bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of cerebral aneurysm size on distal intracranial hemodynamics and changes following flow diversion
Authors: Brunozzi Denise , See Alfred , Rizko Mark , Choi Jason , Atwal Gursant , Alaraj Ali 
Published: August 2021

Background The impact of cerebral aneurysm size on distal intracranial hemodynamics such as arterial pressure and Pulsatility Index is not completely understood, either before or after flow diversion. Objective The aim of the study is to assess the impact of aneurysm size on distal Pulsatility Index and pressure before and after flow diversion. Methods From December 2015, prospective measurement of middle cerebral artery pressure and Pulsatility Index was performed in consecutive patients with unruptured cerebral aneurysms in the cavernous to communicating segments of the internal carotid artery, which were treated with single flow diversion. Pressure and Pulsatility Index were recorded at the M1-segment ipsilateral to the cerebral aneurysm. Ratio of middle cerebral artery to radial arterial pressure (pressure ratio) was calculated to control for variations in systemic blood pressure. Correlations between aneurysm size and pressure ratio and Pulsatility Index were assessed before and after treatment. Results A total of 28 aneurysms were treated. The mean aneurysm size was 7.2 mm. Aneurysm size correlated linearly with systolic pressure ratio (1% pressure ratio increase per mm aneurysm size increase, P = 0.002, r2 = 0.33), mean pressure ratio (0.6% per mm, P = 0.03, r2 = 0.17) and Pulsatility Index (5% Pulsatility Index increase per mm, P = 0.003, r2 = 0.43). After flow diversion, aneurysm size preserved a linear correlation with the systolic pressure ratio (1% per mm, P = 0.004, r2  =  0.28), but not with the mean pressure ratio (0.4% per mm, P = 0.15, r2 < 0.1) or Pulsatility Index (0.3% per mm, P = 0.78, r2 < 0.1). Conclusion Aneurysm size affects distal hemodynamics: patients with larger aneurysms have increased systolic and mean pressure ratio, and increased Pulsatility Index. After flow diversion, mean pressure ratio and Pulsatility Index no longer associate with the aneurysm size, suggesting an effect of the flow diversion also on distal intracranial hemodynamics.
Recombinant factor VIIa for hemorrhagic stroke treatment at earliest possible time (FASTEST): Protocol for a phase III, double-blind, randomized, placebo-controlled trial
Authors: Naidech Andrew M , Grotta James , Elm Jordan , Janis Scott , Dowlatshahi Dar , Toyoda Kazunori , Steiner Thorsten , Mayer Stephan A , Khanolkar Pooja , Denlinger Julie , Audebert Heinrich J , Molina Carlos , Khatri Pooja , Sprigg Nikola , Vagal Achala , Broderick Joseph P 
Published: August 2021

Introduction Intracerebral hemorrhage is the deadliest form of stroke. Hematoma expansion, growth of the hematoma between the baseline computed tomography scan and a follow-up computed tomography scan at 24 ± 6 h, predicts long-term disability or death. Recombinant factor VIIa (rFVIIa) has reduced hematoma expansion in previous clinical trials with a variable effect on clinical outcomes, with the greatest impact on hematoma expansion and potential benefit when administered within 2 h of symptom onset. Methods Factor VIIa for Hemorrhagic Stroke Treatment at Earliest Possible Time (FASTEST, NCT03496883) is a randomized controlled trial that will enroll 860 patients at ∼100 emergency departments and mobile stroke units in five countries. Patients are eligible for enrollment if they have acute intracerebral hemorrhage within 2 h of symptom onset confirmed by computed tomography, a hematoma volume of 2 to 60 mL, no or small volumes of intraventricular hemorrhage, do not take anticoagulant medications or concurrent heparin/heparinoids (antiplatelet medications are permissible), and are not deeply comatose. Enrolled patients will receive rFVIIa 80 µg/kg or placebo intravenously over 2 min. The primary outcome measure is the distribution of the ordinal modified Rankin Scale at 180 days. FASTEST is monitored by a Data Safety Monitoring Board. Safety endpoints include thrombotic events (e.g. myocardial infarction). Human subjects research is monitored by an external Institutional Review Board in participating countries. Discussion In the US, FASTEST will be first NIH StrokeNet Trial with an Exception from Informed Consent which allows enrollment of non-communicative patients without an immediately identifiable proxy.
Therapeutic hypothermia for intracerebral hemorrhage: Systematic review and meta-analysis of the experimental and clinical literature
Authors: Baker Turner S , Durbin John , Troiani Zachary , Ascanio-Cortez Luis , Baron Rebecca , Costa Anthony , Rincon Fred , Colbourne Frederick , Lyden Patrick , Mayer Stephan A , Kellner Christopher P 
Published: August 2021

Background Intracerebral hemorrhage remains the deadliest form of stroke worldwide, inducing neuronal death through a wide variety of pathways. Therapeutic hypothermia is a robust and well-studied neuroprotectant widely used across a variety of specialties. Aims This review summarizes results from preclinical and clinical studies to highlight the overall effectiveness of therapeutic hypothermia to improve long-term intracerebral hemorrhage outcomes while also elucidating optimal protocol regimens to maximize therapeutic effect. Summary of review A systematic review was conducted across three databases to identify trials investigating the use of therapeutic hypothermia to treat intracerebral hemorrhage. A random-effects meta-analysis was conducted on preclinical studies, looking at neurobehavioral outcomes, blood brain barrier breakdown, cerebral edema, hematoma volume, and tissue loss. Several mixed-methods meta-regression models were also performed to adjust for variance and variations in hypothermia induction procedures. Twwenty-one preclinical studies and five human studies were identified. The meta-analysis of preclinical studies demonstrated a significant benefit in behavioral scores (ES = −0.43, p = 0.02), cerebral edema (ES = 1.32, p = 0.0001), and blood brain barrier (ES = 2.73, p ≤ 0.00001). Therapeutic hypothermia was not found to significantly affect hematoma expansion (ES = −0.24, p = 0.12) or tissue loss (ES = 0.06, p = 0.68). Clinical study outcome reporting was heterogeneous; however, there was recurring evidence of therapeutic hypothermia-induced edema reduction. Conclusions The combined preclinical evidence demonstrates that therapeutic hypothermia reduced multiple cell death mechanisms initiated by intracerebral hemorrhage; yet, there is no definitive evidence in clinical studies. The cooling strategies employed in both preclinical and clinical studies were highly diverse, and focused refinement of cooling protocols should be developed in future preclinical studies. The current data for therapeutic hypothermia in intracerebral hemorrhage remains questionable despite the highly promising indications in preclinical studies. Definitive randomized controlled studies are still required to answer this therapeutic question.
Implications of renal transplantation on serum testosterone and preoperative factors affecting its levels in the post-transplant period
Authors: Singh Rohit Pratap , Tomar Vinay , Yadav Sher Singh 
Published: August 2021

Objective: Low serum testosterone is highly prevalent in chronic kidney disease patients. The objective of the study was to determine levels of serum testosterone at the time of transplantation, the prevalence of testosterone deficiency/insufficiency in the pre- and post-transplant periods, and its correlation with patients’ age, serum creatinine, duration of preoperative dialysis, human leukocyte antigen (HLA) matching, and graft outcomes. Methods: The study was conducted from January 2019 to April 2020. Forty-five male renal transplant patients were evaluated before and at one and six months following transplant for changes in testosterone and creatinine levels. Six-month follow-up was possible for 28 patients. Result: Renal transplantation resulted in significant improvement in testosterone levels as early as one month after transplantation. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively. We did not find any impact of testosterone levels on graft function. Conclusion: Successful transplantation among the study population produced a positive impact on serum testosterone levels. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively. Level of evidence: XXX.
Epidemiological, Clinical, and Laboratory Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted in a Tertiary COVID Dedicated Hospital, Northern India: A Retrospective Observational Study
Authors: Ahmad Shamshad , Kumar Pragya , Shekhar Saket , Saha Rubina , Ranjan Alok , Pandey Sanjay 
Published: August 2021

Introduction COVID-19 pandemic still poses a serious challenge to health system worldwide. This study was planned to determine exposure characteristics, in-hospital mortality, and predictors of in hospital mortality among COVID-19 patients. Material and methods We retrospectively investigated epidemiological, clinical, and laboratory profile of confirmed COVID-19 patients admitted from 25th March to 31st August 2020. COVID-19 patient profiles were collected from Medical Record Section of the hospital. Results In hospital mortality occurred in 159 (11%) cases. Increasing respiratory rate, higher temperature, higher total leukocyte count, and high blood urea levels were found to be independent risk factors for in hospital mortality whereas higher hemoglobin and higher oxygen saturation at the time of hospital admission were found to be protective against in hospital mortality. Conclusion In hospital mortality among COVID-19 patients is almost 1 in 10 in tertiary care hospital. Patients with advancing age (AOR: 1.048; 95% CI: 1.021-1.076), higher respiratory rate (AOR: 1.248; 95% CI: 1.047-1.489), higher temperature (AOR: 1.758; 95% CI: 1.025-3.016), higher leukocyte count (AOR: 1.147; 95% CI: 1.035-1.270), and higher urea levels (AOR: 1.034; 95% CI: 1.005-1.064) at the time of admission are important predictors of COVID-19 in-hospital mortality.
Bone marrow remodeling supports hematopoiesis in response to immune thrombocytopenia progression in mice
Authors: Herd Oliver J. , Rani Gulab Fatima , Hewitson James P. , Hogg Karen , Stone Andrew P. , Cooper Nichola , Kent David G. , Genever Paul G. , Hitchcock Ian S. 
Published: August 2021

Abstract
Immune thrombocytopenia (ITP) is an acquired autoimmune condition characterized by both reduced platelet production and the destruction of functionally normal platelets by sustained attack from the immune system. However, the effect of prolonged ITP on the more immature hematopoietic progenitors remains an open area of investigation. By using a murine in vivo model of extended ITP, we revealed that ITP progression drives considerable progenitor expansion and bone marrow (BM) remodeling. Single-cell assays using Lin–Sca1+c-Kit+CD48–CD150+ long-term hematopoietic stem cells (LT-HSCs) revealed elevated LT-HSC activation and proliferation in vitro. However, the increased activation did not come at the expense of LT-HSC functionality as measured by in vivo serial transplantations. ITP progression was associated with considerable BM vasodilation and angiogenesis, as well as a twofold increase in the local production of CXCL12, a cytokine essential for LT-HSC function and BM homing expressed at high levels by LepR+ BM stromal cells. This was associated with a 1.5-fold increase in LepR+ BM stromal cells and a 5.5-fold improvement in progenitor homing to the BM. The increase in stromal cells was transient and reverted back to baseline after platelet count returned to normal, but the vasculature changes in the BM persisted. Together, our data demonstrate that LT-HSCs expand in response to ITP and that LT-HSC functionality during sustained hematopoietic stress is maintained through an adapting BM microenvironment.
PRPI-SC: an ensemble deep learning model for predicting plant lncRNA-protein interactions
Authors: Zhou Haoran , Wekesa Jael Sanyanda , Luan Yushi , Meng Jun 
Published: August 2021

Abstract
Background
Plant long non-coding RNAs (lncRNAs) play vital roles in many biological processes mainly through interactions with RNA-binding protein (RBP). To understand the function of lncRNAs, a fundamental method is to identify which types of proteins interact with the lncRNAs. However, the models or rules of interactions are a major challenge when calculating and estimating the types of RBP.

Results
In this study, we propose an ensemble deep learning model to predict plant lncRNA-protein interactions using stacked denoising autoencoder and convolutional neural network based on sequence and structural information, named PRPI-SC. PRPI-SC predicts interactions between lncRNAs and proteins based on the k-mer features of RNAs and proteins. Experiments proved good results on Arabidopsis thaliana and Zea mays datasets (ATH948 and ZEA22133). The accuracy rates of ATH948 and ZEA22133 datasets were 88.9% and 82.6%, respectively. PRPI-SC also performed well on some public RNA protein interaction datasets.

Conclusions
PRPI-SC accurately predicts the interaction between plant lncRNA and protein, which plays a guiding role in studying the function and expression of plant lncRNA. At the same time, PRPI-SC has a strong generalization ability and good prediction effect for non-plant data.
Cell-free fetal DNA testing and its correlation with prenatal indications
Authors: Wang Jing-wei , Lyu Yong-nan , Qiao Bin , Li Yan , Zhang Yan , Dhanyamraju Pavan Kumar , Bamme Yevgeniya , Yu Michael D. , Yang Dongqin , Tong Yong-qing 
Published: August 2021

Abstract
Background
The prenatal test of cell-free fetal DNA (cffDNA) is also known as noninvasive prenatal testing (NIPT) with high sensitivity and specificity. This study is to evaluate the performance of NIPT and its clinical relevance with various clinical indications.

Methods
A retrospective analysis was conducted on 14,316 pregnant women with prenatal indications, including advanced maternal age (≥35 years), maternal serum screening abnormalities, the thickened nuchal translucency (≥2.5 mm) and other ultrasound abnormalities, twin pregnancy/IVF-ET pregnancy, etc. The whole-genome sequencing (WGS) of maternal plasma cffDNA was employed in this study.

Results
A total of 189 (1.32%) positive NIPT cases were identified, and 113/189 (59.79%)cases were confirmed by invasive prenatal testing. Abnormal serological screening (53.14%) was the most common indication, followed by elderly pregnancy (23.02%). The positive prediction value for T21, T18, T13, sex chromosome abnormalities, other autosomal aneuploidy abnormalities, and CNV abnormalities were 91.84, 68.75,37.50, 66.67, 14.29, and 6.45%, respectively. The positive rate and the true positive rate of nuchal translucency (NT) thickening were the highest (4.17 and 3.33%), followed by the voluntary requirement group (3.49 and 1.90%) in the various prenatal screening indications. The cffDNA concentration was linearly correlated with gestational age (≥10 weeks) and the positive NIPT group’s Z-score values.

Conclusions
whole-genome sequencing of cffDNA has extremely high sensitivity and specificity for T21, high sensitivity for T18, sex chromosome abnormalities, and T13. It also provides evidence for other abnormal chromosomal karyotypes (CNV and non-21/18/13 autosomal aneuploidy abnormalities). The cffDNA concentration is closely related to the gestational age and determines the specificity of NIPT. Our results highlight NIPT’s clinical significance, which is an effective prenatal screening tool for high-quality care of pregnancy.
Bone mineral density and its influencing factors in Chinese children with spinal muscular atrophy types 2 and 3
Authors: Peng Xiaoyin , Qu Yujin , Li Xiaohui , Liu Junting , Shan Xinying , Wang Jia , Song Fang 
Published: August 2021

Abstract
Background
Patients with spinal muscular atrophy (SMA) are at risk of decreased bone mineral density (BMD). The bone health status of Chinese patients with SMA has been poorly studied. We aimed to evaluate the BMD of children with SMA types 2 and 3 in mainland China and investigate its influencing factors.

Methods
Forty patients with a mean age of 5.5 years affected by SMA types 2 and 3 (n = 22 and n = 18, respectively) were enrolled between September 2017 and May 2019. Total body less head (TBLH) BMD, lumbar spine (LS) BMD, and body composition were measured using dual-energy X-ray absorptiometry (DXA). Serum bone metabolism markers and complete spinal radiographs were assessed. We utilized a linear regression model to explore the correlations between BMD and its related factors.

Results
A total of 67.5% (27/40) of patients were diagnosed with low BMD and 2.5% (1/40) were diagnosed with osteoporosis. The TBLH BMD and LS BMD Z-scores in children with SMA type 2 were significantly lower than those with SMA type 3. Both TBLH and LS BMD Z-scores tended to increase with the change of SMA subtypes from 2a-3b. Vitamin D insufficiency and deficiency were found in 37.5% (15/40) of the patients. Serum Ca, phosphorus (P), alkaline phosphatase (ALP) and parathormone (PTH) levels were normal. There were no significant differences among the four subtypes in terms of all the serum bone metabolism markers. Phenotype was significantly associated with TBLH BMD and LS BMD Z-scores, and serum PTH levels were significantly associated with TBLH BMD Z-scores.

Conclusions
Low BMD and osteoporosis were highly prevalent in mainland Chinese children with SMA types 2 and 3. Phenotype and serum PTH level might be the influencing factors of BMD. Regular monitoring of BMD by DXA scan and taking active interventions aim to SMA children with different types are important.
Effectiveness of a ‘do not interrupt’ vest intervention to reduce medication errors during medication administration: a multicenter cluster randomized controlled trial
Authors: Berdot Sarah , Vilfaillot Aurélie , Bezie Yvonnick , Perrin Germain , Berge Marion , Corny Jennifer , Thi Thuy Tan Phan , Depoisson Mathieu , Guihaire Claudine , Valin Nathalie , Decelle Claudine , Karras Alexandre , Durieux Pierre , Lê Laetitia Minh Maï , Sabatier Brigitte 
Published: August 2021

Abstract
Background
The use of a ‘do not interrupt’ vest during medication administration rounds is recommended but there have been no controlled randomized studies to evaluate its impact on reducing administration errors. We aimed to evaluate the impact of wearing such a vest on reducing such errors. The secondary objectives were to evaluate the types and potential clinical impact of errors, the association between errors and several risk factors (such as interruptions), and nurses’ experiences.

Methods
This was a multicenter, cluster, controlled, randomized study (March–July 2017) in 29 adult units (4 hospitals). Data were collected by direct observation by trained observers. All nurses from selected units were informed. A ‘Do not interrupt’ vest was implemented in all units of the experimental group. A poster was placed at the entrance of these units to inform patients and relatives. The main outcome was the administration error rate (number of Opportunities for Error (OE), calculated as one or more errors divided by the Total Opportunities for Error (TOE) and multiplied by 100).

Results
We enrolled 178 nurses and 1346 patients during 383 medication rounds in 14 units in the experimental group and 15 units in the control group. During the intervention period, the administration error rates were 7.09% (188 OE with at least one error/2653 TOE) for the experimental group and 6.23% (210 OE with at least one error/3373 TOE) for the control group (p = 0.192). Identified risk factors (patient age, nurses’ experience, nurses’ workload, unit exposition, and interruption) were not associated with the error rate. The main error type observed for both groups was wrong dosage-form. Most errors had no clinical impact for the patient and the interruption rates were 15.04% for the experimental group and 20.75% for the control group.

Conclusions
The intervention vest had no impact on medication administration error or interruption rates. Further studies need to be performed taking into consideration the limitations of our study and other risk factors associated with other interventions, such as nurse’s training and/or a barcode system.

Trial registration
The PERMIS study protocol (V2–1, 11/04/2017) was approved by institutional review boards and ethics committees (CPP Ile de France number 2016-A00211–50, CNIL 21/03/2017, CCTIRS 11/04/2016). It is registered at ClinicalTrials.gov (registration number: NCT03062852, date of first registration: 23/02/2017).
A qualitative assessment of barriers and facilitators associated with addressing social determinants of health among members of a health collaborative in the rural Midwest
Authors: Dauner Kim Nichols , Loomer Lacey 
Published: August 2021

Abstract
Purpose
Rural communities have unique economic and social structures, different disease burdens, and a more patchworked healthcare delivery system compared to urban counterparts. Yet research into addressing social determinants of health has focused on larger, urban, integrated health systems. Our study sought to understand capacities, facilitators, and barriers related to addressing social health needs across a collaborative of independent provider organizations in rural Northeastern Minnesota and Northwestern Wisconsin.

Methods
We conducted qualitative, semi-structured interviews with a purposive sample of 37 key informants from collaborative members including 4 stand-alone critical access hospitals, 3 critical access hospitals affiliated with primary care, 1 multi-clinic system, and 1 integrated regional health system.

Findings
Barriers were abundant and occurred at the organizational, community and policy levels. Rural providers described a lack of financial, labor, Internet, and community-based social services resources, a limited capacity to partner with other organizations, and workflows that were less than optimal for addressing SDOH. State Medicaid and other payer policies posed challenges that made it more difficult to use available resources, as did misaligned incentives between partners. While specific payer programs and organizational innovations helped facilitate their work, nothing was systemic. Relationships within the collaborative that allowed sharing of innovations and information were helpful, as was the role leadership played in promoting value-based care.

Conclusions
Policy change is needed to support rural providers in this work. Collaboration among rural health systems should be fostered to develop common protocols, promote value-based care, and offer economies of scale to leverage value-based payment. States can help align incentives and performance metrics across rural health care entities, engage payers in promoting value-based care, and bolster social service capacity.