bluuebunny/crossref_metadata_2025_split huggingface dataset:
Readmissions after elective orthopedic surgery in a comprehensive co-management care system—a retrospective analysis
Authors: Rohrer Felix , Haddenbruch David , Noetzli Hubert , Gahl Brigitta , Limacher Andreas , Hermann Tanja , Bruegger Jan 
Published: December 2021

Abstract
Background
No surgical intervention is without risk. Readmissions and reoperations after elective orthopedic surgery are common and are also stressful for the patient. It has been shown that a comprehensive ortho-medical co-management model decreases readmission rates in older patients suffering from hip fracture; but it is still unclear if this also applies to elective orthopedic surgery. The aim of the current study was to determine the proportion of unplanned readmissions or returns to operating room (for any reason) across a broad elective orthopedic population within 90 days after elective surgery. All cases took place in a tertiary care center using co-management care and were also assessed for risk factors leading to readmission or unplanned return to operating room (UROR).

Methods
In this observational study, 1295 patients undergoing elective orthopedic surgery between 2015 and 2017 at a tertiary care center in Switzerland were investigated. The proportion of reoperations and readmissions within 90 days was measured, and possible risk factors for reoperation or readmission were identified using logistic regression.

Results
In our cohort, 3.2% (42 of 1295 patients) had an UROR or readmission. Sixteen patients were readmitted without requiring further surgery—nine of which due to medical and seven to surgical reasons. Patient-related factors associated with UROR and readmission were older age (67 vs. 60 years; p = 0.014), and American Society of Anesthesiologists physical status (ASA PS) score ≥ 3 (43% vs. 18%; p < 0.001). Surgery-related factors were: implantation of foreign material (62% vs. 33%; p < 0.001), duration of operation (76 min. vs. 60 min; p < 0.001), and spine surgery (57% vs. 17%; p < 0.001). Notably, only spine surgery was also found to be independent risk factor.

Conclusion
Rates of UROR during initial hospitalization and readmission were lower in the current study than described in the literature. However, several comorbidities and surgery-related risk factors were found to be associated with these events. Although no surgery is without risk, known threats should be reduced and every effort undertaken to minimize complications in high-risk populations. Further prospective controlled research is needed to investigate the potential benefits of a co-management model in elective orthopedic surgery.
Comparison of restrictive fluid therapy with goal-directed fluid therapy for postoperative delirium in patients undergoing spine surgery: a randomized controlled trial
Authors: Wang Duo Duo , Li Yun , Hu Xian Wen , Zhang Mu Chun , Xu Xing Mei , Tang Jia 
Published: December 2021

Abstract
Background
Postoperative delirium (POD) is a common phenomenon after spinal surgery. Intraoperative fluid management may affect POD. The aim of this study was to compare the effects of restrictive fluid therapy (RF) with those of goal-directed fluid therapy (GDT) on POD.

Methods
A total of 195 patients aged ≥ 50 years who underwent spinal surgery were randomly divided into two groups: the RF group and the GDT group. In group RF, a bolus of lactated Ringer’s solution was administered at a dose of 5 mL·kg-1 before the induction of anesthesia, followed by a dose of 5 mL·kg-1·h-1 until the end of surgery. For patients in the GDT group, in addition to the initial administration of lactated Ringer’s solution at 5 mL·kg-1, the subsequent fluid therapy was adjusted by using a continuous noninvasive arterial pressure (CNAP) monitoring system to maintain pulse pressure variation (PPV) ≤ 14%. The primary endpoint was the incidence of POD, assessed once daily with the Confusion Assessment Method-Chinese Reversion (CAM-CR) scale at 1–3 days postoperatively. The secondary endpoints were intraoperative fluid infusion volume, urine volume, mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), regional cerebral oxygen saturation (rSO2) value, lactic acid value, and visual analog scale (VAS) pain score at 1–3 days after surgery. Moreover, postoperative complications and the length of hospital stay were recorded.

Results
The incidence of POD was lower in the GDT group than in the RF group (12.4% vs 4.1%; P = 0.035) in the first 3 days after spine surgery. Compared to group RF, group GDT exhibited a significantly increased volume of intraoperative lactated Ringer’s solution [1500 (interquartile range: 1128 to 1775) mL vs 1000 (interquartile range: 765 to 1300) mL, P < 0.001] and urine volume [398 (interquartile range: 288 to 600) mL vs 300 (interquartile range: 200 to 530) mL, P = 0.012]. Intraoperative MAP, CI and rSO2 values were higher in the GDT group than in the RF group (P < 0.05). Moreover, the length of hospital stay [17.0 (14 to 20) days versus 14.5 (13 to 17.0) days, P = 0.001] was shorter in the GDT group than in the RF group.

Conclusions
GDT reduced the incidence of POD in middle- and old-aged patients undergoing spinal surgery possibly by stabilizing perioperative hemodynamic and improving the supply and demand of oxygen.

Trial registration
ChiCTR2000032603; Registered on May 3, 2020.
Methods for inferring neural circuit interactions and neuromodulation from local field potential and electroencephalogram measures
Authors: Martínez-Cañada Pablo , Noei Shahryar , Panzeri Stefano 
Published: December 2021

AbstractElectrical recordings of neural mass activity, such as local field potentials (LFPs) and electroencephalograms (EEGs), have been instrumental in studying brain function. However, these aggregate signals lack cellular resolution and thus are not easy to be interpreted directly in terms of parameters of neural microcircuits. Developing tools for a reliable estimation of key neural parameters from these signals, such as the interaction between excitation and inhibition or the level of neuromodulation, is important for both neuroscientific and clinical applications. Over the years, we have developed tools based on neural network modeling and computational analysis of empirical data to estimate neural parameters from aggregate neural signals. This review article gives an overview of the main computational tools that we have developed and employed to invert LFPs and EEGs in terms of circuit-level neural phenomena, and outlines future challenges and directions for future research.
Clinical impact of guideline-based practice and patients’ adherence in uncontrolled hypertension
Authors: Sohn Il Suk , Kim Chong Jin , Yoo Byung-Su , Kim Byung Jin , Choi Jae Woong , Kim Doo-Il , Lee Sang-Hak , Song Woo-Hyuk , Jeon Dong Woon , Cha Tae Jun , Kim Dae-Kyeong , Lim Seong-Hoon , Nam Chang-Wook , Shin Joon-Han , Kim Ung , Kwak Jae-Jin , Park Jun-Bean , Cha Jin-Hye , Kim Young-Joo , Choi Jimi , Lee Juneyoung 
Published: December 2021

Abstract
Background
Chronic diseases like hypertension need comprehensive lifetime management. This study assessed clinical and patient-reported outcomes and compared them by treatment patterns and adherence at 6 months among uncontrolled hypertensive patients in Korea.

Methods
This prospective, observational study was conducted at 16 major hospitals where uncontrolled hypertensive patients receiving anti-hypertension medications (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) were enrolled during 2015 to 2016 and studied for the following 6 months. A review of medical records was performed to collect data on treatment patterns to determine the presence of guideline-based practice (GBP). GBP was defined as: (1) maximize first medication before adding second or (2) add second medication before reaching maximum dose of first medication. Patient self-administered questionnaires were utilized to examine medication adherence, treatment satisfaction and quality of life (QoL).

Results
A total of 600 patients were included in the study. Overall, 23% of patients were treated based on GBP at 3 months, and the GBP rate increased to 61.4% at 6 months. At baseline and 6 months, 36.7 and 49.2% of patients, respectively, were medication adherent. The proportion of blood pressure-controlled patients reached 65.5% at 6 months. A higher blood pressure control rate was present in patients who were on GBP and also showed adherence than those on GBP, but not adherent, or non-GBP patients (76.8% vs. 70.9% vs. 54.2%, P < 0.001). The same outcomes were found for treatment satisfaction and QoL (P < 0.05).

Conclusions
This study demonstrated the importance of physicians’ compliance with GBP and patients’ adherence to hypertensive medications. GBP compliance and medication adherence should be taken into account when setting therapeutic strategies for better outcomes in uncontrolled hypertensive patients.
Successful treatment of severe adrenaline-resistant anaphylactic shock with glucagon in a patient taking a beta-blocker: a case report
Authors: Murakami Yu , Kaneko Shohei , Yokoyama Haruka , Ishizaki Hironori , Sekino Motohiro , Murata Hiroaki , Hara Tetsuya 
Published: December 2021

Abstract
Background
The efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial. However, understanding the efficacy of glucagon is important because adrenaline-resistant anaphylactic shock is fatal. We present a case of severe adrenaline-resistant anaphylactic shock in a patient taking a β-blocker, and glucagon was effective in improving hemodynamics.

Case presentation
An 88-year-old woman with severe aortic stenosis and taking a selective β-1 blocker underwent transcatheter aortic valve implantation under general anesthesia. Postoperatively, she received 100 mg sugammadex, but 2 min later developed severe hypotension and bronchospasm. Suspecting anaphylactic shock, we intervened by administering adrenaline, fluid loading, and an increased noradrenaline dose. Consequently, the bronchospasm improved, but her blood pressure only increased minimally. Therefore, we administered 1 mg glucagon intravenously, and the hypotension resolved immediately.

Conclusions
Glucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; however, its efficacy must be further evaluated in more cases.
Assessment of superior cavo-pulmonary anastomoses (Glenn shunt) by cardiac magnetic resonance imaging in comparison with multi-slice computed tomography
Authors: Gamal El-Deen Marwa Ali , Ibrahim Ahmed Samir , Abdeldayem Emad H. , Elia Remon Zaher , Romeih Soha 
Published: December 2021

Abstract
Background
Multi-slice computed tomography (MSCT) angiography is the gold standard imaging modality to evaluate the patency of Glenn shunt and the presence of veno–veno collaterals. The goal of this study is to evaluate the ability of two cardiac magnetic resonance imaging (MRI) techniques to assess the patency of Glenn shunt and the presence of veno–veno collaterals compared to MSCT angiography.

Results
Patients with Glenn shunt had MSCT angiography and cardiac MRI using two techniques: TWIST (Time-resolved angiography With Stochastic Trajectories) and the three-dimensional (3D) post-contrast whole heart techniques. MSCT angiography and cardiac MRI images were post-processed for quantitative and qualitative assessment of Glenn shunt and veno–veno collaterals. Our study included 29 patients (17 male, 59%) with Glenn shunt, the median age was 22 years (range 3–36 years). 3D post-contrast whole heart images give similar results compared to MSCT angiography results in the evaluation of Glenn shunt and veno–veno collaterals, 100% agreement in Glenn shunt visualization and agreement was 86.2% in the detection of veno–veno collaterals with a perfect agreement (kappa = 1) as regards their proximal connection to superior vena cava (SVC). While TWIST showed lower agreement compared to MSCT angiography results, 87.5% agreement in Glenn shunt visualization and agreement was 68.9% in the detection of veno–veno collaterals with poor agreement (kappa = 0.266) as regards their proximal connection to SVC.

Conclusions
3D post-contrast whole heart MRI images have similar results as MSCT angiography in the evaluation of superior cavo-pulmonary anastomosis and can be a good and safer alternative to MSCT angiography.
A systematic review of randomized control trials of HPV self-collection studies among women in sub-Saharan Africa using the RE-AIM framework
Authors: Nwaozuru Ucheoma , Obiezu-Umeh Chisom , Obi-Jeff Chisom , Shato Thembekile , Gbaja-Biamila Titilola , Oladele David , Idigbe Ifeoma , Tucker Joseph , Ezechi Oliver , Iwelunmor Juliet 
Published: December 2021

Abstract
Introduction
Self-collection of samples for HPV testing may increase women’s access to cervical cancer screening in low- and middle-income settings. However, implementation remains poor in many regions. The purpose of this systematic review was to examine implementation data from randomized controlled trials evaluating human papillomavirus (HPV) self-collection testing among women in sub-Saharan Africa using the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework.

Methods
We searched four electronic databases (PubMed, CINAHL, Web of Science, and Global Health) for pragmatic randomized controlled trials that promote HPV self-collection among women in sub-Saharan Africa. Study selection and data extraction were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist. Two researchers independently extracted information from each article using a RE-AIM data extraction tool. The reporting of RE-AIM dimensions was summarized and synthesized across included interventions.

Results
We identified 2008 citations, and eight studies were included. These reported on five unique interventions. The five interventions were conducted in five countries: Cameroon, Ethiopia, Kenya, Nigeria, and Uganda. Intervention reach (80%) was the most commonly reported RE-AIM dimension, followed by adoption (56%), efficacy/effectiveness (52%), implementation (47%), and maintenance (0%). All the interventions described increased uptake of HPV testing among study participants (effectiveness). However, the majority of the studies focused on reporting internal validity indicators such as inclusion criteria (100%) and exclusion criteria (100%), and few reported on external validity indicators such as participation rate (40%), intervention cost (40%), staff selection (20%), and cost of maintenance (0%).

Conclusions
Our review highlights the under-reporting of external validity indicators such as participation rate, intervention, and maintenance costs in studies of self-collection for HPV testing among women in SSA. Future research should focus on including factors that highlight internal validity factors and external validity factors to develop a greater understanding of ways to increase not only reach but also implementation and long-term maintenance of these interventions. Such data may advance the translation of HPV interventions into practice and reduce health disparities in SSA. Findings highlight the need for innovative tools such as participatory learning approaches or open challenges to expand knowledge and assessment of external validity indicators to ultimately increase the uptake of HPV testing among women in SSA.
Depression in advanced disease: a systematic review Part 1. Prevalence and case finding
Authors: Hotopf M , Chidgey J , Addington-Hall J , Ly K Lan 
Published: December 2021

Objective: To identify all literature regarding depression in patients with advanced cancer and among mixed hospice populations, and to summarise the prevalence of depression according to different definitions. Methods: A systematic review was performed using extensive electronic and hand searches. All studies with quantitative data on prevalence of depression were included and categorised according to their definition of depression. Results: We identified 46 eligible studies giving information on the prevalence of depression, and a further four which gave information on case finding. The most widely used assessment of depression was the Hospital Anxiety and Depression Scale (HADS), which gave a median prevalence of ‘definite depression’ (i.e., a score on the depression subscale of 10 of 29%, (interquartile range, IQR, 19.50 34.25%). Studies that used psychiatric interviews indicated a prevalence of major depressive disorder ranging from 5% to 26%, with a median of 15%. Studies were generally small (median sample size 88.5, IQR 50 108), had high numbers of nonresponders, and rarely gave confidence intervals for estimates of prevalence. Conclusions: Depression is a common problem in palliative care settings. The quality of much of the available research is poor, based on small samples of patients with very high nonparticipation rates. The clinical importance of depression is described in subsequent papers.
Catatonia in autism spectrum disorders: A systematic review and meta-analysis
Authors: Vaquerizo-Serrano J. , Salazar De Pablo G. , Singh J. , Santosh P. 
Published: December 2021

AbstractBackgroundCatatonic features can appear in autism spectrum disorders (ASDs). There can be overlap in symptoms across catatonia and ASD. The overall aim of this review is to provide evidence for the presence of catatonic features in subjects with ASD.MethodsA systematic literature search using the Web of Science database from inception to July 10, 2021 was conducted following PRISMA, MOOSE guidelines and the PROSPERO protocol. (CRD42021248615). Twelve studies with information about catatonia and ASD were reviewed. Data from a subset was used to conduct meta-analyses of the presence of catatonia in ASD.ResultsThe systematic review included 12 studies, seven of which were used for the meta-analysis, comprising 969 individuals. The mean age was 21.25 (7.5) years. Two studies (16.6%) included only children and adolescents. A total of 70–100% were males. Our meta-analysis showed that 10.4% (5.8–18.0 95%CI) of individuals with ASD have catatonia. Motor disturbances were common in ASD subjects with catatonia. No differences were found in comorbidity. Several treatments have been used in ASD with catatonic features, including benzodiazepines, antipsychotics, and electroconvulsive therapy (ECT). The findings of the systematic review showed that ECT might help manage catatonic symptoms.ConclusionsDifferent features of catatonia can exist in individuals with ASD and core symptoms of catatonia are reported in ASD. Longitudinal and longer-term studies are required to understand the relationship between catatonia and ASD, and the response of catatonic symptoms to treatment.
Frazzled/Dcc acts independently of Netrin to promote germline survival during Drosophila oogenesis
Authors: Russell Samantha A. , Laws Kaitlin M. , Bashaw Greg J. 
Published: December 2021

ABSTRACT
The Netrin receptor Frazzled/Dcc (Fra in Drosophila) functions in diverse tissue contexts to regulate cell migration, axon guidance and cell survival. Fra signals in response to Netrin to regulate the cytoskeleton and also acts independently of Netrin to directly regulate transcription during axon guidance in Drosophila. In other contexts, Dcc acts as a tumor suppressor by directly promoting apoptosis. In this study, we report that Fra is required in the Drosophila female germline for the progression of egg chambers through mid-oogenesis. Loss of Fra in the germline, but not the somatic cells of the ovary, results in the degeneration of egg chambers. Although a failure in nutrient sensing and disruptions in egg chamber polarity can result in degeneration at mid-oogenesis, these factors do not appear to be affected in fra germline mutants. However, similar to the degeneration that occurs in those contexts, the cell death effector Dcp-1 is activated in fra germline mutants. The function of Fra in the female germline is independent of Netrin and requires the transcriptional activation domain of Fra. In contrast to the role of Dcc in promoting cell death, our observations reveal a role for Fra in regulating germline survival by inhibiting apoptosis.
ECM-integrin signalling instructs cellular position sensing to pattern the early mouse embryo
Authors: Kim Esther Jeong Yoon , Sorokin Lydia , Hiiragi Takashi 
Published: December 2021

ABSTRACT
Development entails patterned emergence of diverse cell types within the embryo. In mammals, cells positioned inside the embryo give rise to the inner cell mass (ICM), which eventually forms the embryo itself. Yet, the molecular basis of how these cells recognise their ‘inside’ position to instruct their fate is unknown. Here, we show that provision of extracellular matrix (ECM) to isolated embryonic cells induces ICM specification and alters the subsequent spatial arrangement between epiblast (EPI) and primitive endoderm (PrE) cells that emerge within the ICM. Notably, this effect is dependent on integrin β1 activity and involves apical-to-basal conversion of cell polarity. We demonstrate that ECM-integrin activity is sufficient for ‘inside’ positional signalling and is required for correct EPI/PrE patterning. Thus, our findings highlight the significance of ECM-integrin adhesion in enabling position sensing by cells to achieve tissue patterning.
Deep-learning reconstruction for ultra-low-dose lung CT: Volumetric measurement accuracy and reproducibility of artificial ground-glass nodules in a phantom study
Authors: mikayama ryoji , Shirasaka Takashi , Kojima Tsukasa , Sakai Yuki , Yabuuchi Hidetake , Kondo Masatoshi , Kato Toyoyuki 
Published: December 2021

Objectives
The lung nodule volume determined by CT is used for nodule diagnoses and monitoring tumor responses to therapy. Increased image noise on low-dose CT degrades the measurement accuracy of the lung nodule volume. We compared the volumetric accuracy among deep-learning reconstruction (DLR), model-based iterative reconstruction (MBIR), and hybrid iterative reconstruction (HIR) at an ultra-low-dose setting.

Methods
Artificial ground-glass nodules (6 mm and 10 mm diameters, −660 HU) placed at the lung-apex and the middle-lung field in chest phantom were scanned by 320-row CT with the ultra-low-dose setting of 6.3 mAs. Each scan data set was reconstructed by DLR, MBIR, and HIR. The volumes of nodules were measured semi-automatically, and the absolute percent volumetric error (APEvol) was calculated. The APEvol provided by each reconstruction were compared by the Tukey-Kramer method. Inter- and intraobserver variabilities were evaluated by a Bland-Altman analysis with limits of agreements.

Results
DLR provided a lower APEvol compared to MBIR and HIR. The APEvol of DLR (1.36%) was significantly lower than those of the HIR (8.01%, p = 0.0022) and MBIR (7.30%, p = 0.0053) on a 10-mm-diameter middle-lung nodule. DLR showed narrower limits of agreement compared to MBIR and HIR in the inter- and intraobserver agreement of the volumetric measurement.

Conclusions
DLR showed higher accuracy compared to MBIR and HIR for the volumetric measurement of artificial ground-glass nodules by ultra-low-dose CT.

Advances in knowledge
DLR with ultra-low-dose setting allows a reduction of dose exposure, maintaining accuracy for the volumetry of lung nodule, especially in patients which deserve a long-term follow-up.