bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clusters Across Multiple Domains of Health-Related Quality of Life Reveal Complex Patient Outcomes After Subarachnoid Hemorrhage
Authors: Murphy Julianne , Shin Hye Jung , Wang Hanyin , Luo Yuan , Jahromi Babak , Bleck Thomas P. , Cella David , Naidech Andrew M. 
Published: September 2021

OBJECTIVES:
Patients with aneurysmal subarachnoid hemorrhage (ruptured brain aneurysm) often have reduced health-related quality of life at follow-up in multiple domains (e.g., cognitive function and social function). We tested the hypothesis that there are distinct patterns of patient outcomes across domains of health-related quality of life, “complex patient outcomes,” in survivors of subarachnoid hemorrhage.

DESIGN:
Patients with subarachnoid hemorrhage were prospectively identified. Clinical data were prospectively recorded. Health-related quality of life was prospectively assessed at 3-month follow-up using the National Institutes of Health Patient Reported Outcomes Measurement Information System and neuro-quality of life in the domains of mobility, cognitive function, satisfaction with social roles, and depression. We used k-means clustering to analyze prospectively recorded health-related quality of life data, identifying clusters of complex patient outcomes. Decision tree analysis identified index hospital stay factors predictive of a patient having a particular complex patient outcome at follow-up.

SETTING:
Academic medical center.

PATIENTS:
One hundred three survivors of subarachnoid hemorrhage.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We analyzed 103 patients, of whom 75 (72.8%) were female, and mean age was 53.6 ± 13.4 years. There were three complex patient outcomes: health-related quality of life greater than 1 sd better than the U.S. mean across all domains (n = 23, 22.3%), health-related quality of life greater than 1 sd worse than U.S. mean across all domains (n = 26, 25.2%), and satisfaction with social roles greater than 0.5 sd worse than U.S. mean with cognitive function, depression, and mobility scores near the U.S. mean (n = 54, 52.4%). In decision tree analysis, hospital disposition and Hunt and Hess Grade were associated with complex patient outcome.

CONCLUSIONS:
Complex patient outcomes across multiple domains of health-related quality of life at follow-up after subarachnoid hemorrhage are distinct and may be predictable.
Virtual Reality to Improve Sequelae of the Postintensive Care Syndrome: A Multicenter, Randomized Controlled Feasibility Study
Authors: Vlake Johan H. , Van Bommel Jasper , Wils Evert-Jan , Korevaar Tim I. M. , Bienvenu O. Joseph , Klijn Eva , Gommers Diederik , van Genderen Michel E. 
Published: September 2021

OBJECTIVES:
Psychologic sequelae after critical illness, part of the postintensive care syndrome, significantly decrease quality of life. A robustly effective treatment intervention is currently lacking. Virtual reality has beneficial effects on several non-ICU–related psychologic disorders. The aim of this study was to explore patient-related determinants of ICU-specific virtual reality, such as the timing of patients’ self-reported readiness to initiate virtual reality and the number of desired sessions and safety, and to explore the effects of ICU-specific virtual reality on mental health.

DESIGN:
A multicenter, randomized controlled feasibility study.

SETTING:
ICU at a university teaching hospital and a secondary care hospital in Rotterdam, The Netherlands.

PATIENTS:
Consecutive mechanically ventilated patients with sepsis or septic shock.

INTERVENTIONS:
Patients were randomly assigned (1:1) to receive ICU-specific virtual reality (ICU-specific virtual reality group) or exposure to a nature virtual reality environment (control virtual reality group).

MEASUREMENT AND MAIN RESULTS:
Explorative outcomes were feasibility, in terms of patient-related determinants, and safety. The effects of ICU-specific virtual reality on the psychologic components of postintensive care syndrome and quality of life were additionally studied. Fifty patients (median age: 61 yr; 21 [42%] female) were included. Patients in the ICU-specific virtual reality group felt ready to initiate the virtual reality intervention 10 days (median, 95% range, 5–21 d) after ICU discharge, and one session (median, 95% range, 1–6) was desired. ICU-specific virtual reality patients experienced higher immersion, cybersickness scores were low, and no changes in vital signs were observed. They also reported reduced posttraumatic stress disorder and depression scores and better mental health from 2 days until 1 month after initial exposure (Short Form-12 Mental Component Scale: ICU-specific virtual reality, 57 [36–67] vs control virtual reality, 47 [26–63]; p < 0.01). Six months after exposure, this effect was still present for posttraumatic stress disorder and depression, but not for mental quality of life.

CONCLUSIONS:
ICU-specific virtual reality is a feasible and acceptable novel intervention that could be used during recovery from an episode of critical illness in the ICU. A future, adequately powered study should confirm whether virtual reality is able to improve mental health and quality of life.
Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits
Authors: Sánchez-García Octavio , López-Juárez Rhode , Corona-Quintanilla Dora Luz , Ruiz Ángeles Carrasco , Martínez-Gómez Margarita , Cuevas-Romero Estela , Castelán Francisco 
Published: September 2021

Abstract

Objective:
To determine the estrogen-dependency of the bladder and urethral function and the coordinated activation of pelvic floor muscles (PFM) during micturition.

Methods:
We allocated age-matched female rabbits to control, 1-month ovariectomized (OVX), and OVX plus 2-week estradiol benzoate (EB) groups to record cystometry, urethral pressure, and electromyograms of bulbospongiosus (Bsm), and pubococcygeus muscles (Pcm) simultaneously. We also measured serum estradiol levels and myofiber cross-sectional area. We assessed urodynamic and urethral variables, categorized the Bsm-Pcm activation patterns at storage and voiding phases, and obtained the power spectrum density of muscle activation around the voiding phase. We investigated the influence of ovarian hormones, in general, and the contribution of estrogen, particularly on the functions of the bladder, urethra, and PFM. Statistical significance was set at P < 0.05.

Results:
Ovarian hormones influence the bladder, urethral, and PFM functions. The urodynamics analyses indicated estrogens contribute to voiding duration and, to a lesser extent, to the time between bladder contractions. Urethral pressure at closure (maximal pressure-to-maximal urethral pressure ratio) improved partially (8%, P < 0.05) in the OVX plus 2-week estradiol benzoate compared with OVX, but urethral resistance increased (∼1.9-fold, P < 0.05) compared with control rabbits. Our findings support that Pcm activity at voiding is estrogen-sensitive, albeit EB administration reduced it at storage resume, which relates to high urethral resistance.

Conclusions:
Ovariectomy impairs bladder and urethral pressures and Bsm and Pcm activation at micturition in anesthetized rabbits. Estrogen administration partially reverts some of these effects and influences Pcm activation.
Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study
Authors: Su Huimin , Jiang Chaoqiang , Zhang Weisen , Zhu Feng , Jin Yali , Cheng Karkeung , Lam Taihing , Xu Lin 
Published: September 2021

Abstract

Objective:
To examine the associations of natural menopausal age with cardiovascular disease risk factors and whether the associations varied by parity in older Chinese women.

Methods:
Information of demographic characteristics, lifestyles, and reproductive factors was collected by face-to-face interview. Framingham Risk Score was used as an indicator of cardiovascular disease risk, with a score ≥ 10% considered as high cardiovascular disease risk (vs low, dichotomous). Multivariable logistic and linear regressions were used to examine the associations of menopausal age with cardiovascular disease risk factors.

Results:
Of 18,339 women aged 50+ years, the average (standard deviation) age was 61.8 (6.9) years. Compared with women with menopausal age of 45 to 54 years, after adjustment for multiple potential confounders, women with menopausal age <45 years or ≥55 years had higher Framingham Risk Score (0.93%, 95% confidence interval: 0.40-1.46, and 0.69%, 95% confidence interval: 0.18-1.20, respectively). Women with menopausal age <45 or ≥55 years had higher odds of high cardiovascular disease risk (vs low) (odds ratio [95% confidence interval]:1.26 (1.10-1.44) and 1.17 (1.02-1.33), respectively). The associations of menopausal age with the Framingham Risk Score varied by parity (P for interaction ≤0.001). The Framingham Risk Score was higher in those with one to three parity (<45 y: 1.01 [0.43-1.59]; ≥55 y: 1.14 [0.60-1.68]) and lower for parity ≥4 (<45 y: −0.33 [−1.84 to 1.18]; ≥55 y: −2.02 [−3.82 to −0.22]). In nulliparous women, the Framingham Risk Score was highest in menopausal age <45 years (3.97 [1.67-6.26]), but the differences were nonsignificant in menopausal age ≥55 years (0.66 [−1.38 to 2.71]).

Conclusions:
Both early and late natural menopausal ages were associated with a higher cardiovascular disease risk, and the associations were stronger in those with lower parity.

Video Summary:

http://links.lww.com/MENO/A813.
The impact of the COVID-19 pandemic on infant and toddler development
Authors: Imboden Annie , Sobczak Bernadette K. , Griffin Valerie 
Published: September 2021

ABSTRACT

Background:
The COVID-19 pandemic has created new cultural norms with pervasive societal implications. Families have experienced a heightened amount of physical, psychological, emotional, and financial stress. Infants and children living with stress have the potential for delayed developmental milestones, difficulty with emotional regulation, and social or behavioral issues.

Purpose:
This study aims to determine if the pandemic has affected developmental outcomes in infants and toddlers.

Methodology:
Prepandemic and postpandemic developmental (ASQ-3) scores were obtained from charts of 1,024 patients (6, 12, 18, 24, and 36 months) from two pediatric practices.

Results:
There were no significant differences in prepandemic and postpandemic ASQ-3 scores for the overall sample. Age-group analysis showed statistically significant differences in domain scores. Postpandemic problem-solving scores decreased among 6-month-olds while increasing among 24-month-olds. Categorization by score interpretation categories showed a slight decrease in postpandemic scores in the communication domain among 6- and 12-month-olds.

Conclusions:
The pandemic has the potential to affect childhood development. However, the results of this study are reassuring, showing only slight differences in developmental scores prepandemic versus postpandemic. More studies are needed to establish causation and possible trends in future developmental trajectories.

Implications:
An increased focus on communication screening and promotion of language and communication skills in young children postpandemic is needed. Education about the importance of parent–child engagement, nurturing relationships, opportunities for free-play and exploration, and caregiver support and stress reduction will continue to be of paramount importance.
Alcohol-Based Hand Rub Consumption and World Health Organization Hand Hygiene Self-Assessment Framework: A Comparison Between the 2 Surveillances in a 4-Year Region-Wide Experience
Authors: Garlasco Jacopo , Vicentini Costanza , Emelurumonye Ifeoma Nneka , D’Alessandro Giulia , Quattrocolo Francesca , Zotti Carla Maria 
Published: September 2021

Objectives
Hand hygiene is essential for infection prevention. In Piedmont (Northwest Italy), hand hygiene is routinely monitored through 2 surveillance systems, the World Health Organization Hand Hygiene Self-Assessment Framework (HHSAF) and alcohol-based hand rub (ABHR) consumption. This study was aimed at (1) comparing the results of these surveillances, investigating the consistence of the 2 systems and (2) inquiring whether organizational differences among healthcare facilities significantly affected hand hygiene performances.

Methods
A retrospective analysis was performed on data collected annually from 2015 to 2018 for both surveillances from 40 hospitals of the region: HHSAF score (500 points maximum) and ABHR consumption in milliliters per patient-day (mL/PD) were considered. Logistic regression models were built to evaluate possible correlations between these variables, and observations were clustered considering both variables to identify whether groups with significant differences could be discerned. A tree-structured partitioning model was used to confirm the obtained results.

Results
A positive correlation was observed between HHSAF score and odds of belonging to the high ABHR consumption group, particularly for cutoffs set to 19 to 23 mL/PD (P = 0.033 for 23 mL/PD). Two ABHR consumption peaks were identified at approximately 10 and 22 mL/PD, corresponding to median HHSAF scores of 353.75 and 375 points, respectively. The group with better performances was mainly composed of hub hospitals (with single-hospital management).

Conclusions
The 2 surveillance systems are consistent, and the HHSAF score could work as a reasonable predictor of hand hygiene compliance in healthcare settings. Different management characteristics are crucial in creating a more/less favorable environment for hand hygiene compliance and infection prevention.
COVID-19 Vaccine Hesitancy Among PLWH in South India: Implications for Vaccination Campaigns
Authors: Ekstrand Maria L. , Heylen Elsa , Gandhi Monica , Steward Wayne T. , Pereira Matilda , Srinivasan Krishnamachari 
Published: September 2021

Background:
The global effort to end the Severe Acute Respiratory Syndrome - Coronavirus 2 pandemic will depend on our ability to achieve a high uptake of the highly efficacious vaccines in all countries. India recently experienced an unprecedented transmission surge, likely fueled by a premature reopening, the highly transmissible delta variant, and low vaccination rates. Indian media have reported high degrees of vaccine hesitancy, which could interfere with efforts to prevent future surges, making it crucial to better understand the reasons for such reluctance in vulnerable populations, such as people living with HIV.

Methods:
We conducted telephone interviews with 438 people living with HIV who were participants in a longitudinal cohort, designed to examine and validate novel antiretroviral therapy ART adherence measures. Interviews were conducted in January and February 2021 and covered COVID-19–related questions on confidence in vaccine safety and efficacy, worries of vaccine side effects, trust in COVID-19 information from specific sources, and intent to get vaccinated.

Results:
Over one-third of participants (38.4%, n = 168) met our definition of “vaccine hesitant” by reporting being either unlikely to get vaccinated at all or wanting to wait. Vaccine hesitancy was associated with lack of confidence in vaccine safety, concerns about side effects and efficacy, and distrust in common sources of vaccine-related information.

Discussion:
These results highlight several challenges for vaccination efforts. Campaigns may benefit from using trusted sources, including antiretroviral therapy center staff, providing clear information about safety and efficacy and emphasizing the role of vaccines in preventing severe disease, hospitalizations and death, and the reduction of forward transmission to unvaccinated household members.
High-Density Fat Grafting Assisted Stromal Vascular Fraction Gel in Facial Deformities
Authors: Cao Zhe , Li Hui , Wang Zhen Hua , Liang Xiao-Qin 
Published: September 2021

Abstract
Autologous fat grafting is commonly used for soft tissue augmentation and reconstruction, this technique is limited by a high rate of graft absorption. The stromal vascular fraction gel (SVF-gel) grafting for facial volume augmentation can exert a positive effect on skin rejuvenation, but its major limitation is the low rate of conversion of Coleman fat. The purpose of our study was to investigate a novel surgery using performing high-density fat in combination with SVF-gel in the treatment of hemifacial atrophy, or Romberg diseases. From October 2017 to October 2019, 13 patients with hemifacial atrophy underwent high-density fat transfer with SVF-gel injection. The outcome was determined by the difference in presurgery and postsurgery FACE-Q modules (FACE-Q conceptual framework: 1, Satisfaction with Facial Appearance; 2, Health-Related Quality of Life; 3, Negative Sequelae; 4, Satisfaction with Process of Care), which were designed as patient-reported outcome instrument to evaluate the unique outcomes of patients undergoing facial cosmetic procedures.
The excellent cosmetic results were observed during follow-up periods, with no adverse events was seen in the treatment group. All patients showed improvements in facial augmentation and contour. In patients with facial volume loss, high-density fat transfer with SVF-gel facial injection resulted in significantly higher improvement scores and better patient satisfaction. The patient-reported FACE-Q modules presurgery and postsurgery results showed statistically significant improvement (P < 0.05). This high-density fat in combination with SVF-gel is an effective method of correcting the facial volume loss that leave no complications during follow-up, having a satisfactory volumization effect. This could largely facilitate the clinical utilization of fat.
Muscle Flap Reconstruction Based on Muscle Tension Line Groups to Repair the Philtrum of Patients With Microform Cleft Lip or Secondary Cleft Lip
Authors: Jiang Chanyuan , Zheng Yilue , Ma Hengyuan , Yin Ningbei 
Published: September 2021

Abstract
The muscle flap reconstruction technique was developed based on the concept of muscle tension line groups, which elucidates how nasolabial muscle tension helps maintain the shape of the philtrum. To investigate the operative effect, we reviewed 43 patients with microform cleft lip and 102 patients with secondary cleft lip treated with muscle flap reconstruction between January 2018 and June 2020. The patients were scanned using the digital three-dimensional stereophotogrammetry face system pre- and post-operatively, and comparative analysis of three-dimensional (3D) images was used to highlight variations of the philtrum. Visual analog scales were used to assess surgical outcomes. More than 6 months after the surgery, comparative 3D images of 37 patients (86.04%) with microform cleft lip and 86 patients (84.31%) with secondary cleft lip showed visible improvement in the prominence of the affected column. In addition, visual analog scale scores showed that 38 microform cleft lip patients (88.37%) and 89 secondary cleft lip patients (87.25%) had a good appearance. The postoperative prominence of the philtral column in both groups improved significantly compared to before surgery (P < 0.001 and P < 0.001, respectively). There was no significant difference in scores for philtrum prominence pre- and post-operatively between the 2 groups (P > 0.05). Muscle flap reconstruction is an effective means to create the 3D configuration of the philtrum. The biomechanical properties of muscles play a vital role in the morphological maintenance of the philtrum.
Standard Setting in Simulation-based Training of Surgical Procedures
Authors: Pietersen Pia Iben , Bjerrum Flemming , Tolsgaard Martin Grønnebæk , Konge Lars , Andersen Steven Arild Wuyts 
Published: September 2021

Objective:
This systematic review aims to examine the use of standard-setting methods in the context of simulation-based training of surgical procedures.

Summary of background:
Simulation-based training is increasingly used in surgical education. However, it is important to determine which level of competency trainees must reach during simulation-based training before operating on patients. Therefore, pass/fail standards must be established using systematic, transparent, and valid methods.

Methods:
Systematic literature search was done in 4 databases (Ovid MEDLINE, Embase, Web of Science, and Cochrane Library). Original studies investigating simulation-based assessment of surgical procedures with the application of a standard setting were included. Quality of evidence was appraised using GRADE.

Results:
Of 24,299 studies identified by searches, 232 studies met the inclusion criteria. Publications using already established standard settings were excluded (N = 70), resulting in 162 original studies included in the final analyses. Most studies described how the standard setting was determined (N = 147, 91%) and most used the mean or median performance score of experienced surgeons (n = 65, 40%) for standard setting. We found considerable differences across most of the studies regarding study design, setup, and expert level classification. The studies were appraised as having low and moderate evidence.

Conclusion:
Surgical education is shifting toward competency-based education, and simulation-based training is increasingly used for acquiring skills and assessment. Most studies consider and describe how standard settings are established using more or less structured methods but for current and future educational programs, a critical approach is needed so that the learners receive a fair, valid, and reliable assessment.
ADataViewer: Exploring Semantically Harmonized Alzheimer’s Disease Cohort Datasets
Authors: Salimi Yasamin , Domingo-Fernándéz Daniel , Bobis-Álvarez Carlos , Hofmann-Apitius Martin ,   for the Alzheimer’s Disease Neuroimaging Initiative,   the Japanese Alzheimer’s Disease Neuroimaging Initiative,   for the Aging Brain: Vasculature, Ischemia, and Behavior Study,   the Alzheimer’s Disease Repository Without Borders Investigators,   for the European Prevention of Alzheimer’s Disease (EPAD) Consortium, Birkenbihl Colin 
Published: September 2021

AbstractINTRODUCTIONCurrently, AD cohort datasets are difficult to find, lack across-cohort interoperability, and the content of the shared datasets often only becomes clear to third-party researchers once data access has been granted.METHODSWe accessed and systematically investigated the content of 20 major AD cohort datasets on data-level. A medical professional and a data specialist manually curated and semantically harmonized the acquired datasets. We developed a platform that facilitates data exploration.RESULTSWe present ADataViewer, an interactive platform that facilitates the exploration of 20 cohort datasets with respect to longitudinal follow-up, demographics, ethnoracial diversity, measured modalities, and statistical properties of individual variables. Additionally, we publish a variable mapping catalog harmonizing 1,196 variables across the 20 cohorts. The platform is available underhttps://adata.scai.fraunhofer.de/.DISCUSSIONADataViewer supports robust data-driven research by transparently displaying cohort dataset content and suggesting datasets suited for discovery and validation studies based on selected variables of interest.