bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Weekend Effect in Septic Shock Patients Using the Nationwide Emergency Department Sample Database
Authors: Bou Chebl Ralphe , Kattouf Nadim , Assaf Mohamad , Abou Dagher Gilbert , Kassir Alaa , Mahmassani Dina , Bachir Rana , El Sayed Mazen 
Published: March 2021

ABSTRACT

Background:
The weekend effect is the increased mortality in hospitalized patients admitted on the weekend. The aim of this study was to examine the effect of weekend admissions on septic shock patients.

Methods:
This is a retrospective observational study of the 2014 Nationwide Emergency Department Sample Database. Septic shock patients were included in this study using ICD-9-CM codes. Descriptive analysis was done, in addition to bivariate analysis to compare variables based on admission day. Multivariate analysis was conducted to examine the association between admission day and mortality in septic shock patients after adjusting for potential confounding factors.

Results:
A total of 364,604 septic shock patients were included in this study. The average age was 67.19 years, and 51.1% were males. 73.0% of patients presented on weekdays. 32.3% of septic shock patients died during their hospital stay. After adjusting for confounders, there was no significant difference in the emergency department or in-hospital mortality of septic shock patients admitted on the weekend compared with those admitted during weekdays, (OR = 1.00 [95% CI: 0.97–1.03], P value = 0.985).

Conclusion:
There was no statistically significant difference in overall mortality between septic shock patients admitted on the weekend or weekday. Our results are contradictory to previous studies showing an increased mortality with the weekend effect. The previous observations that have been made may not stand up with current treatment protocols.
Utilizing Outpatient Pelvic Reconstructive Surgery in the Era of the COVID-19 Pandemic
Authors: Berger Alexander A. , Tan-Kim Jasmine , Menefee Shawn A. 
Published: March 2021

Objective
The COVID-19 pandemic has created a significant strain on the medical system, creating resource scarcity. We sought to demonstrate the reduction in hospital room utilization after implementation of outpatient pelvic reconstructive surgery.

Methods
We included all minimally invasive reconstructive surgical procedures in this retrospective cohort study within a large managed care organization of 4.5 million members (2008–2018). We queried the system-wide medical record for Current Procedural Terminology (CPT), International Classification of Diseases, Ninth Revision (ICD-9), and International Classification of Diseases, Tenth Revision (ICD-10) codes for all included procedures and patient perioperative data. Categorical variables were compared using χ2 test for categorical variables and the Kruskal-Wallis test for continuous variables.

Results
Of the 13,445 patients undergoing pelvic reconstructive surgery, 5,506 were discharged the same day, whereas 7,939 were discharged the next day. Over the 10-year period, patients without hysterectomy had outpatient surgery rates increase from 31.2% to 76.4% (+45.2%), whereas those with hysterectomy increased from 3% to 56.4% (+53.4%). Hospital room utilization decreased by 45,200 room days/100,000 reconstructive procedures without hysterectomy and 53,400 room days/100,000 reconstructive procedures with hysterectomy. When compared to 2008, in 2018 after more widespread adoption of outpatient elective surgery, for the 738 patients undergoing surgery without hysterectomy, 334 less room days were used, whereas 335 less room days were used among the 640 patients who had a surgical procedure with hysterectomy.

Conclusions
The implementation of outpatient pelvic reconstructive procedures leads to a significant reduction in hospital room utilization. Same-day discharge decreases hospital resource utilization, therefore improving hospital access, which may be essential for the delivery of routine care during times of resource scarcity such as the COVID-19 pandemic.
Unmasking the Current Scenario of Indian Biomedical Devices Industry: Ventilators being the Heart of the Discussion
Authors: Pramanik Sheersha , Karmakar Sucheta , Mukherjee Shreyas , Dhavale Indraneel , Shrestha Rohan 
Published: March 2021

AbstractBackgroundThe Indian Biomedical Device Industry has been growing at an unprecedented rate, but several hindrances need to be acknowledged in offering access to quality, budget-friendly medical devices in India. This article explores the current loopholes of the Indian biomedical device industry along with the proposal of various innovative solutions, with emphasis on ventilators.MethodsAn online survey with the help of Google forms was conducted from 1st November to 25th December 2020, addressing the problems of the Indian medical device industry (MDI) along with probable solutions. The survey also provides a glimpse into the complications aroused from the frequent use of ventilators during COVID-19 outburst, along with possible measures.ResultsAccording to the survey, 51.6%, 46.5%, 55.7%, and 47.5% of respondents have agreed to ‘Stringent laws and implementation,’ ‘Safety testing and strict regulations,’ ‘Unfavorable duty structure,’ and ‘Reducing tax rate on domestic manufacturers,’ as a possible solution to advance the implementation of ISO 13485 and ISO 10651, implementation of ISO 14971, the probable cause of limitations of Indian MDI, possible measure to overcome limitations of Indian MDI, respectively. 46.7%, 47.5%, 46.2%, and 44.6% of respondents have agreed to ‘Surgical decompression,’ ‘Nebulized and broad-spectrum antibiotics,’ ‘PEEP,’ and ‘Adopting lung protective ventilation strategies’ as possible solutions to treat various ventilator complications, respectively.ConclusionThe study briefs about the people’s perception of the Indian MDI as well as on the ventilator complications. The results complied with our hypothesis as the majority of the respondents have agreed with almost all the probable solutions in both the sections given by us as options.
Utility of a Clinical Scoring System for Point of Care Triaging in COVID-19 Pneumonia
Authors: Gangemi Andrew J , Gupta Rohit , Fernandez-Romero Gustavo , Zhao Huaqing , Patel Maulin , Chowdhury Junad , Zantah Massa , Zheng Matthew , Abramian Osheen , Codella Stephen , Vien Linda , Dominguez-Castillo Eduardo , Buckey Timothy , Earley Charles , Frankovich Jourdan , Jurkowski Mali , Jurkowski Zachary , O’Brien Jenny , Guo Nanzhou , Stanley Paige , Halsey Brenton , Kahlon Jasleen , Kaur Navjot , Prosniak Roman , Kumaran Maruti , Dass Chandra , Fleece David , Jacobs Michael R , Criner Gerard J. 
Published: March 2021

AbstractBackgroundSurges in COVID-19 disease cases can rapidly overwhelm healthcare resources; triaging to appropriate levels of care can assist in resource planning. At the beginning of the pandemic, we developed a simple triage tool, the Temple COVID-19 Pneumonia Triage Tool (TemCOV) based on a combination of clinical and radiographic features that are readily available on presentation to categorize and predict illness severity.MethodsWe prospectively examined 579 sequential cases admitted to Temple University Hospital who were assigned severity categories on admission. Our primary outcome was to compare the performance of TemCOV in predicting patients who have the highest likely of admission to the ICU at 24 and at 72 hours to other standard triage tools: the National Early Warning System (NEWS), the Modified Early Warning System (MEWS) and the CURB65 score. Additional endpoints included need for invasive mechanical ventilation (IMV) within 72 hours, total hospital admission charges, and mortality.Results26% of patients fell within our highest risk Category 4 and were more likely to require ICU admission at 24 hours (OR 11.51) and 72 hours (OR 8.6). Additionally they had the highest likelihood of needing IMV (OR 29.47) and in-hospital mortality (OR 2.37)., TemCOV performed similar to MEWS in predicting ICU admission at 24 hours (receive operator characteristic (ROC) curve area under the curve (AUC) 0.77 vs. 0.74, p=0.21) but better than NEWS2 and CURB65 (ROC AUC 0.77 vs. 0.69 and 0.77 vs. 0.64, respectively, p<0.01). While all severity scores had a weak correlation to hospital charges, the TemCOV performed the best among all severity scores measured (r=0.18); median hospital charges for Category 4 patients was $170,468 ($96,972-$487,556).ConclusionTemCOV is a simple triage score that can be used upon hospitalization in patients with COVID-19 that predicts the need for hospital resources such as ICU bed capacity, invasive mechanical ventilation and personnel staffing.
SARS-CoV-2 infection in households with and without young children: Nationwide cohort study
Authors: Husby Anders , Corn Giulia , Krause Tyra Grove 
Published: March 2021

ABSTRACTBackgroundInfections with seasonally spreading human coronaviruses (HCoVs) are common among young children during winter months in the northern hemisphere, with immunological response lasting around a year. However, it is not clear whether recent household exposure to HCoVs reduces the risk of SARS-CoV-2 infection.MethodsIn a nationwide cohort study we followed all adults in Denmark aged 18 to 60 years from February 27 to November 15, 2020. Hazard ratios of SARS-CoV-2 infection by number of young children aged ten months to five years living in the household were estimated using Cox regression adjusted for adult age, gender, and other potential confounders. In sensitivity analyses we investigated the effect of age of children in the household, number of children living outside of the household, and number of other adult household-members.ResultsAmong 449,915 adults in Denmark living in households with young children, 5,761 were tested positive for SARS-CoV-2, while among 2,629,821 adults without young children in their household, 33,788 were tested positive for SARS-CoV-2 (adjusted hazard ratio, 1.05; 95% confidence interval, 1.02 to 1.09). Sensitivity analyses of age of children in the household, number of children living outside of the household, and number of additional adult household members found increasing number of children, and especially increasing number of older children, to substantially increase the risk of SARS-CoV-2 infection.ConclusionsLiving in a household with young children was not associated with decreased risk of SARS-CoV-2 infection, thereby suggesting no strong preventive effect of recent exposure to HCoVs against SARS-CoV-2 infection.
Trajectories of Clinical and Laboratory Characteristics Associated with COVID-19 in Hemodialysis Patients by Survival
Authors: Chaudhuri Sheetal , Lasky Rachel , Jiao Yue , Larkin John , Monaghan Caitlin , Winter Anke , Neri Luca , Kotanko Peter , Hymes Jeffrey , Lee Sangho , Wang Yuedong , Kooman Jeroen P. , Maddux Franklin , Usvyat Len 
Published: March 2021

AbstractIntroductionThe clinical impact of COVID-19 has not been established in the dialysis population. We evaluated the trajectories of clinical and laboratory parameters in hemodialysis (HD) patients.MethodsWe used data from adult HD patients treated at an integrated kidney disease company who received a RT-PCR test to investigate suspicion of a SARS-CoV-2 infection between 01 May and 01 Sep 2020. Nonparametric smoothing splines were used to fit data for individual trajectories and estimate the mean change over time in patients testing positive or negative for SARS-CoV-2 and those who survived or died within 30 days of first suspicion or positive test date. For each clinical parameter of interest, the difference in average daily changes between COVID-19 positive versus negative group and COVID-19 survivor versus non-survivor group was estimated by fitting a linear mixed effects model based on measurements in the 14 days before (i.e., day-14 to day 0) day 0.ResultsThere were 12,836 HD patients with a suspicion of COVID-19 who received RT-PCR testing (8,895 SARS-CoV-2 positive). We observed significantly different trends (p<0.05) in pre-HD systolic blood pressure (SBP), pre-HD pulse rate, body temperature, ferritin, lymphocytes, albumin, and interdialytic weight gain (IDWG) between COVID-19 positive and negative patient. For COVID-19 positive group, we observed significantly different clinical trends (p<0.05) in pre-HD pulse rate, lymphocytes, albumin and neutrophil-lymphocyte ratio (NLR) between survivors and non-survivors. We also observed that, in the group of survivors, most clinical parameters returned to pre-COVID-19 levels within 60-90 days.ConclusionWe observed unique temporal trends in various clinical and laboratory parameters among HD patients who tested positive versus negative for SARS-CoV-2 infection and those who survived the infection versus those who died. These trends can help to define the physiological disturbances that characterize the onset and course of COVID-19 in HD patients
The Efficacy of Isoniazid Prophylaxis in Renal Transplant Recipients in a High TB Burden Country
Authors: Dodani Sunil , Nasim Asma , Aziz Tahir , Naqvi Anwar 
Published: March 2021

AbstractIntroductionRenal transplant recipients are at high risk of tuberculosis (TB). We have started Isoniazid (INH) prophylaxis of 1 year duration in all renal transplant recipients from April 2009. Our aim is to assess the incidence of TB on INH prophylaxis and its tolerability.MethodsThis was a retrospective observational study. The files of renal transplant recipients from April 2009 to December 2011 were reviewed till June 2015. We noted the incidence of TB, INH tolerability and development of resistance. We compared the incidence of TB with the historical controls who never received the prophylaxis.ResultsA total of 910 patients were reviewed and followed for 4.8 years. INH prophylaxis was completed by 825 (91%) patients. A total of 46 patients (5%) developed active TB as compared to 15% in the historical controls. The median time of TB diagnosis from transplantation was 2.8 years. In the first-year post transplant, out of total TB cases, 52% occurred in the historical controls whereas 13% occurred in study cohort. Around 67% had TB > 2 years after transplant. Overall 1.43% had hepatotoxicity. There was a significant reduction in TB among those who completed prophylaxis to those who did not (p=0.02). Out of 14 cultures one isolate was INH resistant (7%).ConclusionINH prophylaxis is well tolerated. The incidence of TB has decreased during the first 2 years. However there was a surge in TB cases 1 year after stopping INH therapy. We should consider prolonging the duration of INH prophylaxis in high TB burden countries in renal transplant recipients.
Comparable seasonal pattern for COVID-19 and Flu-Like Illnesses
Authors: Hoogeveen Martijn J. , Hoogeveen Ellen K. 
Published: March 2021

ABSTRACTBackgroundDuring the first wave of COVID-19 it was hypothesized that COVID-19 is subject to multi-wave seasonality, similar to Influenza-Like Illnesses since time immemorial. One year into the pandemic, we aimed to test the seasonality hypothesis for COVID-19.MethodsWe calculated the average annual time-series for Influenza-Like Illnesses based on incidence data from 2016 till 2019 in the Netherlands, and compared these with two COVID-19 time-series during 2020/2021 for the Netherlands. We plotted the time-series on a standardized logarithmic infection scale. Finally, we calculated correlation coefficients and used univariate regression analysis to estimate the strength of the association between the time-series of COVID-19 and Influenza-Like Illnesses.ResultsThe time-series for COVID-19 and Influenza-Like Illnesses were strongly and highly significantly correlated. The COVID-19 peaks were all during flu season, and lows were all in the opposing period. Finally, COVID-19 meets the multi-wave characteristics of earlier flu-like pandemics, namely a short first wave at the tail-end of a flu season, and a longer and more intense second wave during the subsequent flu season.ConclusionsWe conclude that seasonal patterns of COVID-19 incidence and Influenza-Like Illnesses incidence are highly similar, in a country in the temperate climate zone, such as the Netherlands. Further, the COVID-19 pandemic satisfies the criteria of earlier respiratory pandemics, namely a first wave that is short-lived at the tail-end of flu season, and a second wave that is longer and more severe.This seems to imply that the same factors that are driving the seasonality of Influenza-Like Illnesses are causing COVID-19 seasonality as well, such as solar radiation (UV), temperature, relative humidity, and subsequently seasonal allergens and allergies.HIGHLIGHTSTime-series analysis shows that COVID-19 and historic of Influenza-Like illnesses have highly similar seasonal patterns in the Netherlands.COVID-19 satisfies the criteria of earlier flu-like pandemics, namely a short cycle at the end of flu season, and a longer, more intense cycle during the subsequent flu season.The implication is that the seasonal factors driving flu season, are also responsible for COVID-19 seasonality.We developed and applied a new method to determine seasonality, encompassing comparative time-series analysis, a standardized logarithmic infection scale, and qualitative seasonality criteria.
Association of Streptococcus mutans harboring bona-fide collagen binding proteins and Candida albicans with early childhood caries recurrence
Authors: Garcia B.A. , Acosta N.C. , Tomar S.L. , Roesch L.F.W. , Lemos J.A. , Mugayar L.C.F. , Abranches J. 
Published: March 2021

ABSTRACTEarly childhood caries (ECC) recurrence occurs in approximately 40% of treated cases within one year. The association of Streptococcus mutans and Candida albicans with the onset of ECC is well known. Also, S. mutans strains harboring collagen-binding proteins (Cbps) avidly bind to collagen-rich dentin and are linked to increased caries incidence. Here, we investigated the presence of Cbp+S. mutans and C. albicans in saliva and dental plaque of children with varying caries statuses, as well as the salivary microbiome of these children. In this cross-sectional study, 143 children who were caries-free, treated for ECC with no signs of recurrence after 6 months, or treated for ECC and experiencing recurrence within 6 months following treatment were enrolled. Co-infection with C. albicans and S. mutans, especially Cbp+S. mutans, was strongly associated with caries recurrence. Subjects of the recurrence group infected with Cbp+S. mutans showed a greater burden of C. albicans and of Mutans streptococci in dentin than those infected with Cbp−S. mutans. Microbiome analysis revealed that Streptococcus parasanguinis was overrepresented in the caries recurrence group. Our findings indicate that Cbp+S. mutans and C. albicans are intimately associated with caries recurrence, contributing to the establishment of recalcitrant biofilms.
Effects of diffusion signal modeling and segmentation approaches on subthalamic nucleus parcellation
Authors: Milardi Demetrio , Basile Gianpaolo Antonio , Faskowitz Joshua , Bertino Salvatore , Quartarone Angelo , Anastasi Giuseppe , Bramanti Alessia , Cacciola Alberto 
Published: March 2021

AbstractThe subthalamic nucleus (STN) is commonly used as a surgical target for deep brain stimulation in movement disorders such as Parkinson’s Disease. Tractography-derived connectivity-based parcellation (CBP) has been recently proposed as a suitable tool for non-invasive in vivo identification and pre-operative targeting of specific functional territories within the human STN. However, a well-established, accurate and reproducible protocol for STN parcellation is still lacking. The present work aims at testing the effects of different tractography-based approaches for the reconstruction of STN functional territories.We reconstructed functional territories of the STN on the high-quality dataset of 100 unrelated healthy subjects and on the test-retest dataset of the Human Connectome Project (HCP) repository. Connectivity-based parcellation was performed with a hypothesis-driven approach according to cortico-subthalamic connectivity, after dividing cortical areas into three groups: associative, limbic and sensorimotor. Four parcellation pipelines were compared, combining different signal modeling techniques (single-fiber vs multi-fiber) and different parcellation approaches (winner takes all parcellation vs fiber density thresholding). We tested these procedures on STN regions of interest obtained from three different, commonly employed, subcortical atlases. We evaluated the pipelines both in terms of between-subject similarity, assessed on the cohort of 100 unrelated healthy subjects, and of within-subject similarity, using a second cohort of 44 subjects with available test-retest data. We found that each parcellation provides converging results in terms of location of the identified parcels, but with significative variations in size and shape. Higher between-subject similarity was found with multi-fiber signal modeling techniques combined with fiber density thresholding. All the pipelines obtained very high within-subject similarity, with tensor-based approaches outperforming multi-fiber pipelines. We suggest that a fine-tuning of tractography-based parcellation may lead to higher reproducibility and aid the development of an optimized surgical targeting protocol.
Day-night and seasonal variation of human gene expression across tissues
Authors: Wucher Valentin , Sodaei Reza , Amador Raziel , Irimia Manuel , Guigó Roderic 
Published: March 2021

AbstractCircadian and circannual cycles trigger physiological changes whose reflection on human transcriptomes remains largely uncharted. We used the time and season of death of 932 individuals from GTEx to jointly investigate transcriptomic changes associated with those cycles across multiple tissues. Overall, most variation across tissues during day-night and among seasons was unique to each cycle. Although all tissues remodeled their transcriptomes, brain and gonadal tissues exhibited the highest seasonality, whereas those in the thoracic cavity showed stronger day-night regulation. Core clock genes displayed marked day-night differences across multiple tissues, which were largely conserved in baboon and mouse, but adapted to their nocturnal or diurnal habits. Seasonal variation of expression affected multiple pathways and it was enriched among genes associated with the immune response, consistent with the seasonality of viral infections. Furthermore, they unveiled cytoarchitectural changes in brain regions. Altogether, our results provide the first combined atlas of how transcriptomes from human tissues adapt to major cycling environmental conditions.