bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-pharmacological interventions to improve the success of electrical cardioversion in patients with atrial fibrillation
Authors: Nguyen Stephanie T. , Belley-Côté Emilie P. , Lengyel Alexandra , Qiu Yuan , Adli Taranah , Um Kevin J. , Ibrahim Omar , Sibilio Serena , Wong Michael , Benz Alexander , Whitlock Nicola , Acosta J. Gabriel , Healey Jeff S. , McIntyre William F. 
Published: July 2021

Abstract

Background:
Electrical cardioversion (ECV) is a common management strategy for atrial fibrillation (AF). ECV contains multiple modifiable components, including pad size and placement, shock energy, and waveform phases. Guidance on optimal technique, however, is limited. A comprehensive review of interventions used to increase ECV success will guide ideal clinical practice and identify techniques that could be studied in future randomized controlled trials.

Methods:
This review will include RCTs randomized controlled trial and observational studies that compare acute cardioversion success between 2 or more non-pharmacological interventions in patients with AF undergoing ECV. We will search CENTRAL, MEDLINE and EMBASE from inception to present and will also include the grey literature as part of our search. We will assess the risk of bias for each study and summarize the extracted data in a narrative report with a table of findings included.

Results:
Based on a full search strategy developed for MEDLINE along with findings from the grey literature search, the non-pharmacological interventions are expected to include pad placement, shock energy, waveform phases, and manual pressure, among others.

Conclusions:
The objective of this scoping review is to identify and examine the evidence on non-pharmacological interventions to improve electrical cardioversion in patients with AF.
Registered on Open Science Framework: https://osf.io/gdh27/
Quality Improvement Initiative to Improve Endoscopic Reassessment of Eosinophilic Esophagitis
Authors: Khalaf Racha T. , Rosenwald Kent , Zhou Wenru , Pan Zhaoxing , Kramer Robert E. , Menard-Katcher Calies 
Published: July 2021

Background:
The eosinophilic esophagitis (EoE) endoscopic reference score (EREFS) is a validated system for description, recognition, and reporting of EoE findings during esophagogastroduodenoscopy (EGD). This scoring system correlates with esophageal eosinophilia and therapeutic responses and has validated diagnostic accuracy with good inter- and intraobserver reliability in pediatric and adult patients. In this study, we aimed to improve physician education on and documentation of EREFS and correlate EREFS scoring with eosinophil density on histology.

Methods:
Applying the “Plan, Do, Study, Act” methodology for quality improvement between October 2018 and November 2019, we established a baseline rate of EREFS completion by review of the electronic medical record (EMR). Key drivers were identified, and 3 interventions were implemented.

Results:
Over 12 months, 542 distinct endoscopies were performed on 410 patients for EoE surveillance. Patients were 68% male with a mean age of 10.9 years (SD 5.7 years), mean EREFS score of 2.14 (SD 1.88), and mean peak eosinophil count 30.9 eos/hpf (SD 37.1 eos/hpf). Baseline EREFS completion rate of 72.7% (90% CI, 67.4-77.4). Following all 3 PDSA cycles, EREFS completion rate significantly improved to greater than desired target of 90% (94.9%; 90% CI, 90.6-97.6; P < 0.001).

Conclusion:
Interventions including provider education and the inclusion of EREFS in documentation templates can increase adoption rates of EREFS among providers caring for patients with known EoE.
Racial Disparities in the Surgical Management of Benign Craniomaxillofacial Bone Lesions
Authors: Phillips Sarah J. , Reategui Alvaro , Peck Connor J. , Ibrahim Giovanni , Lopez Joseph , Steinbacher Derek M. 
Published: July 2021

Purpose:
Racial disparities can influence surgical care in the United States. The purpose of this study was to determine if race and ethnicity were independent risk factors for adverse 30-day outcomes after surgical management of benign craniomaxillofacial bone tumors.

Methods:
This was a retrospective cohort study from 2012 to 2018 National Surgical Quality Improvement Program databases. Patients undergoing surgical removal of craniomaxillofacial benign lesions based on Current Procedural Terminology and International Classification of Diseases codes were included. Patients who had unrelated concurrent surgeries, or malignant, skull-based or soft tissue lesions were excluded. Primary outcomes were surgical complications and hospital length of stay (LOS). Univariate analyses were used with race as the independent variable to identify predictors of primary outcomes. Statistically significant factors were added to a multivariable logistic regression model.

Results:
This study included 372 patients. Postoperative complications were highest among Black patients, who had a 4-fold increase in minor complications (P = 0.023) and over a 6-fold increase in major complications (P = 0.008) compared to White patients. Black patients also had a mean increase of 2.3 days in LOS compared to White patients (P < 0.001). The multivariate regression model showed higher rates of major complications and longer LOS for Black patients (P = 0.003, P = 0.006, respectively).

Conclusions:
Even when controlling for other variables, Black race was an independent risk factor for major complications and increased LOS. Further research should seek to identify the root cause of these findings in order to ensure safe and equitable surgery for all patients, regardless of race or ethnicity.
Comparisons of Intracranial Volume and Cephalic Index After Correction of Sagittal Craniosynostosis With Either Two or Three Springs
Authors: Fischer Sara , Maltese Giovanni , Tarnow Peter , Wikberg Emma , Søfteland Madiha Bhatti , Kölby Lars 
Published: July 2021

Abstract
In this retrospective study, the authors determined changes in intracranial volume (ICV) and cephalic index (CI) in patients with sagittal craniosynostosis and operated with craniotomy combined with either 2 or 3 springs. The authors included patients (n = 112) with complete follow-up that had undergone surgical correction for isolated sagittal craniosynostosis with craniotomy combined with springs between 2008 and 2017. All patients underwent computed tomography examination preoperative, at the time of spring extraction, and at 3 years of age. Intracranial volume was measured using a semiautomatic MATLAB program, and CI was calculated as the width/length of the skull. The authors found that craniotomy combined with 2 springs increased the ICV from a preoperative value of 792 ± 113 mL (mean ± standard deviation) to 1298 ± 181 mL at 3 years of age and increased the CI from 72.1 ± 4.1 to 74.6 ± 4.3, whereas craniotomy combined with 3 springs increased the ICV from 779 ± 128 mL to 1283 ± 136 mL and the CI from 70.7 ± 4.3 to 74.8 ± 3.7. The relative increase in ICV was 65 ± 21% in the two-spring group and 68 ± 34% in the three-spring group (P value = 0.559), and the relative increase in CI was 3.6 ± 3.3% in the two-spring group as compared with 6.0 ± 5.0% in the three-spring group (P = 0.004). These findings demonstrated that use of 3 springs resulted in additional absolute and relative CI-specific effects as compared with 2 springs during the time when the springs were in place, with this effect maintained at 3 years of age.
How to Learn a Complex Endoscopic Procedure: Knots in Transanal Endoscopic Surgery: Different Skill Among Surgeons
Authors: Serra-Aracil Xavier , Gracia-Roman Raquel , Badía-Closa Jesus , Mora-Lopez Laura , Pallisera-Lloveras Anna , Serra-Pla Sheila , Garcia-Nalda Albert , Navarro-Soto Salvador 
Published: July 2021

Purpose:
The intrarectal suture is considered a high technically complex procedure. The study’s objectives were to assess the feasibility of making an intrarectal knot, through an in vitro study and assessing whether the video tutorial facilitates learning.

Materials and Methods:
A detailed description of the technique. A comparative observational cross-sectional study in surgeons with no previous experience in intrarectal knots.

Results:
Twenty-one of these 32 participants passed the intrarectal knot test without video tutorial (T1) (65.6%), and 26 (81.2%) after the video tutorial (T2) (P=0.26). The mean time taken to tie the knot fell from 74 seconds (SD=46) in T1 to 41 seconds (SD=41) in T2 (P<0.001). At T1, 26 participants (81.3%) described the technique as difficult, but only 7 (21.9%) at T2 (P<0.001).

Conclusions:
Performing the intrarectal knot suture is feasible. Despite the technical difficulty, the video tutorial is sufficient for surgeons to learn the technique.
Long-term survival in high-risk older adults following emergency general surgery admission
Authors: Guttman Matthew P. , Tillmann Bourke W. , Nathens Avery B. , Saskin Refik , Bronskill Susan E. , Huang Anjie , Haas Barbara 
Published: July 2021

BACKGROUND
Emergency general surgery (EGS) conditions are increasingly common among nursing home residents. While such patients have a high risk of in-hospital mortality, long-term outcomes in this group are not well described, which may have implications for goals of care discussions. In this study, we evaluate long-term survival among nursing home residents admitted for EGS conditions.

METHODS
We performed a population-based, retrospective cohort study of nursing home residents (65 years or older) admitted for one of eight EGS diagnoses (appendicitis, cholecystitis, strangulated hernia, bowel obstruction, diverticulitis, peptic ulcer disease, intestinal ischemia, or perforated viscus) from 2006 to 2018 in a large regional health system. The primary outcome was 1-year survival. To ascertain the effect of EGS admission independent of baseline characteristics, patients were matched to nursing home residents without an EGS admission based on demographics and baseline health. Kaplan-Meier analysis was used to evaluate survival across groups.

RESULTS
A total of 7,942 nursing home residents (mean age, 85 years) were admitted with an EGS diagnosis and matched to controls. One quarter of patients underwent surgery, and 18% died in hospital. At 1 year, 55% of cases were alive, compared with 72% of controls (p < 0.001). Among those undergoing surgery, 61% were alive at 1 year, compared with 72% of controls (p < 0.001). The 1-year survival probability was 57% in patients who did not require mechanical ventilation, 43% in those who required 1 to 2 days of ventilation, and 30% in those who required ≥3 days of ventilation.

CONCLUSION
Although their risk of in-hospital mortality is high, most nursing home residents admitted for an EGS diagnosis survive at least 1 year. While nursing home residents presenting with an EGS diagnosis should be cited realistic odds for the risk of death, long-term survival is achievable in the majority of these patients.

LEVEL OF EVIDENCE
Epidemiological, level III.
Identification of unique microRNA expression patterns in bone marrow hematopoietic stem and progenitor cells after hemorrhagic shock and multiple injuries in young and old adult mice
Authors: Darden Dijoia B. , Mira Juan C. , Lopez Maria-Cecilia , Stortz Julie A. , Fenner Brittany P. , Kelly Lauren S. , Nacionales Dina C. , Budharaju Ashrita , Loftus Tyler J. , Baker Henry V. , Moore Frederick A. , Brakenridge Scott C. , Moldawer Lyle L. , Mohr Alicia M. , Efron Philip A. 
Published: July 2021

BACKGROUND
After severe trauma, the older host experiences more dysfunctional hematopoiesis of bone marrow (BM) hematopoietic stem and progenitor cells (HSPCs), and dysfunctional differentiation of circulating myeloid cells into effective innate immune cells. Our main objective was to compare BM HSPC microRNA (miR) responses of old and young mice in a clinically relevant model of severe trauma and shock.

METHODS
C57BL/6 adult male mice aged 8 to 12 weeks (young) and 18 to 24 months (old) underwent multiple injuries and hemorrhagic shock (polytrauma [PT]) that engenders the equivalent of major trauma (Injury Severity Score, >15). Pseudomonas pneumonia (PNA) was induced in some young and old adult mice 24 hours after PT. MicroRNA expression patterns were determined from lineage-negative enriched BM HSPCs isolated from PT and PT-PNA mice at 24 and 48 hours postinjury, respectively. Genome-wide expression and pathway analyses were also performed on bronchoalveolar lavage (BAL) leukocytes from both mouse cohorts.

RESULTS
MicroRNA expression significantly differed among all experimental conditions (p < 0.05), except for old-naive versus old-injured (PT or PT-PNA) mice, suggesting an inability of old mice to mount a robust early miR response to severe shock and injury. In addition, young adult mice had significantly more leukocytes obtained from their BAL, and there were greater numbers of polymorphonuclear cells compared with old mice (59.8% vs. 2.2%, p = 0.0069). Despite increased gene expression changes, BAL leukocytes from old mice demonstrated a more dysfunctional transcriptomic response to PT-PNA than young adult murine BAL leukocytes, as reflected in predicted upstream functional pathway analysis.

CONCLUSION
The miR expression pattern in BM HSPCs after PT (+/−PNA) is dissimilar in old versus young adult mice. In the acute postinjury phase, old adult mice are unable to mount a robust miR HSPC response. Hematopoietic stem and progenitor cell miR expression in old PT mice reflects a diminished functional status and a blunted capacity for terminal differentiation of myeloid cells.
Levosulpiride Relieved Persistent Hiccups in a Patient With COVID-19 and Vascular Cognitive Impairment
Authors: Chiquete Erwin , Toapanta-Yanchapaxi Liz , Aceves-Buendía José Jesús , Ruiz-Ruiz Eduardo , Rodríguez-Perea Elizabeth , Durán-Coyote Salvador , Cantú-Brito Carlos 
Published: July 2021

Background
The coronavirus disease 2019 (COVID-19) is a systemic illness that implies neurological features and complications. Persistent (>48 hours) hiccups (ie, singultus or hiccoughs) have been recently described as a rare presentation of COVID-19. Even when considered benign, the frequency and duration of hiccup spells can be burdensome and sometimes difficult to treat.

Case Presentation
We report the case of a 62-year-old man known by the treating physicians for vascular cognitive impairment, who consulted for progressive persistent hiccups that commenced 5 days earlier, about 24 hours after testing positive for the severe acute respiratory syndrome coronavirus 2 by real-time reverse transcription polymerase chain reaction. The patient could barely sleep because the hiccups reached the highest rate of 47 per minute in a spell lasting almost 72 hours. The patient initially received levomepromazine 25 mg by mouth, but sedation and delirium impeded the continuation of treatment, which only reduced the frequency of the hiccup spells by about 25%. Afterward, the patient was offered levosulpiride 25 mg thrice a day by mouth, resulting in a steady reduction in the hiccups rate, as well as the duration and daily frequency of spells, which disappeared after 3 days of levosulpiride treatment. COVID-19 pneumonia was moderate by chest computed tomography scan imaging and biomarkers, meriting continuous oxygen therapy, dexamethasone 6 mg once a day by mouth for 10 days, and enoxaparin 40 mg once a day, subcutaneously, for 7 days (due to elevated D-dimer serum concentration). Oxygen therapy was gradually withdrawn after 12 days.

Conclusions
Oral levosulpiride is a suitable option in persistent hiccups that occur in patients with COVID-19 pneumonia. To our knowledge, this is the fourth published case of persistent hiccups as a clinical feature of COVID-19.
Rapid vigilance and episodic memory decrements in COVID-19 survivors
Authors: Zhao Sijia , Shibata Kengo , Hellyer Peter J. , Trender William , Manohar Sanjay , Hampshire Adam , Husain Masud 
Published: July 2021

AbstractRecent studies indicate that COVID-19 infection can lead to serious neurological consequences in a small percentage of individuals. However, in the months following acute illness, many more suffer from fatigue, low motivation, disturbed mood, poor sleep and cognitive symptoms, colloquially referred to as ‘brain fog’. But what about individuals who had asymptomatic to moderate COVID-19 and report no concerns after recovering from COVID-19? Here we examined a wide range of cognitive functions critical for daily life (including sustained attention, memory, motor control, planning, semantic reasoning, mental rotation and spatial-visual attention) in people who had previously suffered from COVID-19 but were not significantly different from a control group on self-reported fatigue, forgetfulness, sleep abnormality, motivation, depression, anxiety and personality profile. Reassuringly, COVID-19 survivors performed well in most abilities tested, including working memory, executive function, planning and mental rotation. However, they displayed significantly worse episodic memory (up to 6 months post-infection) and greater decline in vigilance with time on task (for up to 9 months). Overall, the results show that specific chronic cognitive changes following COVID-19 are evident on objective testing even amongst those who do not report a greater symptom burden. Importantly, in the sample tested here, these were not significantly different from normal after six-nine months, demonstrating evidence of recovery over time.
A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia
Authors: Carabali Mabel , Schmidt Alexandra M. , Restrepo Berta N. , Kaufman Jay S. 
Published: July 2021

AbstractThe spatial distribution of surveillance-reported dengue cases and severity are usually analyzed separately, assuming independence between the spatial distribution of non-severe and severe cases. Given the availability of data for the individual geo-location of surveillance-notified dengue cases, we conducted a spatial analysis to model non-severe and severe dengue simultaneously, using a hierarchical Bayesian model. We fit a joint model to the spatial pattern formed by dengue cases as well as to the severity status of the cases. Results showed that age and socioeconomic status were associated with dengue presence, and there was evidence of clustering for overall cases but not for severity. Our findings inform decision making to address the preparedness or implementation of dengue control strategies at the local level.HighlightsA model to jointly assess the spatial distribution of reported dengue and severity.We account for uncertainty in the surveillance-reported dengue while modelling severe cases.We assess spatial clustering of dengue and severe dengue cases in Medellin.Non-monotonic distribution of reported dengue cases across socioeconomic status.
Forward Entrainment: Evidence, Controversies, Constraints, and Mechanisms
Authors: Saberi Kourosh , Hickok Gregory 
Published: July 2021

AbstractWe define forward entrainment as that part of the entrainment process that outlasts the entraining stimulus. In this study, we examine conditions under which one may or may not observe forward entrainment. In part 1, we review and evaluate studies that have observed forward entrainment using a variety of psychophysical methods (detection, discrimination and reaction times), different target stimuli (tones, noise, gaps), different entraining sequences (sinusoidal, rectangular or sawtooth waveforms), a variety of physiological measures (MEG, EEG, ECoG, CSD), in different modalities (auditory and visual), across modalities (audiovisual and auditory-motor), and in different species. In part 2, we review those studies that have failed to observe forward entrainment, with emphasis on evaluating the methodological and stimulus design differences that may clarify the contrasting findings across these two classes of studies. In part 3, we describe those experimental conditions under which we ourselves have failed to observe forward entrainment, and provide new data on use of complex envelope patterns as entraining stimuli, show data on intersubject variability, and provide new findings on psychometric functions that characterize the strength of forward entrainment at different SNRs. In part 4 we theorize on potential mechanisms, describe how neurophysiological and psychophysical studies approach the study of entrainment, and caution against drawing direct causal inferences between the two without compelling evidence beyond correlative measures.
Anthropometric measurements as predictors of hypertension in Busia, Vihiga, Trans Nzoia and Siaya counties of Western Kenya
Authors: Andale Thomas , Orango Vitalis , Lwande Gerald O. , Mwaura Grace W. , Mugo Richard , Limo Obed K. , Mwangi Ann , Kamano Jemima H. 
Published: July 2021

ABSTRACTEmerging data suggest a rise in the incidence rate of hypertension in many countries within Sub-Saharan Africa. This has been attributed to socioeconomic factors that have influenced diet and reduced physical activity further deranging anthropometric measurements. We assessed the predictive power of three anthropometric indicators namely: waist circumference (WC), waist to height ratio (WHtR) and body mass index (BMI) in detecting hypertension. This cross-sectional community survey was conducted in four counties within Western Kenya between October 2018 to April 2019 among 3594 adults. The participants’ sociodemographic data were collected using an interviewer-administered questionnaire and anthropometric measurements taken. We used the R-software for descriptive and inferential statistical analysis. Pearson chi-square test was used to assess the association between anthropometric measurements and hypertension while logistic regressions estimated the likelihood of hypertension. Youden method was used to identify optimal anthropometric cut-offs for sensitivity, specificity and area under the receiver operating characteristics (ROC) curve computation. The crude prevalence of hypertension was 23.3%, however it rose with advancement in age. Furthermore, obese individuals had a three-fold (AOR=2.64; 95% CI: 2.09, 3.35) increased likelihood of hypertension compared to those with a normal BMI. The optimal WC cut-off was 82.5cm for men and 87cm for women, an optimal WHtR of 0.47 for men and 0.55 for women; while the optimal BMI cut-off was 23.7 kg/m2 and 22.6 kg/m2 for men and women respectively. The sensitivity of WC, WHtR and BMI for men was 0.60, 0.65 and 0.39 respectively and 0.71, 0.65 and 0.78 respectively for women. BMI is the best predictor for hypertension among women but a poor predictor for men; WC had a high hypertension predictive power for both gender while WHtR is the best hypertension predictor for men.