bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic intra-aortic balloon pump in patients with left main disease undergoing off-pump coronary artery bypass grafting
Authors: Zheng Ju-Bing , Hua Kun , Zhang Kui , Zhou Shao-You , Xu Shi-Jun , Sheng Juan-Juan , Dong Ran 
Published: June 2020

Abstract
Background
Preventive intra-aortic balloon pump (IABP) for high-risk patients with stable hemodynamics is controversial, and its definition of high-risk is still unclear. This study aimed to investigate the effect of prophylactic IABP on the early outcome of left main disease (LMD) patients receiving off-pump coronary artery bypass grafting (OPCABG) with stable hemodynamics.

Methods
From January 2013 to April 2020, 257 consecutive patients who underwent OPCABG through sternotomy were enrolled in this study. All LMD patients (greater than 70%) had stable hemodynamics (BP>100 mmHg without vasoconstrictor substance infusion). Early outcomes of 125 patients with prophylactic IABP (IABP group) and 132 patients without IABP (Control group) were compared in this study.

Results
IABP did not show favorable effect on the conversion to CPB (RR 0.63, 95%CI 0.05–7.89, P = 0.7211), perioperative MI (RR 0.69, 95%CI 0.22–2.12, P = 0.5163), mortality (RR 0.65, 95%CI 0.04–10.25, P = 0.7608) or the composite end of the conversion, MI and mortality (RR 0.63, 95%CI 0.23–1.74, P = 0.3747). There was greater incidence of prolonged ventilation in IABP after adjustment (RR2.16, 95%CI 1.12–4.18, P = 0.0221). There was no IABP-related mortality or limb ischemia.

Conclusion
No significant difference in early outcomes was observed in hemodynamically stable patients with LMD between prophylactic IABP group and control group. Prophylactic IABP may be unnecessary in patients with LMD undergoing OPCABG.
Global longitudinal strain is associated with better outcomes in transcatheter aortic valve replacement
Authors: Al-Rashid Fadi , Totzeck Matthias , Saur Nadine , Jánosi Rolf Alexander , Lind Alexander , Mahabadi Amir A. , Rassaf Tienush , Mincu Raluca-Ileana 
Published: June 2020

Abstract
Background
Parameters that mark the timing of left ventricular (LV) reverse remodeling following transcatheter aortic valve replacement (TAVR) are incompletely defined. This study aims to identify the dynamics of LV strain derived from speckle tracking echocardiography in a cohort of patients with severe aortic stenosis (AS) who underwent TAVR and its correlation with postprocedural outcomes.

Methods
We selected 150 consecutive patients (82 ± 4 years old, STS score 6.4 ± 6.2) who underwent transfemoral TAVR between 07/2016 and 12/2017 at our tertiary care center. All patients were evaluated at baseline, 1 week after TAVR, and 3 months following TAVR.

Results
The global longitudinal strain (GLS) 1 week following TAVR was comparable to that at baseline (− 15,9 ± 4.3 vs − 16.8 ± 4.1; p = NS) but significantly improved at 3 months following TAVR (− 15.9 ± 4.3% vs. -19.5 ± 3.5%; p < 0.001). No significant changes in global circumferential strain (GCS) and global radial strain (GRS) were detectable. The ejection fraction was significantly improved 1 week after the TAVR procedure. The baseline GLS correlated directly with the complication rate (R = 0.36, p = 0.005). The linear regression analysis showed that the main predictors of the improvement in the GLS at 3 months in our cohort were baseline GRS and GCS.

Conclusion
GLS improves at 3 months after TAVR, while LV ejection fraction does not show a substantial change, signaling an early recovery of LV longitudinal function after the intervention. Additionally, GLS has a direct correlation with the postprocedural outcomes. GLS improvement might emerge as a valuable parameter for a tailored follow-up in TAVR patients.
The semi-automation of title and abstract screening: a retrospective exploration of ways to leverage Abstrackr’s relevance predictions in systematic and rapid reviews
Authors: Gates Allison , Gates Michelle , Sebastianski Meghan , Guitard Samantha , Elliott Sarah A. , Hartling Lisa 
Published: June 2020

Abstract
Background
We investigated the feasibility of using a machine learning tool’s relevance predictions to expedite title and abstract screening.

Methods
We subjected 11 systematic reviews and six rapid reviews to four retrospective screening simulations (automated and semi-automated approaches to single-reviewer and dual independent screening) in Abstrackr, a freely-available machine learning software. We calculated the proportion missed, workload savings, and time savings compared to single-reviewer and dual independent screening by human reviewers. We performed cited reference searches to determine if missed studies would be identified via reference list scanning.

Results
For systematic reviews, the semi-automated, dual independent screening approach provided the best balance of time savings (median (range) 20 (3–82) hours) and reliability (median (range) proportion missed records, 1 (0–14)%). The cited references search identified 59% (n = 10/17) of the records missed. For the rapid reviews, the fully and semi-automated approaches saved time (median (range) 9 (2–18) hours and 3 (1–10) hours, respectively), but less so than for the systematic reviews. The median (range) proportion missed records for both approaches was 6 (0–22)%.

Conclusion
Using Abstrackr to assist one of two reviewers in systematic reviews saves time with little risk of missing relevant records. Many missed records would be identified via other means.
The influence of demographic characteristics on constipation symptoms: a detailed overview
Authors: Verkuijl Sanne J. , Meinds Rob J. , Trzpis Monika , Broens Paul M. A. 
Published: June 2020

Abstract
Background
Diagnosing constipation remains difficult and its treatment continues to be ineffective. The reason may be that the symptom patterns of constipation differ in different demographic groups. We aimed to determine the pattern of constipation symptoms in different demographic groups and to define the symptoms that best indicate constipation.

Methods
In this cross-sectional study the Groningen Defecation and Fecal Continence questionnaire was completed by a representative sample of the adult Dutch population (N = 892). We diagnosed constipation according to the Rome IV criteria for constipation.

Results
The Rome criteria were fulfilled by 15.6% of the study group and we found the highest prevalence of constipation in women and young adults (19.7 and 23.5%, respectively). Symptom patterns differed significantly between constipated respondents of various ages, while we did not observe sex-based differences. Finally, we found a range of constipation symptoms, not included in the Rome IV criteria, that showed marked differences in prevalence between constipated and non-constipated individuals, especially failure to defecate (∆ = 41.2%).

Conclusions
Primarily, we found that certain symptoms of constipation are age-dependent. Moreover, we emphasize that symptoms of constipation not included in the Rome IV criteria, such as daily failure to defecate and an average duration of straining of more than five minutes, are also reliable indicators of constipation. Therefore, we encourage clinicians to adopt a more comprehensive approach to diagnosing constipation.
Liver cirrhosis in a patient with hepatic hereditary hemorrhagic telangiectasia and Budd–Chiari syndrome: a case report
Authors: Xu Bai-Guo , Liang Jing , Jia Ke-Feng , Han Tao 
Published: June 2020

Abstract
Background
Hereditary hemorrhagic telangiectasia (HHT) often involves the liver, and belongs to abnormal blood vessel disease. The etiology of Budd–Chiari syndrome (BCS) is not clear, but congenital vascular dysplasia is considered to be one of the causes. Liver cirrhosis due to hepatic hereditary hemorrhagic telangiectasia concomitant with BCS has not been reported. Here, we report a case of cirrhosis with hepatic hereditary hemorrhagic telangiectasia (HHHT) and BCS.

Case presentation
A 58-year-old woman with hepatic hereditary hemorrhagic telangiectasia showed decompensated liver cirrhosis, and abdominal imaging revealed Budd–Chiari syndrome. Disease has progressed considerably during 2.5 years after hospital discharge despite subsequent transjugular intrahepatic portosystemic shunting (TIPS). One hypothesis that might explain the coexistence of hepatic hereditary hemorrhagic telangiectasia and Budd–Chiari syndrome in this patient is ischemia and thrombosis of hepatic veins.

Conclusions
Further studies are required to evaluate the relationship between HHHT and BCS. Our observations already challenged the TIPS therapeutic strategy in BCS secondary to HHHT patients.
Sedentary behaviour, physical activity, and renal function in older adults: isotemporal substitution modelling
Authors: Kosaki Keisei , Tanahashi Koichiro , Matsui Masahiro , Akazawa Nobuhiko , Osuka Yosuke , Tanaka Kiyoji , Dunstan David W. , Owen Neville , Shibata Ai , Oka Koichiro , Maeda Seiji 
Published: June 2020

Abstract
Background
Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another.

Methods
In 174 older Japanese adults (age, 50–83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels.

Results
In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (rs = − 0.229), LPA (rs = 0.265), and MVPA (rs = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (β = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (β = 5.49, p < 0.05).

Conclusions
These cross-sectional findings suggest that sedentary behaviour (detrimentally) and physical activity (beneficially) may affect renal function and that replacing sedentary behaviour with MVPA may benefit renal health in older adults.
Palato-pharyngo-laryngeal myoclonus with recurrent retrograde feeding tube migration after cerebellar hemorrhagic stroke: a case report and review of hypertrophic olivary degeneration
Authors: Fleet Jamie L. , Calver Ronelle , Perera Gihan C. , Deng Zhihui 
Published: June 2020

Abstract
Background
Palato-pharyngo-laryngeal myoclonus, a variant of palatal myoclonus, is characterized by involuntary rhythmic movements of palatal, pharyngeal, and laryngeal muscles. Symptomatic palatal myoclonus is classically associated with hypertrophic olivary degeneration on MRI imaging due to a lesion in the triangle of Guillain-Mollaret.

Case presentation
We report a case of palato-pharyngo-laryngeal myoclonus in a patient post-cerebellar hemorrhagic stroke who presented with recurrent retrograde migration of his gastrojejunostomy feeding tubes. Treatment with either divalproex sodium or gabapentin resulted in a significant decrease in his gastrointestinal symptoms and no further episodes of gastrojejunostomy tube migration.

Conclusions
This case study indicates that the movement disorder associated with hypertrophic olivary degeneration may involve the gastrointestinal system. Anticonvulsants, such as gabapentin and divalproex sodium, may reduce the severity of gastrointestinal symptoms in cases associated with hypertrophic olivary degeneration. The anatomy of the Guillain-Mollaret triangle and the pathophysiology of hypertrophic olivary degeneration are reviewed.
Predictors of pre-operative cognitive impairment in meningioma patients over 60 years old
Authors: Kang Min Ju , Pyun Jung-Min , Baek Min Jae , Hwang Kihwan , Han Jung Ho , Park Young Ho , Kim Chae-Yong , Kim SangYun 
Published: June 2020

Abstract
Background
The aim of this study was to assess the cognitive function of patients over 60 years old with meningioma using a domain-specific neuropsychological test and to investigate the relevant factors affecting pre-operative cognitive decline in different subdomains.

Methods
We retrospectively investigated 46 intracranial meningioma patients between the ages of 60 and 85 years. All patients underwent brain MRI and neuropsychological test. Tumor size, location, peritumoral edema, and medial temporal atrophy (MTA) were examined to determine the association with cognitive impairment. We performed a logistic regression analysis to examine the odds ratios (ORs) for cognitive decline of four subdomains: verbal memory, language, visuospatial, and executive functions.

Results
Tumor size and age were associated with executive dysfunction (OR 1.083, 95% confidence interval (CI) 1.006–1.166, and OR 1.209, 95% CI 1.018–1.436, respectively). There was no statistically significant association in other cognitive domains (language, verbal memory, and visuospatial function) with variables in regression analysis.

Conclusions
We conclude that tumor size and age are positively related with executive function in pre-operative meningioma patients over 60 years old.
Low birthweight in term singletons mediates the association between maternal smoking intensity exposure status and immediate neonatal intensive care unit admission: the E-value assessment
Authors: Kondracki Anthony J. 
Published: June 2020

Abstract
Background
Research investigating the wellbeing of term neonates in the United States is scarce. The objectives of this study were to estimate the prevalence of low birthweight (LBW) and neonatal intensive care unit (NICU) admission among term singletons in association with maternal smoking intensity exposure status, to explore LBW as a mediator linking smoking to immediate newborn NICU transfer/admission, and to assess the potential impact of unmeasured confounding in effect estimates.

Methods
The Natality File of live births registered in the United States in 2016, the first year that all 50 states implemented the revised 2003 standard birth certificate, was restricted to singleton term births (37–41 completed weeks gestation). The prevalence of LBW (< 2500 g) and NICU transfer/admission was estimated across maternal demographic characteristics and smoking intensity status in early and in late pregnancy. Mediation analyses, based on the counterfactual approach, were conducted to examine the total effect (TE), controlled direct effect (CDE), natural direct (NDE) and indirect effects (NIE), and the percentage mediated through LBW. The E-values based on effect size estimates and on lower-bounds of 95% confidence intervals (CIs) assessed the potential impact of unmeasured confounding.

Results
Nearly 6.8% of women smoked in early and in late pregnancy, most (36.4%) smoked at high intensity (≥ 10 cigarettes /day) and had the highest prevalence of LBW (6.7%) and NICU transfer/admission (7.0%). For the largest smoking intensity exposure category, the estimate of the TE was 1.68 (95% CI: 1.63, 1.73), of the NDE was 1.56 (95% CI: 1.51, 1.61), of the NIE was 1.08 (95% CI:1.07, 1.09), and the percentage mediated by LBW was 17.6%. The E-values for association estimates and for the lower-bounds of 95% CIs demonstrated the minimum strength of the potential unmeasured confounding necessary to explain away observed associations.

Conclusions
These findings fill a gap on the prevalence of LBW and NICU transfer/admission in term neonates of mothers who smoke and on the role of LBW linking to NICU placement, which could be used to update practitioners, to implement smoking cessation interventions, monitor trends, and to inform planning and allocation of healthcare resources.
Similar response rates and survival with PARP inhibitors for patients with solid tumors harboring somatic versus Germline BRCA mutations: a Meta-analysis and systematic review
Authors: Mohyuddin Ghulam Rehman , Aziz Muhammad , Britt Alec , Wade Lee , Sun Weijing , Baranda Joaquina , Al-Rajabi Raed , Saeed Anwaar , Kasi Anup 
Published: June 2020

AbstractBackgroundPARP inhibitors (PARPi) have recently been approved for various malignancies based on the results of several clinical trials. However, these trials have mostly recruited patients with germline BRCA mutations, and it is unclear whether PARPi have similar efficacy in patients with somatic BRCA mutations. Our study aimed to determine the efficacy of PARPi in patients with somatic BRCA mutations.MethodsWe performed a meta-analysis comparing overall response rate to PARPi in patients harboring somatic versus germline BRCA mutations. We looked at studies including somatic and germline mutations in BRCA patients that received PARPi.ResultsAfter screening and removing duplicates, 18 studies met our criteria for including both somatic and germline BRCA mutations. Only 8 studies reported response rates for both somatic and germline BRCA mutations.In those studies, 24 out of 43 patients with somatic BRCA mutations (55.8%), and 69 out of 157 (43.9%) patients with germline BRCA patients had a response to therapy to PARPi. This difference was not statistically significant (p = 0.399).In all five studies that reported progression-free survival, there was no obvious difference in outcomes between somatic versus germline BRCA patients, however a precise statistical analysis could not be performed.ConclusionOur meta-analysis and systematic review of the literature indicates similar response rates of PARPi therapy in patients with somatic and germline BRCA mutations. Investigation of use of PARPi therapy in a broader patient population, and the inclusion of somatic BRCA mutations in further clinical trials is paramount in improving therapeutic options for our patients.
Optimal cumulative dose of cisplatin for concurrent chemoradiotherapy among patients with non-metastatic nasopharyngeal carcinoma: a multicenter analysis in Thailand
Authors: Ngamphaiboon Nuttapong , Dechaphunkul Arunee , Setakornnukul Jiraporn , Dechaphunkul Tanadech , Jiratrachu Rungarun , Suktitipat Bhoom , Jiarpinitnun Chuleeporn , Pattaranutaporn Poompis , Danchaivijitr Pongwut 
Published: June 2020

Abstract
Background
Chemoradiotherapy (CRT) with high cumulative doses (CDs) of cisplatin has been considered the standard of care for non-metastatic nasopharyngeal carcinoma (NPC). However, given most patients’ inability to tolerate high CDs due to cisplatin-related toxicities, the optimal CD of cisplatin during CRT remains undetermined.

Methods
Patients with non-metastatic NPC who received CRT with cisplatin between 2007 and 2017 were identified through the Thai head and neck cancer multicenter database and then categorized according to cisplatin CD (mg/m2) received. All complications and cisplatin-related toxicities during CRT were recorded.

Results
We identified 779 non-metastatic NPC patients receiving low (≤150; n = 97), intermediate (151–250; n = 411), and high (> 250; n = 271) CDs of cisplatin. Low CD patients had significantly lower mean actual radiation dose (p < 0.001) and more radiotherapy delay (p = 0.010), while intermediate CD patients had the least hospitalization (p < 0.001). Overall, 39.3% of the patients experienced cisplatin-related toxicity, which was associated with poor overall survival (OS) (p = 0.001). Acute kidney injury was observed in 7% in all patients, which was highest among low CD patients (15.5%; p = 0.002). Intermediate CD patients had significantly longer median OS than the low and high groups (64 vs. 49.8 vs. 53.2, respectively; p = 0.015). Univariate, but not multivariate, analysis showed that CD of cisplatin was significantly associated with OS.

Conclusion
CD of cisplatin during CRT was not an independent prognostic factor for OS. An intermediate CD induced minimal toxicity without compromising survival and should be considered the optimal CD. Nonetheless, a randomized phase 3 study evaluating the optimal CD of cisplatin is warranted.
Fetal alcohol spectrum disorder among pre-adopted and foster children
Authors: Tenenbaum Ariel , Mandel Asaf , Dor Talia , Sapir Alon , Sapir-Bodnaro Orly , Hertz Pnina , Wexler Isaiah D. 
Published: June 2020

Abstract
Background
Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children in foster care or domestically adopted are at greater risk for FASD. The aim of this study was to determine the prevalence or risk for FASD in a selected population of foster and adopted children.

Methods
Children between 2 and 12 years who were candidates for adoption in foster care were evaluated for clinical manifestations and historical features of fetal alcohol spectrum disorder based on established criteria for FASD.

Results
Of the 89 children evaluated, 18 had mothers with a confirmed history of alcohol consumption during pregnancy. Two children had fetal alcohol syndrome and one had partial fetal alcohol syndrome. In addition, five had alcohol-related neurodevelopmental disorder, one had alcohol-related birth defects, and a single child had manifestations of both. Of the 71 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD were a history of maternal alcohol consumption obtained.

Conclusions
In a population of high-risk children seen in an adoption clinic, many had manifestations associated with FASD especially where prenatal alcohol exposure was established. The reported prevalence in this study is higher than that reported in our previous study of younger children. This is most likely due to the higher number of children diagnosed with alcohol-related neurodevelopmental disorders that typically manifest at an older age.