bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is degree of chronic illness management in heart transplant centers associated with better patient survival? Findings from the intercontinental BRIGHT study
Authors: Cajita Maan Isabella , Denhaerynck Kris , Berben Lut , Dobbels Fabienne , Van Cleemput Johan , Crespo-Leiro Maria , Van Keer Jan , Poncelet Alain Jean , Russell Cynthia , De Geest Sabina 
Published: September 2021

Purpose To explore the association between the degree of Chronic illness management and survival rates at 1-, 3-, 5-years post heart transplantation. Methods Exploratory secondary analysis of a cross-sectional, international study (Building Research Initiative Group study). Latent profile analysis was performed to classify 36 heart transplant centers according to the degree of chronic illness management. Results The analysis resulted in 2 classes with 29 centers classified as “low-degree chronic illness management” and 7 centers as “high-degree chronic illness management”. After 1-year posttransplantation, the high-degree chronic illness management class had a significantly greater mean survival rate compared to the low-degree chronic illness management class (88.4% vs 84.2%, p = 0.045) and the difference had a medium effect size (η2 = .06). No difference in survival for the other time points was observed. Patients in high-degree chronic illness management centers had 52% lower odds of moderate to severe drinking (95% confidence interval .30–.78, p = 0.003). No significant associations between degree of chronic illness management and the other recommended health behaviors were observed. Conclusions The findings from this exploratory study offer preliminary insight into a system-level pathway (chronic illness management) for improving outcomes for heart transplant recipients. The signals observed in our data support further investigation into the effectiveness of chronic illness management-based interventions in heart transplant follow-up care.
Complications Associated With Nasopharyngeal COVID-19 Testing: An Analysis of the MAUDE Database and Literature Review
Authors: Hakimi Amir A. , Goshtasbi Khodayar , Kuan Edward C. 
Published: September 2021

Background Nasopharyngeal swab testing, which has greatly increased in utilization due to the COVID-19 pandemic, is generally safe and well-tolerated, although it may be rarely associated with adverse events. Methods Publicly reported adverse events associated with nasopharyngeal COVID-19 testing within the Manufacturer and User Facility Device Experience (MAUDE) database and the published literature were queried. Results A total of 129 adverse events were reported, including 66 from the MAUDE database and 63 from literature review. The most common complications were swab fracture resulting in retained foreign body (47%), followed by epistaxis (17%), and headache (11%). Seven (12%) of the reported retained foreign body cases required removal under general anesthesia, while 1 (5%) of the epistaxis cases required surgical intervention. The most serious adverse event was meningitis following cerebrospinal fluid leak. Conclusions Patients and healthcare providers should be aware of the potential risks associated with testing, with attention to ensuring proper technique, and be prepared to recognize and manage adverse events.
Remdesivir use and outcomes during the FDA COVID-19 emergency use authorization period
Authors: Elshaboury Ramy H. , Monk Miranda M. , Bebell Lisa M. , Bidell Monique R. , Adamsick Meagan L. , Gandhi Ronak G. , Paras Molly L. , Hohmann Elizabeth L. , Letourneau Alyssa R. 
Published: September 2021

Background: Remdesivir (RDV) was approved for treatment of coronavirus disease 2019 (COVID-19), in May 2020 under US Food and Drug Administration emergency use authorization (EUA). Clinical outcomes related to RDV use in hospitalized patients during the EUA period are not well described. Methods: We conducted a retrospective study of patients who received RDV under EUA. The primary outcome was clinical recovery by day 14 as determined by an eight-category ordinal scale. Secondary outcomes included recovery and survival to day 28, and adverse events. Recovery and survival were calculated using a stratified log-rank Kaplan–Meier estimator and a Cox proportional hazards model. Results: Overall, 164 patients received RDV between May and October 2020, and 153 (93.3%) had evaluable data. Most (77.1%) were hospitalized within 10 days of symptom onset, and 79.7% started RDV within 48 hours. By days 14 and 28, 96 (62.7%) and 117 patients (76.5%) met the definition of clinical recovery, respectively. Median time to recovery was 6 days [interquartile range (IQR) 4–12]. Mortality rates were 6.5% and 11.8% by days 14 and 28, respectively. Age and time to start of RDV after hospital admission were predictive of recovery and 28-day mortality. Conclusions: In this real-world experience, outcomes after 5 days of RDV therapy were comparable to those of clinical trials. Disease severity, age, and dexamethasone use influenced clinical outcomes. Time to RDV initiation appeared to affect recovery and 28-day mortality, a finding that should be explored further. Mortality rate decreased over the analysis period, which could be related to dexamethasone use and improved management of COVID-19.
Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study
Authors: Hijryana M. , MacDougall M. , Ariani N. , Kusdhany L.S. , Walls A.W.G. 
Published: September 2021

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.
Sonographic Estimated Fetal Weight Within an Indian Cohort: Is the Hadlock Four Regression Model Appropriate or Does It Merit Adjustments?
Authors: Joish Upendra Kumar , Rathod Tukaram , Anitha Prabhu S. 
Published: September 2021

Objective: Sonographic estimated fetal weight (EFW) has an influence on the management of a pregnancy. The Hadlock 4 regression model (Hadlock-4), based on fetal biometry, is widely used. There are significant discrepancies noted between EFW, using Hadlock-4, compared to the actual infant birth weights (ABW) in the author’s clinical practice. The research objective was to compare the EFW, using Hadlock-4, with ABW and determine minor arithmetic modifications needed for this population. Materials and Methods: A prospective observational study was done enrolling women in the third trimester, who underwent sonography and delivered within a week of the examination. The sonographic cases were divided into class intervals by gestational age. The EFW were compared with the ABW, using a Pearson coefficient and mean percentage errors (MPE). The EFW values were increased or decreased, by a certain percentage, to keep the mean percentage error in an acceptable range. Results: The strength of association between the EFW and ABW was 0.69 ( p = .014). The EFW and the MPEs for women delivering at 36-40 weeks and beyond was significantly more (13.2 and 18.2%). The EFWs at 36-40 weeks and beyond 40 weeks were reduced by 3 and 8% respectively, which reduced the MPEs. After this modification 97.6% of ABWs fell within +/-2 standard deviations of the EFWs. Conclusion: A simple 3 and 8% reduction of EFWs, using the Hadlock-4, with those sonographic examinations at 36-40 weeks and beyond 40 weeks gestation respectively, is proposed to increase reliable in this Indian patient practice.
CAR T-cell therapy for secondary CNS DLBCL
Authors: Ahmed Gulrayz , Hamadani Mehdi , Shah Nirav N. 
Published: September 2021

Abstract
Management of secondary central nervous system (SCNS) involvement in relapsed or refractory aggressive B-cell lymphomas remains an area of unmet medical need. We report a single-center retrospective analysis of 7 adult patients with SCNS lymphoma (SCNSL) who underwent chimeric antigen receptor (CAR) T-cell therapy for their refractory disease, and we describe the safety of whole brain radiation therapy (WBRT) as a bridging therapy. Six patients (85.7%) achieved a complete response at day 28, and 1 patient had progressive disease. The median progression-free survival was 83 days (range, 28-219 days), and median overall survival was 129 days (range, 32-219 days). Three patients died as a result of disease progression. Of the 5 patients who received WBRT as bridging therapy, 3 had no immune effector cell–associated neurotoxicity syndrome (ICANS), but 2 patients had grade 1 or grade 3 ICANS. No grade 4 ICANS was reported in this subset of patients. We conclude that SCNSL should not preclude patients from receiving CAR T-cell therapy as a treatment option because of concerns regarding ICANS, and bridging with WBRT is not associated with increased ICANS.
Blood transfusion trends in the United States: national inpatient sample, 2015 to 2018
Authors: Goel Ruchika , Zhu Xianming , Patel Eshan U. , Crowe Elizabeth P. , Ness Paul M. , Katz Louis M. , Bloch Evan M. , Tobian Aaron A.R. 
Published: September 2021

Abstract
Blood transfusions are among the most common therapeutic procedures performed in hospitalized patients. This study evaluates contemporary national trends in red blood cell (RBC), plasma, platelet, and cryoprecipitate transfusions. National Inpatient Sample, the largest all-payer inpatient database representing 94% to 97% of the US population, was evaluated from the fourth quarter (Q4) of 2015 through 2018. Quarterly trends for the percentage of hospitalizations with a transfusion procedure were separately examined for each blood product using log binomial regression and reported as quarterly percent change (QPC). The percentage of hospitalizations with an RBC transfusion decreased from 4.22% (2015Q4) to 3.79% (2018Q4) (QPC = −0.72; 95% confidence interval [CI], −1.26 to −0.19; Ptrend = .008). Although plasma transfusions also decreased, QPC = −1.33 (95% CI, −2.00 to −0.65; Ptrend &lt; .001), platelet transfusions remained stable QPC = −0.13 (95% CI, −0.99 to 0.73; Ptrend = .766). In contrast, hospitalizations with cryoprecipitate utilization significantly increased QPC = 2.01 (95% CI, 0.57 to 3.44; Ptrend = .006). Significant quarterly reductions in RBC transfusions were also seen among many, but not all, strata of sex, race/ethnicity, patient risk severity, and admission type (elective vs nonelective). Despite significant declines in RBC transfusions among older adults, there were no significant changes among pediatric age-group (&lt;18 years) and those 18 to 49 years. The decline in RBC and plasma transfusions suggests steady incorporation of robust evidence base showing safety of restrictive transfusions. Increased cryoprecipitate use may be reflective of wider adoption of hypofibrinogenemia management and hemostasis testing for coagulopathic patients.
A rare case of persistent air leak: beware of all the tubes
Authors: Havaldar Amarja Ashok , Fazal Abdul Rahim , Chennabasappa Abhilash 
Published: September 2021

Abstract
Background
Patients with acute respiratory failure, impaired consciousness, and impaired airway reflexes will require invasive mechanical ventilation. Monitoring of such patients is important. The use of ventilator scalars and loops help in monitoring, diagnosing the abnormality, and treating the patients effectively. We report a rare cause one should suspect in a case of persistent and fixed air leak in a patient requiring mechanical ventilation.

Case presentation
We describe a 28-year-old young patient requiring ventilator support due to neuromuscular weakness. His neuromuscular weakness was rapidly progressing involving the respiratory muscles. The patient was intubated and put on mechanical ventilator support. He was transferred from another health care center to our hospital. On evaluation, the patient was intubated with ETT no 8. The patient had persistent air leak as observed on the ventilator graphics. We checked for ETT cuff malfunction, ventilator circuit, catheter mount, and HME for any disconnection causing the leak. The air leak which we observed in our patient was due to the malpositioned Ryle’s tube.

Conclusions
Vigilant monitoring of patients requiring mechanical ventilation is necessary. For the evaluation of the cause of air leak, algorithmic approach will help in correctly identifying the abnormality.
Variation in the vitamin D receptor gene, plasma 25-hydroxyvitamin D, and risk of premenstrual symptoms
Authors: Jarosz Alicia C. , Noori Daniel , Zeitoun Tara , Garcia-Bailo Bibiana , El-Sohemy Ahmed 
Published: September 2021

AbstractBackgroundVitamin D status has been associated with the presence and severity of several premenstrual symptoms (PMSx) in some, but not all studies. Inconsistencies among findings may be explained by unaccounted genetic variation in the vitamin D receptor (VDR).ObjectiveTo determine whether associations between vitamin D status and individual PMSx are influenced byVDRgenotype.MethodsSeven hundred sixteen women aged 20-29 years old from the Toronto Nutrigenomics and Health study provided plasma samples and completed a questionnaire on the presence and severity of 15 common PMSx. Plasma 25-hydroxyvitamin D (25(OH)D) concentration was measured and participants were categorized into sufficient (≥ 50 nmol/L) and insufficient (< 50 nmol/L) vitamin D status groups. DNA was obtained from blood samples to genotype for a commonVDRsingle nucleotide variant, rs796858. Using logistic regression, odds of experiencing PMSx were compared between vitamin D-sufficient and insufficient women, stratified by genotype.ResultsAmong CC homozygotes, insufficient vitamin D status was associated with higher odds of experiencing premenstrual fatigue (OR, 2.53; 95% CI, 1.40, 4.56) and nausea (OR, 2.44; 95% CI, 1.00, 5.95). Among TT homozygotes, insufficient vitamin D status was associated with lower odds of experiencing fatigue (OR, 0.44; 95% CI, 0.20, 0.97) and increased appetite (OR, 0.48; 95% CI, 0.22, 1.04). Insufficient vitamin D status was associated with higher odds of increased appetite in women with the CT genotype (OR, 1.78; 95% CI, 1.03, 3.07).VDRgenotype modified the association between vitamin D status and the following PMSx: increased appetite (interactionp= 0.027), fatigue (interactionp= 0.016), and nausea (interactionp= 0.039).ConclusionWe found evidence thatVDRgenotype may modify the association between 25(OH)D and some PMSx. Insufficient 25(OH)D was associated with a higher risk of premenstrual fatigue in those with the CC genotype, but lower risk in those with the TT genotype.
Relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in patients with obstructed defecation
Authors: Elsawy Mervat Sheta , Saba Emmanuel Kamal Aziz 
Published: September 2021

Abstract
Background
Obstructed defecation is a common pelvic floor medical problem among adult population. Pelvic floor disorders were reported to be associated with sexual dysfunction including erectile dysfunction among male patients. The aim was to determine the relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in male patients with obstructed defecation.

Methods
This cross-sectional study included 65 married male patients with obstructed defecation and a control group consisted of 15 apparently healthy married males. Assessment of obstructed defecation severity was done by using modified obstructed defecation score, time of toileting and Patient Assessment of Constipation-Quality of Life questionnaire. Assessment of erectile functions was done using erectile function domain of International Index of Erectile Function questionnaire and Erectile Dysfunction-Effect on Quality of Life Questionnaire. Anal manometry and dynamic pelvis magnetic resonance imaging were done. Electrophysiological studies included pudendal nerve motor conduction study and needle electromyography of external anal sphincter, puborectalis and bulbocavernosus muscles.

Results
There were 32 patients (49.2%) who had erectile dysfunction. The maximum straining anal pressure was significantly higher among patients with erectile dysfunction. Pudendal nerve terminal motor latency was significantly delayed and the percentage of bilateral pudendal neuropathy was significantly higher among patients with erectile dysfunction. The percentage of electromyography evidence of denervation with chronic reinnervation in the external anal sphincter and bulbocavernosus muscles were significantly higher among patients with erectile dysfunction. Regression analysis detected three co-variables to be associated with significantly increasing the likelihood of development of erectile dysfunction. These were maximum straining anal pressure (odd ratio = 1.122), right pudendal nerve terminal motor latency (odd ratio = 3.755) and left pudendal nerve terminal motor latency (odd ratio = 3.770).

Conclusions
Erectile dysfunction is prevalent among patients with obstructed defecation. It is associated with characteristic pelvic floor electrophysiological abnormalities. Pelvic floor neurophysiological changes vary from minimal to severe neuromuscular abnormalities that usually accompanying erectile dysfunction. Pudendal neuropathy and increased maximum straining anal pressure are essential risk factors for increasing the likelihood of development of erectile dysfunction in patients with obstructed defecation.
Predicting chemotherapy response using a variational autoencoder approach
Authors: Wei Qi , Ramsey Stephen A. 
Published: September 2021

AbstractBackgroundMultiple studies have shown the utility of transcriptome-wide RNA-seq profiles as features for machine learning-based prediction of response to chemotherapy in cancer. While tumor transcriptome profiles are publicly available for thousands of tumors for many cancer types, a relatively modest number of tumor profiles are clinically annotated for response to chemotherapy. The paucity of labeled examples and the high dimension of the feature data limit performance for predicting therapeutic response using fully-supervised classification methods. Recently, multiple studies have established the utility of a deep neural network approach, the variational autoencoder (VAE), for generating meaningful latent features from original data. Here, we report the first study of a semi-supervised approach using VAE-encoded tumor transcriptome features and regularized gradient boosted decision trees (XGBoost) to predict chemotherapy drug response for five cancer types: colon, pancreatic, bladder, breast, and sarcoma.ResultsWe found: (1) VAE-encoding of the tumor transcriptome preserves the cancer type identity of the tumor, suggesting preservation of biologically relevant information; and (2) as a feature-set for supervised classification to predict response-to-chemotherapy, the unsupervised VAE encoding of the tumor’s gene expression profile leads to better area under the receiver operating characteristic curve and area under the precision-recall curve classification performance than the original gene expression profile or the PCA principal components or the ICA components of the gene expression profile, in four out of five cancer types that we tested.ConclusionsGiven high-dimensional “omics” data, the VAE is a powerful tool for obtaining a nonlinear low-dimensional embedding; it yields features that retain biological patterns that distinguish between different types of cancer and that enable more accurate tumor transcriptome-based prediction of response to chemotherapy than would be possible using the original data or their principal components.
Non-small-cell lung cancer classification via RNA-Seq and histology imaging probability fusion
Authors: Carrillo-Perez Francisco , Morales Juan Carlos , Castillo-Secilla Daniel , Molina-Castro Yésica , Guillén Alberto , Rojas Ignacio , Herrera Luis Javier 
Published: September 2021

AbstractBackgroundAdenocarcinoma and squamous cell carcinoma are the two most prevalent lung cancer types, and their distinction requires different screenings, such as the visual inspection of histology slides by an expert pathologist, the analysis of gene expression or computer tomography scans, among others. In recent years, there has been an increasing gathering of biological data for decision support systems in the diagnosis (e.g. histology imaging, next-generation sequencing technologies data, clinical information, etc.). Using all these sources to design integrative classification approaches may improve the final diagnosis of a patient, in the same way that doctors can use multiple types of screenings to reach a final decision on the diagnosis. In this work, we present a late fusion classification model using histology and RNA-Seq data for adenocarcinoma, squamous-cell carcinoma and healthy lung tissue.ResultsThe classification model improves results over using each source of information separately, being able to reduce the diagnosis error rate up to a 64% over the isolate histology classifier and a 24% over the isolate gene expression classifier, reaching a mean F1-Score of 95.19% and a mean AUC of 0.991.ConclusionsThese findings suggest that a classification model using a late fusion methodology can considerably help clinicians in the diagnosis between the aforementioned lung cancer cancer subtypes over using each source of information separately. This approach can also be applied to any cancer type or disease with heterogeneous sources of information.