bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Impact of Dysglycemia in Patients with Sepsis Under Moderate Glycemic Control
Authors: Fujishima Seitaro , Gando Satoshi , Saitoh Daizoh , Kushimoto Shigeki , Ogura Hiroshi , Abe Toshikazu , Shiraishi Atsushi , Mayumi Toshihiko , Sasaki Junichi , Kotani Joji , Takeyama Naoshi , Tsuruta Ryosuke , Takuma Kiyotsugu , Yamashita Norio , Shiraishi Shin-ichiro , Ikeda Hiroto , Shiino Yasukazu , Tarui Takehiko , Nakada Taka-aki , Hifumi Toru , Otomo Yasuhiro , Okamoto Kohji , Sakamoto Yuichiro , Hagiwara Akiyoshi , Masuno Tomohiko , Ueyama Masashi , Fujimi Satoshi , Yamakawa Kazuma , Umemura Yutaka 
Published: May 2021

ABSTRACT
Glycemic control strategies for sepsis have changed significantly over the last decade, but their impact on dysglycemia and its associated outcomes has been poorly understood. In addition, there is controversy regarding the detrimental effects of hyperglycemia in sepsis. To evaluate the incidence and risks of dysglycemia under current strategy, we conducted a preplanned subanalysis of the sepsis cohort in a prospective, multicenter FORECAST study. A total of 1,140 patients with severe sepsis, including 259 patients with pre-existing diabetes, were included. Median blood glucose levels were approximately 140 mg/dL at 0 and 72 h indicating that blood glucose was moderately controlled. The rate of initial and late hyperglycemia was 27.3% and 21.7%, respectively. The rate of early hypoglycemic episodes during the initial 24 h was 13.2%. Glycemic control was accompanied by a higher percentage of initial and late hyperglycemia but not with early hypoglycemic episodes, suggesting that glycemic control was targeted at excess hyperglycemia. In nondiabetic patients, late hyperglycemia (hazard ratio, 95% confidence interval; P value: 1.816, 1.116–2.955, 0.016) and early hypoglycemic episodes (1.936, 1.180–3.175, 0.009) were positively associated with in-hospital mortality. Further subgroup analysis suggested that late hyperglycemia and early hypoglycemic episodes independently, and probably synergistically, affect the outcomes. In diabetic patients, however, these correlations were not observed. In conclusion, a significantly high incidence of dysglycemia was observed in our sepsis cohort under moderate glycemic control. Late hyperglycemia in addition to early hypoglycemia was associated with poor outcomes at least in nondiabetic patients. More sophisticated approaches are necessary to reduce the incidence of these serious complications.
The Use of Ancillary Services Under a Bundled Care Versus a Fee-For-Service Payment Model
Authors: Caldwell Lauren , Halder Gabriela E. , Nutt Stephanie , Rogers Rebecca G. , Wright Michelle L. , Baum Audrey , White Amanda B. 
Published: May 2021

Objectives
Colocated services in a team-based integrated practice unit (IPU) optimize care of pelvic floor disorders. Our goal was to compare ancillary service utilization in a multidisciplinary IPU between patients covered by a bundled payment model (BPM) versus a traditional fee-for-service model (FFSM).

Methods
Medical records of women attending an IPU for pelvic floor disorders with colocated services, including nutrition, social work, psychiatry, physical therapy, and subspecialty care between October 2017 and December 2018, were included in this retrospective chart review. All patients were offered treatment with ancillary services according to standardized care pathways. Data extracted included patient demographics, pelvic floor disorder diagnoses, baseline severity measures, payment model, and ancillary services used. Univariate and multivariate logistic regression identified variables predicting higher uptake of ancillary services.

Results
A total of 575 women with pelvic floor disorders presented for care during the study period, of which 35.14% attended at least 1 appointment with any ancillary services provider. Ancillary service utilization did not differ between patients in the BPM group and those in the FFSM group (36.22 vs 33.47%; P = 0.489). Social work services were more likely to be used by the BPM compared with the FFSM group (15.95 vs 6.28%; P < 0.001). The diagnosis of fecal incontinence was associated with a higher chance of using any ancillary service (odds ratio, 4.91; 95% confidence interval, 1.81–13.33; P = 0.002).

Conclusions
One third of patients with pelvic floor disorders receiving care in an IPU used colocated ancillary services. Utilization does not differ between payment models.
Regularization by denoising sub-sampled Newton method for spectral CT multi-material decomposition
Authors: Perelli Alessandro , Andersen Martin S. 
Published: May 2021

Spectral Computed Tomography (CT) is an emerging technology that enables us to estimate the concentration of basis materials within a scanned object by exploiting different photon energy spectra. In this work, we aim at efficiently solving a model-based maximum-a-posterior problem to reconstruct multi-materials images with application to spectral CT. In particular, we propose to solve a regularized optimization problem based on a plug-in image-denoising function using a randomized second order method. By approximating the Newton step using a sketching of the Hessian of the likelihood function, it is possible to reduce the complexity while retaining the complex prior structure given by the data-driven regularizer. We exploit a non-uniform block sub-sampling of the Hessian with inexact but efficient conjugate gradient updates that require only Jacobian-vector products for denoising term. Finally, we show numerical and experimental results for spectral CT materials decomposition.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
Synergistic multi-contrast cardiac magnetic resonance image reconstruction
Authors: Qi Haikun , Cruz Gastao , Botnar René , Prieto Claudia 
Published: May 2021

Cardiac magnetic resonance imaging (CMR) is an important tool for the non-invasive diagnosis of a variety of cardiovascular diseases. Parametric mapping with multi-contrast CMR is able to quantify tissue alterations in myocardial disease and promises to improve patient care. However, magnetic resonance imaging is an inherently slow imaging modality, resulting in long acquisition times for parametric mapping which acquires a series of cardiac images with different contrasts for signal fitting or dictionary matching. Furthermore, extra efforts to deal with respiratory and cardiac motion by triggering and gating further increase the scan time. Several techniques have been developed to speed up CMR acquisitions, which usually acquire less data than that required by the Nyquist–Shannon sampling theorem, followed by regularized reconstruction to mitigate undersampling artefacts. Recent advances in CMR parametric mapping speed up CMR by synergistically exploiting spatial–temporal and contrast redundancies. In this article, we will review the recent developments in multi-contrast CMR image reconstruction for parametric mapping with special focus on low-rank and model-based reconstructions. Deep learning-based multi-contrast reconstruction has recently been proposed in other magnetic resonance applications. These developments will be covered to introduce the general methodology. Current technical limitations and potential future directions are discussed.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 1’.
Clinical outcomes and cost-effectiveness of COVID-19 vaccination in South Africa
Authors: Reddy Krishna P. , Fitzmaurice Kieran P. , Scott Justine A. , Harling Guy , Lessells Richard J. , Panella Christopher , Shebl Fatma M. , Freedberg Kenneth A. , Siedner Mark J. 
Published: May 2021

ABSTRACTLow- and middle-income countries are implementing COVID-19 vaccination strategies in light of varying vaccine efficacies and costs, supply shortages, and resource constraints. Here, we use a microsimulation model to evaluate clinical outcomes and cost-effectiveness of a COVID-19 vaccination program in South Africa. We varied vaccination coverage, pace, acceptance, effectiveness, and cost as well as epidemic dynamics. Providing vaccines to at least 40% of the population and prioritizing vaccine rollout prevented >9 million infections and >73,000 deaths and reduced costs due to fewer hospitalizations. Model results were most sensitive to assumptions about epidemic growth and prevalence of prior immunity to SARS-CoV-2, though the vaccination program still provided high value and decreased both deaths and health care costs across a wide range of assumptions. Vaccination program implementation factors, including prompt procurement, distribution, and rollout, are likely more influential than characteristics of the vaccine itself in maximizing public health benefits and economic efficiency.
Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales
Authors: Aldridge Robert W , Pineo Helen , Fragaszy Ellen , Eyre Max , Kovar Jana , Nguyen Vincent , Beale Sarah , Byrne Thomas , Aryee Anna , Smith Colette , Devakumar Delanjathan , Taylor Jonathon , Katikireddi Srinivasa Vittal , Erica Fong Wing Lam , Geismar Cyril , Patel Parth , Shrotri Madhumita , Braithwaite Isobel , Navaratnam Annalan M D , Johnson Anne M , Hayward Andrew 
Published: May 2021

AbstractBackgroundHousehold overcrowding is associated with increased risk of infectious diseases across contexts and countries. Limited data exist linking household overcrowding and risk of COVID-19. We used data collected from the Virus Watch cohort to examine the association between overcrowded households and SARS-CoV-2.MethodsThe Virus Watch study is a household community cohort of acute respiratory infections in England & Wales that began recruitment in June 2020. We calculated the persons per room for each household and classified accommodation as overcrowded when the number of rooms□was fewer than the number of people. We considered two primary outcomes - PCR-confirmed positive SARS-CoV-2 antigen tests and laboratory confirmed SARS-CoV-2 antibodies (Roche Elecsys anti-N total immunoglobulin assay). We used mixed effects logistic regression models that accounted for household structure to estimate the association between household overcrowding and SARS-CoV-2 infection.ResultsThe proportion of participants with a positive SARS-CoV-2 PCR result was highest in the overcrowded group (6.6%; 73/1,102) and lowest in the under-occupied group (2.9%; 682/23,219). In a mixed effects logistic regression model that included age, sex, ethnicity, household income and geographical region, we found strong evidence of an increased odds of having a positive PCR SARS-CoV-2 antigen result (Odds Ratio 3.72; 95% CI: 1.92, 7.13; p-value < 0.001) and increased odds of having a positive SARS-CoV-2 antibody result in individuals living in overcrowded houses (2.96; 95% CI: 1.13, 7.74; p-value =0.027) compared to people living in under-occupied houses. The proportion of variation at the household level was 75.1% and 74.0% in the PCR and antibody models respectively.DiscussionPublic health interventions to prevent and stop the spread of SARS-CoV-2 should consider the much greater risk of infection for people living in overcrowded households and pay greater attention to reducing household transmission. There is an urgent need to better recognise housing as a leading determinant of health in the context of a pandemic and beyond.
Quantifying the potential dominance of immune-evading SARS-CoV-2 variants in the United States
Authors: Sah Pratha , Vilches Thomas N. , Shoukat Affan , Fitzpatrick Meagan C. , Pandey Abhishek , Singer Burton H. , Moghadas Seyed M. , Galvani Alison P. 
Published: May 2021

AbstractRecent evidence suggests that some new SARS-CoV-2 variants with spike mutations, such as P.1 (Gamma) and B.1.617.2 (Delta), exhibit partial immune evasion to antibodies generated by natural infection or vaccination. By considering the Gamma and Delta variants in a multi-variant transmission dynamic model, we evaluated the dominance of these variants in the United States (US) despite mounting vaccination coverage and other circulating variants. Our results suggest that while the dominance of the Gamma variant is improbable, the Delta variant would become the most prevalent variant in the US, driving a surge in infections and hospitalizations. Our study highlights the urgency for accelerated vaccination and continued adherence to non-pharmaceutical measures until viral circulation is driven low.
Contribution of white matter hyperintensities to ventricular enlargement in older adults
Authors: Jochems Angela CC , Maniega Susana Muñoz , del C Valdés Hernández Maria , Barclay Gayle , Anblagan Devasuda , Ballerini Lucia , Meijboom Rozanna , Wiseman Stewart , Taylor Adele M , Corley Janie , Chappell Francesca M , Backhouse Ellen V , Stringer Michael S , Dickie David Alexander , Bastin Mark E , Deary Ian J , Cox Simon R , Wardlaw Joanna M 
Published: May 2021

AbstractBackground and PurposeVentricular enlargement, especially enlargement of the lateral ventricles, is thought to be positively associated with white matter hyperintensities (WMH). Possible mechanisms behind the association are unclear. Lateral ventricles might increase due to generalised brain tissue loss not specific to periventricular WMH. Alternatively, they may expand into areas of tissue loss related to WMH, take up space and grow in size.MethodsWe investigated relations between longitudinal lateral ventricle and WMH volume changes, alongside vascular risk factors, in community-dwelling older people. We assessed lateral ventricle and WMH volumes, accounting for total brain volume, blood pressure, medical assessments and self-reported history of stroke, cardiovascular disease, diabetes and smoking. We used longitudinal data at three time points, each three years apart, between ages 73 to 79, including MRI data from all available time points.ResultsLateral ventricle volume increased steadily with age in all participants, WMH volume change was more variable. Decrease of WMH volume was found in around 20% and increase in remaining subjects. Using a repeated-measurements linear mixed model we found that over 6 years, lateral ventricle volume increased by 3% per year of age, 0.1% per mm Hg increase in mean blood pressure, 3.2% per 1% decrease of total brain volume, and 4.5% per 1% increase of WMH volume. Over time, lateral ventricle volumes were 19% smaller in women than men. No associations were found with other variables.ConclusionsChanges in lateral ventricle volumes and WMH volumes over time are only modestly associated, independent of general brain atrophy.
Clinicopathological features and outcome of COVID-19- early experiences from three covid hospitals, Chittagong, Bangladesh
Authors: Biswas Rajat Sanker Roy , Nath Jishu Deb , Barua Pranab Kumar , Karim Md Rejaul , Safatujjahan  , Islam Mohammad Saiful , Ahmed Kazi Farhad 
Published: May 2021

AbstractIntroductionCOVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study is to find the clinicopathological features and outcome of COVID patients admitted in three COVID dedicated hospitals of Chittagong, Bnagladesh.MethodsThis was an observational study where a total of 209 patients admitted in three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data was compiled and analyzed by SPSS-20.ResultsAmong 209 patients most of them were male 139(66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in age group 41-50 years 36(17.2%), 51-60 years 54(25.8%) and 61-70 years 57(27.3%). Among all 92(44%) patients were RT-PCR positive and 117(56%) were probable cases. Fever was present in 195(93.3%) cases, cough in 180(86.1%), respiratory distress in 105(50.2%) anosmia in 123(58.8%), aguesea in 112 (53.58%) and lethargy was present in 143(68.42%). Chest X-ray findings revealed 73(34.9%) had bilateral patchy opacities, 20(9.6%) had unilateral opacities 65(31.1%) had consolidations, 6(2.9%) had ground glass opacities and 2(1.0%) had pleural effusion. Supplemental O2 was given in 173(82.8%) patients, Favipiravir in 59(28.2%), Remdisivir in 111(53.1%), Methylprednisolone in 87(41.6%), Dexamethasone in 93(44.5%), Antibiotics in 204(97.60%), Toccilizumab in 34(16.3%), plasma in 18(8.6%) and LMWH in 200(95.7%) patients. Regarding outcome of the COVID patients admitted, 85(92.4%) patients improved, 6(6.5%) died who were RT-PCR positive and 107(91.15%) improved, 9(7.7%) died who were probable cases. Total death rate was 7.1%.ConclusionPresent study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.
Mental health of Adolescents in the Pandemic: Long-COVID19 or Long-Pandemic Syndrome?
Authors: Blankenburg Judith , Wekenborg Magdalena K. , Reichert Jörg , Kirsten Carolin , Kahre Elisabeth , Haag Luise , Schumm Leonie , Czyborra Paula , Berner Reinhard , Armann Jakob P. 
Published: May 2021

AbstractBackroundPost-COVID19 complications such as pediatric inflammatory multisystem syndrome (PIMS) and Long-COVID19 move increasingly into focus, potentially causing more harm in this age group than the acute infection. To better understand the symptoms of long-COVID19 in adolescents and to distinguish infection-associated symptoms from pandemic-associated symptoms, we conducted a Long-COVID19 survey, comparing responses from seropositive and seronegative adolescents. To our knowledge, data of Long-COVID19 surveys with seronegative control groups have not been published yet.MethodsSince May 2020 students grade 8-12 in fourteen secondary schools in Eastern Saxony were enrolled in the SchoolCovid19 study. Seroprevalence was assessed via serial SARS-CoV-2 antibody testing in all participants. Furthermore, during the March/April 2021 study visit all participants were asked to complete a 12 question Long-COVID19 survey regarding the occurrence and frequency of difficulties concentrating, memory loss, listlessness, headache, abdominal pain, myalgia/ arthralgia, fatigue, insomnia and mood (sadness, anger, happiness and tenseness).Findings1560 students with a median age of 15 years participated in this study. 1365 (88%) were seronegative, 188 (12%) were seropositive. Each symptom was present in at least 35% of the students within the last seven days before the survey. However, there was no statistical difference comparing the reported symptoms between seropositive students and seronegative students. Whether the infection was known or unknown to the participant did not influence the prevalence of symptoms.InterpretationThe lack of differences comparing the reported symptoms between seropositive and seronegative students suggests that Long-COVID19 might be less common than previously thought and emphasizing the impact of pandemic-associated symptoms regarding the well-being and mental health of young adolescents.FundingThis study was supported by a grant by the Federal State of Saxony. M.K.W. was supported by the Else Kröner-Fresenius Center for Digital Health (EKFZ), TU Dresden, Germany.
COVID-19 Pandemic and Academic Speculation of Medical Students of Bangladesh: A Cross-sectional, Comparative Study
Authors: Johora Fatema , Abbasy Asma Akter , Jeenia Fatiha Tasmin , Bhowmik Mithun Chandro , Moitra Priyanka , Mahboob Sabiha , Ferdous Jannatul 
Published: May 2021

AbstractBackgroundCOVID-19 pandemic has caused unprecedented disruptions worldwide including education system. While the necessary focus has been on patient care andwellbeing of healthcare professionals, the impacts on medical students need to be discussed.MethodsThis cross-sectional comparative study was conducted to evaluate the academic speculation of medical students studying in government and non-government institute during COVID-19 pandemic. A structured questionnaire survey linked in the google form was used as study instrument and was distributed among study population through email, messenger, whatsapp and other social media. Total 1020 students were participated in the studyResultsIn this research, 441 (43.24%) and 579 (56.77%) students were from government and non-government medical colleges respectively. Opinion of both group was almost similar regarding disruption of medical education, loss of clinical skills and competency, future career plan, and stress and anxiety but significant differences were observed between both group regarding issue of financial burden, meaningful learning opportunities, fear of getting infected and maintenance of social distancing in hostel.ConclusionThe study revealed similar kind of viewpoint about disruption of education, loss of clinical skill and competency, changing aspects of future career plan and increased level of stress and anxiety among medical students of government and non-government institutes of Bangladesh but different speculations were found regarding issue of financial burden, meaningful learning opportunities, fear of getting infected and possibility of maintenance of social distancing in hostel.
Mechanosensitivity of amoeboid cells crawling in 3D
Authors: Gaertner Florian , Reis-Rodrigues Patricia , de Vries Ingrid , Hons Miroslav , Aguilera Juan , Riedl Michael , Leithner Alexander , Merrin Jack , Zheden Vanessa , Kaufmann Walter Anton , Hauschild Robert , Sixt Michael 
Published: May 2021

SUMMARYEfficient immune-responses require migrating leukocytes to be in the right place at the right time. When crawling through the body amoeboid leukocytes must traverse complex three-dimensional tissue-landscapes obstructed by extracellular matrix and other cells, raising the question how motile cells adapt to mechanical loads to overcome these obstacles. Here we reveal the spatio-temporal configuration of cortical actin-networks rendering amoeboid cells mechanosensitive in three-dimensions, independent of adhesive interactions with the microenvironment. In response to compression, Wiskott-Aldrich syndrom protein (WASp) assembles into dot-like structures acting as nucleation sites for actin spikes that in turn push against the external load. High precision targeting of WASp to objects as delicate as collagen fibers allows the cell to locally and instantaneously deform its viscoelastic surrounding in order to generate space for forward locomotion. Such pushing forces are essential for fast and directed leukocyte migration in fibrous and cell-packed tissues such as skin and lymph nodes.In BriefWASp-driven actin spikes counter compressive loads of crowded tissue-landscapes.