bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Feasibility of Discharge Without an Opioid Prescription for Patients Undergoing Gynecologic Surgery
Authors: Margolis Benjamin , Andriani Leslie , Baumann Katherine , Hirsch Anna M. , Pothuri Bhavana 
Published: March 2021

(Abstracted from Obstet Gynecol 2020;136:1126–1134)
Hysterectomy is the second most common surgical procedure among women in the United States, with approximately 600,000 hysterectomies performed annually. Opioids are prescribed to reduce postoperative pain from these and other gynecologic procedures.
Introduction to Artificial Intelligence in Ultrasound Imaging in Obstetrics and Gynecology
Authors: Drukker L. , Noble J. A. , Papageorghiou A. T. 
Published: March 2021

(Abstracted from Ultrasound Obstet Gynecol 2020;56:498–505)
Artificial intelligence (AI) uses specific algorithms to come to conclusions and process human intelligence possibly better than humans can. Thus far, AI has had relatively little impact in the field of obstetrics and gynecology, although in the field providers rely on ultrasound images to make diagnoses.
Reduction in Twin Stillbirth Following Implementation of NICE Guidance
Authors: Khalil A. , Giallongo E. , Bhide A. , Papageorghiou A. T. , Thilaganathan B. 
Published: March 2021

(Abstracted from Ultrasound Obstet Gynecol 2020;56:566–571)
In the United Kingdom, the rate of stillbirths in twin pregnancies has been on the decline. The rate of stillbirths dropped from 11.1 per 1000 births in 2014 to 6.6 in 2016 (95% confidence interval, 9.8–12.5 and 5.2–7.2, respectively).
Cytokine Release Syndrome Biology and Management
Authors: Cobb Dustin A. , Lee Daniel W. 
Published: March 2021

Abstract
The successful application of chimeric antigen receptor (CAR) T cells for the treatment of relapsed and refractory B-cell malignancies has ushered in a new frontier for the immunotherapy of cancer. Despite its successes, CAR T-cell therapy presents several challenges. Cytokine release syndrome (CRS) triggered by robust and exponential CAR T-cell expansion is the most common adverse effect and may be severe or life-threatening. Although modulation of the interleukin 6 axis was appreciated early on as a means to manage CRS, the exact underlying mechanisms leading to severe CRS remain to be elucidated. What is clear is that severe CRS involves recruitment of the broader immune system into a hyperinflammatory and unregulated state. Myeloid-derived cells appear to play a critical role in this regard and are at the center of active investigation. In this article, we will focus on important elements of CRS, the clinical manifestations, underlying biology, and management strategies including grading, supportive care, and treatment via immunosuppression.
Quantitative Morphometric Analysis of Anatomical Landmarks Involved in Bilateral Sagittal Split Osteotomy in Different Skeletal Malocclusions Using Cone-Beam Computed Tomography
Authors: Khalighi Sigaroudi Ali , Nazarpour Yousefdeh Ali , Dalili Kajan Zahra , Rafiei Elahe 
Published: March 2021

Background:
To assess and compare the anatomical landmarks involved in bilateral sagittal split osteotomy (BSSO) in different skeletal malocclusions quantitatively using cone-beam computed tomography (CBCT).

Methods:
This retrospective study evaluated 63 CBCT scans of the three malocclusion classes (n = 21). Twenty-one quantitative variables were measured and compared between different malocclusion classes. One-way ANOVA, Welch test, Kruskal Wallis test and the Mann–Whitney test with Bonferroni adjustment were used for data analysis. The level of significance was set at ≤0.05.

Results:
The patients had a mean age of 26.35 years (range 18–58 years). The width of the lateral cortex in the posterior third (T1-P) of ramus in the left side, and the mean value in the right and left sides were significantly different between different classes of malocclusion (P = 0.049) such that class II patients had significantly thinner lateral cortex. No other significant differences were noted between different malocclusion classes in other variables.

Conclusion:
The quantitative morphological assessment of the mandible in BSSO of different malocclusion classes did not reveal significant differences. There is no superiority in the dimensions of discussed landmarks involved in BSSO among different malocclusion classes. So the risk or the safety of this kind of surgery is similar for these classes. Thus, diagnostic preoperative workup by CBCT is imperative for selection of a surgical approach with minimal postoperative complications.
Sports-Related Cervical Spine Injuries – Background, Triage, and Prevention
Authors: Basil Gregory W. , Burks S. Shelby , Green Barth A. 
Published: March 2021

Abstract
Cervical spinal injuries are a rare, but potentially devastating occurrence in sports. Although many of these injuries occur in unsupervised sports, they are also seen in organized sports – most commonly in football, wrestling, and ice hockey. Additionally, although each sport is associated with its own unique injury patterns, axial loading remains a common theme seen in cervical injuries associated with significant neurologic impairment. Regardless of the mechanism, a cautious and conservative approach should be taken with regards to evaluation, management, and return to play.
Trauma outcome predictor: An artificial intelligence interactive smartphone tool to predict outcomes in trauma patients
Authors: Maurer Lydia R. , Bertsimas Dimitris , Bouardi Hamza Tazi , El Hechi Majed , El Moheb Mohamad , Giannoutsou Katerina , Zhuo Daisy , Dunn Jack , Velmahos George C. , Kaafarani Haytham M.A. 
Published: March 2021

BACKGROUND
Classic risk assessment tools often treat patients’ risk factors as linear and additive. Clinical reality suggests that the presence of certain risk factors can alter the impact of other factors; in other words, risk modeling is not linear. We aimed to use artificial intelligence (AI) technology to design and validate a nonlinear risk calculator for trauma patients.

METHODS
A novel, interpretable AI technology called Optimal Classification Trees (OCTs) was used in an 80:20 derivation/validation split of the 2010 to 2016 American College of Surgeons Trauma Quality Improvement Program database. Demographics, emergency department vital signs, comorbidities, and injury characteristics (e.g., severity, mechanism) of all blunt and penetrating trauma patients 18 years or older were used to develop, train then validate OCT algorithms to predict in-hospital mortality and complications (e.g., acute kidney injury, acute respiratory distress syndrome, deep vein thrombosis, pulmonary embolism, sepsis). A smartphone application was created as the algorithm’s interactive and user-friendly interface. Performance was measured using the c-statistic methodology.

RESULTS
A total of 934,053 patients were included (747,249 derivation; 186,804 validation). The median age was 51 years, 37% were women, 90.5% had blunt trauma, and the median Injury Severity Score was 11. Comprehensive OCT algorithms were developed for blunt and penetrating trauma, and the interactive smartphone application, Trauma Outcome Predictor (TOP) was created, where the answer to one question unfolds the subsequent one. Trauma Outcome Predictor accurately predicted mortality in penetrating injury (c-statistics: 0.95 derivation, 0.94 validation) and blunt injury (c-statistics: 0.89 derivation, 0.88 validation). The validation c-statistics for predicting complications ranged between 0.69 and 0.84.

CONCLUSION
We suggest TOP as an AI-based, interpretable, accurate, and nonlinear risk calculator for predicting outcome in trauma patients. Trauma Outcome Predictor can prove useful for bedside counseling of critically injured trauma patients and their families, and for benchmarking the quality of trauma care.
Modelling the population-level protection conferred by COVID-19 vaccination
Authors: Padmanabhan Pranesh , Desikan Rajat , Dixit Narendra M. 
Published: March 2021

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines work predominantly by eliciting neutralizing antibodies (NAbs), how the protection they confer depends on the NAb response to vaccination is unclear. Here, we collated and analysed in vitro dose-response curves of >70 NAbs and constructed a landscape defining the spectrum of neutralization efficiencies of NAbs elicited. We mimicked responses of individuals by sampling NAb subsets of known sizes from the landscape and found that they recapitulated responses of convalescent patients. Combining individual responses with a mathematical model of within-host SARS-CoV-2 infection post-vaccination, we predicted how the population-level protection conferred would increase with the NAb response to vaccination. Our predictions captured the outcomes of vaccination trials. Our formalism may help optimize vaccination protocols, given limited vaccine availability.One sentence summaryViremic control by the spectrum of neutralizing antibodies elicited by vaccination determines COVID-19 vaccine efficacies.
Improving postpartum hemorrhage risk prediction using longitudinal electronic medical records
Authors: Zheutlin Amanda B , Vieira Luciana , Li Shilong , Wang Zichen , Schadt Emilio , Gross Susan , Stone Joanne , Schadt Eric , Li Li 
Published: March 2021

ABSTRACTObjectivePostpartum hemorrhage (PPH) remains a leading cause of preventable maternal mortality in the US. Our goal was to develop a novel risk assessment tool and compare its accuracy to those used in current practice.Materials and MethodsWe used a PPH digital phenotype we developed and validated previously to identify 6,639 cases from our delivery cohort (N=70,948). Using a vast array of known and potential risk factors extracted from electronic medical records available prior to delivery, we trained a gradient boosting model in a subset of our cohort. In a held-out test sample, we compared performance of our model to three clinical risk tools and one previously published model.ResultsOur 24-feature model achieved an area under the curve (AUC) of 0.71 (95% confidence interval [CI], 0.69-0.72), higher than all other tools (research-based AUC: 0.67 [95%CI, 0.66-0.69], clinical AUCs: 0.55 [95%CI, 0.54-0.56] to 0.61 [95%CI, 0.59-0.62]). Five features were novel including red blood cell indices and infection markers measured standardly upon admission. Additionally, we identified inflection points for several vital signs and labs where risk rose substantially. Most notably, patients with median intrapartum systolic blood pressure above 132mmHg had an 11% [interquartile range, 4%] median increase in relative risk for PPH.ConclusionsWe developed a novel approach for predicting PPH and identified clinical feature thresholds that can guide intrapartum monitoring for PPH risk. Our results suggest our model is an excellent candidate for prospective evaluation and could ultimately reduce PPH morbidity and mortality through early detection and prevention.
A Longitudinal Study of BNT162b2 Vaccine-Induced Humoral Response and Reactogenicity in Health Care Workers with Prior COVID-19 Disease
Authors: Kelsen Steven G. , Braverman Alan S. , Aksoy Mark O. , Hayman Jacob A. , Patel Puja , Rajput Charu , Zhao Huaqing , Fisher Susan G. , Ruggieri Michael R. , Gentile Nina T. 
Published: March 2021

ABSTRACTBackgroundCurrent recommendations in the United States are that subjects with a previous history of COVID-19 disease receive the full 2 dose mRNA vaccine regimen. We tested the hypothesis that humoral immune responses and reactogenicity to a SARS-CoV-2 mRNA vaccine (BNT-162b2) differ qualitatively and quantitatively in subjects with prior SARS-CoV-2 infection versus infection-naïve subjects.MethodsHealth care workers (n=61) from a single academic institution with and without prior COVID-19 received two 30 µg doses of BNT162b2 vaccine 3 weeks apart. The COVID group (n=30) received vaccine approximately 7 months post infection. IgG antibody against the Spike receptor-binding domain (RBD), serum neutralizing activity and vaccine adverse reactions were assessed every 2 weeks for 56 days after the 1st injection. A longitudinal design and long study duration allowed the onset, maximum response and initial decay rate of Spike IgG antibody to be assessed in each subject. In addition, Spike IgG antibody levels are expressed as µg / mL to provide normal values for clinical decision making.FindingsSpike IgG responses were highly variable in both groups. However, the COVID group manifested rapid increases in Spike IgG antibody and serum neutralizing activity post 1st vaccine dose but little or no increase in Spike IgG or serum neutralizing activity after the 2nd dose. In fact, Spike IgG was maximum prior to the 2nd dose in 36% of the COVID group and 0% of controls. Peak IgG antibody was lower but appeared to fall more slowly in the COVID than in the control group. Finally, adverse systemic reactions e.g., fever, headache and malaise, after both the 1st and 2nd injection were more frequent and lasted longer in the COVID group than in the control group.ConclusionsHealth care workers with prior COVID-19 demonstrate a robust, accelerated humoral immune response to the 1st dose of the COVID-19 mRNA vaccine but attenuated response to the 2nd dose. They also experience greater reactogenicity than controls. Accordingly, subjects with prior COVID-19 may require only a single dose of vaccine.
A ketogenic supplement improves white matter energy supply and processing speed in mild cognitive impairment
Authors: Roy Maggie , Fortier Mélanie , Rheault François , Edde Manon , Croteau Etienne , Castellano Christian-Alexandre , Langlois Francis , St-Pierre Valérie , Cuenoud Bernard , Bocti Christian , Fulop Tamas , Descoteaux Maxime , Cunnane Stephen C. 
Published: March 2021

AbstractINTRODUCTIONWhite matter (WM) energy supply is crucial for axonal function and myelin maintenance. Providing ketones, the brain’s alternative fuel to glucose, is a therapeutic strategy to bypass the brain’s glucose-specific energy deficit in mild cognitive impairment (MCI). How an additional supply of ketones affects glucose or ketone uptake in specific WM fascicles in MCI has not previously been described.METHODSThis 6-month interventional study included MCI participants randomized to a placebo (n = 16) or ketogenic medium chain triglyceride (kMCT; n = 17) drink. A neurocognitive battery and brain imaging were performed pre- and post-intervention. WM fascicle uptake of ketone and glucose and structural properties were assessed using positron emission tomography and diffusion imaging, respectively.RESULTSKetone uptake was increased by 2.5 to 3.2-fold in nine fascicles of interest (P < 0.001) only in the kMCT group, an effect seen both in deep WM and in fascicle cortical endpoints. Improvement in processing speed was associated with WM ketone uptake globally and in individual fascicles, most importantly the fornix (r = +0.61; P = 0.014).DISCUSSIONA 6-month ketogenic supplementation in MCI improved WM energy supply globally. The significant positive association with processing speed suggests that ketones may have a role in myelin integrity in MCI.
Integrated immunovirological profiling validates plasma SARS-CoV-2 RNA as an early predictor of COVID-19 mortality
Authors: Brunet-Ratnasingham Elsa , Anand Sai Priya , Gantner Pierre , Moquin-Beaudry Gaël , Dyachenko Alina , Brassard Nathalie , Beaudoin-Bussières Guillaume , Pagliuzza Amélie , Gasser Romain , Benlarbi Mehdi , Point Floriane , Prévost Jérémie , Laumaea Annemarie , Niessl Julia , Nayrac Manon , Sannier Gérémy , Boutin Marianne , Descôteux-Dinelle Jade , Gendron-Lepage Gabrielle , Goyette Guillaume , Bourassa Catherine , Medjahed Halima , Orban Catherine , Butler-Laporte Guillaume , Morrison David , Zhou Sirui , Nakanishi Tomoko , Laurent Laetitia , Richard Jonathan , Dubé Mathieu , Fromentin Rémi , Rébillard Rose-Marie , Arbour Nathalie , Prat Alexandre , Larochelle Catherine , Durand Madeleine , Brent Richards J , Chassé Michaël , Tétreault Martine , Chomont Nicolas , Finzi Andrés , Kaufmann Daniel E. 
Published: March 2021

ABSTRACTDespite advances in COVID-19 management, it is unclear how to recognize patients who evolve towards death. This would allow for better risk stratification and targeting for early interventions. However, the explosive increase in correlates of COVID-19 severity complicates biomarker prioritisation. To identify early biological predictors of mortality, we performed an immunovirological assessment (SARS-CoV-2 viral RNA, cytokines and tissue injury markers, antibody responses) on plasma samples collected from 144 hospitalised COVID-19 patients 11 days after symptom onset and used to test models predicting mortality within 60 days of symptom onset. In the discovery cohort (n=61, 13 fatalities), high SARS-CoV-2 vRNA, low RBD-specific IgG levels, low SARS-CoV-2-specific antibody-dependent cellular cytotoxicity, and elevated levels of several cytokines and lung injury markers were strongly associated with increased mortality in the entire cohort and the subgroup on mechanical ventilation. Model selection revealed that a three-variable model of vRNA, age and sex was very robust at identifying patients who will succumb to COVID-19 (AUC=0.86, adjusted HR for log-transformed vRNA=3.5; 95% CI: 2.0-6.0). This model remained robust in an independent validation cohort (n=83, AUC=0.85). Quantification of plasma SARS-CoV-2 RNA can help understand the heterogeneity of disease trajectories and identify patients who may benefit from new therapies.
Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection
Authors: Perez-Gomez A , Vitalle J , Gasca-Capote MC , Gutierrez-Valencia A , Trujillo-Rodriguez M , Serna-Gallego A , Muñoz-Muela E , Jimenez-Leon MR , Rafii-El-Idrissi Benhnia M , Rivas-Jeremias I , Sotomayor C , Roca-Oporto C , Espinosa N , Infante-Dominguez C , Crespo-Rivas JC , Fernández-Villar A , Pérez-González A , Lopez-Cortes LF , Poveda E , Ruiz-Mateos E 
Published: March 2021

SUMMARYSevere Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and non-hospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers as CD86 and CD4 were only restored in previously non-hospitalized patients while integrin β7 and indoleamine 2,3- dyoxigenase (IDO) no restoration was observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19.
Prevalence and determinants of serum antibodies to SARS-CoV-2 in the general population of the Gardena Valley
Authors: Melotti Roberto , Scaggiante Federica , Falciani Michela , Weichenberger Christian X. , Foco Luisa , Lombardo Stefano , Grandi Alessandro De , Laer Dorothee von , Mahlknecht Angelika , Pramstaller Peter P. , Pagani Elisabetta , Meier Horand , Gaertner Timon , Troi Christina , Mascalzoni Deborah , Pattaro Cristian , Mian Michael 
Published: March 2021

ABSTRACTBackgroundCommunity-based studies are essential to quantify the spread of SARS-CoV-2 infection and for unbiased characterization of its determinants and outcomes. We conducted a cross-sectional study in the Gardena valley, a major Alpine touristic destination which was struck in the expansion phase of the COVID-19 pandemic over the winter 2020.MethodsWe surveyed 2244 representative study participants who underwent swab and serum antibody tests. We made multiple comparisons among the Abbott and Diasorin bioassays and serum neutralization titers. Seroprevalence accounted for the stratified design, non-response and test accuracy. Determinants and symptoms predictive of infection were analyzed by weighted multiple logistic regression.ResultsSARS-CoV-2 seroprevalence was 26.9% (95% confidence interval: 25.2%, 28.6%) by June 2020. The serum antibody bioassays had modest agreement with each other. Receiver operating characteristic curve analysis on the serum neutralizing capacity showed better performance of the Abbott test at lower than the canonical threshold. Socio-demographic characteristics showed no clear evidence of association with seropositivity, which was instead associated with place of residence and economic activity. Loss of taste or smell, fever, difficulty in breathing, pain in the limbs, and weakness were the most predictive symptoms of positive antibody test results. Fever and weakness associations were age-dependent.ConclusionThe Gardena valley had one of the highest SARS-CoV-2 infection prevalence in Europe. The age-dependent risk associated with COVID-19 related symptoms implies targeted strategies for screening and prophylaxis planning.
Cancer services during the COVID-19 pandemic: systematic review of patients’ and caregivers’ experiences
Authors: Dhada Symran , Stewart Derek , Cheema Ejaz , Hadi Muhammed Abdul , Paudyal Vibhu 
Published: March 2021

AbstractBackgroundCancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients’ and caregivers’ experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing.MethodsA protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline.ResultsA total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19.ConclusionsPatients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.Protocol RegistrationPublished protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906)