bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel treatments for alcoholic hepatitis
Authors: German Margarita N. , Musto Jessica , Lucey Michael R. 
Published: March 2021

Purpose of review
The current article aims to review the latest literature on updates in therapeutics for alcohol-associated liver disease (ALD), integration of treatment of alcohol use disorder (AUD) into the management of ALD, and the role of liver transplantation for alcoholic hepatitis.

Recent findings
ALD has recently become the most common indication for liver transplantation due to the increasing prevalence of AUD and the paucity of therapeutic options. There is broad consensus on the importance of early identification of AUD and the incorporation of its treatment in the management of ALD. New targets for treatment of alcoholic hepatitis include the gut–liver axis, anti-inflammatory drugs, antioxidants, and drugs with hepatic regenerative potential. Fecal transplantation in particular has had favorable outcomes at 1 year. n-Acetylcysteine in addition to corticosteroids, granulocyte colony stimulating factor, and IL-22 have also shown improved short-term outcomes. A number of other therapies are being studied in clinical trials and their results are anxiously awaited.

Summary
In summary, there are several promising therapeutic options under clinical investigation for the treatment of alcoholic hepatitis and ALD; however, alcohol abstinence is key. In the absence of other effective therapies, liver transplantation for ALD remains a life-saving treatment with excellent patient and graft survival.
Intricacies of conditional genetics in vascular biology
Authors: Garcia-Gonzalez Irene , Benedito Rui 
Published: March 2021

Purpose of review
Conditional or inducible recombinase-based genetics is still the gold standard to analyse gene function, given its high specificity, temporal control, limited toxicity and the many available genetic tools. However, it is based on methods that have inherent limitations and shortcomings. The purpose of this review is to summarize and contrast the different available methods used to perform conditional gene function analysis to better inform the community about their particularities and the need to use better methods.

Recent findings
As any other biomedical field, the vascular biology field has moved from using and analysing standard gene knockout (KO) mice, to use conditional genetics to delete a given gene only at a given time point, cell-type or organ of interest. This is the only way to accurately understand a gene function and avoid other confounding factors. Therefore, nowadays the majority of laboratories working with mice use CreERT2-tamoxifen-inducible genetics. However, this necessary transition from the relatively simple KO genetics to the more sophisticated conditional genetics brought a series of additional methodological issues that are often overlooked or unappreciated. Recent findings from several laboratories have shown how important is to know what to expect from and control for in conditional genetics. Without this a priori knowledge, the quality, robustness, time and costs of conditional genetic experiments can be significantly compromised.

Summary
We start this review by discussing the intricacies of the most simple and widely used methods to perform conditional genetics and then extend on the need of novel and more advanced methods to increase the ease, efficiency and reliability of conditional mutagenesis and gene function analysis.
Virtual Communication Embedded Bedside ICU Rounds: A Hybrid Rounds Practice Adapted to the Coronavirus Pandemic
Authors: Bavare Aarti C. , Goldman Jordana R. , Musick Matthew A. , Sembera Kerry A. , Sardual Alex A. , Lam Anne K. , Tume Sebastian C. , Thammasitboon Satid X. , Williams Eric A. 
Published: March 2021

OBJECTIVES:
Coronavirus disease 2019 containment strategies created challenges with patient-centered ICU rounds. We examined how hybrid rounds with virtual communication added to in-person rounds could facilitate social distancing while maintaining patient-centered care.

DESIGN:
Continuous quality improvement.

SETTING:
Quaternary care referral pediatric hospital.

PATIENTS:
Daytime rounds conducted on PICU patients.

INTERVENTIONS:
Following a needs assessment survey and pilot trials, multiple technological solutions were implemented in a series of plan-do-study-act cycles. Hybrid rounds model was deployed where a videoconference platform was used to establish communication between the bedside personnel (nurse, patient/family, and partial ICU team) with remotely located remaining ICU team, ancillary, and consultant providers. Floor labels marking 6-feet distance were placed for rounders.

MEASUREMENTS AND MAIN RESULTS:
Outcome metrics included compliance with social distancing, mixed methods analysis of surveys, direct interviews of providers and families, and reports of safety concerns. The clinicians adopted hybrid rounds readily. Compliance with social distancing and use of floor labels needed reminders. One-hundred fourteen providers completed the feedback survey. Twenty-five providers and 11 families were interviewed. Feedback about hybrid rounds included inability to teach effectively, suboptimal audio-video quality, loss of situational awareness of patient/unit acuity, alarm interference, and inability to socially distance during other ICU interactions. Benefits noted were improved ancillary input, fewer interruptions, improved efficiency, opportunity to integrate with data platforms, and engage remote consultants and families. Nurses and families appreciated the efforts to ensure safety but wanted the ICU attending/fellow supervising the team to participate at bedside, during rounds. Clinicians appreciated the multidisciplinary input but felt that teaching was difficult.

CONCLUSIONS:
Hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds. A change to ingrained rounding habits needs team commitment and ongoing optimization. The hybrid rounds model has potential for generalizability to other settings.
Impact of Modified Cardiac Rehabilitation Within a Stroke Recovery Program on All-Cause Hospital Readmissions
Authors: Cuccurullo Sara J. , Fleming Talya K. , Kostis John B. , Greiss Christine , Eckert Anne , Ray Arlen Razon , Scarpati Rosann , Zinonos Stavros , Gizzi Martin , Cosgrove Nora M. , Cabrera Javier , Oh-Park Mooyeon , Kostis William J. 
Published: March 2021

Objective
A Stroke Recovery Program (SRP) including cardiac rehabilitation demonstrated lower all-cause mortality rates, improved cardiovascular function, and overall functional ability among stroke survivors. Neither an effect of SRP on acute care hospital readmission rates nor cost savings have been reported.

Design
This prospective matched cohort study included 193 acute stroke survivors admitted to an inpatient rehabilitation facility between 2015 and 2017. The 105 SRP participants and 88 nonparticipants were matched exactly for stroke type, sex, and race and approximately for age, baseline functional scores, and medical complexity scores. Primary outcome measured acute care hospital readmission rate up to 1 yr post-stroke. Secondary outcomes measured costs.

Results
A 22% absolute reduction (P = 0.006) in hospital readmissions was observed between the SRP participant (n = 47, or 45%) and nonparticipant (n = 59, or 67%) groups. This resulted in significant cost savings. The conventional care cost to the Center for Medicare and Medicaid Services for stroke patients for both readmissions and outpatient therapy is estimated at $9.67 billion annually. The yearly cost for these services with utilization of the SRP is $8.55 billion.

Conclusion
Acute care hospital readmissions were reduced in stroke survivors who participated in SRP. Future study is warranted to examine whether widespread application of a similar program may improve quality of life and decrease cost.
Out of the Laboratory and Into the Field: Validation of Portable Cell Culture Protocols
Authors: McDade Thomas W. , Aronoff Jacob E. , Leigh Adam K. K. , Finegood Eric D. , Weissman-Tsukamoto Rachel M. , Brody Gene H. , Miller Gregory E. 
Published: March 2021

ABSTRACT

Objective
Field-based research on inflammation and health is typically limited to baseline measures of circulating cytokines or acute-phase proteins, whereas laboratory-based studies can pursue a more dynamic approach with ex vivo cell culture methods. The laboratory infrastructure required for culturing leukocytes limits application in community-based settings, which in turn limits scientific understandings of how psychosocial, behavioral, and contextual factors influence the regulation of inflammation. We aim to address this gap by validating two “field-friendly” cell culture protocols, one using a small volume of venous whole blood and another using finger-stick capillary whole blood.

Methods
We evaluated the performance of both protocols against a standard laboratory-based protocol using matched venous and capillary blood samples collected from young adults (n = 24). Samples were incubated with lipopolysaccharide and hydrocortisone, and the production of proinflammatory cytokines interleukin 1β, interleukin 6, and tumor necrosis factor α was measured in response.

Results
Comparisons indicate a high level of agreement in responses across the protocols and culture conditions. The overall correlation in results was 0.88 between the standard and small-volume protocols and 0.86 between the standard and capillary blood protocols. Repeatability for the small-volume and capillary blood protocols was high, with mean coefficients of variation across five replicates of 6.2% and 5.4%, respectively.

Conclusions
These results demonstrate the feasibility of culturing cells and quantifying the inflammatory response to challenge outside the laboratory, with a wide range of potential applications in biobehavioral research in community-based and remote field settings.
Qualitative and Quantitative Analysis of a Spiral Gradient Echo Sequence for Contrast-Enhanced Fat-Suppressed T1-Weighted Spine Magnetic Resonance Imaging
Authors: Sartoretti Elisabeth , Sartoretti Thomas , van Smoorenburg Luuk , Sartoretti-Schefer Sabine , Wyss Michael , Binkert Christoph A. 
Published: March 2021

Objectives
Pulse sequences with non-Cartesian k-space sampling enable improved imaging in anatomical areas with high degrees of motion artifacts. We analyzed a novel spiral 3-dimensional (3D) gradient echo (GRE) magnetic resonance imaging (MRI) sequence (“spiral,” 114.7 ± 11 seconds) and compared it with a radial 3D GRE (“vane,” 216.7 ± 2 seconds) and a conventional Cartesian 2D turbo spin echo (TSE) sequence (“TSE,” 266.7 ± 82 seconds) for contrast-enhanced fat-suppressed T1-weighted spine imaging.

Materials and Methods
Forty consecutive patients referred for contrast-enhanced MRI were prospectively scanned with all 3 sequences. A qualitative analysis was performed by 3 readers using 4- or 5-point Likert scales to independently grade images in terms of overall image quality, occurrence of artifacts, lesion conspicuity, and conspicuity of nerve roots. The numbers of visible nerve roots per sequence and patient were counted in consensus. Coefficient of variation measurements were performed for the paravertebral musculature (CVPM
) and the spinal cord (CVSC
).

Results
Spiral (median [interquartile range], 5 [4–5]) exhibited improved overall image quality in comparison to TSE (3 [3–4]) and vane (4 [4–5]; both P < 0.001). Vane surpassed TSE in terms of overall image quality (P < 0.001). Spiral (4 [3.75–4]) and vane (3.5 [3–4]) presented with less artifacts than TSE (3 [2.75–3.25]; both P < 0.001). Spiral (4 [4–5]) outperformed vane (4 [3–5]; P = 0.01) and TSE (4 [3–4]; P = 0.04) in terms of lesion conspicuity. Conspicuity of nerve roots was superior on spiral (3 [3–4]) and vane (4 [3–4]) when compared with TSE (1.5 [1–2]; both P < 0.001). Readers discerned significantly more nerve roots on spiral (4 [2.75–8]) and vane (4 [3.75–7.25]) images when compared with TSE (2 [0–4]; both P < 0.001). Interreader agreement ranged from moderate (α = 0.639) to almost perfect (α = 0.967). CVPM
and CVSC
were significantly lower on spiral as compared with vane and TSE (P < 0.001, P = 0.04). Vane exhibited lower CVPM
and CVSC
than TSE (P < 0.001, P = 0.01).

Conclusions
A novel spiral 3D GRE sequence improves contrast-enhanced fat-suppressed T1-weighted spinal imaging qualitatively and quantitatively in comparison with a conventional Cartesian 2D TSE sequence and to a lesser extent with a radial 3D GRE sequence at shorter scan times.
Keystone Flaps for Coverage of Defects in the Posterior Neck and Lower Occipital Scalp: A Retrospective Clinical Study
Authors: Kong Yu Taek , Kim Junekyu , Shin Hyun Woo , Kim Kyu Nam 
Published: March 2021

Abstract
The coverage of the posterior neck and lower occipital scalp defects should be approached carefully. Thick, stiff, and inelastic skin properties of these areas tend to make coverage of even small defects difficult. Herein, the authors present a retrospective review of our experience with posterior neck and lower occipital scalp reconstruction using the keystone flap (KF) and describe the expanding versatility of KF reconstruction. The medical records of 17 patients who underwent KF reconstruction to cover the posterior neck and lower occipital defect from April 2017 to May 2020 were reviewed. Clinical and operative data were collected. All defects were successfully covered with the KFs. The defect sizes ranged from 2.5 × 3.5 cm to 6 × 11 cm, and the flap sizes ranged from 3 × 5.5 cm to 9 × 18 cm. All flaps fully survived, although marginal maceration developed in one case; however, it healed with conservative management. The final results were favorable, and all patients were satisfied with their final outcomes. Consequently, the KF can be considered as a good reconstruction modality with few complications and provides an alternative to other reconstructive options for coverage of the posterior neck and lower occipital defects.
Heads Up Play: Acute Assessment and Management of Basketball-Related Craniofacial Injuries by On-Court Personnel
Authors: Slavin Benjamin R. , Pierrot Randall G. , Sprau Annelise C. , Wolfe Erin M. , Mathew Prakash J. , Chopra Karan , Thaller Seth R. 
Published: March 2021

Introduction:
With a following of over 825 million people, basketball currently ranks amongst the world's most popular sports. Despite a number of concussion awareness and player safety protocols that have been implemented at the professional level of organized play, a standardized, layperson-friendly algorithm for the acute management of basketball-related craniofacial injuries does not appear to presently exist.

Methods:
This 10-year retrospective cohort study was conducted using the National Electronic Injury Surveillance System database to examine basketball-related craniofacial injuries from 2010 to 2019. Within the National Electronic Injury Surveillance System dataset, factors including patient age, gender, diagnosis, injury type, and injury location were included in our analysis.

Results:
Overall, 22,529 basketball-related craniofacial injuries occurred between 2010 and 2019 in players ages 5 to 49 years old. Adolescent (12–18-year-old) and young adult (19–34-year-old) age groups had the highest incidence of craniofacial injuries. The adolescent cohort experienced a significantly greater proportion of concussions and lower proportion of both facial lacerations and fractures compared with the within group null hypothesis of equal proportions (P < 0.05). The young adult cohort experienced a significantly greater proportion of facial lacerations and fractures and lower proportion of concussions, contusions/abrasions, hematomas, and internal injuries compared to this cohort's null hypothesis (P < 0.05). Males experienced a significantly greater proportion of fractures, lacerations, and dental injuries and lower proportion of concussions, contusions/abrasions, and internal injuries compared to the hypothesized equality of proportions (P < 0.05). Females experienced a significantly greater proportion of concussions, contusions/abrasions, and internal injuries and lower proportion of fractures, lacerations, and dental injuries compared to the hypothesized equality of proportions (P < 0.05).

Conclusions:
Although several steps have already been taken at the professional level to try to promote player safety, particularly with concussion protocols and prevention of lower extremity injuries, there remains a paucity of resources to guide management of other types of acute craniofacial injury. The role of layperson-friendly educational interventions remains intriguing as a potential means of improving outcomes regardless of socioeconomic status or health literacy. Additional studies still need to be completed to determine efficacy and best future direction.
Outcomes of Graves’ Disease Patients Following Antithyroid Drugs, Radioactive Iodine, or Thyroidectomy as the First-line Treatment
Authors: Liu Xiaodong , Wong Carlos K. H. , Chan Wendy W. L. , Tang Eric H. M. , Woo Yu Cho , Lam Cindy L. K. , Lang Brian H. H. 
Published: March 2021

Background:
The long-term outcomes of first-line choice among ATD, RAI, and thyroidectomy for GD patients remain unclear.

Objective:
To compare the long-term morbidity, mortality, relapse, and costs of GD patients receiving first-line treatment.

Methods:
A population-based retrospective cohort of GD patients initiating first-line treatment with ATD, RAI, or thyroidectomy as a first-line primary treatment between 2006 and 2018 from Hong Kong Hospital Authority was analyzed. Risks of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension were estimated using Cox proportional hazards regression models. The 10-year healthcare costs, change of comorbidities, and risk of relapse were compared across treatments.

Results:
Over a median follow-up of 90 months with 47,470 person-years, 6385 patients (ATD, 74.93%; RAI, 19.95%; thyroidectomy, 5.12%) who received first-line treatment for GD were analyzed. Compared with ATD group, patients who had undergone surgery had significantly lower risks of all-cause mortality [hazard ratio (HR) = 0.363, 95% confidence interval (CI) = 0.332–0.396], CVD (HR = 0.216, 95% CI = 0.195–0.239), AF (HR = 0.103, 95% CI = 0.085–0.124), psychological disease (HR = 0.279, 95% CI = 0.258–0.301), diabetes (HR = 0.341, 95% CI = 0.305–0.381), and hypertension (HR = 0.673, 95% CI = 0.632–0.718). Meanwhile, RAI group was also associated with decreased risks of all-cause mortality (HR = 0.931, 95% CI = 0.882–0.982), CVD (HR = 0.784, 95% CI = 0.742–0.828), AF (HR = 0.622, 95% CI = 0.578–0.67), and psychological disease (HR = 0.895, 95% CI = 0.855–0.937). The relapse rate was 2.41% in surgery, 75.60% in ATD, and 19.53% in RAI group. The surgery group was observed with a significant lower Charlson Comorbidity Index score than the other 2 groups at the tenth-year follow-up. The mean 10-year cumulative healthcare costs in ATD, RAI, and surgery group was US$23915, US$24260, and US$20202, respectively.

Conclusions:
GD patients who received surgery as an initial treatment appeared to have lower chances of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension in the long-term when compared to those treated with ATD or RAI. The surgery group had the lowest relapse and direct healthcare costs among the 3 treatment modalities. This long-term cohort study suggested surgery may have a larger role to play as an initial treatment for GD patients.
Antifungal Prophylaxis After Lung Transplantation: Where Are We Now?
Authors: De Mol Wim , Bos Saskia , Beeckmans Hanne , Lagrou Katrien , Spriet Isabel , Verleden Geert M. , Vos Robin 
Published: March 2021

Background.
Lung transplantation is an important treatment option for various end-stage lung diseases. However, survival remains limited due to graft rejection and infections. Despite that fungal infections are frequent and carry a bad prognosis, there is currently no consensus on efficacy, optimal drug, route, or duration of antifungal prophylaxis. This narrative review summarizes current strategies for antifungal prophylaxis after lung transplantation.

Methods.
English language articles in Embase, Pubmed, UptoDate, and bibliographies were used to assess the efficacy and safety of available antifungal agents for prophylaxis in adult lung transplant recipients.

Results.
Overall, there are limited high-quality data. Universal prophylaxis is more widely used and may be preferable over targeted prophylaxis. Both formulations of inhaled amphotericin B and systemic azoles are effective at reducing fungal infection rates, yet with their own specific advantages and disadvantages. The benefit of combination regimens has yet to be proven. Considering the post-transplant timing of the onset of fungal infections, postoperative prophylaxis during the first postoperative months seems indicated for most patients.

Conclusions.
Based on existing literature, universal antifungal prophylaxis with inhaled amphotericin B and systemic voriconazole for at least 3–6 mo after lung transplantation may be advisable, with a slight preference for amphotericin B because of its better safety profile.
Survival Benefit of Donation After Circulatory Death Kidney Transplantation in Children Compared With Remaining on the Waiting List for a Kidney Donated After Brain Death
Authors: Kizilbash Sarah J. , Evans Michael D. , Chavers Blanche M. 
Published: March 2021

Background.
Kidneys donated after circulatory death (DCD) are increasingly being used for transplantation in adults to alleviate organ shortage. Pediatric data on survival benefits of DCD transplantation compared with remaining on the waitlist for a kidney donated after brain death (DBD) offer are lacking.

Methods.
We used Scientific Registry of Transplant Recipients to identify 285 pediatric (<18 y) DCD kidney transplants performed between 1987 and 2017. Propensity score matching was used to create a comparison group of 1132 DBD transplants. We used sequential Cox analysis to evaluate survival benefit of DCD transplantation versus remaining on the waitlist and Cox regression to evaluate patient and graft survival.

Results.
DCD transplantation was associated with a higher incidence of delayed graft function (adjusted odds ratio: 3.0; P < 0.001). The risks of graft failure (adjusted hazard ratio [aHR], 0.89; P = 0.46) and death (aHR, 1.2; P = 0.67) were similar between DCD and DBD recipients. We found a significant survival benefit of DCD transplantation compared with remaining on the waitlist awaiting a DBD kidney (aHR, 0.44; P = 0.03).

Conclusions.
Despite a higher incidence of delayed graft function, long-term patient and graft survival are similar between pediatric DCD and DBD kidney transplant recipients. DCD transplantation in children is associated with a survival benefit, despite pediatric priority for organ allocation, compared with remaining on the waitlist.