–9.3 days, P = 0.60). After controlling for baseline discrepancies, down-titration was not an independent predictor of time to ICU discharge (HR = 0.99, 95% CI: 0.85–1.15, P = 0.91). There was no difference in ICU mortality (21.8% vs. 18.0%, P = 0.13) or hospital mortality (28.9% vs. 31.1%, P = 0.44). Although incidence of hypotension was similar (39.7% vs. 41.7%, P = 0.53), patients in the down-titration group more frequently required an escalation of AVP dose (5.7% vs. 11.1%, P < 0.001). Median AVP duration was shorter in the abrupt discontinuation group (1.4 days [IQR: 0.6–2.6 days] vs. 1.8 days [IQR: 1.1–3.2 days], P < 0.001).

Conclusions:
A difference in time to ICU discharge was not detected between abrupt AVP discontinuation and down-titration in patients recovering from septic shock. In patients recovering from septic shock, abrupt discontinuation of AVP appears to be safe and may lead to shortened AVP duration.
A Microdebriefing Crisis Resource Management Program for Simulated Pediatric Resuscitation in a Community Hospital
Authors: Jafri Farrukh N. , Mirante Doreen , Ellsworth Kelly , Shulman Jodi , Dadario Nicholas B. , Williams Kimiko , Yu Seongah , Thomas Jinu , Kumar Anshul , Edwards Roger A. , Torres Rafael E. , Straff Dean J. 
Published: August 2020

Introduction
Crisis Resource Management (CRM) is a team training tool used in healthcare to enhance team performance and improve patient safety. Our program intends to determine the feasibility of high-fidelity simulation for teaching CRM to an interprofessional team in a community hospital and whether a microdebriefing intervention can improve performance during simulated pediatric resuscitation.

Methods
We conducted a single-center prospective interventional study with 24 teams drawn from 4 departments. The program was divided into an initial assessment simulation case (pre), a 40-minute microdebriefing intervention, and a final assessment simulation case (post). Post and pre results were analyzed for each team using t tests and Wilcoxon signed-rank tests. Primary outcome measures included (a) completion of program, (b) percent enrollment, (c) participant reaction, and (d) support of continued programs on completion. Secondary outcomes included (a) change in teamwork performance, measured by the Clinical Teamwork Scale; (b) change in time to initiation of chest compressions and defibrillation; and (c) pediatric advanced life support adherence, measured by the Clinical Performance Tool.

Results
We successfully completed a large-scale training program with high enrollment. Twenty-four teams with 162 participants improved in Clinical Teamwork Scale scores (42.8%–57.5%, P < 0.001), Clinical Performance Tool scores (61.7%–72.1%, P < 0.001), and time to cardiopulmonary resuscitation initiation (70.6–34.3 seconds, P < 0.001).

Conclusions
Our center ran a well-attended, well-received interprofessional program in a community hospital site demonstrating that teaching CRM skills can improve simulated team performance in a diverse experienced cohort.
Evaluation of nasopharyngeal swab collection techniques for nucleic acid recovery and participant experience: recommendations for COVID-19 diagnostics
Authors: Kinloch Natalie N. , Shahid Aniqa , Ritchie Gordon , Dong Winnie , Lawson Tanya , Montaner Julio S.G. , Romney Marc G. , Stefanovic Aleksandra , Matic Nancy , Brumme Chanson J. , Lowe Christopher F. , Brumme Zabrina L. , Leung Victor 
Published: August 2020

AbstractNasopharyngeal swabs are critical to the diagnosis of respiratory infections including COVID-19, but collection techniques vary. We compared two recommended nasopharyngeal swab collection techniques in adult volunteers and found that swab rotation following nasopharyngeal contact did not recover additional nucleic acid (as measured by human DNA/RNA copy number). Rotation was also less tolerable for participants. Notably, both discomfort and nucleic acid recovery were significantly higher in Asians, consistent with nasal anatomy differences. Our results suggest that it is unnecessary to rotate the swab in place following contact with the nasopharynx, and reveal that procedural discomfort levels can differ by ethnicity.summaryNasopharyngeal swabs are critical to COVID-19 diagnostics, but collection techniques vary. Comparison of two collection techniques revealed that swab rotation did not recover more nucleic acid and was more uncomfortable. Discomfort and biological material recovery also varied by participant ethnicity.