bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopically Assisted Open Reduction and Internal Fixation of Sub-Condylar Fractures: Debunking Some of the Myths
Authors: Frenkel Boaz , Abu Shqara Fadi , Berg Tal , Rachmiel Adi 
Published: May 2020

Abstract
Endoscopically assisted open reduction and internal fixation has cumulate advantages over both open and closed techniques. Even though, this approach had not become popular. The study intended to summarize the outcomes and complications from the first 12 consecutive cases of sub condylar fractures that treated by endoscope and trans-buccal trocar. All patients experienced improvement in mouth opening. No postoperative malocclusion was noticed. The learning curve was assessed subjectively regarding the use of the endoscope and objectively by operating time reduction. The significant decrease in operating time and the ease of handling the endoscope were already noticed after the 5th operation. The mean time for endoscopically assisted open reduction and internal fixation in our study was 180 minutes, which was the same as for external approaches open reduction and internal fixation for sub-condylar fracture cases. No special designed instruments except an endoscope and a trans-buccal trocar were used. We can conclude that the learning curve for this technique is not as steep as it was thought to be, and it can be mastered after a relatively small number of operations. There is no difference in mean operation time comparing to external approaches. No need for special designed instruments.
Do Fellows and Faculty Share the Same Perception of Simulation Fidelity? A Pilot Study
Authors: Singh Devika , Kojima Taiki , Gurnaney Harshad , Deutsch Ellen S. 
Published: May 2020

Introduction
Simulation is increasingly integrated into graduate medical education, and simulation faculty generally attempt to optimize the fidelity of simulators and simulations on behalf of trainees, so as to approach the realism of actual patient care experiences. As residents and fellows participate as learners in simulations, which faculty design, this investigation sought to address whether fellows and faculty have similar perceptions of fidelity by comparing ratings of 2 types of simulation experiences.

Methods
Prospective single-center observational study comparing surveys completed by fellows and faculty participating in multiple simulation sessions during a one-day simulation-based boot camp.

Results
Overall, both the fellows and the faculty provided moderate to high ratings of fidelity for both a technical skill and a teamwork simulation session. Fellows' ratings of an airway skills session were significantly higher than faculty ratings in 4 of 6 questions but similar to faculty ratings of a teamwork scenario session.

Conclusions
Pediatric anesthesia fellows' ratings of simulation fidelity were at least as high as faculty ratings during an annual boot camp, suggesting that faculty in this setting developed simulations that the fellows found to be realistic. Faculty were relatively more critical of the fidelity of a skill session, compared with a teamwork scenario session. If this finding is generalizable, this may reassure faculty designing simulations for fellows. Continued inspection of the entwined nature of fidelity and simulation will help inform more effective learning for this growing educational modality.
Neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody-associated disease: current topics
Authors: Fujihara Kazuo , Cook Lawrence J. 
Published: May 2020

Purpose of review
We reviewed present topics on neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein (MOG)-antibody-associated disease (MOGAD).

Recent findings
The number of NMOSD-related publications have increased year by year after the discovery of aquaporin 4 (AQP4)-antibody, and those on MOGAD started to surge since 2012–2013. Recent clinic-epidemiological surveys in NMOSD suggest that some racial differences in the prevalence and the clinical course. At present, experts feel the 2015 diagnostic criteria of AQP4-antibody-seronegative NMOSD should be revised. Randomized controlled trials of monoclonal antibodies in NMOSD have demonstrated a significant risk reduction of relapse, especially in AQP4-antibody-positive cases. Meanwhile, the efficacy in seronegative NMOSD was unclear. MOGAD can show NMO and other clinical phenotypes, but the clinical manifestations and frequencies are different in children and adults. One pathological study has suggested that MOGAD is distinct from AQP4-antibody-positive NMOSD, but may share some features with multiple sclerosis and acute disseminated encephalomyelitis. Immunosuppressive therapy can reduce relapse in MOGAD, but, unlike AQP4-antibody-positive NMOSD, some MOGAD patients treated with rituximab experience relapses despite a complete B-cell depletion.

Summary
Our understanding and therapy of AQP4-antibody-positive NMOSD has made a significant progress, and recent research has identified challenges in seronegative NMOSD and MOGAD.
Frequent tumor burden monitoring of esophageal squamous cell carcinoma with circulating tumor DNA using individually designed digital PCR
Authors: Iwaya T. , Endo F. , Yaegashi M. , Sasaki N. , Fujisawa R. , Hiraki H. , Akiyama Y. , Sasaki A. , Suzuki Y. , Masuda M. , Yamada T. , Takahashi F. , Tokino T. , Sasaki Y. , Nishizuka S.S. 
Published: May 2020

BackgroundCirculating tumor DNA (ctDNA) test has not yet been an established tool for monitoring cancer. Sensitive, yet affordable methods should allow frequent ctDNA monitoring that can assist in clinical management.Patients and MethodsThis prospective observational study was conducted in a total of 36 patients with Stage I to IV esophageal squamous cell cancer (ESCC) were enrolled between September 1, 2015 and February 28, 2018. We investigated whether frequent ctDNA monitoring during treatment followed by routine surveillance by digital PCR (dPCR) using tumor-specific mutations offers clinical validity in daily practice for ESCC patients.ResultsMutation screening of tumors from analyzable 35 patients using a specifically-designed "SCC panel" revealed 221 mutations with variant allele frequency (VAF) >2%. VAF of ctDNA was informative in 34 patients surveillance by dPCR using 58 mutations (1-3 per patient). A total of 569 plasma samples at 332 time points for ctDNA testing were evaluated. In pretreatment plasma, the average VAF was higher in advanced stages than earlier stages (P < .0001); tumor volume was also higher for higher VAF (r = 0.71). The ctDNA-positive rate in the pretreatment plasma of stage II or higher was 85.2% (23/27) whereas 85.7% (6/7) stage I were below the detection limit. Ninety-one % (10/11) patients whose ctDNA increased during chemotherapy showed disease progression. Among patients who recurred, ctDNA elevated with a median lead time of 149 days to the imaging diagnosis. Patients with decreased ctDNA within 3 months of initial treatment (n = 10) showed significantly better outcomes than did patients with ctDNA-positive (n = 11; P < .0001, HR 0.10, 95% CI, 0.03-0.30).ConclusionsOur results indicate that frequent tumor burden monitoring using a small number of tumor-specific ctDNAs by dPCR enables prediction of relapse and chemotherapeutic efficacy, as well as relapse-free corroboration in management of ESCC patients.
Repeated population-based surveys of antibodies against SARS-CoV-2 in Southern Brazil
Authors: Silveira Mariângela F , Barros Aluísio J D , Horta Bernardo L , Pellanda Lúcia C , Dellagostin Odir A , Struchiner Claudio J , Burattini Marcelo N , Valim Andréia R M , Berlezi Evelise M , Mesa Jeovany M , Ikeda Maria Letícia R , Mesenburg Marilia A , Mantesso Marina , Dall’Agnol Marinel M , Bittencourt Raqueli A , Hartwig Fernando P , Menezes Ana M B , Barros Fernando C , Hallal Pedro C , Victora Cesar G 
Published: May 2020

ABSTRACTPopulation based data on COVID-19 are urgently needed for informing policy decisions, yet few such studies are available anywhere, as most surveys rely on self-selected volunteers. In the Brazilian State of Rio Grande do Sul (population 11.3 million), we are carrying out fortnightly household surveys in nine of the largest cities. Multi-stage probability sampling was used in each city to select 500 households, within which one resident was randomly chosen for testing. The Wondfo lateral flow rapid test for detecting antibodies against SARS-CoV-2 has been validated in four different settings, including our own, with pooled estimates of sensitivity (84.8%, 95% CI 81.4%;87.8%) and specificity (99.0%, 95% CI 97.8%;99.7%), which are within the acceptable range for epidemiological studies. In the first wave of the study (April 11-13), 4,188 subjects were tested, of whom two were positive (0.0477%; 95% confidence interval (CI) 0.0058%;0.1724%). In the second round (Apr 25-27) there were six positive subjects (0.1333%; 95% CI 0.0489%;0.2900%). We also tested family members of positive index cases, and nine out of 19 had positive results. Testing of reported COVID-19 cases according to RT-PCR confirmed that the test was highly sensitive under field conditions. The epidemic is at an early stage in the State, as the first case was reported on Feb 28, and by Apr 30, 50 deaths were registered. Strict lockdown measures were implemented in mid-March, and our results suggest that compliance was high, with full or near full compliance rates of 79.4% in the first and 71.7% in the second round. As far as we know, this is the only large population anywhere undergoing regular household serological surveys for COVID-19. The results show that the epidemic is at an early phase, and findings from the next rounds will allow us to document time trends and propose Public Health measures.
Control dynamics of the COVID-19 pandemic in China and South Korea
Authors: Moreira João Manoel Losada 
Published: May 2020

AbstractSocial isolation measures reduce the population’s infection rate with the COVID-19 virus, but its effectiveness is difficult to quantify. The successful control of the pandemic carried out by China and South Korea is studied using a scheme based on the net relative rate of infection which is very sensitive to sudden changes in the epidemic evolution. The net relative rate of infection for China and South Korea without containment measures, that is, with free proliferation of the virus, lies between 10 and 40 %/day or doubling times of infected persons between 3.5 and 2 days. After measures of containment it dropped and stabilized. South Korea stabilized it around 1 %/day and China around 0.05 %/day with doubling times of 70 days and 1400 days, respectively. A discussion is provided about their processes of control and stabilization of the epidemic process and about the scheme used to study them.
Correlation of coagulation parameters with clinical outcomes in Coronavirus-19 affected minorities in United States: Observational cohort
Authors: Gil Morayma Reyes , Gonzalez-Lugo Jesus D. , Rahman Shafia , Barouqa Mohammad , Szymanski James , Ikemura Kenji , Lo Yungtai , Billett Henny H 
Published: May 2020

ABSTRACTImportanceCOVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the United States. Currently Bronx has the highest prevalence per capita in New York.ObjectiveTo investigate the coagulopathic presentation of COVID and its natural course and to investigate whether hematologic and coagulation parameters can be used to assess illness severity and death.DesignRetrospective case study of positive COVID inpatients between 3/20/2020-3/31/2020.SettingMontefiore Health System main hospital, Moses, a large tertiary care center in the Bronx.ParticipantsAdult inpatients with positive COVID tests hospitalized at MHS.Exposure (for observational studies)Datasets of participants were queried for physiological, demographic (age, sex, socioeconomic status and self-reported race and/or ethnicity) and laboratory data.Main Outcome and MeasuresRelationship and predictive value of measured parameters to mortality and illness severity.ResultsOf the 217 in this case review, 70 died during hospitalization while 147 were discharged home. Only the admission PT and first D-Dimer could very significantly differentiate those who were discharged alive and those who died. Logistic regression analysis shows increased odds ratio for mortality by first D-Dimer within 48 hrs. of admission. The optimal cut-point for the initial D-Dimer to predict mortality was found to be 1.65 μg/mLConclusionsWe describe here a comprehensive assessment of hematologic and coagulation parameters in COVID and examine the relationship of these to mortality. We demonstrate that both initial and maximum D-Dimer values are biomarkers that can be used for survival assessments.
Impact of policy interventions and social distancing on SARS-CoV-2 transmission in the United States
Authors: Dreher Nickolas , Spiera Zachary , McAuley Fiona M. , Kuohn Lindsey , Durbin John R. , Marayati Naoum Fares , Ali Muhammad , Li Adam Y. , Hannah Theodore C. , Gometz Alex , Kostman JT , Choudhri Tanvir F. 
Published: May 2020

AbstractBackgroundPolicymakers have employed various non-pharmaceutical interventions (NPIs) such as stay-at-home orders and school closures to limit the spread of Coronavirus disease (COVID-19). However, these measures are not without cost, and careful analysis is critical to quantify their impact on disease spread and guide future initiatives. This study aims to measure the impact of NPIs on the effective reproductive number (Rt) and other COVID-19 outcomes in U.S. states.MethodsIn order to standardize the stage of disease spread in each state, this study analyzes the weeks immediately after each state reached 500 cases. The primary outcomes were average Rtin the week following 500 cases and doubling time from 500 to 1000 cases. Linear and logistic regressions were performed in R to assess the impact of various NPIs while controlling for population density, GDP, and certain health metrics. This analysis was repeated for deaths with doubling time from 50 to 100 deaths and included several healthcare infrastructure control variables.ResultsStates that had a stay-at-home order in place at the time of their 500th case are associated with lower average Rtthe following week compared to states without a stay-at-home order (p < 0.001) and are significantly less likely to have an Rt>1 (OR 0.07, 95% CI 0.01 to 0.37, p = 0.004). These states also experienced a significantly longer doubling time from 500 to 1000 cases (HR 0.35, 95% CI 0.17 to 0.72, p = 0.004). States in the highest quartile of average time spent at home were also slower to reach 1000 cases than those in the lowest quartile (HR 0.18, 95% CI 0.06 to 0.53, p = 0.002).DiscussionFew studies have analyzed the effect of statewide stay-at-home orders, school closures, and other social distancing measures in the U.S., which has faced the largest COVID-19 case burden. States with stay-at-home orders have a 93% decrease in the odds of having a positive Rtat a standardized point in disease burden. States that plan to scale back such measures should carefully monitor transmission metrics.
Impact of ethnicity on outcome of severe COVID-19 infection. Data from an ethnically diverse UK tertiary centre
Authors: Teo James TH , Bean Daniel M , Bendayan Rebecca , Dobson Richard JB , Shah Ajay M 
Published: May 2020

AbstractDuring the current COVID-19 pandemic, anecdotal reports suggest that BAME background patients may be disproportionately affected compared to White but few objective data are available. We took advantage of near real-time hospital data access and analysis pipelines to look at the impact of ethnicity in 437 consecutive patients admitted during March to King’s College Hospital NHS Trust in London.Our key findings are firstly that BAME patients are significantly younger and have different co-morbidity profiles than White individuals. Secondly, there is no significant effect of ethnicity itself on severe outcomes (death or ITU admission) within 14-days of symptom onset, with adjustment for age/sex/comorbidities.
Incorporating and Addressing Testing Bias Within Estimates of Epidemic Dynamics for SARS-CoV-2
Authors: Suhail Yasir , Afzal Junaid , Kshitiz  
Published: May 2020

ABSTRACTThe disease burden of SARS-CoV-2 as measured by tests from various countries present varying estimates of infection and fatality rates. Models based on these acquired data may suffer from systematic errors and large estimation variances due to the biases associated with testing and lags between the infection and death counts. Here, we present an augmented compartment model to predict epidemic dynamics while explicitly modeling for the sampling bias involved in testing. Our simulations show that sampling biases in favor of patients with higher disease manifestation could significantly affect direct estimates of infection and fatality rates calculated from the numbers of confirmed cases and deaths, and serological testing can partially mitigate these biased estimates. We further recommend a strategy to obtain unbiased estimates, calculating the dependence of expected confidence on a randomized sample size, showing that relatively small sample sizes can provide statistically significant estimates for SARS-CoV-2 related death rates.
Management and Outcomes of ST-segment Elevation Myocardial Infarction During Coronavirus 2019 Pandemic in a Center with 24/7 Primary Angioplasty Capability: Should We Change Our Practice During Outbreak?
Authors: Salarifar Mojtaba , Ghavami Mojgan , Poorhosseini Hamidreza , Masoudkabir Farzad , Jenab Yaser , Amirzadegan Alireza , Alidoosti Mohammad , Aghajani Hassan , Bozorgi Ali , Hosseini Kaveh , Lotfi-Tokaldany Masoumeh , Mortazavi Seyedeh Hamideh , Aein Afsaneh , Ahmadian Tahere , Sadeghian Saeed 
Published: May 2020

AbstractBackgroundST-Elevation Myocardial Infarction (STEMI) is associated with high mortality and morbidity. In order to minimize cardiac tissue injury, primary per-cutaneous coronary intervention (PPCI) as treatment of choice should be performed as soon as possible. Coronavirus Disease 2019 (COVID-19) as an ongoing major global concern affects the other parts of health care system. Applying preventive strategies during this outbreak is necessary. However, critical times in STEMI management and outcomes may be influenced by infection control protocols implementation. The aim of this study is to investigate the differences in time intervals related to STEMI care and 15-day major adverse cardiac events (MACE) during this outbreak compared with the same period in last year and to determine whether the STEMI protocol should be changed to thrombolytic therapy during COVID-19 outbreak or not.MethodsThe patients with STEMI who underwent PPCI in Tehran Heart Center were included. Chest Computed tomography (CT) imaging and real time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) were only performed for COVID-19 suspected patients. Seventy-seven patients from 29th February to 29th March 2020 were compared with 62 patients from 1st to 30th March 2019.ResultsCOVID-19 infection was confirmed by rRT-PCR in 5 cases. CT imaging in 4 out of 5 patients was in favor of COVID-19. The median of door-to-device time was reduced 13 minutes during this outbreak (p: 0.007). In-hospital mortality before and during outbreak was 3.22% and 5.19%, respectively (p: 0.57). Confirmed infection with COVID-19 was only reported in one of expired cases. The difference in 15-day MACE between two time periods was not statistically significant.Discussion/ConclusionGiven that 15-day outcome in acute STEMI patients is not affected by COVID-19 outbreak, we did not find it reasonable to change our protocol. However, further studies are needed to determine a standard protocol for emergency management.
30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: a prospective cohort study
Authors: Giacomelli Andrea , Ridolfo Anna Lisa , Milazzo Laura , Oreni Letizia , Bernacchia Dario , Siano Matteo , Bonazzetti Cecilia , Covizzi Alice , Schiuma Marco , Passerini Matteo , Piscaglia Marco , Coen Massimo , Gubertini Guido , Rizzardini Giuliano , Cogliati Chiara , Brambilla Anna Maria , Colombo Riccardo , Castelli Antonio , Rech Roberto , Riva Agostino , Torre Alessandro , Meroni Luca , Rusconi Stefano , Antinori Spinello , Galli Massimo 
Published: May 2020

AbstractBackgroundItaly was the first European country hit by the COVID-19 pandemic and has the highest number of recorded COVID-19 deaths in Europe.MethodsThis prospective cohort study of the correlates of the risk of death in COVID-19 patients was conducted at the Infectious Diseases and Intensive Care units of Luigi Sacco Hospital, Milan, Italy. The clinical characteristics of all the COVID-19 patients hospitalised in the early days of the epidemic (21 February -19 March 2020) were recorded upon admission, and the time-dependent probability of death was evaluated using the Kaplan-Meier method (censored as of 20 April 2020). Cox proportional hazard models were used to assess the factors independently associated with the risk of death.ResultsForty-eight (20.6%) of the 233 patients followed up for a median of 40 days (interquartile range 33-47) died during the follow-up. Most were males (69.1%) and their median age was 61 years (IQR 50-72). The time-dependent probability of death was 19.7% (95% CI 14.6-24.9%) 30 days after hospital admission. Age (adjusted hazard ratio [aHR] 2.08, 95% CI 1.48-2.92 per ten years more) and obesity (aHR 3.04, 95% CI 1.42-6.49) were independently associated with an increased risk of death, which was also associated with critical disease (aHR 8.26, 95% CI 1.41-48.29), C-reactive protein levels (aHR 1.17, 95% CI 1.02-1.35 per 50 mg/L more) and creatinine kinase levels above 185 U/L (aHR 2.58, 95% CI 1.37-4.87) upon admission.ConclusionsCase-fatality rate of patients hospitalized with COVID-19 in the early days of the Italian epidemic was about 20%. Our study adds evidence to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19.
A new approach to recognize term and preterm infants with impaired kidney function (IKF) during the first week of life
Authors: Perazzo Sofia , Revenis Mary , Massaro An , Short Billie L. , Ray Patricio E. 
Published: May 2020

AbstractBackgroundCurrent definitions of neonatal acute kidney injury (nAKI) are not sensitive enough to identify all newborns with impaired kidney function (IKF) during the first week of life. Previous studies in term newborns with hypoxic ischemic encephalopathy showed that the rate of serum creatinine (SCr) decline during the first week of life could be used to assess their renal status.MethodsWe reviewed the medical records of 329 critically ill newborns ≥ 27 weeks of gestational age (GA), to determine whether the rate of SCr decline combined with SCr thresholds provides a sensitive approach to identify newborns with IKF during the first week of life.ResultsExcluding neonates with nAKI, identified based on standard definitions, a SCr decline < 31 % by the 7th day of life, combined with a SCr threshold ≥ 0.7 mg/dl, recognized newborns of 40-31 weeks of GA with IKF. A SCr decline < 21% combined with a SCr threshold ≥ 0.8 mg/dl identified newborns of 30-27 weeks of GA with IKF. These neonates (~ 17%) showed a more prolonged hospital stay and required more days of mechanical ventilation, vasoactive drugs, and diuretics, when compared to critically ill controls. Changes in urine output did not distinguish newborns with IKF.ConclusionThe rate of SCr decline combined with SCr thresholds identifies newborns with IKF during the first week of life. This distinctive group of newborns that is missed by standard definitions of nAKI, warrants close monitoring in the NICU to prevent acute and chronic renal complications.