bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-Time Effort Driven Ventilator Management: A Pilot Study*
Authors: Hotz Justin C. , Bornstein Dinnel , Kohler Kristen , Smith Erin , Suresh Anil , Klein Margaret , Bhalla Anoopindar , Newth Christopher J. , Khemani Robinder G. 
Published: September 2020

Objectives:
Mechanical ventilation of patients with acute respiratory distress syndrome should balance lung and diaphragm protective principles, which may be difficult to achieve in routine clinical practice. Through a Phase I clinical trial, we sought to determine whether a computerized decision support–based protocol (real-time effort–driven ventilator management) is feasible to implement, results in improved acceptance for lung and diaphragm protective ventilation, and improves clinical outcomes over historical controls.

Design:
Interventional nonblinded pilot study.

Setting:
PICU.

Patients:
Mechanically ventilated children with acute respiratory distress syndrome.

Interventions:
A computerized decision support tool was tested which prioritized lung-protective management of peak inspiratory pressure–positive end-expiratory pressure, positive end-expiratory pressure/Fio
2, and ventilatory rate. Esophageal manometry was used to maintain patient effort in a physiologic range. Protocol acceptance was reported, and enrolled patients were matched 4:1 with respect to age, initial oxygenation index, and percentage of immune compromise to historical control patients for outcome analysis.

Measurements and Main Results:
Thirty-two patients were included. Acceptance of protocol recommendations was over 75%. One-hundred twenty-eight matched historical controls were used for analysis. Compared with historical controls, patients treated with real-time effort–driven ventilator management received lower peak inspiratory pressure–positive end-expiratory pressure and tidal volume, and higher positive end-expiratory pressure when Fio
2 was greater than 0.60. Real-time effort–driven ventilator management was associated with 6 more ventilator-free days, shorter duration until the first spontaneous breathing trial and 3 fewer days on mechanical ventilation among survivors (all p ≤ 0.05) in comparison with historical controls, while maintaining no difference in the rate of reintubation.

Conclusions:
A computerized decision support–based protocol prioritizing lung-protective ventilation balanced with reduction of controlled ventilation to maintain physiologic levels of patient effort can be implemented and may be associated with shorter duration of ventilation.
Psychologically informed physical therapy for musculoskeletal pain: current approaches, implications, and future directions from recent randomized trials
Authors: Coronado Rogelio A. , Brintz Carrie E. , McKernan Lindsey C. , Master Hiral , Motzny Nicole , Silva Flavio M. , Goyal Parul M. , Wegener Stephen T. , Archer Kristin R. 
Published: September 2020

Abstract
Psychologically informed physical therapy (PIPT) blends psychological strategies within a physical therapist's treatment approach for the prevention and management of chronic musculoskeletal pain. Several randomized trials have been conducted examining the efficacy of PIPT compared to standard physical therapy on important patient-reported outcomes of disability, physical function, and pain. In this review, we examine recent trials published since 2012 to describe current PIPT methods, discuss implications from findings, and offer future directions. Twenty-two studies, representing 18 trials, were identified. The studied PIPT interventions included (1) graded activity or graded exposure (n = 6), (2) cognitive-behavioral-based physical therapy (n = 9), (3) acceptance and commitment-based physical therapy (n = 1), and (4) internet-based psychological programs with physical therapy (n = 2). Consistent with prior reviews, graded activity is not superior to other forms of physical activity or exercise. In a few recent studies, cognitive-behavioral-based physical therapy had short-term efficacy when compared to a program of standardized exercise. There is a need to further examine approaches integrating alternative strategies including acceptance-based therapies (ie, acceptance and commitment therapy or mindfulness) or internet-based cognitive-behavioral programs within physical therapy. Although PIPT remains a promising care model, more convincing evidence is needed to support widespread adoption, especially in light of training demands and implementation challenges.
Improved Computed Tomography Contrast Injection Rates Through Implantable Chest Power Ports
Authors: Fielding James C. , Wagner-Bartak Nicolaus A. , Javadi Sanaz , Morani Ajaykumar C. , Ganeshan Dhakshinamoorthy , Ibarra-Rovira Juan J. , Liu Xinming , Jensen Corey T. 
Published: September 2020

Objective
The aim of this study was to optimize chest port contrast injections using stepwise improvements.

Methods
Ex vivo injections were tested. Two hundred scans using power port injections were then evaluated.

Results
The highest flow rate was achieved using a 19G access needle, larger diameter tubing, and warmed contrast.
The mean injection rates in baseline and postimprovement groups were 2.7 ± 0.4 and 4.8 ± 0.4 mL/s, respectively (P < .0001).

Conclusion
Component optimization of the port apparatus can maximize contrast flow rates.
Differentiation of Multiple Myeloma and Lytic Bone Metastases: Histogram Analysis
Authors: Yildirim Mustafa , Baykara Murat 
Published: September 2020

Objective
Metastasis and multiple myeloma are common malignant bone marrow lesions. It may be difficult to distinguish because of similar imaging findings. The purpose of this study was to determine the value of histogram analysis on the computed tomography imaging.

Methods
Twenty-three patients with primary tumor and 23 patients with multiple myeloma were included in the study. All patients had lytic bone lesions on the thorax and abdominal computed tomography scan with contrast. Multiple bone lesions of patients with primary tumor were accepted as metastasis. Multiple bone lesions of patients with multiple myeloma were accepted as multiple myeloma involvement. Histogram analysis was performed from lytic bone metastases and bone involvement of multiple myeloma. Results of both groups were compared.

Results
In histogram analysis, minimum, median, and maximum gray level parameters were found to be significantly higher in lytic bone metastases (P < 0.001).

Conclusion
Computed tomography histogram analysis can be considered as a method to be used in the differentiation of multiple myeloma and lytic bone metastases.
Do Not Judge an Ossicle by Its Size: Type 1 Ossicles Associated With Posterior Tibial Tendon Dysfunction
Authors: Gonzalez Felix M. , Singer Adam D. , Robertson Douglas D. , Chamieh Jad , Umpierrez Monica , Labib Sameh A. 
Published: September 2020

Introduction
Patients with type II navicular ossicles have traditionally been considered to be symptomatic, whereas patients with type I and III bones are considered asymptomatic without additional relevant imaging findings. The main objective of this study is to investigate the association of type I os naviculare with clinical symptomology and magnetic resonance imaging findings in comparison to types II and III ossicles.

Methods
Three hundred nine subjects with accessory navicular bone types were identified, and their associations with focal navicular pain, pes planus alignment, ossicle or proximal navicular bone marrow edema pattern presence (BMEP), and posterior tibial tendon (PTT) sheath fluid distension were assessed. Fisher's exact test was used for categorical data and unpaired t tests for continuous data. Intraobserver and interobserver agreement was calculated.

Results
Overall, 28% (85/309) of type I, 57% (176/309) of type II, and 16% (48/309) of type III accessory bones had focal navicular pain (type I vs type II, P = 0.17; type III vs type II, P = 0.001). Thirty-two percent of type I, 38% type II, and 8% type III accessory bones had pes planus (type I vs II, P = 0.3; type III vs type II, P = 0.001). Nine percent of type I, 48% of type II, and 6% of type III accessory bones had BMEP (type I vs II, P < 0.0001; type III vs type II, P = 0.001). Thirty-three percent of type I, 42% of type II, and 6% of type III accessory bones had PTT intrasheath fluid (type I vs II, P = 0.16; type III vs type II, P = 0.001).

Conclusions
Symptomatic type I navicular ossicle patients demonstrate an increased tendency to present with early findings of PTT dysfunction and morphologic pes planus to a greater degree than previously recognized.
Level of Clinical Evidence: 3
Early Achievement of Enteral Nutrition Protein Goals by Intensive Care Unit Day 4 is Associated With Fewer Complications in Critically Injured Adults
Authors: Hartwell Jennifer L. , Cotton Ann , Wenos Chelsea D. , Timsina Lava , Zarzaur Ben L. , Rozycki Grace 
Published: September 2020

Objective: We hypothesized that failure to achieve protein goals early in the critical care course via enteral nutrition is associated with increased complications.

Background:
Although robust randomized controlled trials are lacking, present data suggest that early, adequate nutrition is associated with improved outcomes in critically ill patients. Injured patients are at risk of accumulating significant protein debt due to interrupted feedings and intolerance.

Methods:
Critically injured adults who were unable to be volitionally fed were included in this retrospective review. Data collected included demographics, injury characteristics, number and types of operations, total prescribed and delivered protein and calories during the first 7 days of critical care admission, complications, and outcomes. Group-based trajectory modeling was applied to identify subgroups with similar feeding trajectories in the cohort.

Results:
There were 274 patients included (71.2% male). Mean age was 50.56  ± 19.76 years. Group-based trajectory modeling revealed 5 Groups with varying trajectories of protein goal achievement. Group 5 fails to achieve protein goals, includes more patients with digestive tract injuries (33%, P = 0.0002), and the highest mean number of complications (1.52, P = 0.0086). Group 2, who achieves protein goals within 4 days, has the lowest mean number of complications (0.62, P = 0.0086) and operations (0.74, P = 0.001).

Conclusions:
There is heterogeneity in the trajectory of protein goal achievement among various injury pattern Groups. There is a sharp decline in complication rates when protein goals are reached within 4 days of critical care admission, calling into question the application of current guidelines to healthy trauma patients to tolerate up to 7 days of nil per os status and further reinforcing recommendations for early enteral nutrition when feasible.
Chitin biosynthesis genes inDiaphorina citri, Asian citrus psyllid
Authors: Miller Sherry , Shippy Teresa D. , Tamayo Blessy , Hosmani Prashant S , Flores-Gonzalez Mirella , Mueller Lukas A , Hunter Wayne B , Brown Susan J , D’elia Tom , Saha Surya 
Published: September 2020

AbstractThe polysaccharide chitin is critical for the formation of many insect structures, including the exoskeleton, and is required for normal development. Here we report the annotation of three genes from the chitin synthesis pathway in the Asian citrus psyllid,Diaphorina citri(Hemiptera: Liviidae), the vector of Huanglongbing (citrus greening disease). Most insects have two chitin synthase (CHS) genes but, like other hemipterans,D. citrihas only one. In contrast,D. citriis unusual among insects in having two UDP-N-acetylglucosamine pyrophosphorylase (UAP) genes. One of theD. citriUAP genes is broadly expressed, while the other is expressed predominantly in males. Our work helps pave the way for potential utilization of these genes as pest control targets to reduce the spread of Huanglongbing.
First phylogenetic analysis of Malian SARS-CoV-2 sequences provide molecular insights into the genomic diversity of the Sahel region
Authors: Kouriba B , Dürr A , Rehn A , Sangaré AK , Traoré BY , Bestehorn-Willmann MS , Ouedraogo WLJ , Heitzer A , Sogodogo E , Maiga A , Walter MC , Zimmermann F , Wölfel R , Antwerpen MH 
Published: September 2020

AbstractWe are currently facing a pandemic of COVID-19, caused by a spillover from an animal-originating coronavirus to humans occuring in the Wuhan region, China, in December 2019. From China the virus has spread to 188 countries and regions worldwide, reaching the Sahel region on the 2nd of March 2020. Since whole genome sequencing (WGS) data is very crucial to understand the spreading dynamics of the ongoing pandemic, but only limited sequence data is available from the Sahel region to date, we have focused our efforts on generating the first Malian sequencing data available. Screening of 217 Malian patient samples for the presence of SARS-CoV-2 resulted in 38 positive isolates from which 21 whole genome sequences were generated. Our analysis shows that both, the early A (19B) and the fast evolving B (20A/C) clade, are present in Mali indicating multiple and independent introductions of the SARS-CoV-2 to the Sahel region.
Genetic Associations with Age at Dementia Onset in thePSEN1 E280AColombian Kindred
Authors: Cochran J. Nicholas , Acosta-Uribe Juliana , Esposito Bianca T. , Madrigal Lucia , Aguillón David , Giraldo Margarita M. , Taylor Jared W. , Bradley Joseph , Fulton-Howard Brian , Andrews Shea J. , Acosta-Baena Natalia , Alzate Diana , Garcia Gloria P. , Piedrahita Francisco , Lopez Hugo E. , Anderson Ashlyn G. , Rodriguez-Nunez Ivan , Roberts Kevin ,   Dominantly Inherited Alzheimer Network, Absher Devin , Myers Richard M. , Beecham Gary W. , Reitz Christiane , Rizzardi Lindsay F. , Fernandez Maria Victoria , Goate Alison M. , Cruchaga Carlos , Renton Alan E. , Lopera Francisco , Kosik Kenneth S. 
Published: September 2020

AbstractINTRODUCTIONGenetic associations with Alzheimer’s disease (AD) age at onset (AAO) could reveal genetic variants with therapeutic applications. We present a large Colombian kindred with autosomal dominant AD (ADAD) as a unique opportunity to discover AAO genetic associations.METHODSA genetic association study was conducted for ADAD dementia AAO in 340 individuals with thePSEN1 E280Amutation via TOPMed array imputation. Replication was assessed in two ADAD cohorts, one sporadic EOAD study, and four late onset AD studies.RESULTS13 variants hadp<1×10−7orp<1×10−5with replication including three independent loci with candidate associations with clusterin including nearCLU. Other suggestive associations were identified in or nearHS3ST1, HSPG2, ACE, LRP1B, TSPAN10, andTSPAN14.DISCUSSIONVariants with suggestive associations with AAO were associated with biological processes including clusterin, heparin sulfate and amyloid processing. The detection of these effects in the presence of a strong mutation for ADAD reinforce their potentially impactful role.
Suitability of Two Rapid Lateral Flow Immunochromatographic Assays for Predicting SARS-CoV-2 Neutralizing Activity of Sera
Authors: Valdivia Arantxa , Torres Ignacio , Latorre Víctor , Francés-Gómez Clara , Ferrer Josep , Forqué Lorena , Costa Rosa , de la Asunción Carlos Solano , Huntley Dixie , Gozalbo-Rovira Roberto , Buesa Javier , Giménez Estela , Rodríguez-Díaz Jesús , Geller Ron , Navarro David 
Published: September 2020

ABSTRACTPurposeAssessment of commercial SARS-CoV-2 immunoassays for their capacity to provide reliable information on sera neutralizing activity is an emerging need. We evaluated the performance of two commercially-available lateral flow immunochromatographic assays (LFIC) (Wondfo SARS-CoV-2 Antibody test and the INNOVITA 2019-nCoV Ab test) in comparison with a SARS-CoV-2 neutralization pseudotyped assay for COVID-19 diagnosis in hospitalized patients, and investigate whether the intensity of the test band in LFIC associates with neutralizing antibody (NtAb) titers.Patients and MethodsNinety sera were included from 51 patients with moderate to severe COVID-19. A green fluorescent protein (GFP) reporter-based pseudotyped neutralization assay (vesicular stomatitis virus coated with SARS-CoV-2 spike protein) was used. Test line intensity was scored using a 4-level scale (0 to 3+).ResultsOverall sensitivity of LFIC assays was 91.1% for the Wondfo SARS-CoV-2 Antibody test, 72.2% for the INNOVITA 2019-nCoV IgG, 85.6% for the INNOVITA 2019-nCoV IgM and 92.2% for the NtAb assay. Sensitivity increased for all assays in sera collected beyond day 14 after symptoms onset (93.9%, 79.6%,93.9% and 93.9%, respectively). Reactivities equal to or more intense than the positive control line (≥2+) in the Wondfo assay had a negative predictive value of 100% and a positive predictive value of 96.4% for high NtAb50titers (≥1/160).ConclusionsOur findings support the use of LFIC assays evaluated herein, particularly the Wondfo test, for COVID-19 diagnosis. We also find evidence that these rapid immunoassays can be used to predict high SARS-CoV-2-S NtAb50titers.
Dysbiosis in metabolic genes of the gut microbiomes of patients with an ileo-anal pouch resembles that observed in Crohn’s Disease
Authors: Dubinsky Vadim , Reshef Leah , Rabinowitz Keren , Yadgar Karin , Godny Lihi , Zonensain Keren , Wasserberg Nir , Dotan Iris , Gophna Uri 
Published: September 2020

AbstractBackgroundCrohn’s disease (CD), ulcerative colitis (UC) and pouchitis are multifactorial and chronic inflammatory diseases of the gastrointestinal tract, termed together as inflammatory bowel diseases (IBD). Pouchitis develops in former patients with UC after total proctocolectomy and ileal pouch-anal anastomosis (“pouch surgery”) and is characterized by inflammation of the previously normal small intestine comprising the pouch. It has been extensively shown that broad taxonomic and functional alterations (“dysbiosis”) occur in the gut microbiome of patients with IBD. However, the extent to which microbial dysbiosis in pouchitis resembles that of CD or UC has not been investigated in-depth, and the pathogenesis of pouchitis largely remains unknown.ResultsIn this study we collected 250 fecal metagenomes from 75 patients with a pouch, including both non-inflamed (normal pouch) and inflamed (pouchitis) phenotypes, and compared them to publicly available metagenomes of patients with CD (n=88), and UC (n=76), as well as healthy controls (n=56). Patients with pouchitis presented the highest level of dysbiosis compared to other IBD phenotypes based on species, metabolic pathways and enzyme profiles, and their level of dysbiosis was correlated with intestinal inflammation. In patients with pouchitis, the microbiome mucin degradation potential was lower, but was accompanied by an enrichment of Ruminococcus gnavus strains encoding specific mucin-degrading glycoside hydrolases, which might be pro-inflammatory. Butyrate and secondary bile acids producers were decreased in all IBD phenotypes and were especially low in pouchitis. Butyrate synthesis genes were positively correlated with total dietary fiber intake. Patients with pouchitis harbored more facultative anaerobic bacteria encoding enzymes involved in oxidative stress response, suggesting high oxidative stress during pouch inflammation. Finally, we have developed enzymes-based classifiers that can distinguish between patients with a normal pouch and pouchitis with an area under the curve of 0.91.ConclusionsWe propose that the non-inflamed pouch is already dysbiotic (function- and species-wise) and microbially is more similar to CD than to UC. Our study reveals microbial functions that underlie the pathogenesis of pouchitis and suggests bacterial groups and functions that could be targeted for nutritional intervention to attenuate or prevent small intestinal inflammation present in pouchitis and CD.
More than words: Extra-Sylvian neuroanatomic networks support indirect speech act discourse comprehension in behavioral variant frontotemporal dementia
Authors: Healey Meghan , Howard Erica , Ungrady Molly , Olm Christopher , Nevler Naomi , Irwin David J. , Grossman Murray 
Published: September 2020

ABSTRACTIndirect speech acts— responding “I forgot to wear my watch today” to someone who asked for the time — are ubiquitous in daily conversation, but are understudied in current neurobiological models of language. To comprehend an indirect speech act like this one, listeners must not only decode the lexical-semantic content of the utterance, but also make a pragmatic, bridging inference. This inference allows listeners to derive the speaker’s true, intended meaning—in the above dialogue, for example, that the speaker cannot provide the time. In the present work, we address this major gap by asking non-aphasic patients with behavioral variant frontotemporal dementia (bvFTD, n=21) and brain-damaged controls with amnestic mild cognitive impairment (MCI, n=17) to judge simple question-answer dialogues of the form: “Do you want some cake for dessert?” “I’m on a very strict diet right now”, and relate the results to structural and diffusion MRI. Accuracy and reaction time results demonstrate that subjects with bvFTD, but not MCI, are selectively impaired in indirect relative to direct speech act comprehension, due in part to their social and executive limitations, and performance is related to caregivers’ judgment of communication efficacy. MRI imaging associates the observed impairment in bvFTD to cortical thinning not only in traditional language-associated regions, but also in fronto-parietal regions implicated in social and executive cerebral networks. Finally, diffusion tensor imaging analyses implicate white matter tracts in both dorsal and ventral projection streams, including superior longitudinal fasciculus, frontal aslant, and uncinate fasciculus. These results have strong implications for updated neurobiological models of language, and emphasize a core, language-mediated social disorder in patients with bvFTD.