bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival and Mid-Term Neurologic Outcome After Extracorporeal Cardiopulmonary Resuscitation in Children
Authors: Kramer Peter , Mommsen Annick , Miera Oliver , Photiadis Joachim , Berger Felix , Schmitt Katharina R. L. 
Published: March 2020

Objectives:
Extracorporeal cardiopulmonary resuscitation in children with refractory cardiac arrest has been shown to improve survival, however, risk factors associated with mortality and neurologic impairments are not well defined. We analyzed our recent institutional experience with pediatric extracorporeal cardiopulmonary resuscitation to identify variables associated with survival and neurocognitive outcome.

Design:
Retrospective observational study.

Setting:
Pediatric cardiology and congenital heart surgery departments of a tertiary referral heart center.

Patients:
Seventy-two consecutive children (median age, 0.3 yr [0.0–1.9 yr]) who underwent extracorporeal cardiopulmonary resuscitation at our institution during the study period from 2005 to 2016.

Interventions:
Not applicable.

Measurements and Main Results:
Median duration of resuscitation was 60 minutes (42–80 min) and median extracorporeal support duration was 5.4 days (2.2–7.9 d). Forty-three (59.7%) extracorporeal cardiopulmonary resuscitation events occurred during off-hours, however, neither duration of resuscitation (65 min [49–89 min] vs 51 min [35–80 min]; p = 0.16) nor survival (34.9% vs 37.9%; p = 0.81) differed significantly compared to working hours. Congenital heart disease was present in 84.7% of the patients. Survival to hospital discharge was 36.1%; younger age, higher lactate levels after resuscitation, acute kidney injury, renal replacement therapy, hepatic injury, and complexity of prior cardiothoracic surgical procedures were significantly associated with mortality. At mid-term follow-up (median, 4.1 yr [3.7–6.1 yr]), 22 patients (84.6% of discharge survivors) were still alive with 77.3% having a favorable neurologic outcome. High lactate levels, arrest location other than ICU, and requirement for renal replacement therapy were associated with unfavorable neurologic outcome. Interestingly, longer duration of resuscitation did not negatively impact survival or neurologic outcome.

Conclusions:
Extracorporeal cardiopulmonary resuscitation is a valuable tool for the treatment of children with refractory cardiac arrest and a favorable neurologic outcome can be achieved in the majority of survivors even after prolonged resuscitation. Mortality after extracorporeal cardiopulmonary resuscitation in postcardiac surgery children is associated with procedural complexity.
Using Quality Improvement to Reduce IV Acetaminophen Use in a PICU
Authors: Howell Katelyn A. , Ruggles Cassandra A. , Thompson Marlene , Metzger Kelly Z. , Christopher Jean A. , Bigham Michael T. 
Published: March 2020

Objectives:
Improve medication-related variable ICU costs by increasing value related to a locally identified high-frequency/high-cost medication, IV acetaminophen.

Design:
Structured quality improvement initiative using the Institute for Healthcare Improvement’s Model for Improvement.

Setting:
Twenty-three–bed tertiary PICU.

Patients:
All patients admitted to the PICU receiving IV acetaminophen during the study period of 2015–2018.

Interventions:
PICU staff survey, education to close nurse/provider knowledge gap, optimization of order sets and electronic health record order entry, improving oral/enteral medication transition, and optimization of pharmacy dispensing.

Measurements and Main Results:
The primary outcome of interest was IV acetaminophen doses per patient day reported as a 12-month rolling average. Baseline IV acetaminophen prescribing prior to the study period was initially 0.55 doses per patient day, and in 2014, there were 3,042 doses administered. IV acetaminophen is $43 per dose. The rolling 12-month average post intervention was 0.33 doses per patient day. Enteral and rectal doses increased from 0.42 to 0.58 doses per patient day. Opioid utilization varied throughout the study. A 40% reduction in IV acetaminophen equated to a $35,507 cost savings in a single year.

Conclusions:
IV acetaminophen is prescribed with high frequency and impacts variable PICU costs. Value can be improved by optimizing IV acetaminophen prescribing.
Testing for Common Respiratory Viruses in Children Admitted to Pediatric Intensive Care: Epidemiology and Outcomes
Authors: Moynihan Katie M. , McGarvey Tambra , Barlow Andrew , Heney Claire , Gibbons Kristen , Clark Julia E. , Schlebusch Sanmarié , Schlapbach Luregn J. 
Published: March 2020

Objectives:
Viral infections are common in children, but there is a lack of data on severe viral infections in critically ill children. We investigated testing for viral infections in children requiring PICU admission and describe the epidemiology and outcomes.

Design:
Multicenter retrospective study. Results of viral testing for nine respiratory viruses using polymerase chain reaction were collected.

Participants:
Children less than 16 years old nonelectively admitted to PICU over a 6-year period.

Setting:
Two tertiary PICUs in Queensland, Australia.

Interventions:
None.

Main Outcome Measures:
Primary outcome was PICU length of stay. Secondary outcomes included need for and duration of intubation and mortality in PICU. Univariate and multivariate regression analyses were performed, adjusting for age, indigenous status, comorbidities, and severity of illness.

Results:
Of 6,426 nonelective admissions, 2,956 (46%) were polymerase chain reaction tested for a virus of which 1,353 (46%) were virus positive. Respiratory syncytial virus was the most common pathogen identified (n = 518, 33%), followed by rhinovirus/enterovirus and adenovirus. Across all patients who underwent polymerase chain reaction testing, identification of a respiratory virus was not significantly associated with longer overall length of stay (multivariate odds ratio, 1.08; 95% CI, 0.99–1.17; p = 0.068) or longer intubation (p = 0.181), whereas the adjusted odds for intubation and mortality were significantly lower (p < 0.01). Subgroup analyses restricted to patients with acute respiratory infections (n = 1,241), bronchiolitis (n = 761), pneumonia (n = 311), confirmed bacterial infection (n = 345), and malignancy (n = 95) showed that patients positive for a virus on testing had significantly longer PICU length of stay (multivariate p < 0.05). In children with pneumonia, identification of a respiratory virus was associated with significantly increased duration of ventilation (p = 0.003). No association between positive test results for multiple viruses and outcomes was observed.

Conclusion:
Viral infections are common in critically ill children. Viral infections were associated with lower intubation and mortality rates compared with all children testing negative for viral infections. In several subgroups studied, identification of viral pathogens was associated with longer PICU length of stay while mortality was comparable. Prospective studies are required to determine the benefit of routine testing for respiratory viruses at the time of PICU admission.
The Effect of Patient- and Treatment-Related Factors on Circuit Lifespan During Continuous Renal Replacement Therapy in Critically Ill Children
Authors: Cortina Gerard , McRae Rosemary , Chiletti Roberto , Butt Warwick 
Published: March 2020

Objectives:
To examine the effects of patient and treatment variables on circuit lifespan in critically ill children requiring continuous renal replacement therapy.

Design:
Retrospective observational study based on a prospective registry.

Setting:
Tertiary referral 30-bed PICU.

Patients:
One hundred sixty-one critically ill children undergoing continuous renal replacement therapy during an 8-year period (2007–2014) were included in the study.

Interventions:
Continuous renal replacement therapy.

Measurements and Main Results:
During the study period, 161 patients received a total of 22,190 hours of continuous renal replacement therapy, with a median duration of 74.75 hours (interquartile range, 32–169.5) per patient. Of the 572 filter circuits used, 276 (48.3%) were changed due to circuit clotting and 262 (45.8%) were electively changed. Median circuit life was 24.62 hours (interquartile range, 10.6–55.3) for all filters and significantly longer for those electively removed as compared to those prematurely removed because of clotting (35.50 hr [interquartile range, 16.9–67.6] vs 22.00 hr [interquartile range, 13.8–42.5]; p < 0.001). Multivariate regression analyses revealed that admission diagnosis (p < 0.001), anticoagulation type (p < 0.001), access type (p = 0.016), and circuit size (p = 0.027) were associated with prolonged circuit life, as well as, in patients on heparin anticoagulation, with higher doses of heparin (p < 0.001) and a prolonged activated partial thromboplastin time (p < 0.001).

Conclusions:
In this study, circuit lifespan in pediatric continuous renal replacement therapy was low and appeared to depend upon the patient’s diagnosis, the type of access and anticoagulation used as well as the size of the circuit used.
Gastrostomy and Tracheostomy After Complete Repair of Tetralogy of Fallot in Children With 22q11.2 Deletion Syndrome
Authors: Herington Danielle M. , Tang Xinyu , Spray Beverly J. , Reemtsen Brian L. , Prodhan Parthak , Richter Gresham T. , Kyle William B. , Bolin Elijah H. 
Published: March 2020

Objectives:
Caring for a child with gastrostomy and/or tracheostomy can cause measurable parental stress. It is generally known that children with 22q11.2 deletion syndrome are at greater risk of requiring gastrostomy or tracheostomy after heart surgery, although the magnitude of that risk after complete repair of tetralogy of Fallot has not been described. We sought to determine the degree to which 22q11.2 deletion is associated with postoperative gastrostomy and/or tracheostomy after repair of tetralogy of Fallot.

Design:
Retrospective cohort study.

Setting:
Pediatric Health Information System.

Patients:
Children undergoing complete repair of tetralogy of Fallot (ventricular septal defect closure and relief of right ventricular outflow tract obstruction) from 2003 to 2016. Patients were excluded if they had pulmonary atresia, other congenital heart defects, and/or genetic diagnoses other than 22q11.2 deletion.

Measurements and Main Results:
Two groups were formed on the basis of 22q11.2 deletion status. Outcomes were postoperative tracheostomy and postoperative gastrostomy. Bivariate analysis and Kaplan-Meier analysis at 150 days postoperatively were performed. There were 4,800 patients, of which 317 (7%) had a code for 22q11.2 deletion. There were no significant differences between groups for age at surgery or sex. Patients with 22q11.2 deletion had significantly higher rates of gastrostomy (18% vs 5%; p < 0.001) and higher rates of tracheostomy (7% vs 1%; p < 0.001); there was no difference for mortality. Kaplan-Meier analyses also showed higher rates of gastrostomy (p = 0.024) and tracheostomy (p = 0.037).

Conclusions:
The present study establishes rates of postoperative gastrostomy and tracheostomy in children with 22q11.2 deletion after complete repair of tetralogy of Fallot. These data are useful to clinicians for providing families with preoperative counseling.
Deep Convolutional Neural Network–Based Diagnosis of Anterior Cruciate Ligament Tears
Authors: Germann Christoph , Marbach Giuseppe , Civardi Francesco , Fucentese Sandro F. , Fritz Jan , Sutter Reto , Pfirrmann Christian W.A. , Fritz Benjamin 
Published: March 2020

Objectives
The aim of this study was to clinically validate a Deep Convolutional Neural Network (DCNN) for the detection of surgically proven anterior cruciate ligament (ACL) tears in a large patient cohort and to analyze the effect of magnetic resonance examinations from different institutions, varying protocols, and field strengths.

Materials and Methods
After ethics committee approval, this retrospective analysis of prospectively collected data was performed on 512 consecutive subjects, who underwent knee magnetic resonance imaging (MRI) in a total of 59 different institutions followed by arthroscopic knee surgery at our institution. The DCNN and 3 fellowship-trained full-time academic musculoskeletal radiologists evaluated the MRI examinations for full-thickness ACL tears independently. Surgical reports served as the reference standard. Statistics included diagnostic performance metrics, including sensitivity, specificity, area under the receiver operating curve (“AUC ROC”), and kappa statistics. P values less than 0.05 were considered to represent statistical significance.

Results
Anterior cruciate ligament tears were present in 45.7% (234/512) and absent in 54.3% (278/512) of the subjects. The DCNN had a sensitivity of 96.1%, which was not significantly different from the readers (97.5%–97.9%; all P ≥ 0.118), but significantly lower specificity of 93.1% (readers, 99.6%–100%; all P < 0.001) and “AUC ROC” of 0.935 (readers, 0.989–0.991; all P < 0.001) for the entire cohort. Subgroup analysis showed a significantly lower sensitivity, specificity, and “AUC ROC” of the DCNN for outside MRI (92.5%, 87.1%, and 0.898, respectively) than in-house MRI (99.0%, 94.4%, and 0.967, respectively) examinations (P = 0.026, P = 0.043, and P < 0.05, respectively). There were no significant differences in DCNN performance for 1.5-T and 3-T MRI examinations (all P ≥ 0.753, respectively).

Conclusions
Deep Convolutional Neural Network performance of ACL tear diagnosis can approach performance levels similar to fellowship-trained full-time academic musculoskeletal radiologists at 1.5 T and 3 T; however, the performance may decrease with increasing MRI examination heterogeneity.
Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing
Authors: Ferretti Luca , Wymant Chris , Kendall Michelle , Zhao Lele , Nurtay Anel , Abeler-Dörner Lucie , Parker Michael , Bonsall David , Fraser Christophe 
Published: March 2020

AbstractThe newly emergent human virus SARS-CoV-2 is resulting in high fatality rates and incapacitated health systems. Preventing further transmission is a priority. We analysed key parameters of epidemic spread to estimate the contribution of different transmission routes and determine requirements for case isolation and contact-tracing needed to stop the epidemic. We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people. By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society. We discuss the ethical requirements for an intervention of this kind.
Retrospective Analysis of Clinical Features in 101 Death Cases with COVID-19
Authors: Fan Hua , Zhang Lin , Huang Bin , Zhu Muxin , Zhou Yong , Zhang Huan , Tao Xiaogen , Cheng Shaohui , Yu Wenhu , Zhu Liping , Chen Jian 
Published: March 2020

SummaryBackgroundIn December 2019, viral pneumonia outbreaks caused by the novel coronavirus occurred in Wuhan, China, and spread rapidly worldwide, the illness progress of coronavirus disease 2019(COVID-19) in partial patients is rapid and the mortality rate is relatively high. The present study aims to describe the clinical features in the death cases with COVID-19.MethodsIn this single center and observational study, we recruited 101 death cases with COVID-19 from Dec 30, 2019 to Feb 16, 2020 in Intensive Care Unit (ICU) of Wuhan Jinyintan Hospital. Demographics, underlying diseases, X-ray/CT images, possible therapy strategies and test results were collected and analyzed on patients admission to the ICU and 48 hours before deaths.FindingsOf 101 COVID-19 dead cases, 47 patients went directly to the ICU because of critical condition, and 54 patients were transferred to ICU with aggravated condition. Over fifty six percent (56.4%) of patients were laboratory confirmed by RT-PCR, and 43.6% were consistent with clinical diagnostic criteria.Among them, 64 were males and 37 were females, with average age of 65.46 years (SD 9.74). Interestingly, all deaths shwed significant difference in blood type distribution, with 44.44% of type A, 29.29% of type B, 8.08% of type AB, and 18.19% of type O.The clinical manifestations of the novel coronavirus pneumonia are non-specific,the common symptoms included fever (91,,90.10%), cough (69,68.32%) and dyspnea (75,74.26%). Neutrophils, procalcitonin(PCT),C-reactive protein(CRP),and interleukin-6(IL-6), D-dimer gradually increased with progress of the disease. Myocardial enzymes were abnormal in most patients at admission, myocardial damage indicators were significantly increased. Sixty one (60.40%) patients were given antiviral drugs, 59(58.42%),received glucocorticoids, 63.37% were given intravenous immunoglobulins, and 44.55% were treated with thymosin preparations. All patients received antibiotic treatment, 63(62.38%) were given restricted antibiotics, 23(22.78%) were administrated to antifungal drugs. Non-invasive ventilator or high-flow oxygen therapy were given in 84(83.17%) patients, and invasive mechanical ventilation was used in 76.24% patients. The median time from acute respiratory distress syndrome(ARDS) to invasive mechanical ventilation was 3.00 days(IQR 0.00-6.00). The duration of invasive mechanical ventilation was 5 days (IQR2.00-8.00).InterpretationCritical COVID-19 can cause fatal respiratory distress syndrome and multiple organ failure with high mortality. The blood group distribution of the deaths remarkably differred from that of Han population in Wuhan.Heart may be the earliest damaged organ except the lungs. Hospital-acquired pneumonia(HAP) in the later period is worthy of attention.FundingSupported by “the Fundamental Research Funds for the Central Universities (WK9110000037)”.
Development of Reverse Transcription Loop-mediated Isothermal Amplification (RT-LAMP) Assays Targeting SARS-CoV-2
Authors: Park Gun-Soo , Ku Keunbon , Baek Seung-Hwa , Kim Seong Jun , Kim Seung Il , Kim Bum-Tae , Maeng Jin-Soo 
Published: March 2020

AbstractEpidemics of Coronavirus Disease 2019 (COVID-19) now have more than 100,000 confirmed cases worldwide. Diagnosis of COVID-19 is currently performed by RT-qPCR methods, but the capacity of RT-qPCR methods is limited by its requirement of high-level facilities and instruments. Here, we developed and evaluated RT-LAMP assays to detect genomic RNA of SARS-CoV-2, the causative virus of COVID-19. RT-LAMP assays in this study can detect as low as 100 copies of SARS-CoV-2 RNA. Cross-reactivity of RT-LAMP assays to other human Coronaviruses was not observed. We also adapted a colorimetric detection method for our RT-LAMP assay so that the tests potentially performed in higher throughput.
Comprehensive valuation of the ecosystem services of the Arctic National Wildlife Refuge
Authors: Turner Adam C. , Young Margaret A. , McClung Maureen R. , Moran Matthew D. 
Published: March 2020

AbstractEcosystem services (ES) have been well studied in most biomes, but the Arctic tundra has received little attention, despite covering over 10% of terrestrial Earth. Using established ES methodologies, we calculated values for the United States Arctic National Wildlife Refuge, a region virtually undisturbed by humans, but slated for future oil and gas drilling. We estimated the Refuge is worth about 1,709 USD/hectare/year, equal to over 13 billion USD annually.Globally important services, such as climate regulation (e.g., carbon storage) and non-use services (e.g., aesthetic information), contributed the most value and were similar to valuations from more productive ecosystems. Local services made smaller contributions to the total, but they remain vitally important to local indigenous cultures. Strikingly, a contingent valuation survey of U.S. residents found that, after neutral educational information, willingness-to-pay to maintain the Refuge in its current state exceeded estimated values of the oil and gas deposits.Our study shows that citizens may value Arctic habitats beyond their traditional economic development potential. Our comprehensive ecosystem services valuation suggests that maintaining the Refuge in its current condition (i.e.,de factowilderness) with its full range of ES is more valuable to humanity compared to development for oil and gas.
SFRP1 shapes astrocyte to microglia cross-talk in acute and chronic neuroinflammation
Authors: Rueda-Carrasco Javier , Mateo María Inés , Borroto Aldo , Martin-Bermejo María Jesús , Kummer Markus P. , Schwartz Stephanie , López-Atalaya José P. , Alarcon Balbino , Heneka Michael T. , Esteve Pilar , Bovolenta Paola 
Published: March 2020

AbstractNeuroinflammation is a common feature of many neurodegenerative diseases, which fosters a dysfunctional neuron-microglia-astrocyte crosstalk that, in turn, maintains microglial cells into a perniciously reactive state that often enhance neuronal damage. The molecular components that mediate this critical communication are however not fully explored. Here, we have asked whether Secreted-Frizzled-Related-Protein-1 (SFRP1), a multifunctional regulator of cell-to-cell communication, is part of the cellular crosstalk underlying neuroinflammation. We show that in mouse models of acute and chronic neuroinflammation, astrocyte-derived SFRP1 is sufficient to promote and sustain microglial activation, and thus a chronic inflammatory state. SFRP1 allows the upregulation of components of Hypoxia Induced Factors-dependent inflammatory pathway and, to a lower extent, of those downstream of the Nuclear Factor-kappaB. We thus propose that SFRP1 acts as a critical astrocyte to microglia amplifier of neuroinflammation, representing a potential valuable therapeutic target for counteracting the harmful effect of chronic inflammation present in several neurodegenerative diseases.
rePROBE: Workflow for Revised Probe Assignment and Updated Probe-Set Annotation in Microarrays
Authors: Hadlich Frieder , Reyer Henry , Oster Michael , Trakooljul Nares , Muráni Eduard , Ponsuksili Siriluck , Wimmers Klaus 
Published: March 2020

AbstractCommercial and customized microarrays are valuable tools for the analysis of holistic expression patterns, but require the integration of the latest genomic information. This study provides a comprehensive workflow implemented in an R package (rePROBE) to assign the entire probes and to annotate the probe sets based on up-to-date genomic and transcriptomic information. The rePROBE R package is freely available athttps://github.com/friederhadlich/rePROBE. It can be applied to available gene expression microarray platforms and addresses both public and custom databases. The revised probe assignment and updated probe-set annotation were applied to commercial microarrays available for different livestock species,i.e.ChiGene-1_0-st (Gallus gallus, 443,579 probes;18,530 probe sets), PorGene-1_1-st (Sus scrofa, 592,005;25,779) and BovGene-1_0-st (Bos taurus, 530,717;24,759) as well as human (Homo sapiens, HuGene-1_0-st) and mouse (Mus musculus, HT_MG-430_PM) microarrays. Using current specie-specific transcriptomic information (RefSeq, Ensembl and partially non-redundant nucleotide sequences) and genomic information, the applied workflow revealed 297,574 probes for chickens (pig: 384,715; cattle: 363,077; human: 481,168; mouse: 324,942) assigned to 15,689 probe sets (pig: 21,673; cattle: 21,238; human: 23,495; mouse: 32,494). These are representative of 12,641 unique genes that were both annotated and positioned (pig: 15,758; cattle: 18,046; human: 20,167; mouse: 16,335). Additionally, the workflow collects information on the number of single nucleotide polymorphisms (SNPs) within respective targeted genomic regions and thus provides a detailed basis for comprehensive analyses such as quantitative trait locus (eQTL) expression studies to identify quantitative and functional traits.