bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
Authors: Komori Akira , Iriyama Hiroki , Aoki Makoto , Deshpande Gautam A. , Saitoh Daizoh , Naito Toshio , Abe Toshikazu 
Published: March 2021

Abstract
Although transfusion is a primary life-saving technique, the assessment of transfusion requirements in children with trauma at an early stage is challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma.
This was a case–control study that employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included patients aged <16 years with blunt trauma between 2004 and 2015. An assessment of blood consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤90 mm Hg, heart rate ≥120/min, Glasgow coma scale (GCS) score <15, and positive focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cutoff points for different ages.
Among 5943 pediatric patients with trauma, 540 patients had transfusion within 24 hours after trauma. The in-hospital mortality rate was 2.6% (145/5615). The transfusion rate increased from 7.6% (430/5631) to 35.3% (110/312) in patients with systolic blood pressure ≤90 mm Hg (1 point), from 6.1% (276/4504) to 18.3% (264/1439) in patients with heart rate ≥120/min (1 point), from 4.1% (130/3198) to 14.9% (410/2745) in patients with disturbance of consciousness with GCS score <15 (1 point), and from 7.4% (400/5380) to 24.9% (140/563) in patients with positive FAST scan (1 point). Ped-ABC scores of 0, 1, 2, 3, and 4 points were associated with transfusion rates of 2.2% (48/2210), 7.5% (198/2628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% confidence interval, 0.74–0.78).
The ped-ABC score using vital signs and FAST scan may be helpful in predicting the requirement for transfusion within 24 hours in children with trauma.
The semantic of a pandemic
Authors: Mapelli Massimo , Mantegazza Valentina , Agostoni Piergiuseppe 
Published: March 2021

Abstract

Rationale:
Northern Italy has been particularly hit by the current Covid-19 pandemic. Italian deceased patients have a mean age of 78.5 years and only 1.2% have no comorbidities. These data started a public debate whether patients die “with” or “from” Covid-19. If on one hand the public opinion has been persuaded to believe that Covid-19 infection has poor outcomes just in elderly and/or fragile subjects, on the other hand, hospitals are admitting an increasing number of healthy young patients needing semi-intensive or intensive care units.

Patient concerns:
At the end of March 2020, a 79-year-old patient (M.G.) was admitted to the emergency department of our hospital with a 5 days history of fever, dyspnea, and cough. He was known for hypertension and coronary artery disease with a previous coronary artery stenting. Both the comorbidities were carried out without complications and the patient was previously asymptomatic and in good health. At admission, he was febrile and showed signs of respiratory failure with hypoxia and hypocapnia at blood gas analysis.

Diagnosis:
The day after, he was tested for SARS-CoV-2 with a real-time reverse transcriptase-polymerase chain reaction assay of nasopharyngeal swab, which turned positive and a chest CT-Scan was consistent with the diagnosis of interstitial pneumonia.

Interventions:
He was treated with i.v. diuretics, paracetamol, prolonged noninvasive ventilation (CPAP), and empiric antibiotic therapy on top of his chronic treatment.

Outcomes:
A treatment with heparin and corticosteroids was started; however, he developed irreversible respiratory failure. Invasive ventilation was not considered appropriate due to his comorbidities, low chances of recovery, and intensive care unit overcrowding. The patient died 9 days after admission.

Lessons:
Health conditions that are most reported as risk factors are common cardiovascular diseases that can be managed in modern clinical practice. Through a brief illustrative clinical case, we would like to underline how Covid-19 can be per se the cause of death in patients that would otherwise have had an acceptable life expectancy.
Impacts of early insulin treatment vs glimepiride in diabetic patients with background metformin therapy
Authors: Yen Fu-Shun , Hsu Chih-Cheng , Su Yuan-Chih , Wei James Cheng-Chung , Hwu Chii-Min 
Published: March 2021

Abstract
Type 2 diabetes mellitus (T2DM) is a progressive disease. After metformin failure, the addition of insulin or sulfonylureas might increase the risk of hypoglycemia and cardiovascular (CV) morbidity. Here, the risk of all-cause mortality was compared between early insulin treatment and glimepiride use in T2DM patients with background metformin therapy.
We conducted a 9-year retrospective cohort study from the population-based National Health Insurance Research Database in Taiwan. A total of 2054 patients with T2DM under insulin or glimepiride treatment were enrolled during 2004 to 2012. Overall event rates of all-cause mortality were compared between 1027 insulin users and 1027 matched glimepiride users.
After the propensity score matching, the mortality rates were 72.5 and 4.42 per 1000 person-years for insulin users and glimepiride users. The adjusted hazard ratio of mortality was 14.47 (95% CI: 8.64–24.24; P value <.001) as insulin compared with glimepiride users. The insulin users had significantly higher risk of CV death (adjusted hazard ratio 7.95, 95% CI 1.65–38.3, P = .01) and noncardiovascular death (adjusted hazard ratio 14.9, 95% CI 8.4–26.3, P < .001).
The nationwide study demonstrated that metformin plus insulin therapy was associated with higher risk of all-cause mortality.
Differences in gut microbiota between allergic rhinitis, atopic dermatitis, and skin urticaria
Authors: Su Yu-Jih , Luo Sheng-Dean , Hsu Chung-Yuan , Kuo Ho-Chang 
Published: March 2021

Abstract

Introduction.
Several forms of allergy have been clinically presented, including, among others, atopic dermatitis (eczema), urticaria (hives), and allergic rhinitis (rhinitis). As their detailed pathogenesis continues to be researched, we aimed in the current study to compare gut microbiota differences between eczema, hives, and rhinitis patients.

Methods.
We enrolled 19 eczemas, nine hives, and 11 allergic rhinitis patients in this study. Fecal samples were examined using 16S ribosomal ribonucleic acid amplicon sequencing, followed by bioinformatics and statistical analyses. We compared microbiota in dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis).

Results.
All clinical data were similar between the subgroups. The microbiota results indicated that Bacteroidales species were found in skin allergies, both urticaria and eczema, when compared to rhinitis. The microbiota differs substantially between those patients with atopic dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis), thus indicating that the gut-skin and gut-nose axes exist. Gut flora colonies differ significantly between skin allergy and nose allergy. Bacteroidales species could be a clinical link between gut flora and skin allergy; of those, Bacteroids Plebeius DSM 17135 is significantly associated with the urticaria (hives) subgroup.Conclusion. Our results demonstrated high intra-group homogeneous and high inter-group heterogeneous microbiota. The clinical symptoms of eczema, hives, and rhinitis can all be linked to specific microbiota in the current study. In this pilot study, the Ruminococcaceae and Bacteroidales species are associated with allergic disease, in line with several previous published articles, and the abundance of Firmicutes Phylum is representative of intestinal dysbiosis. In the future, a larger cohort and thorough biochemical studies are needed for confirmation.
Clinical Practice Patterns in Nonsyndromic Craniosynostosis: A Review of Continuous Certification Tracer Data From the American Board of Plastic Surgery
Authors: Yuksel Selcen S. , Kearney Aaron M. , Taub Peter J. , Gosain Arun K. 
Published: March 2021

Abstract
Since 2003, the American Board of Plastic Surgery has collected data on 20 plastic surgery operations as part of the Maintenance of Certification process. The goal of this study was to describe national trends in craniosynostosis repair as they relate to Evidence-Based Medicine (EBM) articles published during this timeframe. Cumulative tracer data for nonsyndromic craniosynostosis were reviewed from 2006 to March 2020, and compared with EBM articles published in Plastic and Reconstructive Surgery. Topics were categorized as:
As of March 2020, 940 cases of nonsyndromic craniosynostosis had been entered. The median age at the time of surgery was 8 months (range, 1–204 months). Practice patterns from 2006 through 2013 were compared with those between 2013 and 2020. The most common surgical technique from 2006 through 2013 was anterior regional cranioplasty, and from 2013 to 2020 was orbital rim advancement. Differences in practice between these time periods included an increase in patients with asymptomatic clinical presentation (27% versus 42%, P < 0.001) and presentation with papilledema (1% versus 4%, P = 0.003). Use of preoperative MRI significantly increased (1% versus 6%, P < 0.001). Significant changes were noted in surgical technique and methods of fixation. By examining the American Board of Plastic Surgery tracer data, the authors can describe national trends in presentation, imaging, and surgical techniques for non -syndromic craniosynostosis repair over a 14-year period.
“Looks Can be Deceptive” – Radicular Cyst Mimicking a Developmental Origin Cyst
Authors: Khan Imran , Ansari Mohammad Irfan , Mansoori Shahnaz , Saalim Mohd. 
Published: March 2021

Abstract
Cysts of the jaws are not rare, among them the radicular cyst being the most common. It is an inflammatory type of odontogenic cyst forming as a consequence of a long-standing sequel of pulpal necrosis. In contrast to its usual location of occurrence (ie, the maxilla), herewith we report a case of successful management of a 45 year old female patient with a large radiolucent lesion in the left mandibular posterior region with a mandibular ramus extension. The pathology which was strongly presenting as a developmental variety of odontogenic cyst radiographically, was diagnosed as a radicular cyst after histopathological confirmation. To the authors best of knowledge radicular cyst extending into the mandibular ramus is extremely rare and has never been reported previously.
On the Environmental Determinants of COVID-19 Seasonality
Authors: Choi Yeon-Woo , Tuel Alexandre , Eltahir Elfatih A. B. 
Published: March 2021

AbstractViral respiratory diseases (VRDs), such as influenza and COVID-19, are thought to spread faster over winter than during summer. It has been previously argued that cold and dry conditions were more conducive to the transmission of VRD than warm and humid climates, although this relationship appears restricted to temperate regions, and the causal relationship is not well understood. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 has emerged as a serious global public health problem after the first COVID-19 reports in Wuhan, China, in late 2019. It is still unclear whether this novel respiratory disease will ultimately prove to be a seasonal endemic disease. Here, we suggest that Air Drying Capacity (ADC; an atmospheric state-variable known to control the fate/evolution of the virus-laden droplets) and ultraviolet radiation (UV) are probable environmental determinants in shaping the transmission of COVID-19 at the seasonal time scale. These variables, unlike temperature and humidity, provide a physically-based framework consistent with the apparent seasonal variability in COVID-19 prevalence across a broad range of climates (e.g., Germany and India). Since this disease is known to be influenced by the compounding effect of social, biological, and environmental determinants, this study does not claim that these environmental determinants exclusively shape the seasonality of COVID-19. However, we argue that ADC and UV play a significant role in COVID-19 dynamics at the seasonal scale. These findings could help guide the development of a sound adaptation strategy against the pandemic over the coming seasons.Plain Language SummaryThere is growing scientific interest in the potential seasonality of COVID-19 and its links to climate variables. This study aims to determine whether four environmental variables, namely temperature, humidity, Air Drying Capacity (ADC), and ultraviolet radiation (UV), are probable environmental determinants for the observed seasonal dynamics of COVID-19 prevalence, based on extensive country-level data spanning the first year of the pandemic. Although the influence of socio-economic factors may be dominant, we here suggest that ADC and UV are key environmental determinants of COVID-19 and can potentially affect the transmission and seasonality of the disease across a wide range of climates.Key PointsThe seasonality of COVID-19 appears to follow seasonality of some environmental variables.Seasonality of air drying capacity and ultraviolet radiation consistently match seasonality of COVID-19, across climatic zones.Seasonality of air humidity and temperature, match seasonality of COVID-19 in temperate climates, but not in tropical monsoon climates.
Elevated Neutrophil to Lymphocyte Ratio Predicts In-hospital Mortality Among Stroke Patients in a Metropolitan hospital in Australia, Universal Value-added measure in Stroke Care
Authors: Wijeratne Tissa , Sales Carmela , Karimi Leila , Jakovljevic Mihajlo 
Published: March 2021

AbstractNeutrophil counts (innate immunity) and lymphocyte counts (adaptive immunity) are common markers of inflammation in the context of acute stroke, and Neutrophil lymphocyte ratio (NLR) is likely to be expected to predict the post-stroke outcome.This study aimed to explore the predictive value of NLR to predict the very early mortality during the acute hospital admission (death within the first week of hospital stay) as this has management implications for the ongoing investigations, family discussions and resource allocation. This the first such study attempting at exploring the role of NLR in hyperacute in-patient mortality in the world to the best of our knowledge.This retrospective study included 120 patients (60 acute stroke patients who died within the first week of the hospital stay and 60 age, sex-matched controls who were discharged within two weeks of the hospital admission, alive. We reviewed the total white cell counts of these patients (first 72 hours of the hospital admission) and NLR was calculated manually. While there was no statistically significant difference between mean neutrophil counts and mean lymphocyte counts between the two cohorts [neutrophil counts (mean, SD), 8.52(3.20) in the death cohort, 6.48(2.20) among survivors and lymphocyte (mean, SD), 1.83(1.48) in the death cohort,1.66 (0.69) among survivors], there was a statistically significant difference in NLR between the two cohorts. NLR (mean, SD) was 6.51 (4.98) in the death cohort while the survivors had mean NLR of 4.64 with an SD 2.90 with a p-value of 0.048. Hypertension, diabetes, atrial fibrillation, previous vascular events were common in both groups indicating the value of exploring the evidence of background compromised vascular system and metabolic syndrome and bringing the systems biology approach to the management of stroke.
A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals
Authors: Limato Ralalicia , Nelwan Erni J. , Mudia Manzilina , Brabander Justin de , Guterres Helio , Enty Enty , Mauleti Ifael Y. , Mayasari Maria , Firmansyah Iman , Hizrani May , Hamers Raph L. 
Published: March 2021

SynopsisBackgroundAntibiotic misuse and overuse are a major driver of antimicrobial resistance, but systematic data in Indonesia are scarce.ObjectivesTo evaluate patterns and quality indicators of antibiotic prescribing in six acute-care hospitals in Jakarta, Indonesia.MethodsWe conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials for systemic use (antibiotics).ResultsOf 1602 inpatients, 993 (62.0%) received ≥1 antimicrobials. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Most common reasons for prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), gastrointestinal prophylaxis (7.9%), and gastrointestinal infections (5.4%). The most common indication was community-acquired infection (42.6%), followed by surgical prophylaxis (22.6%), hospital-acquired infection (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other indications (2.1%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), penicillins with B-lactamase inhibitor (6.8%) and aminoglycosides (6.0%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access, 2.4% Reserve, and 2.2% Unclassified. Reason for prescribing, stop/review date and planned duration were poorly documented. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and guideline compliance was 52.2% (478/915). Parenteral administration was high (85.1%). Targeted (non-empirical) prescriptions comprised 8.1% (44/542) for community-acquired infections and 26.8% (63/235) for hospital-acquired infections.ConclusionsOur data indicate a high rate of parenteral, empiric use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.
Exposure-response analysis of the association of maternal smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a national US sample, 2016-2018
Authors: Wang Xi , Lee Nora L , Burstyn Igor 
Published: March 2021

AbstractWe aimed to estimate exposure-response associations between smoking or vaping, and preterm and small-for-gestational age (SGA) births. We included 99,201 mothers who delivered live singletons in 2016-2018 from the Pregnancy Risk Assessment Monitoring System. We created exposure categories based on participants’ self-reported average number of cigarettes smoked per day and vaping frequency. Dual users in late pregnancy were a heterogeneous group: 36% heavily smoked and occasionally vaped; 29% lightly smoked and frequently vaped; 19% lightly smoked and frequently vaped; and 15% both heavily smoked and frequently vaped. While dual users who heavily smoked and occasionally vaped had the highest adjusted OR for SGA (3.4, 95% CI 1.7-6.6), all the dual users were on average at about twice the odds of having SGA than non-users. While the risks of preterm birth were higher among sole light smokers (adjusted OR 1.3, 95% CI 1.1-1.5) and sole heavy smokers (adjusted OR 1.4. 95 CI 1.2-1.8) than non-users, the adjusted odds of preterm births for dual users were not noticeably higher than those of non-users, unless they were also heavy smokers. Excess of preterm births among heavy vapers was suggested. Among younger non-Hispanic white women (where vaping is most common), only excess risk of SGA, not preterm, with vaping was apparent. Relative to non-users, both smoking and vaping during pregnancy appear to increase risk of SGA, but excess risk of preterm births appears to be primarily attributable to smoking alone. Higher levels of exposure tended to confer more risk.HighlightsNo observable change in prevalence of vaping during pregnancy from 2016 to 2018Both smoking and vaping during pregnancy appear to increase risk of SGA birthsExcess risk of preterm births appears to be primarily attributable to smoking alone
Maternal psychiatric diagnosis and comorbidities around pregnancy
Authors: Khachadourian Vahe , Kodesh Arad , Levine Stephen Z. , Lin Emma , Buxbaum Joseph D. , Bergink Veerle , Sandin Sven , Reichenberg Abraham , Janecka Magdalena 
Published: March 2021

ABSTRACTIMPORTANCEComorbidity between mental and physical health is a frequent problem, resulting in greater morbidity than the sum of the effects of individual diseases. Despite pervasive physiological and behavioral changes during pregnancy, the pattern of comorbidities among pregnant women is not well-understood.OBJECTIVESystematically examine the associations between mental and physical diagnoses around pregnancy.DESIGN, SETTING, PARTICIPANTSPopulation-based sample, containing all children born between January 1st, 1997 and December 31st, 2008 within a health maintenance organization (HMO) in Israel. Cohort children were linked to their mothers’ health information, creating mother-child dyads.MAIN OUTCOMES AND MEASURESThe primary outcome was any ICD-9 mental health diagnosis within the pregnancy period or the preceding 12 months. The secondary outcomes were specific ICD-9 mental health diagnoses. Exposures were all ICD-9 physical (non-mental) health diagnoses received during the exposure period. We used logistic regression to test the risk of physical health diagnoses in pregnant women associated with mental health diagnoses. The covariates for this study included maternal age, birth year, socioeconomic status and total number of ICD-9 diagnoses during the exposure period.RESULTSThe analytical sample included 76,783 mother-child dyads, with 30,084 unique mothers. The mean age at birth was 29.8 years, with 4.4% of mothers diagnosed with a mental health disorder during the pregnancy period. Of the 18 major ICD-9 diagnostic categories, 10 were positively associated with mental health disorders, including ICD categories of e.g., symptoms, signs, and ill-defined conditions (OR=1.69; 95% CI=1.50, 1.89), musculoskeletal (OR=1.33; 95% CI=1.22,1.45) and digestive system diseases (OR=1.25; 95% CI=1.15, 1.37). Comorbidity between mental and physical health diagnoses was higher than that observed between various physical health diagnoses. Associations between physical health diagnoses and specific mental health conditions were consistent with the results of the general mental health and physical health comorbidity.CONCLUSION AND RELEVANCEWe observed that associations between maternal diagnoses and mental health stand out from the general pattern of comorbidity between non-mental health diseases. The high co-occurrence of mental health and physical health diagnoses has implications for diagnoses and management of morbidity among pregnant women, with potential impact on pregnancy and child health outcomes.