bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 Case Surveillance: Trends in Person-Level Case Data Completeness, United States, April 5–September 30, 2020
Authors: Gold Jeremy A.W. , DeCuir Jennifer , Coyle Jayme P. , Duca Lindsey M. , Adjemian Jennifer , Anderson Kayla N. , Baack Brittney N. , Bhattarai Achuyt , Dee Deborah , Durant Tonji M. , Ewetola Raimi , Finlayson Teresa , Roush Sandra W. , Yin Shaoman , Jackson Brendan R. , Fullerton Kathleen E. 
Published: April 2021

Objectives To obtain timely and detailed data on COVID-19 cases in the United States, the Centers for Disease Control and Prevention (CDC) uses 2 data sources: (1) aggregate counts for daily situational awareness and (2) person-level data for each case (case surveillance). The objective of this study was to describe the sensitivity of case ascertainment and the completeness of person-level data received by CDC through national COVID-19 case surveillance. Methods We compared case and death counts from case surveillance data with aggregate counts received by CDC during April 5–September 30, 2020. We analyzed case surveillance data to describe geographic and temporal trends in data completeness for selected variables, including demographic characteristics, underlying medical conditions, and outcomes. Results As of November 18, 2020, national COVID-19 case surveillance data received by CDC during April 5–September 30, 2020, included 4 990 629 cases and 141 935 deaths, representing 72.7% of the volume of cases (n = 6 863 251) and 71.8% of the volume of deaths (n = 197 756) in aggregate counts. Nationally, completeness in case surveillance records was highest for age (99.9%) and sex (98.8%). Data on race/ethnicity were complete for 56.9% of cases; completeness varied by region. Data completeness for each underlying medical condition assessed was <25% and generally declined during the study period. About half of case records had complete data on hospitalization and death status. Conclusions Incompleteness in national COVID-19 case surveillance data might limit their usefulness. Streamlining and automating surveillance processes would decrease reporting burdens on jurisdictions and likely improve completeness of national COVID-19 case surveillance data.
SNAP Participants and High Levels of Food Insecurity in the Early Stages of the COVID-19 Pandemic
Authors: Siddiqi Sameer M. , Cantor Jonathan , Dastidar Madhumita Ghosh , Beckman Robin , Richardson Andrea S. , Baird Matthew D. , Dubowitz Tamara 
Published: April 2021

Objectives The coronavirus disease 2019 (COVID-19) pandemic has disproportionately strained households experiencing poverty, particularly Black and Latino households. Food insecurity, which entails having limited or uncertain access to a sufficient quantity of nutritious food, is a key pandemic-related consequence. We examined how people enrolled in the Supplemental Nutrition Assistance Program (SNAP) have been affected by the pandemic, particularly Black participants and participants residing in food deserts. Methods Using survey data from a longitudinal cohort study of predominantly Black low-income adults aged ≥18 residing in urban food deserts in Pittsburgh, Pennsylvania, we examined changes in food insecurity and SNAP participation before COVID-19 (2018) and early in the COVID-19 pandemic (March–May 2020). We modeled changes in food insecurity from 2018 to 2020 via covariate-adjusted logistic regression. Results Food insecurity increased significantly among participants enrolled in SNAP and surveyed in both 2018 and 2020 (from 25.9% in 2018 to 46.9% in 2020; P < .001). Compared with cohort participants not enrolled in SNAP at both points, cohort participants enrolled in SNAP in 2018 and 2020 had the highest rates of using a food bank in 2020 (44.4%) and being newly food insecure in 2020 (28.9%) (ie, they were food insecure in 2020 but not in 2018). Conclusions Food insecurity during the COVID-19 pandemic increased among low-income Black households enrolled in SNAP and residing in a food desert. Public health recovery efforts might focus on modifying SNAP to improve the food security of people experiencing poverty.
Consumption of carbonated soft drinks among Ghanaian adolescents: associations with socio-demographic factors, health risk factors and psychological distress
Authors: Atorkey Prince , Akwei Mariam , Asare-Doku Winifred 
Published: April 2021

Background: Carbonated soft drinks consumption is associated with weight gain and other chronic diseases. Aim: To examine whether socio-demographic factors, health risk factors and psychological distress are associated with carbonated soft drink consumption among adolescents in selected senior high schools in Ghana. Methods: Data were obtained from the 2012 Ghana Global School-based Student Health Survey (GSHS). Participants consisted of 1756 school-going adolescents sampled using a two-stage cluster sampling method. Binomial logistic regression was used to determine whether socio-demographic factors, health risk factors and psychological distress were associated with consumption of soft drinks. Results: The prevalence of carbonated soft drinks consumption was 34.9%. Males (odds ratio (OR) = 0.73 (95% confidence intervals (CI) 0.59–0.92); p = 0.007), and participants with high socio-economic status (OR = 0.76 (95% CI 0.48–0.97); p = 0.033) had smaller odds for consumption of soft drinks. Also, adolescents in Senior High School (SHS) 3 (OR = 0.72 (95% CI 0.53–0.97); p = 0.034) and SHS 4 (OR = 0.63 (95% CI 0.43–0.91); p = 0.014) had smaller odds for soft drinks intake compared to those in SHS 1. Health risk factors associated with greater odds of high soft drink consumption were tobacco use (OR = 1.68, (95% CI 1.07–2.65); p = 0.025), fast food consumption (OR = 1.88, (95% CI 1.47–2.41); p = 0.011) and alcohol consumption (OR = 1.43, (95% CI 1.02–1.99); p = 0.039). Consuming adequate fruit (OR = 0.19 (95% CI 0.15–0.24); p = 0.000) and adequate vegetable (OR = 0.55 (95% CI 0.34–0.87); p = 0.011) were associated with lower odds for soft drink consumption. Adolescents who reported feeling anxious had smaller odds for soft drink intake (OR = 0.65, (95% CI 0.47–0.91); p = 0.011). Conclusions: The findings from this study show that socio-demographic characteristics, health risk factors and psychological distress are associated with the soft drink consumption among adolescents in Ghana. Interventions aimed at reducing soft drink consumption and other health risk factors are needed.
Vancomycin concentrations during cardiopulmonary bypass in pediatric cardiac surgery: a prospective study
Authors: Ferrari Fiorenza , Benegni Simona , Marinari Eleonora , Haiberger Roberta , Garisto Cristiana , Rizza Alessandra , Giorni Chiara , Quattrone Maria Giovanna , Arpicco Silvia , Muntoni Elisabetta , Milla Paola , Ricci Zaccaria 
Published: April 2021

Introduction: Few data are available regarding intraoperative plasma concentrations of vancomycin administered as prophylaxis in pediatric cardiac surgery. The aims of this study were to investigate during pediatric cardiac surgery with cardiopulmonary bypass(CPB) the attainment of the area-under-the-curve of the vancomycin serum concentrations versus time over surgery to minimum inhibitory concentration ratio(AUCintra/MIC) of 400 (mg × h)/l and/or a target concentration of 15–20 mg/l. Methods: In a prospective study, 40 patients divided into four subgroups (neonates, infants, children <10 years-old, ⩾10 years-old) undergoing cardiac surgery with cardiopulmonary bypass (CPB) were enrolled. A slow vancomycin bolus of 20 mg/kg, up to a maximum dose of 1000 mg was administered before skin incision and a further dose of 10 mg/kg (up to 500 mg) at CPB start. Vancomycin samples were collected intraoperatively at four time points. Results: The median (interquartile range) age was 241.5 days (47–3898) and the median weight was 7.1 kg (3.1–37). The median AUCintra/MIC was 254.73 (165.89–508.06). In 11 patients the AUCintra/MIC target was not reached. Neonates displayed the lowest AUCintra/MIC values, and these were significantly lower than those of children ⩾10 years old (p = 0.02). Vancomycin concentrations were above the maximal target of 20 mg/l in 82.5% and 80% of patients at surgery and CPB start, respectively. At CPB and surgery end, 42.5% of patients showed vancomycin concentrations above 20 mg/l and 42.5% below 15 mg/l. Patients⩾10 years old showed the highest peak values whereas neonates were those with the lowest troughs. AUCintra/MIC correlated with age(r:0.36, p = 0.02), weight(r:0.35, p = 0.03), intraoperative protein value(r:0.40, p = 0.01), CPB priming volume/kg(r:−0.33, p = 0.04), CPB duration(r:0.36, p = 0.02) and vancomycin troughs(r:0.35, p = 0.04). Conclusions: An AUCintra/MIC ⩾400 target was not reached in one-quarter of children undergoing heart surgery. Vancomycin peaked before the start of surgery and neonates were those with the lowest troughs. Vancomycin concentrations are affected by CPB hemodilution and by patients’ age and weight.
One-stop hybrid surgery for treatment of complex Stanford type B aortic dissection
Authors: Guo Yongzhong , Shao Jinjie , Shi Wenjian , Tian Mei , Li Ling , Ermek Tangsakar , Zhang Zonggang 
Published: April 2021

Objectives To compare the efficacy and prognosis of one-stop hybrid surgery using the elephant trunk procedure for treatment of complex Stanford type B aortic dissection. Methods We retrospectively analyzed patients who underwent surgical treatment from January 2014 to July 2019. The patients were divided into those who underwent the elephant trunk procedure (n = 10) and those who underwent one-stop hybrid surgery (n = 10). The cardiopulmonary bypass time, mechanical ventilation time, length of hospital stay, and red blood cell usage were compared between the two groups. All patients’ 3-month postoperative aortic computed tomography angiography (CTA) findings were also reviewed. Results The cardiopulmonary bypass time, mechanical ventilation time, and length of hospital stay were significantly shorter and red blood cell usage was significantly lower in the one-stop hybridization group. The aortic cross-clamp time was not significantly different between the two groups. Aortic CTA review after hybrid surgery showed that the true lumen of the descending aorta was almost completely restored at 3 months. Conclusion One-stop hybrid surgery effectively alleviated the occlusion of the aortic dissection, prevented the need for additional surgery, and expanded the indications for covered-stent endovascular repair.
Association between renal urolithiasis after extracorporeal shock wave lithotripsy therapy and new-onset hypertension: an updated meta-analysis
Authors: Wu Qiao , Liang Rui , Huang Yi , Tan Chunlin , Zhu Guangqiang , Chen Yanjun , Cao Liang , Zou Bing , Li Xin , Wang Haiyun , Wang Xiaojun , Tang Tielong , Wu Tao 
Published: April 2021

Objective The long-term effect of extracorporeal shock wave lithotripsy (SWL) is still controversial. A previous meta-analysis showed no association between new-onset hypertension and entire upper urinary urolithiasis after SWL. Recently, there have been some reports on this topic. Therefore, we aimed to examine the association between new-onset hypertension and nephrolithiasis after SWL therapy. Methods Embase, the Cochrane Central Search Library, and PubMed were used to search for reports on new-onset hypertension and patients with nephrolithiasis after SWL. A meta-analysis of the association between new-onset hypertension and nephrolithiasis after SWL was carried out. The data of relevant research were synthesized and the relative risk was computed. Results Seven eligible studies were included in our meta-analysis. There was a significant association between nephrolithiasis after SWL and new-onset hypertension. The overall relative risk with a 95% confidence interval was 1.21 (1.11–1.31) in a fixed-effects model. Conclusion Our meta-analysis suggests an association between new-onset hypertension and patients with nephrolithiasis after SWL, which is in contrast with the finding of a previous meta-analysis.
Plasma exosomal miR-596: a novel biomarker predicts survival in patients with idiopathic pulmonary artery hypertension
Authors: Huang Yang , Wang Zuo-Gang , Tang Liang , Gong Su-Gang , Sun Yuan-Yuan , Wang Lan , Jiang Rong , Wu Wen-Hui , Luo Ci-Jun , Zhang Jie , Yang Xiao-Jun , Li Jin-Ling , Yuan Xun-Tao , Zhao Qin-Hua , Yuan Ping 
Published: April 2021

Objective To determine if plasma exosomal microRNAs (miRNAs) can predict survival in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods The study enrolled patients with IPAH that underwent right heart catheterization. Plasma was collected and exosomal miRNAs were extracted. Exosomes were evaluated using transmission electron microscopy, Western blot analysis and particle size distribution analysis. MiRNAs were evaluated using a miRNA microarray and validated using real-time polymerase chain reaction. Results This study included 12 patients with IPAH in the study group and 48 patients with IPAH in the validation group. The mean ± SD follow-up duration was 60.3 ± 35.4 months in the overall cohort. The levels of miR-596 were higher in the nonsurvivors compared with the survivors. The levels of miR-596 significantly correlated with survival time, mean right atrial pressure, pulmonary vascular resistance (PVR) and cardiac index. High levels of miR-596 and PVR were significantly associated with poor overall survival. Multivariate analysis demonstrated that exosomal miR-596 (hazard ratio [HR] = 2.119; 95% confidence interval [CI] 1.402, 3.203) and PVR (HR = 1.146; 95% CI 1.010, 1.300) were independent predictors of survival. Conclusions High levels of plasma exosomal miR-596 were significantly associated with disease severity and poor prognosis of patients with IPAH.
Trends in microbiological profiles and antibiotic resistance in periprosthetic joint infections
Authors: Hu Lifeng , Fu Jun , Zhou Yonggang , Chai Wei , Zhang Guoqiang , Hao Libo , Chen Jiying 
Published: April 2021

Objective This study examined the trends in demographics, the distribution of microorganisms, and antibiotic resistance in patients with periprosthetic joint infection (PJI). Methods We conducted a retrospective study of 231 consecutive patients diagnosed with PJI in our hospital from January 2006 to December 2015 (93 and 138 patients diagnosed in 2006–2010 and 2011–2015, respectively). The linear-by-linear chi-squared test was used to assess the trends in demographics, the distribution of microorganisms, and antibiotic resistance. Results Gram-positive cocci accounted for 63.9% of all pathogens, and coagulase-negative Staphylococcus (CoNS) accounted for 38.1% of all isolates. The proportion of isolates identified as methicillin-resistant CoNS significantly increased over the study period (39.0% vs. 61.8%). In addition, the proportions of levofloxacin-resistant CoNS (4.9% vs. 21.8%) and Staphylococcus aureus (6.3% vs. 45.0%) isolates significantly increased over the study period. By contrast, the proportions of penicillin-resistant CoNS (82.9% vs. 40.0%) and S. aureus (75.0% vs. 30.0%) isolates decreased over the study period. Conclusion Our research revealed changes in the distribution of microorganisms and antibiotic resistance profile of the pathogens responsible for PJI over time, which could complicate treatment. These findings may serve as a reference for strategies to prevent and empirically treat PJI in China.
The combination of fibrinogen concentrations and the platelet-to-lymphocyte ratio predicts survival in patients with advanced lung adenocarcinoma treated with EGFR-TKIs
Authors: He Qiong , Li Yamin , Zhou Xihong , Zhou Wen , Xia Chunfang , Zhang Ruzhe , Zhang Zhengjie , Hu Aiyang , Peng Siyin , Li Jing 
Published: April 2021

Objective This study aimed to identify a predictive marker of response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR-mutant advanced lung adenocarcinoma. Methods A cohort of 190 patients with EGFR-mutant advanced lung adenocarcinoma was analyzed. Receiver operating characteristic curve analysis was used to evaluate the optimal cutoffs for fibrinogen levels, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) for predicting progression-free survival (PFS). Univariate and multivariate survival analyses were performed to identify factors correlated with PFS and overall survival (OS). Results High NLR was associated with worse performance status. In univariate analysis, fibrinogen levels, NLR, and PLR were correlated with OS and PFS. In multivariate analysis, all three variables remained predictive of OS, whereas only fibrinogen levels and PLR were independent prognostic factors for PFS. Furthermore, the combination of fibrinogen levels and PLR (F-PLR score) could stratify patients into three groups with significantly different prognoses, and the score was independently predictive of survival. Conclusion The F-PLR score predicted the prognosis of patients with EGFR-mutant advanced lung adenocarcinoma who received EGFR-TKIs, and this score may serve as a convenient blood-based marker for identifying high-risk patients.
Role of TLR4/MyD88/NF-κB signaling in heart and liver-related complications in a rat model of type 2 diabetes mellitus
Authors: Tian Jiajia , Zhao Yanyan , Wang Lingling , Li Lin 
Published: April 2021

Aims To analyze expression of members of the Toll-like receptor (TLR)4/myeloid differentiation primary response 88 (MyD88)/nuclear factor (NF)-κB signaling pathway in the heart and liver in a rat model of type 2 diabetes mellitus (T2DM). Our overall goal was to understand the underlying pathophysiological mechanisms. Methods We measured fasting blood glucose (FBG) and insulin (FINS) in a rat model of T2DM. Expression of members of the TLR4/MyD88/NF-κB signaling pathway as well as downstream cytokines was investigated. Levels of mRNA and protein were assessed using quantitative real-time polymerase chain reaction and western blotting, respectively. Protein content of tissue homogenates was assessed using enzyme-linked immunosorbent assays. Results Diabetic rats had lower body weights, higher FBG, higher FINS, and higher intraperitoneal glucose tolerance than normal rats. In addition, biochemical indicators related to heart and liver function were elevated in diabetic rats compared with normal rats. TLR4 and MyD88 were involved in the occurrence of T2DM as well as T2DM-related heart and liver complications. TLR4 caused T2DM-related heart and liver complications through activation of NF-κB. Conclusions TLR4/MyD88/NF-κB signaling induces production of tumor necrosis factor-α, interleukin-6, and monocyte chemoattractant protein-1, leading to the heart- and liver-related complications of T2DM.
The Fate of Bone Marrow Lesions After Open Wedge High Tibial Osteotomy: A Comparison Between Knees With Primary Osteoarthritis and Subchondral Insufficiency Fractures
Authors: Choi Han Gyeol , Kim Joo Sung , Yoo Hyun Jin , Jung You Sun , Lee Yong Seuk 
Published: April 2021

Background: Subchondral insufficiency fracture of the knee (SIFK) is characterized by a subchondral lesion that may lead to end-stage osteoarthritis (OA). In patients who have SIFK in a precollapse state with varus malalignment, a joint-preserving technique such as open wedge high tibial osteotomy (OWHTO) should be considered. Purpose: To evaluate the efficacy of OWHTO in primary OA and SIFK-dominant OA by clinical and radiological evaluations including magnetic resonance imaging (MRI). Study Design: Cohort study; Level of evidence 3. Methods: A total of 33 SIFK-dominant OA knees and 66 with primary OA that underwent biplanar OWHTO between March 2014 and February 2016 were included after 1:2 propensity score matching. The MRI Osteoarthritis Knee Score was used to assess bone marrow lesions (BMLs) preoperatively and at follow-up. The weightbearing line ratio, the hip-knee-ankle angle, and the joint line convergence angle were measured. The clinical outcomes assessed were range of motion, the American Knee Society Score, and the Western Ontario and McMaster University (WOMAC) score. Results: The mean follow-up period was 41.2 ± 12.6 months. The distribution of preoperative BML grade in the SIFK-dominant OA group was significantly higher in both the femur and tibia ( P < .001 and <.001, respectively) than that in the primary OA group. However, the difference was not significant postoperatively (femur, P = .425; tibia, P = .462). In both groups, postoperative BMLs showed significant improvement compared with preoperative BMLs (primary OA [femur, P < .001; tibia, P = .001] and SIFK-dominant OA [femur, P < .001; tibia, P < .001]). The WOMAC pain score was higher in the SIFK-dominant OA group preoperatively (primary OA, 7.0 ± 3.73; SIFK-dominant OA, 9.17 ± 2.6; P = .032) even though it was not different at the final follow-up (primary OA, 2.11 ± 1.7; SIFK-dominant OA, 1.79 ± 1.32; P = .179). Conclusion: OWHTO is an effective procedure not only for primary OA but also for SIFK-dominant OA. OWHTO can improve BMLs, which represent the main pathological feature of SIFK. Therefore, in patients who have SIFK with varus malalignment, OWHTO can be an attractive treatment option for preserving the joint and enhancing subchondral bone healing.
Effect of High Tibial Osteotomy on the Distribution of Subchondral Bone Density Across the Proximal Tibial Articular Surface of the Knee With Medial Compartment Osteoarthritis
Authors: Iwasaki Koji , Kondo Eiji , Matsubara Shinji , Matsuoka Masatake , Endo Kaori , Yokota Isao , Onodera Tomohiro , Iwasaki Norimasa 
Published: April 2021

Background: The effect of high tibial osteotomy (HTO) on the stress distribution across the knee joint is not completely understood. Subchondral bone density is considered to reflect the pattern of stress distribution across a joint surface. Purpose: To assess the distribution of subchondral bone density across the proximal tibia in nonarthritic knees and in the knees of patients with osteoarthritis (OA) before and after HTO. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively collected radiological and computed tomography data from 16 patients without OA (control group) and 17 patients with OA. Data from the OA group were collected before and 1.5 years after HTO. Subchondral bone density of the proximal tibia was assessed with computed tomography–osteoabsorptiometry. The locations and percentages represented by high-density areas (HDAs) on the articular surface were quantitatively analyzed. Results: The ratio of the HDA of the medial compartment to the total HDA (medial ratio) was significantly higher in the preoperative OA group (mean, 80.1%) than in the control group (61.3%) ( P < .001). After HTO, the medial ratio decreased significantly to 75.1% ( P = .035 in comparison with preoperative values) and was significantly correlated with the hip-knee-ankle angle in both groups: control ( r = −0.551; P = .033) and OA ( r = −0.528; P = .043). The change in medial ratio after HTO was significantly correlated with the change in hip-knee-ankle angle ( r = 0.587; P = .035). In the medial compartment, the HDA in the most lateral region of 4 subregions increased after HTO, but that in 3 medial subregions decreased. Conclusion: In this exploratory study, HTO shifted the HDA of the medial compartment of the proximal tibial articular surface toward the lateral compartment. In contrast, the HDA of the most lateral region of the medial compartment increased after HTO. This change in subchondral bone density may result from the change in stress distribution.