bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Quantitative Systematic Review of Clinical Outcome Measure Use in Peripheral Nerve Injury of the Upper Limb
Authors: Murphy Ralph N A , Elsayed Heba , Singh Sahiba , Dumville Jo , Wong Jason K F , Reid Adam J 
Published: February 2021

Abstract

BACKGROUND
Peripheral nerve injury (PNI) is common, leading to reduced function, pain, and psychological impact. Treatment has not progressed partly due to inability to compare outcomes between centers managing PNI. Numerous outcome measures exist but there is no consensus on which outcome measures to use nor when.

OBJECTIVE
To perform a systematic review in order to describe and classify outcome measures used in PNI.

METHODS
A search of Ovid Medline, Ovid Embase, Allied and Complementary Medicine Database (AMED), and CENTRAL (Cochrane Clinical Trials) was conducted. Randomized control trials (RCTs), cohort studies, and case-controlled and case series (≥5 participants) published from inception of the database until 2019 investigating adult patients with a traumatic upper limb PNI in which an outcome measurement was utilized were included.

RESULTS
A total of 96 studies were included (15 RCTs, 8 case-control studies, 18 cohort studies, 5 observational studies, and the remainder were case series or retrospective reviews). A total of 56 individual outcome measures were identified, utilized across 28 different countries and 7097 patients. Ten core domains were defined: sensory subjective, sensory objective, motor subjective, motor objective, sensorimotor function, psychology and well-being, disability, quality of life, pain and discomfort, and neurotrophic measures.

CONCLUSION
Lack of consensus on outcome measure use hinders comparison of outcomes between nerve injury centers and the development of novel treatments. Development of a core outcome set will help standardize outcome reporting, improve translation of novel treatments from lab to clinical practice, and ensure future research in PNI is more amenable to systematic review and meta-analysis.
A descriptive analysis of end-of-life discussions for high-grade glioma patients
Authors: Chikada Ai , Takenouchi Sayaka , Arakawa Yoshiki , Nin Kazuko 
Published: February 2021

Abstract

Background
End-of-life discussions (EOLDs) in patients with high-grade glioma (HGG) have not been well described. Therefore, this study examined the appropriateness of timing and the extent of patient involvement in EOLDs and their impact on HGG patients.

Methods
A cross-sectional survey was conducted among 105 bereaved families of HGG patients at a university hospital in Japan between July and August 2019. Fisher’s exact test and the Wilcoxon rank-sum test were used to assess the association between patient participation in EOLDs and their outcomes.

Results
In total, 77 questionnaires were returned (response rate 73%), of which 20 respondents replied with refusal documents. Overall, 31/57 (54%) participated in EOLDs at least once in acute hospital settings, and a significant difference was observed between participating and nonparticipating groups in communicating the patient’s wishes for EOL care to the family (48% vs 8%, P = .001). Moreover, &gt;80% of respondents indicated that the initiation of EOLDs during the early diagnosis period with patients and families was appropriate. Most EOLDs were provided by neurosurgeons (96%), and other health care providers rarely participated. Additionally, patient goals and priorities were discussed in only 28% of the EOLDs. Patient participation in EOLDs was not associated with the quality of EOL care and a good death.

Conclusions
Although participation in EOLDs is relatively challenging for HGG patients, this study showed that participation in EOLDs may enable patients to express their wishes regarding EOL care. It is important to initiate EOLDs early on through an interdisciplinary team approach while respecting patient goals and priorities.
Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies
Authors: Clancy Cornelius J , Schwartz Ilan S , Kula Brittany , Nguyen M Hong 
Published: February 2021

Abstract

Background
Limited clinical data suggest a ~16% prevalence of bacterial superinfections among critically ill patients with coronavirus disease 2019 (COVID-19).

Methods
We reviewed postmortem studies of patients with COVID-19 published in English through September 26, 2020, for histopathologic findings consistent with bacterial lung infections.

Results
Worldwide, 621 patients from 75 studies were included. The quality of data was uneven, likely because identifying superinfections was not a major objective in 96% (72/75) of studies. Histopathology consistent with a potential lung superinfection was reported in 32% (200/621) of patients (22–96 years old; 66% men). Types of infections were pneumonia (95%), abscesses or empyema (3.5%), and septic emboli (1.5%). Seventy-three percent of pneumonias were focal rather than diffuse. The predominant histopathologic findings were intra-alveolar neutrophilic infiltrations that were distinct from those typical of COVID-19-associated diffuse alveolar damage. In studies with available data, 79% of patients received antimicrobial treatment; the most common agents were beta-lactam/beta-lactamase inhibitors (48%), macrolides (16%), cephalosoprins (12%), and carbapenems (6%). Superinfections were proven by direct visualization or recovery of bacteria in 25.5% (51/200) of potential cases and 8% of all patients in postmortem studies. In rank order, pathogens included Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Lung superinfections were the cause of death in 16% of potential cases and 3% of all patients with COVID-19.

Conclusions
Potential bacterial lung superinfections were evident at postmortem examination in 32% of persons who died with COVID-19 (proven, 8%; possible, 24%), but they were uncommonly the cause of death.
Risk Factors for Pneumonia and Death in Adult Patients With Seasonal Influenza and Establishment of Prediction Scores: A Population-Based Study
Authors: Miyashita Koichi , Nakatani Eiji , Hozumi Hironao , Sato Yoko , Miyachi Yoshiki , Suda Takafumi 
Published: February 2021

Abstract

Background
Seasonal influenza remains a global health problem; however, there are limited data on the specific relative risks for pneumonia and death among outpatients considered to be at high risk for influenza complications. This population-based study aimed to develop prediction models for determining the risk of influenza-related pneumonia and death.

Methods
We included patients diagnosed with laboratory-confirmed influenza between 2016 and 2017 (main cohort, n = 25 659), those diagnosed between 2015 and 2016 (validation cohort 1, n = 16 727), and those diagnosed between 2017 and 2018 (validation cohort 2, n = 34 219). Prediction scores were developed based on the incidence and independent predictors of pneumonia and death identified using multivariate analyses, and patients were categorized into low-, medium-, and high-risk groups based on total scores.

Results
In the main cohort, age, gender, and certain comorbidities (dementia, congestive heart failure, diabetes, and others) were independent predictors of pneumonia and death. The 28-day pneumonia incidence was 0.5%, 4.1%, and 10.8% in the low-, medium-, and high-risk groups, respectively (c-index, 0.75); the 28-day mortality was 0.05%, 0.7%, and 3.3% in the low-, medium-, and high-risk groups, respectively (c-index, 0.85). In validation cohort 1, c-indices for the models for pneumonia and death were 0.75 and 0.87, respectively. In validation cohort 2, c-indices for the models were 0.74 and 0.87, respectively.

Conclusions
We successfully developed and validated simple-to-use risk prediction models, which would promptly provide useful information for treatment decisions in primary care settings.
Afro-Communitarianism and the Role of Traditional African Healers in the COVID-19 Pandemic
Authors: Cordeiro-Rodrigues Luís , Metz Thaddeus 
Published: February 2021

Abstract
The COVID-19 pandemic has brought significant challenges to healthcare systems worldwide, and in Africa, given the lack of resources, they are likely to be even more acute. The usefulness of Traditional African Healers in helping to mitigate the effects of pandemic has been neglected. We argue from an ethical perspective that these healers can and should have an important role in informing and guiding local communities in Africa on how to prevent the spread of COVID-19. Particularly, we argue not only that much of the philosophy underlying Traditional African Medicine is adequate and compatible with preventive measures for COVID-19, but also that Traditional African Healers have some unique cultural capital for influencing and enforcing such preventive measures. The paper therefore suggests that not only given the cultural context of Africa where Traditional African Healers have a special role, but also because of the normative strength of the Afro-communitarian philosophy that informs it, there are good ethical reasons to endorse policies that involve Traditional Healers in the fight against COVID-19. We also maintain that concerns about Traditional African Healers objectionably violating patient confidentiality or being paternalistic are much weaker in the face of COVID-19.
How Conservatives Lost Confidence in Science: The Role of Ideological Alignment in Political Polarization
Authors: Kozlowski Austin C 
Published: February 2021

AbstractConfidence in the scientific community became politically polarized in the United States at the turn of the twenty-first century, with conservatives displaying lower confidence in scientists than liberals. Using data from the General Social Survey from 1984 to 2016, I show that moral and economic conservatives played distinct but complementary roles in producing this divide. I find that moral conservatives exhibited low confidence in scientists before any substantial division existed between self-identified political conservatives and liberals on this issue. However, as moral conservatism increasingly consolidated under the label of political conservatism, a negative association between political conservatism and confidence in the scientific community emerged. Economic conservatives, by contrast, previously held disproportionately high confidence in scientists, but this positive relationship wanes in the beginning of the twenty-first century. These findings suggest that interpreting political polarization requires attention to the multiple dimensions along which political attitudes are organized and ideological coalitions are formed.
Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea
Authors: Parekh Ankit , Kam Korey , Mullins Anna E , Castillo Bresne , Berkalieva Asem , Mazumdar Madhu , Varga Andrew W , Eckert Danny J , Rapoport David M , Ayappa Indu 
Published: February 2021

Abstract

Study Objectives
Determine if changes in K-complexes associated with sustained inspiratory airflow limitation (SIFL) during N2 sleep are associated with next-day vigilance and objective sleepiness.

Methods
Data from thirty subjects with moderate-to-severe obstructive sleep apnea who completed three in-lab polysomnograms: diagnostic, on therapeutic continuous positive airway pressure (CPAP), and on suboptimal CPAP (4 cmH2O below optimal titrated CPAP level) were analyzed. Four 20-min psychomotor vigilance tests (PVT) were performed after each PSG, every 2 h. Changes in the proportion of spontaneous K-complexes and spectral characteristics surrounding K-complexes were evaluated for K-complexes associated with both delta (∆SWAK), alpha (∆αK) frequencies.

Results
Suboptimal CPAP induced SIFL (14.7 (20.9) vs 2.9 (9.2); %total sleep time, p &lt; 0.001) with a small increase in apnea–hypopnea index (AHI3A: 6.5 (7.7) vs 1.9 (2.3); p &lt; 0.01) versus optimal CPAP. K-complex density (num./min of stage N2) was higher on suboptimal CPAP (0.97 ± 0.7 vs 0.65±0.5, #/min, mean ± SD, p &lt; 0.01) above and beyond the effect of age, sex, AHI3A, and duration of SIFL. A decrease in ∆SWAK with suboptimal CPAP was associated with increased PVT lapses and explained 17% of additional variance in PVT lapses. Within-night during suboptimal CPAP K-complexes appeared to alternate between promoting sleep and as arousal surrogates. Electroencephalographic changes were not associated with objective sleepiness.

Conclusions
Sustained inspiratory airflow limitation is associated with altered K-complex morphology including the increased occurrence of K-complexes with bursts of alpha as arousal surrogates. These findings suggest that sustained inspiratory flow limitation may be associated with nonvisible sleep fragmentation and contribute to increased lapses in vigilance.
A MATLAB toolbox for modeling genetic circuits in cell-free systems†
Authors: Singhal Vipul , Tuza Zoltan A , Sun Zachary Z , Murray Richard M 
Published: February 2021

Abstract
We introduce a MATLAB-based simulation toolbox, called txtlsim, for an Escherichia coli-based Transcription–Translation (TX–TL) system. This toolbox accounts for several cell-free-related phenomena, such as resource loading, consumption and degradation, and in doing so, models the dynamics of TX–TL reactions for the entire duration of solution phase batch-mode experiments. We use a Bayesian parameter inference approach to characterize the reaction rate parameters associated with the core transcription, translation and mRNA degradation mechanics of the toolbox, allowing it to reproduce constitutive mRNA and protein-expression trajectories. We demonstrate the use of this characterized toolbox in a circuit behavior prediction case study for an incoherent feed-forward loop.
Effect of drying and warming piglets at birth on preweaning mortality
Authors: Vande Pol Katherine D , Tolosa Andres F , Shull Caleb M , Brown Catherine B , Alencar Stephan A S , Ellis Michael 
Published: February 2021

Abstract
Piglets are susceptible to hypothermia early after birth, which is a major predisposing factor for preweaning mortality (PWM). Drying and warming piglets at birth has been shown to reduce early postnatal temperature decline. This study evaluated the effect of drying and warming piglets at birth on PWM and weaning weight (WW) under commercial conditions. A completely randomized design was used with 802 sows/litters (10,327 piglets); sows/litters were randomly allotted at start of farrowing to one of two Intervention Treatments (applied at birth): Control (no drying or warming); Drying+Warming (dried with a cellulose-based desiccant and placed in a box under a heat lamp for 30 min). Piglets were weighed at birth and weaning; PWM was recorded. Rectal temperature was measured at 0 and 30 min after birth on all piglets in a subsample of 10% of litters. The effect of farrowing pen temperature (FPT) on WW and PWM was evaluated by comparing litters born under COOL (&lt;25°C) to those born under WARM (≥25°C) FPT. The effect of birth weight on WW and PWM was evaluated by comparing three birth weight categories (BWC; Light: &lt;1.0 kg, Medium: 1.0 to 1.5 kg, or Heavy: &gt;1.5 kg). PROC GLIMMIX and MIXED of SAS were used to analyze mortality and other data, respectively. Litter was the experimental unit; piglet was a subsample of litter. The model included fixed effects of Intervention Treatment, and FPT or BWC as appropriate, the interaction, and the random effects of litter. Piglet rectal temperature at 30 min after birth was greater (P ≤ 0.05) for the Drying+Warming than the Control treatment (+2.33°C). Overall, there was no effect (P &gt; 0.05) of Intervention Treatment on PWM or WW, and there were no Intervention Treatment by BWC interactions (P &gt; 0.05) for these measurements. There was an Intervention Treatment by FPT interaction (P ≤ 0.05) for PWM. Drying and warming piglets reduced (P ≤ 0.05) PWM under COOL (by 2.4 percentage units) but not WARM FPT. In addition, WW were lower (P ≤ 0.05) under WARM (by 0.79 kg) than COOL FPT; however, there was no interaction (P &gt; 0.05) with Intervention Treatment. In conclusion, this study suggests that drying and warming piglets at birth increases rectal temperature and may reduce PWM under cooler conditions, which are typically experienced in temperate climates during the majority of the year.
Development-Dependent Plasticity in Vasoactive Intestinal Polypeptide Neurons in the Infralimbic Cortex
Authors: Collins Stuart A , Ninan Ipe 
Published: February 2021

Abstract
The onset of several neuropsychiatric disorders including anxiety disorders coincides with adolescence. Consistently, threat extinction, which plays a key role in the regulation of anxiety-related behaviors, is diminished during adolescence. Furthermore, this attenuated threat extinction during adolescence is associated with an altered synaptic plasticity in the infralimbic medial prefrontal cortex (IL-mPFC), a brain region critical for threat extinction. However, the mechanism underlying the altered plasticity in the IL-mPFC during adolescence is unclear. Given the purported role of vasoactive intestinal polypeptide expressing interneurons (VIPINs) in disinhibition and hence their potential to affect cortical plasticity, we examined whether VIPINs exhibit an adolescence-specific plasticity in the IL-mPFC. We observed an increase in GABAergic transmission and a decrease in excitability in VIPINs during adolescence. Male mice show a significantly higher VIPIN-pyramidal neuron GABAergic transmission compared with female mice. The observed increase in GABAergic transmission and a decrease in membrane excitability in VIPINs during adolescence could play a role in the altered plasticity in the adolescent IL-mPFC. Furthermore, the suppression of VIPIN-mediated GABAergic transmission in females might be relevant to sex differences in anxiety disorders.
Effects of positive end-expiratory pressure/recruitment manoeuvres compared with zero end-expiratory pressure on atelectasis in children
Authors: Zhu Change , Zhang Saiji , Dong Junli , Wei Rong 
Published: February 2021

BACKGROUND
Atelectasis is a common postoperative complication. Peri-operative lung protection can reduce atelectasis; however, it is not clear whether this persists into the postoperative period.

OBJECTIVE
To evaluate to what extent lung-protective ventilation reduces peri-operative atelectasis in children undergoing nonabdominal surgery.

DESIGN
Randomised, controlled, double-blind study.

SETTING
Single tertiary hospital, 25 July 2019 to 18 January 2020.

PATIENTS
A total of 60 patients aged 1 to 6 years, American Society of Anesthesiologists physical status 1 or 2, planned for nonabdominal surgery under general anaesthesia (≤2 h) with mechanical ventilation.

INTERVENTIONS
The patients were assigned randomly into either the lung-protective or zero end-expiratory pressure with no recruitment manoeuvres (control) group. Lung protection entailed 5 cmH2O positive end-expiratory pressure and recruitment manoeuvres every 30 min. Both groups received volume-controlled ventilation with a tidal volume of 6 ml kg−1 body weight. Lung ultrasound was conducted before anaesthesia induction, immediately after induction, surgery and tracheal extubation, and 15 min, 3 h, 12 h and 24 h after extubation.

MAIN OUTCOME MEASURES
The difference in lung ultrasound score between groups at each interval. A higher score indicates worse lung aeration.

RESULTS
Patients in the lung-protective group exhibited lower median [IQR] ultrasound scores compared with the control group immediately after surgery, 4 [4 to 5] vs. 8 [4 to 6], (95% confidence interval for the difference between group values −4 to −4, Z = -6.324) and after extubation 3 [3 to 4] vs. 4 [4 to 4], 95% CI −1 to 0, Z = −3.161. This did not persist from 15 min after extubation onwards. Lung aeration returned to normal in both groups 3 h after extubation.

CONCLUSIONS
The reduced atelectasis provided by lung-protective ventilation does not persist from 15 min after extubation onwards. Further studies are needed to determine if it yields better results in other types of surgery.

TRIAL REGISTRATION
Chictr.org.cn (ChiCTR2000033469).
Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery
Authors: Spies Claudia D. , Knaak Cornelia , Mertens Mandy , Brockhaus Wolf-Rüdiger , Shadenok Anna , Wiebach Janine , Kunzmann Kevin , Feldheiser Aarne , Pratschke Johann , Müller Olga , Kipping Valesca , Fabian Maria , Abels Wiltrud , Borchers Friedrich , Akyüz Levent , Ely E. Wesley , Wernecke Klaus-Dieter , Menon David Krishna , Piper Sophie K. 
Published: February 2021

BACKGROUND
Anecdotally, cholinergic stimulation has been used to treat delirium and reduce cognitive dysfunction.

OBJECTIVE
The aim of this investigation was to evaluate whether physostigmine reduced the incidence of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in patients undergoing liver resection.

DESIGN
This was a double-blind, randomised, placebo-controlled trial. Between 11 August 2009 and 3 March 2016, patients were recruited at the Charité – Universitätsmedizin Berlin in Germany. Follow-ups took place at 1 week (T1), 90 days (T2) and 365 days (T3) after surgery.

SETTING
This single-centre study was conducted at an academic medical centre.

PARTICIPANTS
In total, 261 participants aged at least 18 years scheduled for elective liver surgery were randomised. The protocol also included 45 non-surgical matched controls to provide normative data for POCD and neurocognitive deficit (NCD).

INTERVENTION
Participants were allocated to receive either intravenous physostigmine, as a bolus of 0.02 mg kg−1 body weight followed by 0.01 mg kg−1 body weight per hour (n = 130), or placebo (n = 131), for 24 h after induction of anaesthesia.

MAIN OUTCOMES AND MEASURES
Primary outcomes were POD, assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-4-TR) twice daily up to day 7 after surgery, and POCD assessed via the CANTAB neuropsychological test battery, and two paper pencil tests on the day before surgery, and on postoperative days 7, 90 and 365.

RESULTS
In total, 261 patients were randomised, 130 to the physostigmine and 131 to the placebo group. The incidence of POD did not differ significantly between the physostigmine and placebo groups (20 versus 15%; P = 0.334). Preoperative cognitive impairment and POCD frequencies did not differ significantly between the physostigmine and placebo groups at any time. Lower mortality rates were found in the physostigmine group compared with placebo at 3 months [2% (95% confidence interval (CI), 0 to 4) versus 11% (95% CI, 6 to 16), P = 0.002], and 6 months [7% (95% CI, 3 to 12) versus 16% (95% CI, 10 to 23), P = 0.012] after surgery.

CONCLUSION
Physostigmine had no effect on POD and POCD when applied after induction of anaesthesia up to 24 h.

TRIAL REGISTRATION
DOI 10.1186/ISRCTN18978802, EudraCT 2008-007237-47, Ethics approval ZS EK 11 618/08 (15 January 2009).