bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Frailty in Patients Undergoing Cardiac Surgery
Authors: Chen Wei-Yi , Liu Chieh-Yu , Shih Chun-Che , Chen Yih-Sharng , Cheng Hsiao-Wei , Chiou Ai-Fu 
Published: June 2021

Background
Frailty may increase the risk of complications and mortality in patients undergoing cardiac surgery. Few studies on frailty and its associated factors have been conducted in these patients.

Objective
The aim of this study was to explore frailty and related factors in patients undergoing cardiac surgery.

Methods
A total of 154 patients undergoing cardiac surgery in northern Taiwan were recruited using a longitudinal study design and interviewed using structured questionnaires assessing physical activity, anxiety and depression, and social support before surgery and at 1 month and 3 months after surgery.

Results
The prevalence of frailty in patients undergoing cardiac surgery was 16.2%, 20.5%, and 16.6% before surgery and at 1 month and 3 months after surgery, respectively. Frail and prefrail patients undergoing cardiac surgery were more likely to be unemployed, have gout, have a higher New York Heart Association class, have preoperative dysrhythmia, undergo cardiopulmonary bypass, have a lower functional ability, have a higher European System for Cardiac Operative Risk Evaluation score, have a longer anesthesia time, have longer endotracheal tube and extracorporeal circulation times, have longer intensive care unit and hospital stays, have lower hemoglobin and albumin levels, have higher anxiety and depression levels, and have lower Mini-Mental State Examination scores. The significant predictors of prefrailty and frailty included unemployment, the presence of gout, higher New York Heart Association classes, less independence in activities of daily living, lower hemoglobin levels, and higher levels of depression.

Conclusions
Frailty was associated with patients' functional status, perioperative conditions and psychosocial factors. Preoperative assessments of frailty and appropriate interventions are needed to improve frailty in patients undergoing cardiac surgery.
Effects of Bedtime Dosing With Suvorexant and Zolpidem on Balance and Psychomotor Performance in Healthy Elderly Participants During the Night and in the Morning
Authors: Bland Hubert , Li Xiaodong , Mangin Eric , Yee Ka Lai , Lines Christopher , Herring W. Joseph , Gillespie Gillian 
Published: June 2021

Abstract

Purpose/Background
This study was designed as an early assessment of the safety of the orexin receptor antagonist suvorexant, but also included exploratory assessments of balance and psychomotor performance that are the focus of this report.

Methods/Procedures
This was a double-blind, randomized, 3-period, crossover, phase 1 study. Balance and psychomotor performance were evaluated during the night in 12 healthy elderly participants after bedtime administration of suvorexant 30 mg (a supratherapeutic dose), the GABAergic agonist zolpidem 5 mg (the recommended dose in the elderly), or placebo. Balance (body sway measured by platform stability) and psychomotor performance (measured by choice reaction time) were assessed predose and at 1.5, 4, and 8 hours postdose in each period. Memory (measured by word recall) was assessed predose and at 4 hours postdose.

Findings/Results
At 1.5 hours after nighttime administration of each drug (the approximate time of their anticipated maximal plasma concentrations), both zolpidem and suvorexant increased body sway versus placebo, with a greater increase for zolpidem than suvorexant. Suvorexant increased choice reaction time compared with placebo or zolpidem at 1.5 hours. There were no treatment differences on body sway or choice reaction time at 4 or 8 hours, or on word recall at 4 hours.

Implications/Conclusions
These exploratory data suggest that a 30-mg dose of suvorexant (supratherapeutic) and a 5-mg dose of zolpidem (recommended dose in the elderly) impaired balance at 1.5 hours in healthy elderly people, with potentially less impairment for suvorexant relative to zolpidem, but no treatment differences on body sway or psychomotor performance at 4 and 8 hours. Because of their exploratory nature, these findings and their clinical relevance, if any, require confirmation in a prospective study.
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
Authors: Bryant Andrew , Lawrie Theresa A. , Dowswell Therese , Fordham Edmund J. , Mitchell Scott , Hill Sarah R. , Tham Tony C. 
Published: June 2021

Background:
Repurposed medicines may have a role against the SARS-CoV-2 virus. The antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has now been tested in numerous clinical trials.

Areas of uncertainty:
We assessed the efficacy of ivermectin treatment in reducing mortality, in secondary outcomes, and in chemoprophylaxis, among people with, or at high risk of, COVID-19 infection.

Data sources:
We searched bibliographic databases up to April 25, 2021. Two review authors sifted for studies, extracted data, and assessed risk of bias. Meta-analyses were conducted and certainty of the evidence was assessed using the GRADE approach and additionally in trial sequential analyses for mortality. Twenty-four randomized controlled trials involving 3406 participants met review inclusion.

Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in a trial sequential analysis using the same DerSimonian–Laird method that underpinned the unadjusted analysis. This was also robust against a trial sequential analysis using the Biggerstaff–Tweedie method. Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less certain evidence. Low-certainty evidence suggested that there may be no benefit with ivermectin for “need for mechanical ventilation,” whereas effect estimates for “improvement” and “deterioration” clearly favored ivermectin use. Severe adverse events were rare among treatment trials and evidence of no difference was assessed as low certainty. Evidence on other secondary outcomes was very low certainty.

Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.
Comparison of Surgical Outcomes After Total Laparoscopic Hysterectomy or Total Vaginal Hysterectomy for Large Uteri
Authors: Sailofsky Sybil , Darin Christina , Alfahmy Anood , Sheyn David 
Published: June 2021

(Abstracted from Obstet Gynecol 2021;137:445–453)
Laparoscopic hysterectomy is associated with less postoperative pain, shorter hospital stays, and faster recoveries when compared with abdominal hysterectomy. Because of these superior outcomes, laparoscopic hysterectomy has dramatically increased in frequency, and 1 result of this is a decrease in vaginal hysterectomy.
Inherent Mosaicism and Extensive Mutation of Human Placentas
Authors: Coorens Tim H. H. , Oliver Thomas R. W. , Sanghvi Rashesh , Sovio Ulla , Cook Emma , Vento-Tormo Roser , Haniffa Muzlifah , Young Matthew D. , Rahbari Raheleh , Sebire Neil , Campbell Peter J. , Charnock-Jones D. Stephen , Smith Gordon C. S. , Behjati Sam 
Published: June 2021

(Abstracted from Nature 2021;592:80–85)
Approximately 1% to 2% of pregnancies involve chromosomal aberrations confined to the placenta. During the first few days of embryogenesis when fetal and placental lineages diverge, clonal expansion and mosaicism may occur, representing a potential pathological divergence from normal clonal dynamics of early embryogenesis.
Prediction of Stillbirth: An Umbrella Review of Evaluation of Prognostic Variables
Authors: Townsend R. , Sileo F. G. , Allotey J. , Dodds J. , Heazell A. , Jorgensen L. , Kim V. B. , Magee L. , Mol B. , Sandall J. , Smith G. C. S. , Thilaganathan B. , vonDadelszen P. , Thangaratinam S. , Khalil A. 
Published: June 2021

(Abstracted from BJOG 2021;128:238–250)
The global incidence of stillbirth remains high, despite decreases in maternal and neonatal morbidity. Therefore, developing strategies to predict and prevent stillbirth is a priority.
No Increase in Kawasaki Disease–Like Illnesses During the COVID-19 Pandemic Compared With 4 Previous Years
Authors: Molin Amber , Kulenthirarajan Rajesh , Lopez-Peña Maricarmen , Knuth Emily , Barillas-Arias Liliana , Andrews Shannon L. 
Published: June 2021

Background
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection produces a wide variety of inflammatory responses in children, including multisystem inflammatory syndrome in children, which has similar clinical manifestations as Kawasaki disease (KD).

Methods
We performed a chart review of all patients with KD-like illnesses from January 1, 2016, to May 31, 2020, at a tertiary care children's hospital within a larger health system. Relevant symptoms, comorbid illnesses, laboratory results, imaging studies, treatment, and outcomes were reviewed. Descriptive analyses to compare features over time were performed.

Results
We identified 81 cases of KD-like illnesses from January 1, 2016, to May 31, 2020. Few clinical features, such as gallbladder involvement, were more prevalent in 2020 than in previous years. A few patients in 2020 required more intensive treatment with interleukin 1 receptor antagonist therapy. There were no other clear differences in incidence, laboratory parameters, number of doses of intravenous immunoglobulin, or outcomes over the years of the study.

Conclusions
There was no difference in incidence, laboratory parameters, or number of doses of intravenous immunoglobulin required for treatment of KD-like illnesses during the COVID-19 pandemic when compared with previous years at our institution. Kawasaki disease–like illnesses, including multisystem inflammatory syndrome in children, may not have changed substantially during the COVID-19 pandemic.
Investigation of clinical characteristics and genome associations in the ‘UK Lipoedema’ cohort
Authors: Grigoriadis Dionysios , Sackey Ege , Riches Katie , van Zanten Malou , Brice Glen , England Ruth , Mills Mike , Dobbins Sara E ,   Lipoedema Consortium, Genomics England Research Consortium, Jeffery Steve , Dong Liang , Savage David B. , Mortimer Peter S. , Keeley Vaughan , Pittman Alan , Gordon Kristiana , Ostergaard Pia 
Published: June 2021

AbstractLipoedema is a chronic adipose tissue disorder mainly affecting women, causing excess subcutaneous fat deposition on the lower limbs with pain and tenderness. There is often a family history of lipoedema, suggesting a genetic origin, but the contribution of genetics is currently unclear. A tightly phenotyped cohort of 200 lipoedema patients was recruited from two UK specialist clinics. Objective clinical characteristics and measures of quality of life data were obtained. In an attempt to understand the genetic architecture of the disease better, genome-wide single nucleotide polymorphism (SNP) genotype data were obtained, and a genome wide association study (GWAS) performed on 130 of the recruits. The analysis revealed genetic loci suggestively associated with the lipoedema phenotype, with further support provided by an independent cohort taken from the 100,000 Genomes Project. Top SNPs included loci associated with lipoma formation, biosynthesis of hormones and lipid hydroxylation. Exactly how these SNPs relate to a lipoedema disease mechanism is not yet understood but the findings are consistent with existing fat and hormone hypotheses. This first GWAS of a UK lipoedema cohort has identified genetic regions of suggestive association with the disease. Further replication of these findings in different populations is warranted.
Integrated Analysis of the Association Between Alzheimer’s Disease (AD) and Cardiovascular Disease (CVD)
Authors: Wei Katherine , Delprato Anna 
Published: June 2021

AbstractAlzheimer’s Disease (AD), the sixth leading cause of death in the US, and cardiovascular disease (CVD), the first leading cause of death in the US, are frequently associated. Past studies hypothesize that amyloid deposits damage organs, causing this association. Examining how vascular factors can influence AD pathogenesis can help in understanding the link between the blood to the brain, which can provide alternative paths of exploration for disease treatment. This study analyzes gene expression and shared biological processes between AD and CVD, specifically myocardial infarction and heart failure, via bioinformatic approaches and published datasets from the Gene Expression Omnibus (GEO). First, 73 differentially expressed genes (DEGs) were identified among four datasets using blood samples from AD and CVD patients. Panther’s Gene Ontology Analysis validated several biological processes such as xylulose biosynthetic process and toll-like receptor TLR1:TLR2 signaling pathway along with molecular functions, cellular components, and pathways to be significantly enriched in the list of 73 DEGs. Analysis of protein-protein interactions and the associated gene network indicated that from the list of 73 DEGs, only six (MAPK14, TLR2, HCK, GRB2, PRKCD, PTPN6) had eight or more degrees. Next, those six genes were identified in a normalized dataset containing different brain regions of AD and non-AD patients. Two-sample t-tests for differences in mean showed statistically significant differences in GRB2 and PRKCD, supporting a blood-brain relationship in the association between AD and CVD. This study can help in developing new medications to target AD and CVD susceptible genes.
Broad Clinical Manifestations of Polygenic Risk for Coronary Artery Disease in the Women’s Health Initiative
Authors: Clarke Shoa L. , Parham Matthew , Lankester Joanna , Shadyab Aladdin H. , Liu Simin , Kooperberg Charles , Manson JoAnn E. , Tcheandjieu Catherine , Assimes Themistocles L. 
Published: June 2021

AbstractBackgroundThe genetic basis for coronary artery disease (CAD) risk is highly complex. Genome-wide polygenic risk scores (PRS) can help to quantify that risk, but the broader impacts of polygenic risk for CAD are not well characterized.MethodsWe measured polygenic risk for CAD using the metaGRS, a previously validated genome-wide PRS, in a subset of genotyped participants from the Women’s Health Initiative (WHI) and applied a phenome-wide association study framework to assess associations between the PRS and broad range of blood biomarkers, clinical measurements, and outcomes.ResultsPolygenic risk for CAD was associated with a variety of biomarkers, clinical measurements, behaviors, and diagnoses related to traditional risk factors, as well as risk-enhancing factors. Analysis of adjudicated outcomes showed a graded association between atherosclerosis related outcomes, with the highest odds ratios being observed for the most severe manifestations of CAD. We identified novel associations between increased polygenic risk for CAD and decreased risk for incident breast and lung cancer, with replication of the breast cancer finding in an external cohort. Genetic correlation and two-sample Mendelian randomization suggest that breast cancer association is likely due to horizontal pleiotropy, while the association with lung cancer may be causal.ConclusionPolygenic risk for CAD has broad clinical manifestations, reflected in biomarkers, clinical measurements, behaviors, and diagnoses. Some of these associations may represent direct pathways between genetic risk and CAD while others may reflect pleiotropic effects independent of CAD risk.
A cross-sectional study of the relationship between exercise, physical activity, and health-related quality of life among Japanese workers during the COVID-19 pandemic
Authors: Sugano Ryosuke , Ikegami Kazunori , Eguchi Hisashi , Tsuji Mayumi , Tateishi Seiichiro , Nagata Tomohisa , Matsuda Shinya , Fujino Yoshihisa , Ogami Akira ,   for the CORoNaWork Project
Published: June 2021

AbstractBackgroundExercise and physical activity positively affect physical and mental health, and healthy workers contribute to increased work productivity. This study aimed to investigate time spent on exercise during leisure time and physical activity, including time at work, in relation to health-related quality of life (HRQOL) among Japanese workers.MethodsAn Internet-based national health survey –Collaborative Online Research on Novel-coronavirus and Work study (CoRoNaWork study) – was conducted among 33,087 Japanese workers in December 2020. After excluding invalid responses, 27,036 participants were categorized into four and five groups according to exercise time and physical activity time, respectively. Each group’s scores were compared on each of the four questions on the Japanese version of the Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL-4) between each group using a linear mixed model. Age-sex adjusted and multivariate models were used to compare each index of the CDC HRQOL-4.ResultsThe more time spent exercising, the better the self-rated health. Self-rated health was better and unhealthy days were fewer in the group that exercised more than a certain amount of time than in the group that spent almost no time on exercising. As for physical activity, the group that spent more than 120 minutes/day or that almost never engaged in physical activity had lower self-rated health. The group with more than 120 minutes/day of physical activity also had more unhealthy days.ConclusionsThe results of the present study suggest that exercise habits improve workers’ HRQOL. Interventions to encourage daily exercise even for a short period of time may be an effective strategy to improve workers’ health and productivity.
Long COVID symptoms from Reddit: Characterizing post-COVID syndrome from patient reports
Authors: Sarker Abeed , Ge Yao 
Published: June 2021

ObjectiveTo mine Reddit to discover long-COVID symptoms self-reported by users, compare symptom distributions across studies, and create a symptom lexicon.Materials and MethodsWe retrieved posts from the /r/covidlonghaulers subreddit and extracted symptoms via approximate matching using an expanded meta-lexicon. We mapped the extracted symptoms to standard concept IDs, compared their distributions with those reported in recent literature and analyzed their distributions over time.ResultsFrom 42,995 posts by 4249 users, we identified 1744 users who expressed at least 1 symptom. The most frequently reported long-COVID symptoms were mental health-related symptoms (55.2%), fatigue (51.2%), general ache/pain (48.4%), brain fog/confusion (32.8%) and dyspnea (28.9%) amongst users reporting at least 1 symptom. Comparison with recent literature revealed a large variance in reported symptoms across studies. Temporal analysis showed several persistent symptoms up to 15 months after infection.ConclusionThe spectrum of symptoms identified from Reddit may provide early insights about long-COVID.
Mass mask-wearing notably reduces COVID-19 transmission
Authors: Leech Gavin , Rogers-Smith Charlie , Sandbrink Jonas B. , Snodin Benedict , Zinkov Robert , Rader Benjamin , Brownstein John S. , Gal Yarin , Bhatt Samir , Sharma Mrinank , Mindermann Sören , Brauner Jan M. , Aitchison Laurence 
Published: June 2021

ABSTRACTMask-wearing has been a controversial measure to control the COVID-19 pandemic. While masks are known to substantially reduce disease transmission in healthcare settings [1–3], studies in community settings report inconsistent results [4–6].Investigating the inconsistency within epidemiological studies, we find that a commonly used proxy, government mask mandates, does not correlate with large increases in mask-wearing in our window of analysis. We thus analyse the effect of mask-wearing on transmission instead, drawing on several datasets covering 92 regions on 6 continents, including the largest survey of individual-level wearing behaviour (n=20 million) [7]. Using a hierarchical Bayesian model, we estimate the effect of both mask-wearing and mask-mandates on transmission by linking wearing levels (or mandates) to reported cases in each region, adjusting for mobility and non-pharmaceutical interventions.We assess the robustness of our results in 123 experiments spanning 22 sensitivity analyses. Across these analyses, we find that an entire population wearing masks in public leads to a median reduction in the reproduction numberRof 25.8%, with 95% of the medians between 22.2% and 30.9%. In our window of analysis, the median reduction inRassociated with the wearing level observed in each region was 20.4% [2.0%, 23.3%]1. We do not find evidence that mandating mask-wearing reduces transmission. Our results suggest that mask-wearing is strongly affected by factors other than mandates.We establish the effectiveness of mass mask-wearing, and highlight that wearing data, not mandate data, are necessary to infer this effect.
Early but not late convalescent plasma is associated with better survival in moderate-to-severe COVID-19
Authors: Briggs Neima , Gormally Michael V. , Li Fangyong , Browning Sabrina L. , Treggiari Miriam M. , Morrison Alyssa , Laurent-Rolle Maudry , Deng Yanhong , Hendrickson Jeanne E. , Tormey Christopher A. , Desruisseaux Mahalia S. 
Published: June 2021

ABSTRACTBackgroundLimited therapeutic options exist for coronavirus disease 2019 (COVID-19). COVID-19 convalescent plasma (CCP) is a potential therapeutic, but there is limited data for patients with moderate-to-severe disease.Research QuestionWhat are outcomes associated with administration of CCP in patients with moderate-to-severe COVID-19 infection?Study Design and MethodsWe conducted a propensity score-matched analysis of patients with moderate-to-severe COVID-19. The primary endpoints were in-hospital mortality. Secondary endpoints were number of days alive and ventilator-free at 30 days; length of hospital stay; and change in WHO scores from CCP administration (or index date) to discharge. Of 151 patients who received CCP, 132 had complete follow-up data. Patients were transfused after a median of 6 hospital days; thus, we investigated the effect of convalescent plasma before and after this timepoint with 77 early (within 6 days) and 55 late (after 6 days) recipients. Among 3,217 inpatients who did not receive CCP, 2,551 were available for matching.ResultsEarly CCP recipients, of whom 31 (40%) were on mechanical ventilation, had lower 14-day (15% vs 23%) and 30-day (38% vs 49%) mortality compared to a matched unexposed cohort, with nearly 50% lower likelihood of in-hospital mortality (HR 0.52, [95% CI 0.28-0.96]; P=0.036). Early plasma recipients had more days alive and ventilator-free at 30 days (+3.3 days, [95% CI 0.2 to 6.3 days]; P=0.04) and improved WHO scores at 7 days (−0.8, [95% CI: −1.2 to - 0.4]; P=0.0003) and hospital discharge (−0.9, [95% CI: −1.5 to −0.3]; P=0.004) compared to the matched unexposed cohort. No clinical differences were observed in late plasma recipients.InterpretationEarly administration of CCP improves outcomes in patients with moderate-to-severe COVID-19, while improvement was not observed with late CCP administration. The importance of timing of administration should be addressed in specifically designed trials.