bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Validation of the Cardiac Surgery Score in a Quaternary Hospital in the United States of America
Authors: Singh Asha , Liang Chen , Mick Stephanie L. , Udeh Chiedozie 
Published: December 2021

Background The Cardiac Surgery Score (CASUS) was developed to assist in predicting post-cardiac surgery mortality using parameters measured in the intensive care unit. It is calculated by assigning points to ten physiologic variables and adding them to obtain a score (additive CASUS), or by logistic regression to weight the variables and estimate the probability of mortality (logistic CASUS). Both additive and logistic CASUS have been externally validated elsewhere, but not yet in the United States of America (USA). This study aims to validate CASUS in a quaternary hospital in the USA and compare the predictive performance of additive to logistic CASUS in this setting. Methods Additive and logistic CASUS (postoperative days 1-5) were calculated for 7098 patients at Cleveland Clinic from January 2015 to February 2017. 30-day mortality data were abstracted from institutional records and the Death Registries for Ohio State and the Centers for Disease Control. Given a low event rate, model discrimination was assessed by area under the curve (AUROC), partial AUROC (pAUC), and average precision (AP). Calibration was assessed by curves and quantified using Harrell's Emax, and Integrated Calibration Index (ICI). Results 30-day mortality rate was 1.37%. For additive CASUS, odds ratio for mortality was 1.41 (1.35-1.46, P <0.001). Additive and logistic CASUS had comparable pAUC and AUROC (all >0.83). However, additive CASUS had greater AP, especially on postoperative day 1 (0.22 vs. 0.11). Additive CASUS had better calibration curves, and lower Emax, and ICI on all days. Conclusions Additive and logistic CASUS discriminated well for postoperative 30-day mortality in our quaternary center in the USA, however logistic CASUS under-predicted mortality in our cohort. Given its ease of calculation, and better predictive accuracy, additive CASUS may be the preferred model for postoperative use. Validation in more typical cardiac surgery centers in the USA is recommended.
Combined treatment of prednisone and hydroxychloroquine may improve outcomes of frozen embryo transfer in antinuclear antibody-positive patients undergoing IVF/ICSI treatment
Authors: Gao Rui , Deng Wei , Meng Cheng , Cheng Kemin , Zeng Xun , Qin Lang 
Published: December 2021

Background The influence of anti-nuclear antibody (ANA) on induced ovulation was controversial, and the effect of prednisone plus hydroxychloroquine (HCQ) treatment on frozen embryo transfer outcomes of in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) for ANA-positive women was unclear. Methods Fifty ANA-positive women and one-hundred ANA-negative women matched for age and anti-Mullerian hormone (AMH) were included from a Reproductive Medical Central of a University Hospital. Sixty-one oocytes pick-up (OPU) cycles in ANA+ group and one-hundred OPU cycles in ANA− group were compared; 30 frozen embryo transfer cycles without treatment and 66 with prednisone plus HCQ treatment among ANA-positive women were compared. Results There was no statistical difference in number of retrieved oocytes (13.66 ± 7.71 vs 13.72 ± 7.23, p = .445), available embryos (5.23 ± 3.37 vs 5.47 ± 3.26, p = .347), high-quality embryos (3.64 ± 3.25 vs 3.70 ± 3.52, p = .832), and proportion of high-quality embryos (26.5% vs. 26.7%, p = .940). Biochemical pregnancy rate (33.3% vs. 68.2%, p < .05), clinical pregnancy rate (20.0% vs. 50.1%, p < .05), and implantation rate (5.6% vs. 31.8%, p < .05) were lower, and pregnancy loss rate (83.3% vs. 23.1%, p < .05) was higher in patients with treatment than no treatment. Conclusion The influence of ANA on number of retrieved oocytes, available embryos, high-quality embryos, and proration of high-quality embryos was not found. The treatment of prednisone plus HCQ may improve implantation rate, biochemical pregnancy rate, and clinical pregnancy rate, and reduce pregnancy loss rate in frozen embryo transfer outcomes for ANA-positive women.
The importance of the local twitch response during needling interventions in spinal pain associated with myofascial trigger points: a systematic review and meta-analysis
Authors: Fernández-de-las-Peñas César , Plaza-Manzano Gustavo , Sanchez-Infante Jorge , Gómez-Chiguano Guido F , Cleland Joshua A , Arias-Buría José L , Navarro-Santana Marcos J 
Published: December 2021

Objective: To compare the clinical effects of needling interventions eliciting local twitch responses (LTRs) versus needling without eliciting LTRs when applied to muscle trigger points (TrPs) associated with spinal pain of musculoskeletal origin. Databases and data treatment: Electronic databases were searched for randomized or non-randomized clinical trials where one group received needling intervention where LTRs were elicited and was compared with another group receiving the same intervention without elicitation of LTRs in spinal pain disorders associated with TrPs. Outcomes included pain intensity, pain-related disability, and pressure pain thresholds. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool or ROBINS-I tool, methodological quality was assessed with the PEDro score, and quality of evidence was evaluated using the GRADE approach. Results: Six trials were included. The application of a needling intervention eliciting LTRs was associated with a significant reduction in pain intensity immediately after treatment (mean difference (MD): −2.03 points, 95% confidence interval (CI): −3.77 to −0.29; standardized MD (SMD): −1.35, 95% CI: −2.32 to −0.38, p = 0.02) when compared to the same needling intervention without elicitation of LTRs. No effect at short-term follow-up (MD: −0.20 points, 95% CI: −1.46 to 1.06, p = 0.75) was observed. No significant differences based on elicitation or non-elicitation of LTRs were found in related disability (SMD: −0.05, 95% CI: −0.41 to 0.30, p = 0.77) or pressure pain thresholds (MD: 23.39 kPa, 95% CI: −13.68 to 60.47, p = 0.22). Discussion: Low-level evidence suggests an immediate effect of obtaining LTRs during needling interventions on pain intensity, with no significant effects on related disability or pressure pain sensitivity in spinal pain disorders associated with muscle TrPs. Registration number: OSF Registry— https://doi.org/10.17605/OSF.IO/5ZX9N
Effects of dry needling on function, hypertonia and quality of life in chronic stroke: a randomized clinical trial
Authors: Calvo Sandra , Brandín-de la Cruz Natalia , Jiménez-Sánchez Carolina , Bravo-Esteban Elisabeth , Herrero Pablo 
Published: December 2021

Background: Persons with stroke commonly have impairments associated with a reduction in functionality. Motor impairments are the most prevalent, causing an impact on activities of daily life. Objective: The aim of this study was to evaluate the effect of a session of dry needling (DN) applied to the upper extremity muscles on the sensorimotor function, hypertonia, and quality of life of persons with chronic stroke. Methods: A randomized, sham-controlled clinical trial was performed. Participants were randomly assigned into an intervention group that received a single session DN in the biceps brachii, brachialis, flexor digitorum superficialis and profundus, extensor digitorum, adductor pollicis and triceps brachii muscles, or into a control group that received the same treatment but with a sham DN intervention. Treatment outcomes included the Fugl–Meyer Assessment Scale for the upper extremity, the Modified Modified Ashworth Scale, and the EuroQol-5D questionnaire. Measurements were carried out before, immediately after, and 14 days after intervention. Results: Twenty-three persons participated in the study. Significant differences between groups were observed after the intervention in the total wrist–hand motor score (p = 0.023) and sensorimotor score (p = 0.022), for hypertonia in the elbow extensors both after treatment (p = 0.002) and at follow-up (p = 0.018), and in quality of life at follow-up (p = 0.030). Conclusions: A single session of DN improved total wrist–hand motor function and total sensorimotor function in persons with chronic stroke immediately after treatment, as well as quality of life 2 weeks after treatment. Trial registration number: NCT03546517 (ClinicalTrials.gov)
The impact of cumulative colorectal cancer screening delays: A simulation study
Authors: Rutter Carolyn M. , Inadomi John M. , Maerzluft Christopher E. 
Published: December 2021

Objective Annual fecal immunochemical tests can reduce colorectal cancer incidence and mortality. However, screening is a multi-step process and most patients do not perfectly adhere to guideline-recommended screening schedules. Our objective was to compare the reduction in colorectal cancer incidence and life-years gained based on US guideline-concordant fecal immunochemical test screening to scenarios with a range of delays. Method The Colorectal Cancer Simulated Population model for Incidence and Natural history (CRC-SPIN) microsimulation model was used to estimate the effect of systematic departures from fecal immunochemical test screening guidelines on lifetime screening benefit. Results The combined effect of consistent modest delays in screening initiation (1 year), repeated fecal immunochemical test screening (3 months), and receipt of follow-up or surveillance colonoscopy (3 months) resulted in up to 1.3 additional colorectal cancer cases per 10,000, 0.4 additional late-stage colorectal cancer cases per 10,000 and 154.7 fewer life-years gained per 10,000. A 5-year delay in screening initiation had a larger impact on screening effectiveness than consistent small delays in repeated fecal immunochemical test screening or receipt of follow-up colonoscopy after an abnormal fecal immunochemical test. The combined effect of consistent large delays in screening initiation (5 years), repeated fecal immunochemical test screening (6 months), and receipt of follow-up or surveillance colonoscopy (6 months) resulted in up to 3.7 additional colorectal cancer cases per 10,000, 1.5 additional late-stage colorectal cancer cases per 10,000 and 612.3 fewer life-years gained per 10,000. Conclusions Systematic delays across the screening process can result in meaningful reductions in colorectal cancer screening effectiveness, especially for longer delays. Screening delays could drive differences in colorectal cancer incidence across patient groups with differential access to screening.
Pulmonary Hypertensive Changes Secondary to COVID-19 Pneumonia in a Chronically SARS-CoV-2-Infected Bilateral Lung Explant
Authors: Rohr Joseph M. , Strah Heather , Berkheim David , Siddique Aleem , Radio Stanley J. , Swanson Benjamin J. 
Published: December 2021

COVID-19, the syndrome caused by the novel coronavirus SARS-CoV-2, has spread throughout the world, causing the death of at least three million people. For the over 81 million who have recovered, however, the long-term effects are only beginning to manifest. We performed a bilateral lung transplant on a 31-year-old male patient for chronic hypoxic respiratory failure, severe pulmonary hypertension and radiographically identified pulmonary fibrosis five months after an acute COVID-19 infection. The explant demonstrated moderate pulmonary vascular remodeling with intimal thickening and medial hypertrophy throughout, consistent with pulmonary hypertension. The parenchyma demonstrated an organizing lung injury in the proliferative phase, with severe fibrosis, histiocytic proliferation, type II pneumocyte hyperplasia, and alveolar loss consistent with known COVID-19 pneumonia complications. This report highlights a novel histologic finding in severe, chronic COVID-19. Although the findings in acute COVID-19 pneumonia have been well-examined at autopsy, the chronic course of this complex disease is not yet understood. The case presented herein suggests that COVID-induced pulmonary hypertension may become more common as more patients survive severe SARS-CoV-2-related pneumonia. Pulmonologists and pulmonary pathologists should be aware of this possible association and look for the clinical, radiographic, and histologic criteria in the appropriate clinical setting.
Assessment of serum symmetric dimethylarginine and creatinine concentrations in cats with urethral obstruction
Authors: Wilson Kendall E , Berent Allyson C , Weisse Chick W , Szlosek Donald 
Published: December 2021

Objectives The aims of this study were to evaluate serum symmetric dimethylarginine (SDMA) and creatinine concentrations in cats with urethral obstruction pre- and post-decompression of the obstruction, and to determine if pre-decompression values were predictive of post-decompression renal function, as measured by SDMA and creatinine. Methods This was a prospective observational study. Twenty-five client-owned cats with urethral obstruction were hospitalized for decompression of the obstruction. Serum SDMA and creatinine were prospectively assessed at presentation, 24 h post-decompression and 5–20 days post-decompression. Urinalysis and culture were assessed at presentation and at the final follow-up. Exclusion criteria included positive urine culture, reobstruction or failure to obtain required samples. Results Mean SDMA concentration dropped by 41.8% from an initial pre-decompression concentration of 17.6 µg/dl to 10.3 µg/dl 24 h post-decompression ( P <0.001). The mean creatinine value dropped by 38.4% from an initial pre-decompression concentration of 2.5 mg/dl to 1.5 mg/dl 24 h post-decompression ( P <0.001). There was no association between SDMA concentration at initial presentation and SDMA concentration 5–20 days after urethral catheterization (Spearman’s ρ = 0.205, P = 0.314). Creatinine concentration upon initial presentation was associated with the 5–20 day values after urethral catheterization (Spearman’s ρ = 0.583, P <0.002). Twenty percent of cases were excluded due to bacterial growth on initial urine culture. SDMA and creatinine concentrations were significantly higher in these cases (median 59 µg/dl and 10.9 mg/dl, respectively) compared with those with negative cultures (median 14 µg/dl and 1.6 mg/dl [ P <0.002 and P <0.001], respectively). Conclusions and relevance Both SDMA and creatinine decreased significantly after urethral catheterization, suggesting that renal function post-decompression cannot be predicted by the pre-decompression concentrations of these values.
Pac-Man Method: A New Technique for Nuclear Management Of Posterior Polar Cataract
Authors: Rahman Sharah , Rahman Anisur , Ahmed Jalal , Anwar Ishtiaque , de Sarker Bipul Kumar , Malek Mohammad Ibn Abdul , Pathan Arif Hayat Khan , Mitu Sharifa Zahan , Mahfooz Shahrina 
Published: December 2021

Purpose We introduce an innovative technique, “Pac-Man”, for the nuclear management of posterior polar cataracts and compare it with “Chop in situ” and “Fishbowl” techniques. Method A total of 60 eyes from 60 patients were randomly assigned to groups A, B, and C, with 20 eyes in each group. Pac-Man, Chop in situ, and Fishbowl techniques were used for groups A, B, and C. In the Pac-Man method, adequate single trench sculpts, and a right-sided lateral sculpt were performed and cracked. The triangular piece was emulsified, after which the rest of the nucleus looked like a “Pac-Man” cartoon. Techniques were compared by age, visual outcome, Posterior Capsule Rupture (PCR), Cumulative Dissipated Energy (CDE), and time of surgery. Result Postoperative BCVA was significantly improved after surgery ( P = 0.0001, paired t-test). Time taken for surgeries were 25 ± 2.57, 30 ± 3.78, 40 ± 3.25 min, the CDE were 10 ± 0.95, 20 ± 1.2, 15 ± 0.48, and the PCR were 0%, 5%, and 10% for group A,B,C respectively. The total number of PCR was 3 out of 60 patients, and the percentage was 5.00%. Conclusion The “Pac-Man” method is a recommended technique due to its visual outcome, reduced surgical time, less CDE, and less chance of PCR.
OCT-angiography for the diagnosis of radiation maculopathy in patients treated with proton beam therapy: A 2-year prospective study
Authors: Marin Louis , Toumi Elsa , Caujolle Jean-Pierre , Doyen Jérôme , Martel Arnaud , Nahon-Esteve Sacha , Maschi Célia , Baillif Stephanie 
Published: December 2021

Purpose Radiation maculopathy (RM) is the leading cause of visual acuity (VA) loss after proton beam therapy (PBT) of choroidal melanoma. The aim of this study was to assess the value of optical coherence tomography-angiography (OCT-A) for the diagnosis of RM in patients with choroidal melanoma treated with PBT. Materials & methods This 2-year prospective, descriptive, single-center study included patients treated with PBT for choroidal melanoma. VA measurement, retinography, OCT and OCT-A were performed. Vascular density (VD) in the superficial capillary plexus (SCP), peri-foveal anastomotic ring changes and foveal avascular zone (FAZ) enlargement were studied. Results Nineteen patients were included in the study. The median baseline melanoma thickness was 5.7 [3.6–8.1] mm. The median melanoma-to-macula distance was 3.5 [2.6–4.6] mm. The earliest signs of RM identified on retinography were hard exudates developing at 12 [12–24] months, followed by retinal hemorrhages at 18 [12–30] months, found in 88.9% and 77.8% of patients respectively. On OCT, the earliest sign was the onset/progression of cystoid macular edema (CME) at 12 [6–12] months, found in 10 patients (52.6%). On OCT-A, 100% of patients presented with a discontinuity of the perifoveal anastomotic ring and a FAZ enlargement after 12 [6–24] months. After 12 months, a VD loss in the SCP by 11.7% and 10.8% compared to baseline, was found in the macular and foveal areas respectively. A significant negative correlation was found between the VA and the VD in the macular SCP (R = −0.43; p = 0.029). Conclusion OCT-A is a reliable and effective diagnostic tool for RM in patients with choroidal melanoma treated with PBT.
The Role of Household Flooring on Childhood Diarrhea Among Children 0 to 23 Months of Age in Ethiopia: A Nationally Representative Cross-Sectional Study Using a Multi-Level Mixed Effect Analysis
Authors: Sahiledengle Biniyam , Kumie Abera , Atlaw Daniel , Tekalegn Yohannes , Woldeyohannes Demelash , Zenbaba Demisu , Awoke Tadesse 
Published: December 2021

Introduction: Household flooring has been associated with diarrhea, but few studies have examined the association between childhood diarrhea and type of household flooring considering the individual and community level characteristics. We aimed to determine if household flooring was associated with childhood diarrhea among children 0 to 23 months of age in Ethiopia. Methods: Data from the fourth round of the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 is used to carry out the analysis. The EDHS was large, cross-sectional by design and nationally representative. In the current analysis, we included children 0 to 23 months of age (n = 4552) with their mother and 636 community clusters. To get information about the occurrence of diarrhea, mothers/caregivers were asked, “Has (NAME) had diarrhea in the last 2 weeks?” The response to this question was recorded as, “yes” or “no.” A multilevel binary logistic regression model was fitted to identify factors associated with childhood diarrhea. Results: The overall prevalence of diarrhea among children 0 to 23 months of age in Ethiopia was 15.5% (95% CI [confidence interval] 14.4-16.5). No association was found between childhood diarrhea and type of household flooring (adjusted odds ratio [AOR] 1.05, 95% CI 0.59-1.88). The adjusted odds also showed that the age of the child, having an acute respiratory infection (ARI), and size of the child at birth were associated with diarrhea. Conclusion: We found no association between childhood diarrhea and the type of household flooring. Further research with strong research design is needed to determine the effect of household flooring on childhood diarrhea.
Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017)
Authors: Pérez Adriana , Bluestein Meagan A. , Kuk Arnold E. , Chen Baojiang , Sterling Kymberle L. , Harrell Melissa B. 
Published: December 2021

Introduction Initiation of tobacco products is increasing in young adulthood. This study prospectively estimated the age of onset of susceptibility to cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos among young adults, which is a cognitive precursor to initiation. Methods Secondary data analyses of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative longitudinal cohort study of US adults. Young adults (18-24 years) who were non-susceptible to each tobacco product (cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos) at waves 2 or 3 were followed-up into waves 3-4 to prospectively estimate the age of onset of susceptibility to each tobacco product. Weighted interval-censored survival methods and interval-censored Cox regression models were implemented to estimate the age of onset of susceptibility, and to estimate differences in the hazard function by sex and by race/ethnicity, while controlling for the total number of other tobacco products ever used at their first wave of participation in PATH. Results By age 21, 16.5%, 16.0%, 12.6%, 12.4%, and 5.9% of young adults reported onset of susceptibility to hookah, e-cigarettes, cigarillos, cigarettes, and smokeless tobacco, respectively. Among young adults who were non-susceptible to each tobacco product at waves 2 or 3, the highest increase in onset of susceptibility occurred between ages 18 and 19 for cigarettes, e-cigarettes, and hookah, while the highest increase in onset of susceptibility occurs between ages 22 and 23 for cigarillos. Young adult males had increased risk of onset of susceptibility to cigarillos and smokeless tobacco at earlier ages than young adult females. Differences in onset of susceptibility to each tobacco product were also observed by race/ethnicity among young adults. Conclusions With the changing landscape of tobacco products, monitoring the age of onset of susceptibility of tobacco product use among non-susceptible young adults longitudinally is critical to prevent initiation. Communication and education campaigns tailored to address differences in susceptibility among young adults by tobacco product and sociodemographic factors will be useful.