bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gerstmann-Sträussler-Scheinker syndrome misdiagnosed as cervical spondylotic myelopathy
Authors: Cao Liming , Feng Hongye , Huang Xuming , Yi Jiamei , Zhou Yanxia 
Published: April 2021

Abstract

Rationale:
Gerstmann-Sträussler-Scheinker syndrome (GSS) is a rare autosomal dominant disease caused by a mutation in the prion protein gene (PRNP) that is not well known among neurologists and is therefore easily misdiagnosed.

Patient concerns
: A 49-year-old man was admitted for the first time because of an unsteady walk with mogilalia for 1 year. He underwent a cervical discectomy and a plate-screw fixation 6 months prior, although postoperative gait instability did not improve.

Diagnosis:
Whole exome sequencing identified a pathogenic and heterozygous mutation in the PRNP 4 years after onset. The patient was eventually diagnosed with GSS.

Interventions:
Symptomatic treatment to improve cerebrocirculation and cerebrometabolism was provided.

Outcomes:
The neurological decline continued. The Mini-Mental State Examination and modified Rankin Scale scores changed from 19 to 11 and 2 to 5, respectively. Progressive cerebral and cerebellar atrophy on magnetic resonance imaging was observed.

Lessons:
Cerebral and cerebellar atrophy are neuroimaging features symptomatic of GSS that become more apparent as the disease progresses. This atrophy is positively correlated with the severity of symptoms and reduced quality of life. Neurologists treating middle-aged patients with progressive ataxia, cognitive impairment or dysarthria, and brain atrophy need to consider the possibility of GSS.
The Emergent Pelvic Artery Embolization in the Management of Postpartum Hemorrhage: A Systematic Review and Meta-analysis
Authors: Zhang Xiu Quan , Chen Xi Ting , Zhang Yu Ting , Mai Cai Xiu 
Published: April 2021

Importance
Postpartum hemorrhage (PPH) is an emergent obstetric complication and the leading cause of maternal mortality. Pelvic arterial embolization (PAE) is an effective treatment for intractable PPH. However, a unique protocol has not been accepted in obstetrical practice.

Objective
To evaluate its efficiency, safety, complications, and outcomes, we conducted a systematic review and meta-analysis of PAE for PPH in the literature.

Evidence Acquisition
The Medline, the database of abstract of reviews, the index to allied health literature, and the Chinese database Sino-Med were searched on March 31, 2020, for studies on PAE for PPH. The data for PAE indication, agents, arteries, success rate, complications, and outcomes were extracted and syncretized for meta-analysis.

Results
From 1075 identified articles, 113 abstracts or full articles were retrieved and 43 studies were finally identified as meeting the including criteria. The results demonstrated that the indications for PAE were as follows: uterine atony, placental abnormality, delivery tract injury, disseminated intravascular coagulation, arteriovenous malformation, and vaginal hematoma. The embolization agents mostly in order were gelatin sponge particles, polyvinyl alcohol particles, Gelfoam, N-butyl cyanoacrylate, microcoil, and glue; for arteries, they were mostly uterine artery and internal iliac artery. The clinical success rate was 90.5%, whereas the technical success rate was 99.3%. The most common complications of PAE were postembolization syndrome and menstrual abnormality.

Conclusions and Relevance
The emergent PAE is a safe and effective method with high success rate in life-threatening PPH management. Gelatin sponge granules measuring 500 to 1000 μm in diameter have safe results. Pelvic arterial embolization may affect the recovery of menses and increase PPH in the subsequent pregnancy, but there was no noted correlation with fetal growth restriction.

Target Audience
Obstetricians and gynecologist, family physicians

Learning Objectives
After participating in this activity, physicians should be better able to explain the causes of PPH; identify which arteries should be chosen for embolization; and describe the advantages of PAE for PPH management.
Recommendations on the use of virtual interviews in the orthopaedic trauma fellowship match
Authors: Yong Taylor M. , Davis Max E. , Coe Marcus P. , Perdue Aaron M. , Obremskey William T. , Gitajn Ida L. 
Published: April 2021

Abstract

Objective
The aim of this study was to assess applicant and fellowship director (FD) perspectives on virtual interviewing based on the 2019 to 2020 orthopaedic trauma fellowship interview experience and to develop recommendations for future application cycles.

Methods
Web-based surveys were distributed to all matched applicants and orthopaedic trauma FDs after the 2019 and 2020 orthopaedic trauma fellowship match. Thirty-one applicants and 23 FDs completed the survey—response rates of 34% and 38%, respectively.

Results
Virtual interviews were completed by 68% of applicants and 17% of FDs. Twenty-nine percent of applicants felt they were able to familiarize themselves with the culture of programs, and 38% of applicants were satisfied with their ability to present themselves. Most (62%) were comfortable ranking programs based on the virtual interview, but 38% reported the format influenced them to rank a program lower. Among all applicants, 77% preferred the in-person interview. Most FDs (75%) reported virtual interviews limited their ability to familiarize themselves with an applicant, and only 50% were comfortable ranking an applicant afterward. Still, 78% of FDs believe there is a role for virtual interviews in the fellowship match. Choosing a virtual interview may negatively affect applicants as 97% of applicants worry the choice conveys less interest to programs, while 43% of FDs would interpret it as less interest.

Conclusions
Virtual interviews have multiple shortcomings but are technically feasible and provide reasonable information to applicants and FDs to complete the match process. Our recommendations, based on the perspectives of applicants and FDs, can guide their implementation.
Cohort study protocol to characterize the incidence and severity of neuropathic pain in patients with severe acute respiratory syndrome coronavirus 2 infection
Authors: Odozor Chioma U. , Roles Kristen , Burk Carrie , Kannampallil Thomas , Clifford David B. , Piccirillo Jay F. , Haroutounian Simon 
Published: April 2021

Abstract

Introduction and Objectives:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in patients experiencing symptoms that include neurological dysfunction. As many viral infections are associated with neuropathy, the aim of the study is to characterize the incidence and severity of neuropathic pain in patients with COVID-19.

Methods:
A cohort study will be conducted in adult (≥18 years) patients who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at Washington University/Barnes-Jewish Hospital. Participants who are deceased, with incomplete test results, or who cannot be contacted will be excluded. Approximately 1320 participants will be recruited in a 1:2 ratio of those with a positive-to-negative SARS-CoV-2 test result. Each participant will be invited to complete a survey to assess their symptoms related to neuropathy, 30 to 90 days after their initial SARS-CoV-2 test. Survey responses, demographics, and clinical data from the electronic health record will be used for analysis. The primary outcome is the incidence of new symptoms of neuropathic pain. The self-reported DN4 and Neuropathic Pain Symptom Inventory questionnaires (Appendix 1, http://links.lww.com/PR9/A103) will be used for neuropathic pain screening and severity assessment, respectively. Exploratory analyses will be performed to investigate other potential clinical endpoints and trends.

Results/Conclusion:
Similar to previous coronavirus infections, an increased incidence of new-onset neuropathic pain after COVID-19 disease is expected, along with an increase in the severity experienced by patients with COVID-19 with pre-existing chronic pain. Comprehensive understanding of how COVID-19 affects the nervous system can provide a better framework for managing pain in this disease.
Self-collected oral, nasal and saliva samples yield sensitivity comparable to professional-collected oro-nasopharyngeal swabs in SARS-CoV-2 diagnosis
Authors: Gertler Maximilian , Krause Eva , van Loon Welmoed , Krug Niklas , Kausch Franka , Rohardt Chiara , Rössig Heike , Michel Janine , Nitsche Andreas , Mall Marcus A. , Nikolai Olga , Hommes Franziska , Burock Susen , Lindner Andreas K. , Mockenhaupt Frank P. , Pison Ulrich , Seybold Joachim 
Published: April 2021

Summary/AbstractIntroductionContainment of the COVID-19 pandemic requires broad-scale testing. Laboratory capacities for real-time-PCR were increased, and are complemented by Ag-tests. However, sample-collection still requires qualified personnel and protective equipement, may produce transmission to others during conduct and travel, and is perceived uncomfortable. We tested sensitivity of three simplified self-sampling techniques compared to professional-collected combined oro-nasopharyngeal samples (cOP/NP).MethodsFrom 62 symptomatic COVID-19 outpatients, we obtained simultaneously three self- and one professional-collected sample after initial confirmation in a testing centre: (i) combination swab (tongue, cheek, both nasal vestibula, MS, (ii) saliva sponge combined with both nasal vestibula, SN, and (iii) gargled tap water, GW, (iv) professionally-collected cOP/NP (standard). We compared the results of SARS-CoV-2 PCR-assays detecting E-gene and ORF1ab for the different sample types and performed bivariate statistical analysis to determine the variables reducing sensitivity of the self-collecting procedures.ResultsSARS-CoV-2 RNA was detected in all 62 professionally-collected cOP/NP. MS and SN samples showed a sensitivity of 95.2% (95%CI 86.5-99.0) and GW samples of 88.7% (78.1-95.3). Compared to the medianct-values of cOP/NP samples forE-gene(20.7) andORF1ab(20.2) these were higher for MS (22.6 and 21.8), SN (23.3 and 22.3), and for GW (30.3 and 29.8).For MS and SN samples but not for GW specimens, false negativity in bivariate analysis was associated with non-German mother-tongue, number of sampling errors, and with symptom duration. For symptom duration of ≤8 days, test sensitivity for SN samples was 98.2% (95%CI 90.4-100.0) and for MS 96.4% (95%CI 87.7-99.6) and drops after day 8 below 90%.DiscussionThe study is limited to sensitivity of self-collection in symptomatic patients. Still, in this group, self-collected oral/nasal/saliva samples are reliable alternatives to professional-collected cOP/NP samples, if symptom duration does not exceed eight days and operational errors are minimized. Self-sampling could contribute to up-scaling of safe and efficient testing.
Substantia nigra ferric overload and neuromelanin loss in Parkinson’s disease measured with 7T MRI
Authors: Rua Catarina , O’Callaghan Claire , Ye Rong , Hezemans Frank H. , Passamonti Luca , Jones P Simon , Williams Guy B , Rodgers Christopher T , Rowe James B 
Published: April 2021

AbstractBackgroundVulnerability of the substantia nigra dopaminergic neurons in Parkinson’s disease is associated with ferric overload, leading to neurodegeneration with cognitive and motor decline. Here, we quantify iron and neuromelanin-related markers in vivo using ultra-high field 7-Tesla MRI, and examine the clinical correlates of these imaging assessments.MethodsTwenty-five people with mild-to-moderate Parkinson’s disease and twenty-six healthy controls underwent high-resolution imaging at 7-Tesla with a T2*-weighted sequence (measuring susceptibility-χ and R2*, sensitive to iron) and a magnetization transfer-weighted sequence (MT-w, sensitive to neuromelanin). From an independent control group (N=29), we created study-specific regions-of-interest for five neuromelanin- and/or iron-rich subregions within the substantia nigra. Mean R2*, susceptibility-χ and their ratio, as well as the MT-w contrast-to-noise ratio (MT-CNR) were extracted from these regions and compared between groups. We then tested the relationships between these imaging metrics and clinical severity.ResultsPeople with Parkinson’s disease showed a significant ~50% reduction in MT-CNR compared to healthy controls. They also showed a 1.2-fold increase in ferric iron loading (elevation of the ratio from 0.19±0.058ms/ppm to 0.22±0.059ms/ppm) in an area of the substantia nigra identified as having both high neuromelanin and susceptibility MRI signal in healthy controls. In this region, the ferric-to-ferrous iron loading was associated with disease duration (β=0.0072, pFDR=0.048) and cognitive impairment (β=−0.0115, pFDR=0.048).ConclusionsT2*-weighted and MT-weighted high-resolution 7T imaging markers identified neurochemical consequences of Parkinson’s disease, in overlapping but not-identical regions. These changes correlated with non-motor symptoms.
Introducing the EMPIRE Index: A novel, value-based metric framework to measure the impact of medical publications
Authors: Pal Avishek , Rees Tomas James 
Published: April 2021

AbstractArticle-level measures of publication impact (alternative metrics or altmetrics) can help authors and other stakeholders assess engagement with their research and the success of their communication efforts. The wide variety of altmetrics can make interpretation and comparative assessment difficult; available summary tools are either narrowly focused or do not reflect the differing values of metrics from a stakeholder perspective. We created the EMPIRE (EMpirical Publication Impact and Reach Evaluation) Index, a value-based, multi-component metric framework for medical publications. Metric weighting and grouping were informed by a statistical analysis of 2891 Phase III clinical trial publications and by a panel of stakeholders who provided value assessments. The EMPIRE Index comprises three component scores (social, scholarly, and societal impact), each incorporating related altmetrics indicating a different aspect of engagement with the publication. These are averaged to provide a total impact score and benchmarked so that a score of 100 equals the mean scores of Phase III clinical trial publications in the New England Journal of Medicine (NEJM) in 2016. Predictor metrics are defined to estimate likely long-term impact. The social impact component correlated strongly with the Altmetric Attention Score and the scholarly impact component correlated modestly with CiteScore, with the societal impact component providing unique insights. Analysis of fresh metrics collected 1 year after the initial dataset, including an independent sample, showed that scholarly and societal impact scores continued to increase, whereas social impact scores did not. Analysis of NEJM ‘notable articles’ showed that observational studies had the highest total impact and component scores, except for societal impact, for which surgical studies had the highest score. The EMPIRE Index provides a richer assessment of publication value than standalone traditional and alternative metrics and may enable medical researchers to assess the impact of publications easily and to understand what characterizes impactful research.
Comparative Effectiveness of Standard and Contingency-based Cleaning in Acute and Long-Term Care Facilities amidst Staff Shortages and a COVID-19 Surge
Authors: Lesho Emil , Newhart Donna , Reno Lisa , Sleeper Scott , Nary Julia , Gutowski Jennifer , Yu Stephanie , Walsh Edward , Vargas Roberto , Riedy Dawn , Mayo Robert 
Published: April 2021

AbstractBackgroundCleanliness of hospital surfaces helps prevent healthcare-associated infections, but larger evaluations of the effectiveness of various cleaning strategies during SARS-CoV-2 surges and worker shortages are scarce.MethodsIn an acute care hospital (ACH) and a long-term care facility (LTCF), 417 surfaces were tested for SARS-CoV-2 and adenosine triphosphate before and after various cleaning strategies, including ultraviolet light (UV-C), electrostatic spraying, and room fogging.ResultsACH surface contamination differed among outbreak and non-outbreak wards (p = 0.001). RNA was detected on 66% of surfaces before cleaning and on 23% of those surfaces immediately after terminal cleaning, for a 65% post-cleaning reduction (p = 0.001). UV-C resulted in an 87% reduction (p = 0.023), while spraying with electrostatic bleach resulted in a 47% reduction (p = 0.010). LTCF contamination rates differed between the dementia, rehabilitation, and the residential units (p = 0.005). 67% of surfaces had RNA after room fogging without terminal-style wiping. Fogging with wiping led to an 11% reduction in the proportion of positive surfaces.DiscussionBaseline contamination varied by type of unit and outbreak conditions, but not facility type. Removal of viral RNA varied according to strategy. Unlike previous reports, time spent cleaning was associated with cleaning thoroughness.
Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19
Authors: Kumar Andre , Weng Isabel , Graglia Sally , Lew Thomas , Gandhi Kavita , Lalani Farhan , Chia David , Duanmu Youyou , Jenson Trevor , Lobo Viveta , Nahn Jeffrey , Iverson Nicholas , Rosenthal Molly , Gordon June , Kugler John , Tran Minh Chi , Jia Xiaolin , Liao Charles , Cha Alice , Baum Evan , Halket Douglas , Madhok Jai , Fazal Muhhamad 
Published: April 2021

AbstractIntroductionPoint-of-care ultrasound (POCUS) may detect the cardiopulmonary manifestations of COVID-19 and expediently predict patient outcomes.MethodsWe conducted a prospective cohort study at four medical centers from 3/2020-1/2021 to evaluate POCUS findings and clinical outcomes with COVID-19. Our inclusion criteria included adult patients hospitalized for COVID-19 who received cardiac or lung POCUS with a 12-zone protocol. Images were interpreted by two reviewers blinded to clinical outcomes. Our primary outcome was ICU admission incidence. Secondary outcomes included intubation and supplemental oxygen usage.ResultsN=160 patients (N=201 scans) were included. Scans were collected a median 23 hours (IQR:7-80) from emergency department triage. Triage POCUS findings associated with ICU admission included B-lines (OR 4.41 [95% CI:1.71-14.30]; p<0.01) or consolidation (OR 2.49 [95% CI:1.35-4.86]; p<0.01). B-lines were associated with intubation (OR 3.10 [95% CI:1.15-10.27]; p=0.02) and supplemental oxygen usage (OR 3.74 [95% CI:1.63-8.63; p<0.01).Consolidations present on triage were associated with the need for oxygen at discharge (OR 2.16 [95% CI: 1.01-4.70]; p=0.047). A normal lung triage scan was protective for ICU admission (OR 0.28 [95% CI:0.09-0.75; p<0.01) or need for supplemental oxygen during the hospitalization (OR 0.26 [95% CI:0.11-0.61]; p<0.01). Triage cardiac POCUS scans were not associated with any outcomes.DiscussionLung POCUS findings detected early in the hospitalization may provide expedient risk stratification for important COVID-19 clinical outcomes, including ICU admission, intubation, or need for oxygen on discharge. A normal admission scan appears protective against adverse outcomes, which may aid in triage decisions of patients.
Gender Differences in Health Protective Behaviors During the COVID-19 Pandemic in Taiwan: An Empirical Study
Authors: Tan Jasmine , Yoshida Yilin , Ma Kevin Sheng-Kai , Mauvais-Jarvis Franck 
Published: April 2021

AbstractIntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces more severe symptoms and a higher mortality in men than in women. The role of biological sex in the immune response to SARS-CoV-2 is believed to explain this sex disparity. However, the contribution of gender factors that influence health protective behaviors and therefore health outcomes, remains poorly explored.MethodsWe assessed the contributions of gender in attitudes towards the COVID-19 pandemic, using a hypothetical influenza pandemic data from the 2014 Taiwan Social Change Survey. Participants were selected through a stratified, three-stage probability proportional-to-size sampling from across the nation, to fill in questionnaires that asked about their perception of the hypothetical pandemic, and intention to adopt health protective behaviors.ResultsA total of 1,990 participants (median age 45.92 years, 49% women) were included. Significant gender disparities (p<0.001) were observed. The risk perception of pandemic (OR=1.28, 95% CI=1.21-1.35, p<0.001), older age (1.06, 95%=1.05-1.07, p<0.001), female gender (OR = 1.18, 95% CI = 1.09□1.27, p<0.001), higher education (OR=1.10, 95% CI=1.06-1.13, p<0.001), and larger family size (OR=1.09, 95% CI=1.06-1.15, p<0.001) were positively associated with health protective behaviors. The risk perception of pandemic (OR=1.25, 95% CI=1.15-1.36), higher education (OR=1.07, 95% CI=1.02-1.13, p<0.05), being married (OR=1.17, 95% CI=1.01-1.36, p<0.05), and larger family size (OR=1.33, 95% CI=1.25-1.42, p<0.001), were positively associated with intention to receive a vaccine. However, female gender was negatively associated with intention to receive a vaccine (OR=0.85, 95% CI=0.75-0.90, p<0.01) and to comply with contact-tracing (OR=0.95, 95% CI=0.90-1.00, p<0.05) compared to men. Living with children was also negatively associated with intention to receive vaccines (OR=0.77, 95% CI=0.66-0.90, p<0.001).ConclusionThis study unveils gender differences in risk perception, health protective behaviors, vaccine hesitancy, and compliance with contact-tracing using a hypothetical viral pandemic. Gender-specific health education raising awareness of health protective behaviors may be beneficial to prevent future pandemics.
A Bibliometric Analysis of Global Pediatric Emergency Medicine Research Networks
Authors: Barrett Michael J , Dalziel Stuart , Lyttle Mark , O’Sullivan Ronan ,   for the Pediatric Emergency Research Networks (PERN)
Published: April 2021

AbstractObjectiveDuring the last three decades newly formed pediatric emergency medicine (PEM) research networks have been publishing research. A desire of these networks is to produce and disseminate research to improve patient health and outcomes. To quantitatively analyze and compare the literature by PEM research networks globally through numeric and visual bibliometrics.MethodsA bibliometric analysis of articles published from 1994 to 2019 (26 years) by authors from PEM research networks globally were retrieved using PubMed®, Web of Science™ (Thompson Reuters) and accessing individual research network databases. Bibliometric analysis was performed utilizing Web of Science™, VOSviewer and Dimensions. Research was quantified to ascertain the number of articles, related articles, citations and Altmetric attention score.ResultsA total of 493 articles were published across nine research networks in three decades. Pediatric Emergency Care Applied Research Network (PECARN) produced the most articles, citations, and h-index of all networks. We identified three main groupings of productive authors across the networks who collaborate globally. The gender of the first author was female in 46% of publications and the corresponding author(s) was female in 45%. A non-significant moderate positive correlation between the number of years publishing and the number of publications was identified. There was non-significant moderate negative association between the number of countries in a network and total publications per annum.ConclusionsThis study is the first bibliometric analysis of publications from PEM research networks that collaborate globally. The gender gap in first authorship compared to high impact medical journals and high impact emergency medicine journals is narrower. Exploring the relationships of numerical bibliometric indicators and visualizations of productivity will benefit the understanding of the generation, reach and dissemination of PEM research within the global research community.