bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beneficial Effects of Vasopressin Compared With Norepinephrine on Renal Perfusion, Oxygenation, and Function in Experimental Septic Acute Kidney Injury
Authors: Okazaki Nobuki , Iguchi Naoya , Evans Roger G. , Hood Sally G. , Bellomo Rinaldo , May Clive N. , Lankadeva Yugeesh R. 
Published: August 2020

Objectives:
To compare the effects of restoring mean arterial pressure with vasopressin or norepinephrine on systemic hemodynamics, renal blood flow, intrarenal perfusion and oxygenation, and renal function in ovine septic acute kidney injury.

Design:
Interventional Study.

Setting:
Research Institute.

Subjects:
Adult Merino ewes.

Interventions:
Flow probes were implanted on the pulmonary and renal arteries (and the mesenteric artery in sheep that received vasopressin). Fiber-optic probes were implanted in the renal cortex and medulla to measure tissue perfusion and oxygen tension (Po
2). Conscious sheep were administered Escherichia coli to induce septic acute kidney injury. Vasopressin (0.03 IU/min [0.03–0.05 IU/min]; n = 7) or norepinephrine (0.60 μg/kg/min [0.30–0.70 μg/kg/min]; n = 7) was infused IV and titrated to restore baseline mean arterial pressure during 24–30 hours of sepsis.

Measurements and Main Results:
Ovine septic acute kidney injury was characterized by reduced mean arterial pressure (–16% ± 2%) and creatinine clearance (–65% ± 9%) and increased renal blood flow (+34% ± 7%) but reduced renal medullary perfusion (–44% ± 7%) and Po
2 (–47% ± 10%). Vasopressin infusion did not significantly affect renal medullary perfusion or Po
2 and induced a sustained (6 hr) ~2.5-fold increase in creatinine clearance. Vasopressin reduced sepsis-induced mesenteric hyperemia (+61 ± 13 to +9% ± 6%). Norepinephrine transiently (2 hr) improved creatinine clearance (by ~3.5-fold) but worsened renal medullary ischemia (to –64% ± 7%) and hypoxia (to –71% ± 6%).

Conclusions:
In ovine septic acute kidney injury, restoration of mean arterial pressure with vasopressin induced a more sustained improvement in renal function than norepinephrine, without exacerbating renal medullary ischemia and hypoxia or reducing mesenteric blood flow below baseline values.
Volume Infusion Markedly Increases Femoral dP/dtmax in Fluid-Responsive Patients Only*
Authors: Vaquer Sergi , Chemla Denis , Teboul Jean-Louis , Ahmad Umar , Cipriani Flora , Oliva Joan Carles , Ochagavia Ana , Artigas Antonio , Baigorri Francisco , Monnet Xavier 
Published: August 2020

Objectives:
To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients.

Design:
Retrospective database analysis.

Setting:
Two adult polyvalent ICUs.

Patients:
Twenty-five critically ill patients with acute circulatory failure.

Interventions:
Thirty-five fluid infusions of 500 mL normal saline.

Measurements and Main Results:
Changes in femoral dP/dtmax, systolic, diastolic, and pulse femoral arterial pressure were obtained from the pressure waveform analysis using the PiCCO2 system (Pulsion Medical Systems, Feldkirchen, Germany). Stroke volume index was obtained by transpulmonary thermodilution. Statistical analysis was performed comparing results before and after volume expansion and according to the presence or absence of preload dependence (increases in stroke volume index ≥ 15%). Femoral dP/dtmax increased by 46% after fluid infusion in preload-dependent cases (mean change = 510.6 mm Hg·s–1; p = 0.005) and remained stable in preload-independent ones (mean change = 49.2 mm Hg·s–1; p = 0.114). Fluid-induced changes in femoral dP/dtmax correlated with fluid-induced changes in stroke volume index in preload-dependent cases (r = 0.618; p = 0.032), but not in preload-independent ones. Femoral dP/dtmax strongly correlated with pulse and systolic arterial pressures and with total arterial stiffness, regardless of the preload dependence status (r > 0.9 and p < 0.001 in all cases).

Conclusions:
Femoral dP/dtmax increased with volume expansion in case of preload dependence but not in case of preload independence and was strongly related to pulse pressure and total arterial stiffness regardless of preload dependence status. Therefore, femoral dP/dtmax is not a load-independent marker of left ventricular contractility and should be not used to track contractility in critically ill patients.
Evaluation of the Risk Prediction Tools for Patients With Coronavirus Disease 2019 in Wuhan, China: A Single-Centered, Retrospective, Observational Study*
Authors: Liu Fang-Yan , Sun Xue-Lian , Zhang Yong , Ge Lin , Wang Jing , Liang Xiao , Li Jun-Fen , Wang Chang-Liang , Xing Zheng-Tao , Chhetri Jagadish K. , Sun Peng , Chan Piu 
Published: August 2020

Objectives:
To evaluate and compare the efficacy of National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment on predicting in-hospital death in patients with coronavirus disease 2019.

Design:
A retrospective, observational study.

Setting:
Single center, West Campus of Wuhan Union hospital-a temporary center to manage critically ill patients with coronavirus disease 2019.

Patients:
A total of 673 consecutive adult patients with coronavirus disease 2019 between January 30, 2020, and March 14, 2020.

Interventions:
None.

Measurements and Main Results:
Data on demography, comorbidities, vital signs, mental status, oxygen saturation, and use of supplemental oxygen at admission to the ward were collected from medical records and used to score National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment. Total number of patients was 673 (51% male) and median (interquartile range) age was 61 years (50–69 yr). One-hundred twenty-one patients died (18%). For predicting in-hospital death, the area under the receiver operating characteristics (95% CI) for National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment were 0.882 (0.847–0.916), 0.880 (0.845–0.914), 0.839 (0.800–0.879), 0.766 (0.718–0.814), and 0.694 (0.641–0.746), respectively. Among the parameters of National Early Warning Score, the oxygen saturation score was found to be the most significant predictor of in-hospital death. The area under the receiver operating characteristic (95% CI) for oxygen saturation score was 0.875 (0.834–0.916).

Conclusions:
In this single-center study, the discrimination of National Early Warning Score/National Early Warning Score 2 for predicting mortality in patients with coronavirus disease 2019 admitted to the ward was found to be superior to Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment. Peripheral oxygen saturation could independently predict in-hospital death in these patients. Further validation of our finding in multiple settings is needed to determine its applicability for coronavirus disease 2019.
The efficacy and safety of pioglitazone in psoriasis vulgaris
Authors: Chen Pengfei , Chen Xiubing , Lei Lei , Zhang Yang , Xiang Jianjun , Zhou Jinxia , Lv Jun 
Published: August 2020

Abstract
Pioglitazone may have potential benefits in the treatment of cutaneous and metabolic derangements of psoriasis, but its role in the treatment of psoriasis remains in debate. We therefore conducted a meta-analysis to evaluate the clinical efficacy and safety of pioglitazone in psoriasis vulgaris (PsV).
We performed a comprehensive search in database of PubMed, Web of Science, Cochrane library, Embase and China National Knowledge Infrastructure (CNKI), and Wan fang database through March 2019 to identify eligible studies. Randomized controlled trials that have evaluated the effect and safety of pioglitazone in PsV were included. Treatment success was defined as ≥75% reduction in psoriasis area and severity index (PASI) score after treatment. Weighted mean differences (WMD), relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were pooled to compare the clinical efficacy and safety between different groups.
Six randomized controlled trials (n = 270) were included. Meta-analysis showed that pioglitazone was associated with a remarkable reduction in PASI score in patients with PsV (weight mean difference: 2.68, 95% CI 1.41–3.94, P < .001). The treatment success rate in the pioglitazone group was higher than in the control group (RR 3.60, 95 CI 1.61–8.01, P < .001). Compared with control group, pioglitazone was not related to a pronounced increase in total adverse events (RR 1.180, 95 CI 0.85–1.63, P = .33). Moreover, the risk of common adverse events in the 2 groups were similar, such as elevated liver enzyme, fatigue, nausea, weight gain.
This meta-analysis suggested pioglitazone is an effective and safe drug in the treatment of patients with PsV.
The effect on deep brain stimulation of subthalamic nucleus and dopaminergic treatment in Parkinson disease
Authors: Lo Buono Viviana , Palmeri Rosanna , Stroscio Giuseppe , Corallo Francesco , Di Lorenzo Giuseppe , Sorbera Chiara , Ciurleo Rosella , Cimino Vincenzo , Bramanti Placido , Marino Silvia , Bonanno Lilla 
Published: August 2020

Abstract
Impulsivity is a frequent non-motor symptom in Parkinson disease (PD). It comprises psycho-behavioral alterations that negatively impact quality of life. Dopaminergic treatments underpin many impulsive controls disorders however, side effects, such as increased impulsivity, are described also after neurosurgical procedure of deep brain stimulation (DBS). We investigated the effect of deep brain stimulation on psycho-behavioral alterations and quality of life (QoL) in PD patients, analyzing, also, the role of dopaminergic therapies.
Twenty idiopathic PD patients with and 20 idiopathic PD patients without DBS were included in the study. All patient underwent to neuropsychological assessment for a screening of executive functions, impulsivity, anxiety and depressive symptoms and QoL.
Differences were found between DBS and no DBS groups and in term of dopaminergic therapies. The comparison between 2 groups showed a greater motor and attentional impulsivity in DBS patients. Moreover, this impulsivity worse QoL and interpersonal relationships. The combination of Levodopa and dopamine agonists exerted a great impact on impulsivity behavior.
The emergence of postoperative impulsivity seems to be a neurostimulator phenomenon related to the computational role of the subthalamic nucleus in modulation of behavior.
Autoimmune Encephalitis Presenting with Malignant Catatonia in a 40-Year-Old Male Patient with Covid-19
Authors: Mulder Jan , Feresiadou Amalia , Fällmar David , Frithiof Robert , Virhammar Johan , Rasmusson Annica , Rostami Elham , Kumlien Eva , Cunningham Janet L. 
Published: August 2020

SUMMARYAcute malignant catatonia with autonomic instability developed in a previously healthy man with PCR-verified SARS-CoV-2. CT and MRI were normal, EEG showed slowing and cerebrospinal fluid showed a subtle indication of inflammation. There were no signs of pathology in other organs.18F-FDG-PET conveyed high bilateral uptake in the striatum. While commercial tests were negative, immunohistochemical staining of mouse brain revealed anti-neuronal IgG antibodies against neuronal targets in the hippocampus, thalamus, striatum and cortex. Early treatment with plasmapheresis and corticosteroid reversed disease progression and may have prevented large-scale neurological damage. We are not aware of other types of encephalitis with such distinct pyramidal tract symptoms and raise the possibility that this may be a novel form of autoimmune encephalitis induced by infection with SARS-CoV-2.
The Impact of COVID-19 on Medical Practice: A Nationwide Survey of Dermatologists and Healthcare Providers
Authors: Shanshal Mohammed , Ahmed Hayder Saad , Asfoor Hayder , Salih Raad Ibrahim , Ali Shehab Ahmed , Aldabouni Yusif k. 
Published: August 2020

AbstractBackgroundThe COVID-19 pandemic has dramatically changed medical practice worldwide. It posed a significant impact on different health services, including dermatology.MethodsA Cross-sectional observational study of 200 healthcare providers and 100 dermatologists (survey 1 and 2, respectively) were conducted.ObjectivesTo determine the prevalence of occupational skin diseases among healthcare providers working amid the pandemic, and to demonstrate the outbreak’s impact on dermatology practice.ResultsMost healthcare providers (83%) reported hygiene-related hand dermatitis. The rates of PPE-related dermatoses were estimated to be 73%, including pressure injuries (51.9%), acne (33.1%), non-gloves contact dermatitis (29.9%), nonspecific rash (17.5%), urticaria (9.1%) and skin infections (3.2%). The emerging COVID-19-related cutaneous manifestations were recognized by 20% of surveyed dermatologists, including maculopapular rash (41.67%), urticaria (37.50%), chilblain (25%) and vasculitis (16.67). Telemedicine was provided by 73% of the dermatologists, and 89% reported minimal use of immunosuppressive drugs amid the pandemic.ConclusionsThis article highlights the emergence of hygiene-related hand dermatitis and PPE-related dermatoses among healthcare providers working in the COVID-19 era. It also provides an appreciation of the major impact of COVID-19 on different aspects of dermatology practice in Iraq, and how the dermatologists adapt to these unfamiliar circumstances to meet the challenges.HighlightsCOVID-19 is associated with an ongoing emergence of occupational skin disease among healthcare providersCOVID-19 posed a significant impact on medical practice, including the epidemiology of diseases, the use of telemedicine, and modification of management plansDermatologists play a crucial role in recognizing the cutaneous manifestations associated with COVID-19 infection.
Detection of asymptomatic SARS-CoV-2 infections among healthcare workers: results from a large-scale screening program based on rapid serological testing
Authors: Carozzi Francesca Maria , Cusi Maria Grazia , Pistello Mauro , Galli Luisa , Bartoloni Alessandro , Anichini Gabriele , Azzari Chiara , Emdin Michele , Gandolfo Claudia , Maggi Fabrizio , Mantengoli Elisabetta , Moriondo Maria , Moscato Giovanna , Paganini Irene , Passino Claudio , Profili Francesco , Voller Fabio , Zappa Marco , Quattrone Filippo , Rossolini Gian Maria , Francesconi Paolo ,   SARS-CoV-2 serosurvey Tuscan working group
Published: August 2020

AbstractObjectiveTo evaluate the performance of two available rapid immunological tests for identification of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) antibodies and their subsequent application to a regional screening of health care workers (HCW) in Tuscany (Italy).Designmeasures of accuracy and HCW serological surveillanceSetting6 major health facilities in Tuscany, Italy.Participants17,098 HCW of the Tuscany Region. Measures of accuracy were estimated to assess sensitivity in 176 hospitalized Covid-19 clinical subjects at least 14 days after a diagnostic PCR-positive assay result. Specificity was assessed in 295 sera biobanked in the pre-Covid-19 era in winter or summer 2013-14Main outcome measuresSensitivity and specificity, and 95% confidence intervals, were measured using two serological tests, named T-1 and T-2. Positive and Negative predictive values were estimated at different levels of prevalence. HCW of the health centers were tested using the serological tests, with a follow-up nasopharyngeal PCR-test swab in positive tested cases.ResultsSensitivity was estimated as 99% (95%CI: 95%-100%) and 97% (95% CI: 90%-100%), whereas specificity was the 95% and 92%, for Test T-1 and T-2 respectively. In the historical samples IgM cross-reactions were detected in sera collected during the winter period, probably linked to other human coronaviruses. Out of the 17,098 tested, 3.1% have shown the presence of SARS-CoV-2 IgG antibodies, among them 6.8% were positive at PCR follow-up test on nasopharyngeal swabs.ConclusionBased on the low prevalence estimate observed in this survey, the use of serological test as a stand-alone test is not justified to assess the individual immunity status. Serological tests showed good performance and might be useful in an integrated surveillance, for identification of infected subjects and their contacts as required by the policy of contact tracing, with the aim to reduce the risk of dissemination, especially in health service facilities.
Genomic heterogeneity and clinical characterization of SARS-CoV-2 in Oregon
Authors: Dowdell Alexa K , Matlock Kevin , Robinson Fred L. , Weerasinghe Roshanthi , Rattray Rogan , Pukay Marina , Lathara Melvin , Harlan Anastacia , Ward Thomas R. , Campbell Mary , Urba Walter , Srinivasa Ganapati , Bifulco Carlo B. , Piening Brian D. 
Published: August 2020

ABSTRACTThe first reported case of COVID-19 in the State of Oregon occurred in late February 2020, with subsequent outbreaks occurring in the populous Portland metro area but also with significant outbreaks in less-populous and rural areas. Here we report viral sequences from 188 patients across the hospitals and associated clinics in the Providence Health System in the State of Oregon dating back to the early days of the outbreak. We show a significant shift in dominant clade lineages over time in Oregon, with the rapid emergence and dominance of Spike D614G-positive variants. We also highlight significant diversity in SARS-CoV-2 sequences in Oregon, including a large number of rare mutations, indicative that these genomes could be utilized for outbreak tracing. Lastly, we show that SARS-CoV-2 genomic information may offer additional utility in combination with clinical covariates in the prediction of acute disease phenotypes.
Clinical course and severity outcome indicators among COVID-19 hospitalized patients in relation to comorbidities distribution: Mexican cohort
Authors:   COVID-19 Hospitalizations in Mexico, Carrillo Genny , Méndez-Domínguez Nina , Santos-Zaldivar Kassandra Desire , Rochel-Pérez Andrea , Azuela-Morales Mario , Cuevas-Koh Osman , Álvarez-Baeza Alberto 
Published: August 2020

AbstractIntroductionCOVID-19 affected worldwide, causing to date, around 500,000 deaths. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death rates depend mainly on the patients’ comorbidities and age. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study’s objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes.Materials and MethodsRetrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations.Dependent variables were four possible severity outcomes(a) pneumonia, (b) mechanical ventilation (c) intensive care unit, and (d) death; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male. Hospital mortality among patients aged<15 was 9.11%, 51.99% of those aged >65 died. Male gender and increasing age predicted every severity outcome. Diabetes and hypertension predicted every severity outcome significantly. Obesity did not predict mortality, but CKD, respiratory diseases, cardiopathies were significant predictors.ConclusionObesity increased the risk for pneumonia, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death. Patients with respiratory diseases were less prone to develop pneumonia, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death.
R3T (Rapid Research Response Team) One-step RT-qPCR kit for COVID-19 diagnostic using in-house enzymes
Authors: Takahashi Masateru , Tehseen Muhammad , Salunke Rahul , Takahashi Etsuko , Mfarrej Sara , Sobhy Mohamed A. , Alhamlan Fatimah S. , Hala Sharif , Mandujano Gerardo R. , Al-Qahtani Ahmed A. , Alofi Fadwa S. , Alsomali Afrah , Hashem Anwar M. , Khogeer Asim , Almontashiri Naif A. M. , Lee Jae Man , Mon Hiroaki , Sakashita Kosuke , Li Mo , Kusakabe Takahiro , Pain Arnab , Hamdan Samir M. 
Published: August 2020

AbstractOne-step RT-qPCR is the most widely applied method for COVID-19 diagnostics. Designing in-house one-step RT-qPCR kits is restricted by the patent-rights for the production of enzymes and the lack of information about the components of the commercial kits. Here, we provide a simple, economical, and powerful one-step RT-qPCR kit based on patent-free, specifically-tailored versions of Moloney Murine Leukemia Virus Reverse Transcriptase and Thermus aquaticus DNA polymerase termed the R3T (Rapid Research Response Team) One-step RT-qPCR. Our kit was routinely able to reliably detect as low as 10 copies of the synthetic RNAs of the SARS-CoV-2. More importantly, our kit successfully detected COVID-19 in clinical samples of broad viral titers with similar reliability and selectivity as that of the Invitrogen SuperScript™ III Platinum™ One-step RT-qPCR and TaqPath™ 1-Step RT-qPCR kits. Overall, our kit has shown robust performance in both of laboratory settings and the Saudi Ministry of Health-approved testing facility.
A multivariate geostatistical framework for combining multiple indices of abundance for disease vectors and reservoirs: A case study of rattiness in a low-income urban Brazilian community
Authors: Eyre Max T. , Carvalho-Pereira Ticiana S. A. , Souza Fábio N. , Khalil Hussein , Hacker Kathryn P. , Serrano Soledad , Taylor Joshua P. , Reis Mitermayer G. , Ko Albert I. , Begon Mike , Diggle Peter J. , Costa Federico , Giorgi Emanuele 
Published: August 2020

AbstractA key requirement in studies of endemic vector-borne or zoonotic disease is an estimate of the spatial variation in vector or reservoir host abundance. For many vector species, multiple indices of abundance are available, but current approaches to choosing between or combining these indices do not fully exploit the potential inferential benefits that might accrue from modelling their joint spatial distribution. Here, we develop a class of multivariate generalized linear geostatistical models for multiple indices of abundance. We illustrate this novel methodology with a case study on Norway rats in a low-income urban Brazilian community, where rat abundance is a likely risk-factor for human leptospirosis. We combine three indices of rat abundance to draw predictive inferences on a spatially continuous latent process, rattiness, that acts as a proxy for abundance. We show how to explore the association between rattiness and spatially varying environmental factors, evaluate the relative importance of each of the three contributing indices, assess the presence of residual, unexplained spatial variation, and identify rattiness hotspots. The proposed methodology is applicable more generally as a tool for understanding the role of vector or reservoir host abundance in predicting spatial variation in the risk of human disease.