bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Retention in Care After a Palliative Care Referral Among People Living With HIV
Authors: Gilliams Elizabeth A. , Ammirati Rachel J. , Nguyen Minh L.T. , Shahane Amit A. , Farber Eugene W. , Marconi Vincent C. 
Published: January 2020

Background:
Early palliative care addresses biopsychosocial needs for people living with HIV in an outpatient setting. We sought to describe patients referred to a palliative care program and compare the medical outcomes of emergency department (ED) visits, hospitalizations, primary care visits, and viral load suppression among patients enrolled in the program, to patients who did not enroll (no-show group).

Setting:
We completed a retrospective cohort study at an urban, academically affiliated HIV primary care clinic.

Methods:
Data were collected from electronic medical records. Descriptive statistics characterized patient demographics at baseline, comorbidities, and reasons for referral to palliative care. Viral load suppression, rates of ED visits, hospitalizations, primary care visits, and retention in care were compared between the palliative and no-show groups.

Results:
The most common reasons for referral were chronic pain management and medication/appointment adherence. Median percent of viral load measurements suppressed increased over time, but did not differ statistically between groups (pre: 28.6% and 15.5%, post: 70.8% and 50.0%, palliative and no-show groups, respectively). Median rates of ED visits and hospitalizations were low and were not impacted by palliative care. Rates of primary care visit attendance remained stable in the palliative group (4.6/year) but declined in the no-show group (3.5/year), P < 0.05. Retention in care improved significantly after the palliative intervention (palliative: 85.4%–96.1%, no-show: 94.4%–82.5%), and at high and low palliative engagement, suggesting a threshold effect of the intervention.

Conclusion:
Outpatient early palliative care is a promising intervention that might impact retention in HIV care.
The Association Between Magnetic Resonance Imaging Disc Pathology and Provocative Discography at the Lumbar Level
Authors: Waldrop Greer , Trent Graham , Dagher Azar P. , Reinig James , Thompson Kerry J. 
Published: January 2020

Objective
The objective of this study was to show that degenerative lumbar magnetic resonance imaging findings variably increase discography pain by level.

Methods
Lumbar discography and magnetic resonance imaging of 736 patients were retrospectively reviewed. Univariate/multivariate logistic regressions calculated the odds ratio (OR) (95% confidence interval, P < 0.05).

Results
L3-4 multivariate regression OR for a degenerative disc is 9.9; for bulge, 10.9; for annular tear, 38.9; for herniation, 51.5; and for degenerative facet, 2.158. Endplate changes were not significant. L4-5 OR for a degenerative disc is 4.52; for bulge, 13.74, for tear, 19.13; for herniation, 28.65; for endplate edema, 3.47; and fatty change, 3.84. Degenerative facet ORs were not significant. L5-S1 OR for a degenerative disc is 6.86; for bulge, 5.65; for tear, 40.56; and for herniation, 77.98. Endplate changes and degenerative facet OR's were not significant.

Conclusions
Advancing degeneration increases pain at L5-S1 followed by L3-4. Endplate signal is significant only at L4-5.
Neurovascular Perfusion Study With DynaPBV During Preoperative Balloon Test Occlusion: A Feasibility Study on Aneurysm and Tumor Lesions
Authors: Ciceri Elisa F. , Caldiera Valentina , Talenti Giacomo , Caputi Luigi , Cordella Roberto , D'Onofrio Giovanni , Faragò Giuseppe 
Published: January 2020

Abstract
To report feasibility, safety, and technical advantages of flat-detector computed tomography perfusion (FD-CTP) during balloon test occlusion (BTO) angiography studies, 10 patients patients scheduled for BTO were evaluated. Cerebral blood volume maps were extracted from FD-CTP images acquired during the test. The FD-CTP perfusion combined with BTO is feasible and safe in intracranial tumor, and aneurysm cases in which vessel sacrifice should be considered.
Microsurgery Training in the Digital Era
Authors: Margulies Ilana G. , Xu Hope , Henderson Peter W. 
Published: January 2020

Introduction
Significant variation exists in microsurgery training resources provided across plastic surgery residency programs, and dedicated microsurgery courses can be logistically difficult to access (cost, location, protected time, etc). Widespread use of personal digital technology has facilitated the emergence of resources that enable easily accessible microsurgical training through digital modalities that augment traditional training. The authors sought to conduct the first systematic review of all such resources.

Methods
A systematic review of MEDLINE, PubMed Central, and EMBASE was performed according to Preferred Reporting Items for Systematic Review and Meta-analysis guidelines to identify articles describing easily accessible microsurgery training resources. Additional searches on Google, the iOS application store, the Google Play store, and YouTube were conducted using comparable search terms.

Results
Nineteen articles describing easily accessible digital microsurgery training resources were identified, which included 9 interactive and 10 passive training resources. Interactive resources included methods for using smartphones, tablets, and computers to provide magnification for microsurgical skill training. Passive resources included training videos, educational forums, and 3-dimensional anatomical models. Google search revealed an additional interactive, commercially available device for positioning a smartphone above a microsurgical training platform. iOS Store and Google Play search revealed 5 passive training applications with tutorials and technique videos. YouTube search revealed 146 videos on microsurgical technique and training models from 19 users with verifiable affiliations.

Conclusions
In contrast to costly and variable microsurgical courses and laboratories, digital technology gives trainees the opportunity to learn about and practice microsurgical techniques in any setting at any time and can serve as a valuable adjunct to traditional training modalities.
Surgical Management and Outcomes of Cutaneous Mold Infections in Immunocompromised Children
Authors: Mauch Jaclyn T. , Xu Wen , Nathan Shelby L. , Lin Ines C. 
Published: January 2020

Background
Cutaneous mold infections occur infrequently but can be life-threatening in immunocompromised children. The literature regarding its surgical management is limited. This study aims to describe the surgical management and outcomes of cutaneous mold infections in immunocompromised children.

Methods
Hospitalized patients receiving a skin biopsy at a single pediatric hospital in 2003 to 2017 were identified. Inclusion criteria were immunocompromised status, younger than 21 years, and surgical excision of a confirmed cutaneous mold infection. Patient information, details of immunosuppression, operative details, and 6-month postoperative and disease outcomes were collected.

Results
Seventeen patients (21 lesions) were identified with an average age of 6.8 years (range = 0.2–19.5 years). Affected anatomic regions included limb (15, 71%), chest (2, 10%), axilla, back, abdomen, and head (1 or 5% each). Excisions occurred, on average, within 1.7 days of initial biopsy (range = 0–7 days). When specified, margins were 0.5 to 2.0 cm, and surgeons used intraoperative fungal detection techniques in 8 cases (47%). Definitive closure was achieved by secondary intention/dressings changes (9, 43%), skin graft (7, 33%), a skin substitute (2, 10%), immediate primary closure (2, 10%), and delayed primary closure (1, 5%). Overall, 14 patients were alive 6 months after resection (82%).

Conclusions
This study is the first to critically evaluate the methodology for surgical resection of cutaneous fungal infections in immunocompromised children. We suggest timely excision once diagnosed with, at minimum, 0.5-cm margins and intraoperative pathologic study when considering surgical treatment for this rare but serious infection.
Lavage With Lidocaine and Adrenaline Mixture Reduces the Early Side Effects of Septorhinoplasty
Authors: Gümüş Nazım 
Published: January 2020

Background
Pain, ecchymosis, and edema are well-known temporary consequences of septorhinoplasty procedure. They give rise to patient's complaints, discomfort, and dissatisfaction, increasing the patient's anxiety and recovery time in the early postoperative course. Several approaches have been described to reduce the level of these complaints.
The aim of this clinical study was to determine the effect of nasal lavage with lidocaine and adrenaline mixture on early postoperative levels of pain, edema, and ecchymosis in 24 hours after a septorhinoplasty procedure.

Methods
This study included 40 consecutive patients who underwent septorhinoplasty procedure in which nasal septum was entirely dissected and corrected. Patients were randomly divided into 2 groups of 20 patients. At the end of the operation, incisions were closed with sutures, and both blood and seroma collections beneath the flaps were sufficiently drained by means of finger pressure, and then in patients of group A (control group), 5 mL of saline solution was given under the dorsal nasal flap to make lavage and in patients of group B (study group), 5 mL of 2% lidocaine with 1:100,000 adrenaline was given to the area under the dorsal nasal flaps. Five minutes later, nasal package and splint were applied and the operation was finished.
Patients were evaluated for the level of pain sensation, degree of periorbital edema, and ecchymosis at the 1st, 3rd, 6th, 12th, and 24th hours postoperatively. Overall satisfaction scores were also determined at the 24th hour.

Results
A total of 40 patients (19 males and 21 females) between 18 and 42 years of age with a mean ± standard deviation of 24.5 ± 4.52 years were included in the study. Statistically significant differences were found between the A and B groups with regard to early postoperative pain, edema, ecchymosis, analgesic use, and satisfaction scores, suggesting the effectivity of the lavage with lidocaine-adrenaline mixture on the early postoperative pain, edema, and ecchymosis relief.

Conclusions
Lavage of nasal flaps with lidocaine-adrenaline mixture seems an effective and simple way in the control of early postoperative pain, edema, and ecchymosis in septorhinoplasty patients. In addition, it considerably reduces total analgesic consumption and patients' discomfort, leading to high level of satisfaction.
Hospital-level intensive care unit admission for patients with isolated blunt abdominal solid organ injury
Authors: Bowman Jessica A. , Jurkovich Gregory J. , Nuño Miriam , Utter Garth H. 
Published: January 2020

BACKGROUND
The optimal level of care for hemodynamically stable patients with isolated blunt hepatic, renal, or splenic injuries (solid organ injuries [SOIs]) is unknown. We sought to characterize interhospital variability in intensive care unit (ICU) admission of such patients and to determine whether greater hospital-level ICU use would be associated with improved outcomes.

METHODS
We conducted a retrospective cohort study using the 2015 and 2016 National Trauma Data Bank. We included adult patients with blunt trauma with SOIs with an Abbreviated Injury Scale score of 2 to 4. We excluded patients with other significant injuries, hypotension, or another indication for ICU admission, and hospitals with less than 10 eligible patients. We categorized hospitals into quartiles based on the proportion of eligible patients admitted to an ICU. The primary outcome was a composite of organ failure (cardiac arrest, acute lung injury/acute respiratory failure, or acute kidney injury), infection (sepsis, pneumonia, or catheter-related blood stream infection), or death during hospitalization.

RESULTS
Among 14,312 patients at 444 facilities, 7,225 (50%), 5,050 (35%), and 3,499 (24%) had splenic, hepatic, and renal injuries, respectively. The median proportion of ICU use was 44% (interquartile range, 27–59%, range 0–95%). The composite outcome occurred in 180 patients (1.3%), with death in 76 (0.5%), organ failure in 97 (0.7%), and infection in 53 (0.4%). Relative to hospitals with the lowest ICU use (quartile 1), greater hospital-level ICU use was not associated with decreased likelihood of the composite outcome (adjusted odds ratios, 1.31; 95% confidence interval [95% CI], 0.88–1.95; 0.81; 95% CI, 0.52–1.26; and 0.94; 95% CI, 0.62–1.43 for quartiles 2–4, respectively) or its components. Unplanned ICU transfer was no more likely with lower hospital-level ICU use.

CONCLUSION
Admission location of stable patients with isolated mild to moderate abdominal SOIs is variable across hospitals, but hospitalization at a facility with greater ICU use is not associated with substantially improved outcomes.

LEVEL OF EVIDENCE
Therapeutic/care management, Level IV.
Genetic hearing impairment affects cochlear processing and, consequently, speech recognition in noise
Authors: Lanting Cris , Snik Ad , Leijendeckers Joop , Bosman Arjan , Pennings Ronald 
Published: January 2020

AbstractThe relation between speech recognition and hereditary hearing loss is not straightforward. Impaired cochlear processing of sound might be determined by underlying genetic defects. Data obtained in nine groups of patients with a specific type of genetic hearing loss were evaluated. For each group, the affected cochlear structure, or site-of-lesion, was determined based on previously published animal studies. Retrospectively obtained speech recognition scores in noise were related to several aspects of supra-threshold cochlear processing, as assessed by psychophysical measurements. The differences in speech perception in noise between these patient groups could be explained by these factors, and partially by the hypothesized affected structure of the cochlea, suggesting that speech recognition in noise was associated with genetics-related malfunctioning of the cochlea.
Cardiac Microstructural Abnormalities Identify Women at Risk of Incident Heart Failure
Authors: Kwan Alan C. , Demosthenes Emmanuella , Nguyen Trevor , Luong Eric , Salto Gerran , Osypiuk Ewa , Stantchev Plamen , Kim Elizabeth H. , Hiremath Pranoti , Xanthakis Vanessa , Vasan Ramachandran S. , Cheng Susan 
Published: January 2020

ABSTRACTBackgroundIncidence of congestive heart failure is difficult to predict by standard methods. We have developed a method called the signal intensity coefficient that uses echocardiographic texture analysis to quantify microstructural changes which may occur in at-risk patients prior to development of a clinical heart failure syndrome.MethodsParticipants from the Framingham Offspring Cohort study who attended the 8th visit and received screening echocardiography were included. Participants were followed for a mean of 7.4 years for incident congestive heart failure. Cox proportional hazards modeling was used to assess the hazard ratio of signal intensity coefficient in the top quartile of values versus other quartiles in the total and sex-stratified population.Results2511 participants with interpretable echocardiography and no history of congestive heart failure, stroke, or myocardial infarction were included in this study. The top quartile signal intensity coefficient had a hazard ratio of 1.83 (p=0.0048) for incident heart failure. When additional clinical risk factors were added to the model, this became non-significant. Within women, an elevated hazard ratio was significant in multiple models including age and hypertensive medication use. Models were not significant in men.ConclusionsElevated signal intensity coefficient is associated with an increased risk of incident congestive heart failure. This trend remains significant in women after inclusion of age and hypertensive medication use. The signal intensity coefficient may be able to identify patients at risk of developing congestive heart failure using echocardiographic texture analysis.
Computational Exploration of Phytochemicals as Potent Inhibitors of Acetylcholinesterase Enzyme in Alzheimer’s Disease
Authors: Sarkar Bishajit , Ullah Md. Asad , Prottoy Md. Nazmul Islam 
Published: January 2020

AbstractAlzheimer’s Disease (AD) is the most common type of age related dementia in the world. Many hypotheses shed light on several reasons that lead to AD development. The cholinergic hypothesis describes that the destruction of an essential neurotransmitter, acetylcholine (AChE) by acetylcholinesterase (AChE) enzyme, leads to the AD onset. The hydrolysis of acetylcholine by excess amount of AChE decreases the amount of acetylcholine in the brain, thus interfering with the normal brain functions. Many anti-AChE agents can be used to treat AD by targeting AChE. In our study, 14 anti-AChE agents from plants: 1,8-cineol, berberine, carvacrol, cheilanthifoline, coptisine, estragole, harmaline, harmine, liriodenine, myrtenal, naringenin, protopine, scoulerine, stylopine were tested against AChE and compared with two controls: donepezil and galantamine, using different techniques of molecular docking. Molecular docking study was conducted for all the 14 selected ligands against AChE to identify the best three ligands among them. To determine the safety and efficacy of the three best ligands, a set of tests like the druglikeness property test, ADME/T test, PASS & P450 site of metabolism prediction, pharmacophore mapping and modelling and DFT calculations were performed. In our experiment, berberine, coptisine and naringenin were determined as the three ligands from the docking study. Further analysis of these 3 ligands showed coptisine as the most potent anti-AChE agent. The molecular dynamics simulation study showed quite good stability of the coptisine-AChE docked complex. Administration of berberine, coptisine and naringenin might be potential treatments for AD.
FDA orphan drug designations for lysosomal storage disorders – a cross sectional analysis
Authors: Garbade Sven F. , Zielonka Matthias , Mechler Konstantin , Kölker Stefan , Hoffmann Georg F. , Staufner Christian , Mengel Eugen , Ries Markus 
Published: January 2020

AbstractPurposeTo provide a quantitative clinical-regulatory insight into the status of FDA orphan drug designations for compounds intended to treat lysosomal storage disorders (LSD’s).MethodsAssessment of the drug pipeline through analysis of the FDA database for orphan drug designations with descriptive and comparative statistics.ResultsBetween 1983 and 2019, 124 orphan drug designations were granted by the FDA for compounds intended to treat 28 lysosomal storage diseases. Orphan drug designations focused on Gaucher disease (N=16), Pompe disease (N=16), Fabry disease (N=10), MPS II (N=10), MPS I (N=9), and MPS IIIA (N=9), and included enzyme replacement therapies, gene therapies, and small molecules, and others. Twenty-three orphan drugs were approved for the treatment of 11 LSDs. Gaucher disease (N=6), cystinosis (N=5), Pompe disease (N=3), and Fabry disease (N=2) had multiple approvals, CLN2, LAL-D, MPS I, II, IVA, VI, and VII one approval each. This is an increase of nine more approved drugs and four more treatable LSD’s (CLN2, MPS VII, LAL-D, and MPS IVA) since 2013. Mean time between orphan drug designation and FDA approval was 89.7 SD 55.00 (range 8-203, N=23) months.ConclusionsThe development pipeline is growing and evolving into diversified small molecules and gene therapy. CLN2 was the first and only LSD with an approved therapy directly targeted to the brain. Newly approved products included “me-too” – enzymes and innovative compounds such as the first pharmacological chaperone for the treatment of Fabry disease.
Psychiatric symptoms and syndromes transcending diagnostic boundaries in Indian multiplex families: The cohort of ADBS study
Authors: Sreeraj Vanteemar S , Holla Bharath , Ithal Dhruva , Nadella Ravi Kumar , Mahadevan Jayant , Balachander Srinivas , Ali Furkhan , Sheth Sweta , Narayanaswamy Janardhanan C. , Venkatasubramanian Ganesan , John John P. , Varghese Mathew , Benegal Vivek , Jain Sanjeev , Reddy YC Janardhan ,   ADBS Consortium, Viswanath Biju 
Published: January 2020

AbstractAccelerator program for discovery in brain disorders using stem cells (ADBS) is an ongoing longitudinal study investigating the neurobiological aspects of five psychiatric disorders (Alzheimer’s dementia, bipolar disorder, obsessive-compulsive disorder, substance use disorder or schizophrenia) in India. The study uses several techniques (brain-imaging, psychophysics, neuropsychology, next-generation sequencing, cellular models), and in-depth clinical assessments in a longitudinal cohort from multiple-affected families. This article explores the frequency of manifestations of different psychiatric symptoms and syndromes in the participants and their relatives from the first wave of this study (August 2016 to October 2019). We screened 3,583 families and enrolled 481 families (1406 participants; 773 affected with any of the 5 disorders, and 633 relatives). The participants had a high familial prevalence with nearly a third of FDRs affected. Though similar disorders aggregated, the majority (61%) of the families had dissimilar diagnoses among members. Moreover, 15% of affected participants had two or more co-occurring syndromes. Diverse cross-cutting symptoms, unrestricted to the index syndrome, were observed in participants across diagnostic categories. The pattern and extent of co-occurrence validate the need for a transdiagnostic approach. The repository of biomaterials as well as digital datasets will serve as a valuable resource for the larger scientific community.
Autoantibodies to the N-Methyl-D-Aspartate Receptor in Adolescents with Early Onset Psychosis and Healthy Controls
Authors: Engen Kristine , Wortinger Laura Anne , Jørgensen Kjetil Nordbø , Lundberg Mathias , Bohman Hannes , Smelror Runar Elle , Myhre Anne Margrethe , Jacobson Leslie , Vincent Angela , Agartz Ingrid 
Published: January 2020

AbstractBackgroundAutoantibodies to the N-methyl-D-aspartate receptor (NMDAR-Abs) in autoimmune encephalitis have been associated with prominent psychiatric symptoms. The aims of the present study are to identify the prevalence of NMDAR-Abs in adolescents with early onset psychosis disorders (EOP) and healthy controls (HC) and examine its clinical significance.MethodPlasma samples were acquired from 46 adolescent EOP patients and 69 age- and sex matched HC, and assessed for the presence of immunoglobulin G NMDAR-Abs. All participants underwent psychiatric evaluation, neurological examination and head magnetic resonance imaging.ResultsNMDAR-Abs were detected in three of 46 (6.5%) EOP patients and in two of 69 (2.9%) HC. One NMDAR-Abs EOP patient presented with unusual psychopathology and minor T1 weighted lesions of vasculopathological origin located bi-frontally and in the basal ganglia, and had a recent diagnosis of a separate autoimmune disease. One NMDAR-Abs HC displayed a T2 weighted FLAIR hyperintensity lesion in the left frontal lobe. The remaining three NMDAR-Abs participants were two EOP patients without neurological or radiological findings, and one HC without any clinical findings.ConclusionsWe report the presence of NMDAR-Abs in both adolescent EOP patients and HC, similar to the incidence in other studies. This may support the hypothesis of an immunological disease component in a small proportion of adolescent psychosis, but the positive antibody tests must be carefully interpreted and reviewed within the individual clinical context.