bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Volume High-Intensity Aerobic Interval Training Is an Efficient Method to Improve Cardiorespiratory Fitness After Myocardial Infarction
Authors: Jayo-Montoya Jon Ander , Maldonado-Martín Sara , Aispuru G. Rodrigo , Gorostegi-Anduaga Ilargi , Gallardo-Lobo Rodrigo , Matajira-Chia Tatiana , Villar-Zabala Beatriz , Blanco-Guzmán Sonia 
Published: November 2019

Purpose:
To analyze the changes in cardiorespiratory fitness (CRF) and body composition following 2 different (low-volume vs high-volume) high-intensity aerobic interval training (HIIT) programs with Mediterranean diet (Mediet) recommendations in individuals after myocardial infarction (MI) and compared with an attention control group (AC).

Methods:
Body composition and CRF were assessed before and after a 16-wk intervention in 70 participants (58.4 ± 8.5 yr) diagnosed with MI. All participants received Mediet recommendations and were randomly assigned to the AC group (physical activity recommendations, n = 14) or one of the 2 supervised aerobic exercise groups (2 d/wk training): high-volume (40 min) HIIT (n = 28) and low-volume (20 min) HIIT (n = 28).

Results:
Following the intervention, no significant changes were seen in the AC group and no differences between HIIT groups were found in any of the studied variables. Only HIIT groups showed reductions in waist circumference (low-volume HIIT, Δ = −4%, P < .05; high-volume HIIT, Δ = −2%, P < .001) and improvements in CRF (low-volume HIIT, Δ = 15%, P < .01; high-volume HIIT, Δ = 22%; P < .001) with significant between-group differences (attention control vs HIIT groups).

Conclusions:
Results suggest that a 16-wk intervention (2 d/wk) of different HIIT volumes with Mediet recommendations could equally improve CRF and waist circumference after MI. Low-volume HIIT may be a potent and time-efficient exercise training strategy to improve functional capacity.
Visual Outcomes of Patients With Retrobulbar Hemorrhage Undergoing Lateral Canthotomy and Cantholysis
Authors: Bailey Lucy A. , van Brummen Alexandra J. , Ghergherehchi Layla M. , Chuang Alice Z. , Richani Karina , Phillips Margaret E. 
Published: November 2019

Patients with orbital compartment syndrome may see visual recovery after lateral canthotomy and cantholysis, even if performed outside of the previously accepted 3-hour window.

Purpose:
Evaluate visual outcomes in relation to time from injury to intervention in patients who undergo lateral canthotomy with cantholysis (LCC) for retrobulbar hemorrhage (RBH).

Methods:
Retrospective study of patients with orbital compartment syndrome (OCS) secondary to RBH who underwent LCC. OCS due to RBH was defined by a combination of decreased vision, proptosis, resistance to retropulsion, increased intraocular pressure, and relative afferent pupillary defect. Time from injury to intervention and change in visual acuity were calculated, with regression analysis identifying predictors of vision recovery.

Results:
Fifteen participants were included. Three (20%) participants presented with no light perception, 7 (47%) with count fingers (CF) to light perception, and 5 (33%) with better than count fingers vision. All 5 participants who had LCC within 3 hours (twice the standard 90 minutes) gained some vision, and 6 of 10 participants who had LCC after 3 hours recovered some vision. The latest intervention with visual acuity improvement was performed 9 hours postinjury. Of 3 participants who presented with no light perception vision, 1 regained vision to 20/40 (intervention 1.7 hours postinjury), and 2 did not regain any vision (interventions at 5 and 8.7 hours postinjury). Duration from injury to intervention was associated with decreased amount of vision recovery (P = 0.03).

Conclusions:
Increased time to intervention with LCC was associated with less vision recovery after OCS from RBH. However, over half of participants with intervention more than 90 minutes after injury still showed visual acuity improvement. The authors recommend LCC in all patients who present with OCS regardless of the time since injury.
Diabetic polyneuropathy and pain, prevalence, and patient characteristics: a cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes
Authors: Gylfadottir Sandra Sif , Christensen Diana Hedevang , Nicolaisen Sia Kromann , Andersen Henning , Callaghan Brian Christopher , Itani Mustapha , Khan Karolina Snopek , Kristensen Alexander Gramm , Nielsen Jens Steen , Sindrup Søren Hein , Andersen Niels Trolle , Jensen Troels Staehelin , Thomsen Reimar Wernich , Finnerup Nanna Brix 
Published: November 2019

Abstract
Most studies of diabetic polyneuropathy (DPN) and painful DPN are conducted in persons with longstanding diabetes. This cross-sectional study aimed to estimate the prevalence of DPN and painful DPN, important risk factors, and the association with mental health in recently diagnosed type 2 diabetes. A total of 5514 (82%) patients (median diabetes duration 4.6 years) enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes cohort responded to a detailed questionnaire on neuropathy and pain. A score ≥4 on the MNSI questionnaire determined possible DPN, whereas pain presence in both feet together with a score ≥3 on the DN4 questionnaire determined possible painful DPN. The prevalence of possible DPN and possible painful DPN was 18% and 10%, respectively. Female sex, age, diabetes duration, body mass index, and smoking were associated with possible DPN, whereas only smoking showed a clear association with possible painful DPN (odds ratio 1.52 [95% confidence interval: 1.20-1.93]). Possible DPN and painful DPN were independently and additively associated with lower quality of life, poorer sleep, and symptoms of depression and anxiety. Possible DPN itself had greater impact on mental health than neuropathic pain. This large study emphasizes the importance of careful screening for DPN and pain early in the course of type 2 diabetes.
Brief Report: Complete Genome Sequence of CG-0018a-01 Establishes HIV-1 Subtype L
Authors: Yamaguchi Julie , Vallari Ana , McArthur Carole , Sthreshley Larry , Cloherty Gavin A. , Berg Michael G. , Rodgers Mary A. 
Published: November 2019

Background:
The full spectrum of HIV-1 diversity can be found in Central Africa, including 2 divergent HIV-1 strains collected in 1983 and 1990 in Democratic Republic of Congo (DRC) that were preliminarily classified as group M subtype L. However, a third epidemiologically distinct subtype L genome must be identified to designate L as a true subtype.

Methods:
Specimen CG-0018a-01 was collected in 2001 in DRC as part of an HIV diversity study. Previous subgenomic HIV-1 sequences from this specimen branched closely with proposed subtype L references. Metagenomic next-generation sequencing (mNGS) and HIV-specific target-enriched (HIV-xGen) libraries were combined for NGS to extend genome coverage. mNGS reads were analyzed for the presence of other coinfections with the sequence-based ultrarapid pathogen identification bioinformatics pipeline.

Results:
A complete HIV-1 genome was generated with an average coverage depth of 47,783×. After bioinformatic analysis also identified hepatitis B virus reads, a complete hepatitis B virus genotype A genome was assembled with an average coverage depth of 73,830×. The CG-0018a-01 HIV-1 genome branched basal to the 2 previous putative subtype L strains with strong bootstrap support of 100. With no evidence of recombination present, the strain was classified as subtype L.

Conclusions:
The CG-0018a-01 HIV-1 genome establishes subtype L and confirms ongoing transmission in DRC as recently as 2001. Since CG-0018a-01 is more closely related to an ancestral strain than to isolates from 1983 to 1990, additional strains are likely circulating in DRC and possibly elsewhere.
Procalcitonin Differs in Children With Infection and Children With Disease Flares in Juvenile Idiopathic Arthritis
Authors: Trachtman Rebecca , Murray Elizabeth , Wang Cindy M. , Szymonifka Jackie , Toussi Sima S. , Walters Heather , Nellis Marianne E. , Onel Karen B. , Mandl Lisa A. 
Published: November 2019

Background/Objective
Patients with juvenile idiopathic arthritis (JIA) often present with signs and symptoms suggestive of serious bacterial infection (SBI). Procalcitonin (PCT) is a biomarker that is elevated in SBI. We conducted a comparative cohort study to test the hypothesis that PCT levels will differ between active JIA, quiescent JIA, and bacteremic patients and healthy controls.

Methods
From October 2016 to May2018, consecutive children 6 months to 18 years of age with (a) active untreated JIA, (b) quiescent JIA, and (c) healthy elective presurgical candidates were recruited from clinics at a musculoskeletal specialty hospital. Juvenile idiopathic arthritis was defined according to the International League of Associations for Rheumatology criteria. Clinical data and serum samples meeting the same criteria were included from a prior study. Consecutive bacteremic patients were identified over the same period. Procalcitonin and other common measures of inflammation were measured. Descriptive statistics and univariate logistic analyses were performed.

Results
Ninety-two study subjects were recruited. Erythrocyte sedimentation rate, C-reactive protein (CRP), and PCT levels were all elevated in bacteremic patients in comparison to the other groups. Erythrocyte sedimentation rate and CRP both had wide ranges that overlapped between groups; however, the PCT concentration was 0.15 μg/mL or greater in 1 of 59 patients with JIA, whereas it was 0.15 μg/mL or less in only 1 bacteremic patient.

Conclusions
Our study indicates that serum erythrocyte sedimentation rate, CRP, and PCT levels are all biomarkers that can be used to distinguish SBI versus active JIA at presentation. However, PCT is the most accurate, with the least overlap between patients with infection and noninfectious inflammatory arthritis. This finding can help clinicians direct therapy.
Prevalence of Eosinophilic Granulomatosis With Polyangiitis and Associated Health Care Utilization Among Patients With Concomitant Asthma in US Commercial Claims Database
Authors: Gokhale Mugdha , Bell Christopher F. , Doyle Scott , Fairburn-Beech Jolyon , Steinfeld Jonathan , Van Dyke Melissa K. 
Published: November 2019

Objective
To estimate the prevalence and associated disease burden of eosinophilic granulomatosis with polyangiitis (EGPA) in patients with asthma from a US claims database.

Methods
Two cohorts were defined using enrollees (aged ≥18 years) from the Optum deidentified Clinformatics Datamart claims database 2010–2014, based on validated EGPA case definitions with varying specificity: EGPA 1 (main cohort; more specific; patients with 2 codes [in any combination] within 12 months of each other for eosinophilia, vasculitis, or mononeuritis multiplex) and EGPA 2 (sensitivity analysis cohort; less specific; patients with 2 codes of above conditions and/or neurologic symptoms within 12 months of each other). Patients had 3 or more asthma medications in the 12-month baseline before index date (date of the second code). Eosinophilic granulomatosis with polyangiitis prevalence, asthma severity during the baseline period, oral corticosteroid (OCS) use, and health care utilization during the 12-month follow-up period were determined.

Results
Overall, 88 and 604 patients were included in main cohort EGPA 1 and sensitivity analysis cohort EGPA 2, respectively; corresponding annual EGPA prevalence rates were 3.2 to 5.9 and 23.4 to 30.7 cases/million patients. Approximately 75% of patients were prescribed OCS and ~30% experienced 1 or more hospitalization; 75% in EGPA 1 and 52% in EGPA 2 with 1 or more non-OCS prescription in the 90 days before index date had severe asthma.

Conclusions
Eosinophilic granulomatosis with polyangiitis prevalence estimates varied based on specificity of the case definition but were generally consistent with previous country-specific estimates. Despite differences in prevalence, both cohorts displayed a generally similar, high burden of OCS use and health care utilization, highlighting the substantial disease burden among patients with EGPA and the need for specific treatments.
FDG PET/CT and MRI in Primary Spinal Cord Glioblastoma
Authors: Shen Guohua , Ma Huan , Pan Lili , Su Minggang , Kuang Anren 
Published: November 2019

Abstract
Glioblastoma is the most common primary malignant tumor of the central nervous system, most of which occur in the brain. Primary spinal cord glioblastoma is extremely rare. A 47-year-old woman presented with recurrent and progressive paresthesia and paralysis of right lower extremity. MR examination revealed a marked nodular enlargement of spinal cord at the T12 level, showing heterogeneous enhancement. FDG PET/CT showed this intraspinal lesion with high FDG uptake. Imaging findings indicated a possible diagnosis of malignant neoplasm. Surgical resection was performed, and the pathologic results confirmed a primary spinal cord glioblastoma.
Optimized CT Attenuation and SUV Prediction Thresholds for Differentiating Enostoses From Untreated and Treated Metastases on Attenuation-Corrected 18F-FDG PET/CT
Authors: Lee Harrison T. , Pryma Daniel A. , Sebro Ronnie 
Published: November 2019

Purpose
The objective of this study was to evaluate the accuracy of using CT attenuation and SUVs to differentiate enostoses from untreated and treated osteoblastic metastases on the attenuation-correction CT component of 18F-FDG PET/CTs.

Methods
We retrospectively reviewed 18F-FDG PET/CT studies of 117 patients (169 lesions), of which 65 had imaging of enostoses, and 52 had imaging showing the transition of lesions from untreated to treated osteoblastic metastases. We measured the mean CT attenuations and the SUVmax and SUVmean of each lesion. Receiver operating characteristic curve analyses were used to evaluate the accuracy of each metric in distinguishing enostoses from untreated and treated osteoblastic metastases.

Results
For differentiating enostoses from untreated osteoblastic metastases, mean CT attenuation achieved an area under the receiver operating characteristic curve (AUC) of 90.8%, with an optimized threshold of 795 HU. SUVmax achieved an AUC of 94.9%, with an optimized threshold of 2.2. For differentiating enostoses from treated osteoblastic metastases, the AUCs for every metric decreased, with mean CT attenuation being the best at 82.7%. A joint predictive model combining both CT attenuation and SUV increased the AUC to 88.3%, and performance was significantly better than SUVmax or SUVmean alone (P = 0.029 and P = 0.049, respectively).

Conclusions
CT attenuation and SUV can reliably distinguish between enostoses and metastases on 18F-FDG PET/CT. However, the accuracy of these metrics decreases when used to differentiate enostoses from treated metastases. A joint prediction model combining CT attenuation with SUV can improve accuracy.
18F-FDG PET/CT in Graft Versus Host Disease–Associated Polymyositis
Authors: Sood Apurva , Khadwal Alka Rani , Lukose Tinu , Kumar Rajender , Singh Harmandeep , Bal Amanjit , Mittal Bhagwant Rai 
Published: November 2019

Abstract
Graft versus host disease (GVHD) is the most frequent and serious complication of allogenic hematopoietic stem cell transplant. Polymyositis is a rare neuromuscular manifestation of GVHD, which often responds well to corticosteroid and immunosuppression therapy. We present a case of a 38-year-old man with a known case of mixed-phenotype acute leukemia after hematopoietic stem cell transplant presenting with GVHD-associated polymyositis. 18F-FDG PET/CT done in this case not only helped in the detection of the muscle involvement but also helped in obtaining precise muscle sample for histopathological diagnosis using PET-guided biopsy.
Testicular Metastasis of Pancreatic Carcinoma on FDG-PET/CT
Authors: Hou Guozhu , Jiang Yuanyuan , Cheng Xin 
Published: November 2019

Abstract
Pancreatic cancer metastasizing to the testis is extremely rare. We present the case of a 65-year-old man who complained of painless swelling of the left scrotum for 9 months. Scrotal ultrasonography revealed a mass in the left testis. Serum CA199 and CA242 were significantly elevated. 18F-FDG PET/CT was recommended for identifying potential malignancy and showed several hypermetabolic masses in the pancreas, left testis, and right lung. Resection of left testicular and pancreatic masses and fine-needle biopsy of right pulmonary mass were performed, and subsequent pathology confirmed pancreatic adenocarcinoma metastasizing to the testis and lung.
Identifying Acute Low Back Pain Episodes in Primary Care Practice from Clinical Notes
Authors: Miotto Riccardo , Percha Bethany L. , Glicksberg Benjamin S. , Lee Hao-Chih , Cruz Lisanne , Dudley Joel T. , Nabeel Ismail 
Published: November 2019

AbstractBackgroundAcute and chronic low back pain (LBP) are different conditions with different treatments. However, they are coded in electronic health records with the same ICD-10 code (M54.5) and can be differentiated only by retrospective chart reviews. This prevents efficient definition of data-driven guidelines for billing and therapy recommendations, such as return-to-work options.ObjectiveTo solve this issue, we evaluate the feasibility of automatically distinguishing acute LBP episodes by analyzing free text clinical notes.MethodsWe used a dataset of 17,409 clinical notes from different primary care practices; of these, 891 documents were manually annotated as “acute LBP” and 2,973 were generally associated with LBP via the recorded ICD-10 code. We compared different supervised and unsupervised strategies for automated identification: keyword search; topic modeling; logistic regression with bag-of-n-grams and manual features; and deep learning (ConvNet). We trained the supervised models using either manual annotations or ICD-10 codes as positive labels.ResultsConvNet trained using manual annotations obtained the best results with an AUC-ROC of 0.97 and F-score of 0.69. ConvNet’s results were also robust to reduction of the number of manually annotated documents. In the absence of manual annotations, topic models performed better than methods trained using ICD-10 codes, which were unsatisfactory for identifying LBP acuity.ConclusionsThis study uses clinical notes to delineate a potential path toward systematic learning of therapeutic strategies, billing guidelines, and management options for acute LBP at the point of care.
Prevalence of malnutrition and associated factors among adult patients on Antiretroviral Therapy follow up care in Jimma Medical Center, Southwest Ethiopia
Authors: Daka Dawit Wolde , Ergiba Meskerem Seboka 
Published: November 2019

AbstractBackgroundMalnutrition especially under nutrition is the main problem that is seen over people living with HIV/AIDS and can occur at any age. Multiple factors contributed to malnutrition of HIV/AIDS patients and it need immediate identification and prompt action. The objective of this study was to assess the nutritional status of patients and identify factors associated with malnutrition among HIV/AIDS patients on follow-up care in Jimma medical center, Southwest Ethiopia.MethodsA cross-sectional study design was conducted from March-April, 2016. Data was collected retrospectively from clinical records of HIV/AIDS patients enrolled for follow up care in ART clinic from June 2010 to January 2016. Binary and multiple variable logistic regression was done to identify independent predictor of malnutrition.ResultsData of 971 patients were included in the study. The prevalence of under nutrition (BMI<18.5) was (36.8%) (95% CI: 33.8%-39.8%) and out of which severe malnutrition accounts 9.7%. Overweight and obese was 8.6%. Malnutrition was more likely among widowed patients (AOR=1.7, 95% CI, 1.034-2.798), patients in the WHO clinical AIDS staging of three (AOR=2.3, 95% CI, 1.392-3.693) and four (AOR=3.2, 95% CI, 1.667-5.943), patients with CD4 cell count of <200 cells/mm3(AOR=2.0, 95% CI, 1.463-2.837) and patients with a functional status of bedridden (AOR=4.677, 95% CI, 1.761-12.419) and ambulatory (AOR=2.763, 95% CI, 1.833-4.165).ConclusionBoth under nutrition and overweight are prevalent among HIV/AIDS patients in Jimma Medical Center, Ethiopia. Malnutrition was significantly associated with clinical outcome of patients. Hence, nutritional assessment, care and support should be strengthened. Critical identification of malnourished patients and prompt interventions should be undertaken.
Impact of left ventricular assist devices and heart transplant on acute myocardial infarction and heart failure mortality and readmission measures
Authors: Brandt Eric J , Ross Joseph S. , Grady Jacqueline N. , Ahmad Tariq , Pawar Sumeet , Bernheim Susannah M. , Desai Nihar R 
Published: November 2019

AbstractBackgroundConcern has been raised about consequences of including patients with left ventricular assist device (LVAD) or heart transplantation (HT) in readmission and mortality measures.MethodsWe calculated unadjusted and hospital-specific 30-day risk-standardized mortality (RSMR) and readmission (RSRR) rates for all Medicare fee-for-service beneficiaries with a primary diagnosis of AMI or HF discharged between July 2010 and June 2013. Hospitals were compared before and after excluding LVAD and HT patients. LVAD indication was measured.ResultsFor the AMI and HF cohorts, ≤0.2% of patients received an LVAD and ≤0.1% received HT in either cohort. Less than 2% of hospitals had either ≥6 patients who received an LVAD or, independently, had ≥1 HT. The AMI mortality and readmission cohorts used 1.8% and 2.8% of LVADs for semi-permanent/permanent indications, versus 73.8% and 78.0% for HF patients, respectively. The rest were for temporary/external indications.In the AMI cohort, RSMR for hospitals without LVAD patients versus hospitals with ≥6 LVADs was 14.8% and 14.3%, and RSRR was 17.8% and 18.3%, respectively; the HF cohort RSMR was 11.9% and 9.7% and RSRR was 22.6% and 23.4%, respectively. In the AMI cohort, RSMR for hospitals without versus with HT patients was 14.7% and 13.9% and RSRR was 17.8% and 17.7%, respectively; in the HF cohort, RSMR was 11.9% and 11.0%, and RSRR was 22.6% and 22.6%, respectively. Estimations changed ≤0.1% after excluding LVAD or HT patients.ConclusionHospitals caring for ≥6 patients with LVAD or ≥1 HT had lower RSMRs but higher RSRRs on average. Rates were insignificantly changed when these patients were excluded. LVADs were primarily for acute-care in the AMI cohort and chronic support in the HF cohort. LVAD and HT patients are a distinct group with differential care requirements and outcomes, thus should be considered separately from the rest of the HF cohort.