bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic Discontinuation 24 h After Neonatal Late-Onset Sepsis Work-Up—A Validated Decision Tree Model
Authors: Goldberg Ori , Sokolover Nir , Bromiker Ruben , Amitai Nofar , Chodick Gabriel , Scheuerman Oded , Ben-Zvi Haim , Klinger Gil 
Published: August 2021

Objectives: Neonatal late-onset sepsis work-up is a frequent occurrence in every neonatal department. Blood cultures are the diagnostic gold standard, however, a negative culture prior to 48–72 h is often considered insufficient to exclude sepsis. We aimed to develop a decision tree which would enable exclusion of late-onset sepsis within 24 h using clinical and laboratory variables.Study Design: Infants evaluated for late-onset sepsis during the years 2016–2019, without major malformations, in a tertiary neonatal center were eligible for inclusion. Blood cultures and clinical and laboratory data were extracted at 0 and 24 h after sepsis work-up. Infants with bacteriologically confirmed late-onset sepsis were compared to matched control infants. Univariate logistic regression identified potential risk factors. A decision tree based on Chi-square automatic interaction detection methodology was developed and validated.Results: The study cohort was divided to a development cohort (105 patients) and a validation cohort (60 patients). At 24 h after initial evaluation, the best variables to identify sepsis were C-reactive protein &gt; 0.75 mg/dl, neutrophil-to-lymphocyte ratio &gt; 1.5 and sick-appearance at 24 h. Use of these 3 variables together with blood culture status at 24 h, enabled identification of all infants that eventually developed sepsis through the decision tree model. Our decision tree has an area under the receiver operating characteristic curve of 0.94 (95% CI: 0.90–0.98).Conclusions: In non-sick appearing infants with a negative blood culture at 24 h and normal laboratory values, sepsis is highly unlikely and discontinuing antibiotics after 24 h is a viable option.
Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study
Authors: Temsah Mohamad-Hani , Alhboob Ali , Abouammoh Noura , Al-Eyadhy Ayman , Aljamaan Fadi , Alsohime Fahad , Alabdulhafid Majed , Ashry Ahmad , Bukhari Ahmad , ElTahir Omer , Jamal Amr , Halwani Rabih , Alhasan Khalid , Alherbish Adi , Temsah Reem , Al-Tawfiq Jaffar A. , Barry Mazin 
Published: August 2021

Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients.Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses.Setting: PICU, single tertiary-care academic center.Participants: Multidisciplinary PICU HCWs.Interventions: Integration of Zoom meeting into clinical daily PICU rounds.Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used.Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p &lt; 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized.Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.
Inconsistent Time-Dependent Effects of Tetramethylpyrazine on Primary Neurological Disorders and Psychiatric Comorbidities
Authors: Jiang Yue-Peng , Jin Yan , Bao Jie , Wang Song , Lai Wei-Dong , Wen Cheng-Ping , Xu Zheng-Hao , Yu Jie 
Published: August 2021

The aim of this study was to investigate the time dependent effects of tetramethylpyrazine (TMP, main activity compound of Ligusticum chuanxiong Hort) on two neurological disorders and their neuropsychiatric comorbidities. 6 Hz corneal rapid kindling was used to induce epileptogenesis and the inflammatory pain was induced by intra-articular Complete Freund’s adjuvant (CFA) injection. The mechanical pain thresholds were measured using von Frey hair (D4, D11, D18, D25 after CFA first injection), and the vertical rearings of the mice was observed. To test the neuropsychiatric comorbidities, anxiety-like behaviors of mice were examined by open field and elevated plus maze tests. Two behavioral despair models, tail suspension test and forced swimming test were also used to evaluate the depressive like behaviors. The results showed that TMP administered from the initial day (D1-D35 in kindling model, D0-D14 and D0-D28 in CFA model) of modeling retarded both the developments of 6 Hz corneal rapid kindling epileptogenesis and the CFA induced inflammatory pain. In comparison, late periods administration of TMP (D21-D35 in kindling and D14-D28 in CFA model) showed no effect on the epileptogenesis and the generalized seizures (GS) of kindling, but alleviated maintenance of CFA induced inflammatory pain. Furthermore, we also found all TMP treatments from the initial day of modeling alleviated the co-morbid depressive and anxiety-like behaviors in both models; however, late periods treatments did not, either in kindling or the CFA induced inflammatory pain. BDNF/ERK signaling impairment was also tested by western blot, and the results showed that TMP administered from the initial day of modeling increased the hippocampal BDNF/ERK expression, whereas late period administration showed no effects. Overall, our findings reveal the inconsistent time dependent effects of Tetramethylpyrazine on neurological disorders and their relative neuropsychiatric comorbidities, and provide novel insight into the early application of TMP that might enhance hippocampal BDNF/ERK signaling to alleviate neuropsychiatric comorbidities in neurological diseases.
Association of Plasma Metabolic Biomarker Sphingosine-1-Phosphate With Cerebral Collateral Circulation in Acute Ischemic Stroke
Authors: Yu Fang , Feng Xianjing , Li Xi , Liu Zeyu , Liao Di , Luo Yunfang , Wei Minping , Huang Qin , Zhang Lin , Xia Jian 
Published: August 2021

Background: The contribution of metabolic profile to the cerebral collateral circulation in acute ischemic stroke (AIS) has not been fully outlined. In this study, we conducted a metabolomic study to assess the relationship between the metabolic biomarkers and the collateral status of AIS.Methods: A two-stage study was conducted from September 2019 to June 2021 in our hospital. There were 96 subjects including 66 patients with AIS and 30 healthy controls in the discovery stage and 80 subjects including 53 patients with AIS and 27 healthy controls in the validation stage. Collateral circulation was assessed by the Tan score based on computed tomographic angiography (CTA). Liquid chromatography-tandem mass spectrometry was used to identify differential metabolic markers. Then, an ELISA was employed to detect the plasma levels of sphingosine-1-phosphate (S1P).Results:There were 114 differential metabolites between patients with AIS and control groups and 37 differential metabolites between good collateral circulation (GCC) and poor collateral circulation (PCC) groups. The pathway enrichment analysis revealed that arginine biosynthesis was the only statistically significant pathway between AIS and control groups and sphingolipid metabolism was the only statistically significant pathway between GCC and PCC groups. The differential metabolites sphinganine-1-phosphate (SA1P) and S1P belong to the sphingolipid metabolism. In the discovery stage, when the GCC group was compared with the PCC group, the receiver operating characteristic (ROC) analysis showed that plasma SA1P relative levels demonstrated an area under the curve (AUC) of 0.719 (95% CI: 0.582–0.834), and S1P levels demonstrated an AUC of 0.701 (95% CI: 0.567–0.819). In addition, both plasma SA1P and S1P relative levels showed significant negative correlations with the 90-day modified Rankin Scale (mRS) score. In the validation sample, higher plasma S1P levels were independent predictors of GCC (p = 0.014), and plasma S1P levels demonstrated an AUC of 0.738 (95% CI: 0.599–0.849) to differentiate patients with GCC from patients with PCC. In addition, plasma S1P levels also showed significant negative correlations with the 90-day mRS score.Conclusion: We first illustrated the association between plasma metabolic profiles and cerebral collateral circulation in patients with AIS. Plasma S1P levels might be a potential diagnostic biomarker for predicting collateral circulation status in patients with AIS.
Cross-Cultural Differences and Psychometric Properties of the Japanese Actions and Feelings Questionnaire (J-AFQ)
Authors: Huggins Charlotte F. , Cameron Isobel M. , Scott Neil W. , Williams Justin H. G. , Yoshikawa Sakiko , Sato Wataru 
Published: August 2021

Aims: We aimed to assess the psychometric properties of a Japanese version of the Actions and Feelings Questionnaire (J-AFQ), an 18-item self-report measure of non-verbal emotional communication, as well as to examine its transcultural properties.Methods: The J-AFQ was administered to 500 Japanese adults (age 20–49, 250 male), alongside the Japanese Broad Autism Phenotype Questionnaire (BAPQ-J) and Empathy Quotient (EQ-J). These were compared to a group of 597 British and Irish participants (age 16–18, 148 male). J-AFQ was assessed in terms of validity by confirmatory factor analysis and convergence with BAPQ-J and EQ-J using Pearson correlation. Internal consistency and differential item functioning (DIF) were assessed and compared between Japanese and UK/Irish participants.Results: Reversed worded items (RWIs) showed poor item-total correlations but excluding these left a 13-item version of the J-AFQ with good internal consistency and content validity. Consistent with the English version, J-AFQ scores correlated with EQ and lower BAPQ scores. However, comparing across cultures, J-AFQ scores were significantly lower in the Japanese sample, and there was evidence of important DIF by country in over half of the J-AFQ itemsConclusion: Cultural differences in attitudes to self-report, as well as increased acquiescence to RWI's also seen in previous studies, limit the value of the 18-item instrument in Japanese culture. However, the 13-item J-AFQ is a valid and reliable measure of motor empathy, which, alongside the English version, offers promise for research in motor cognition and non-verbal emotional communication across cultures.
Electroencephalographic Parameters Differentiating Melancholic Depression, Non-melancholic Depression, and Healthy Controls. A Systematic Review
Authors: Bruun Caroline Fussing , Arnbjerg Caroline Juhl , Kessing Lars Vedel 
Published: August 2021

Introduction: The objective of this systematic review was to investigate whether electroencephalographic parameters can serve as a tool to distinguish between melancholic depression, non-melancholic depression, and healthy controls in adults.Methods: A systematic review comprising an extensive literature search conducted in PubMed, Embase, Google Scholar, and PsycINFO in August 2020 with monthly updates until November 1st, 2020. In addition, we performed a citation search and scanned reference lists. Clinical trials that performed an EEG-based examination on an adult patient group diagnosed with melancholic unipolar depression and compared with a control group of non-melancholic unipolar depression and/or healthy controls were eligible. Risk of bias was assessed by the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) checklist.Results: A total of 24 studies, all case-control design, met the inclusion criteria and could be divided into three subgroups: Resting state studies (n = 5), sleep EEG studies (n = 10), and event-related potentials (ERP) studies (n = 9). Within each subgroup, studies were characterized by marked variability on almost all levels, preventing pooling of data, and many studies were subject to weighty methodological problems. However, the main part of the studies identified one or several EEG parameters that differentiated the groups.Conclusions: Multiple EEG modalities showed an ability to distinguish melancholic patients from non-melancholic patients and/or healthy controls. The considerable heterogeneity across studies and the frequent methodological difficulties at the individual study level were the main limitations to this work. Also, the underlying premise of shifting diagnostic paradigms may have resulted in an inhomogeneous patient population.Systematic Review Registration: Registered in the PROSPERO registry on August 8th, 2020, registration number CRD42020197472.
Application of a Cloud Video Conference Method for Recruiting Healthy Subjects Into an Early-Phase Clinical Trial During the COVID-19 Pandemic
Authors: Wang Zejuan , Du Aihua , Li Min , Zang Siqi , Liu Xiaona , Zhang Dan , Chen Gang , Zhang Lina , Zhang Yanan , Wang Jin 
Published: August 2021

Objective: Our objective is to explore the effect of applying cloud video conferencing methods to the informed consent process in an early-phase clinical trial during the COVID-19 pandemic.Methods: All participants who intended to participate in the trial were informed via a cloud video conference before signing the informed consent forms (ICF). Then, the attitudes of the participants with the cloud video conference and their understanding of the trial were evaluated using a questionnaire when they visited to sign the ICF onsite.Results: A total of 165 subjects participated in the cloud video conference process, and 142 visited the site to sign and date the ICFs at the center during the appointment time. The survey showed that nearly 100% of the subjects evaluated the video-based informed consent process as very good or good and gave correct answers to questions about the trial. Furthermore, 136 (95.8%) subjects believed that the knowledge about the trial derived via the video-based informed consent process was consistent with the onsite reality, and 139 (97.9%) subjects expressed their willingness to participate in an informed consent procedure undertaken through an online video conference.Conclusions: The video-based informed consent process achieved the same effects as an onsite informed consent process. The former saves time and cost of transportation for the subject and exhibits good public acceptance; especially in light of the COVID-19 pandemic, this process is conducive for reducing the risk of subject infection due to travel and would also help avoid crowding on site.
Identifying the Phenotypic and Temporal Heterogeneity of Knee Osteoarthritis: Data From the Osteoarthritis Initiative
Authors: Li Mengjiao , Lan Lan , Luo Jiawei , Peng Li , Li Xiaolong , Zhou Xiaobo 
Published: August 2021

Objective: Previous studies discussing phenotypic and temporal heterogeneity of knee osteoarthritis (KOA) separately have fatal limitations that either clustering patients with similar severity or assuming all knees have a single common progression pattern, which are unreliable. This study tried to uncover more reliable information on phenotypic and temporal heterogeneity of KOA.Design: Data were from Osteoarthritis Initiative database. Six hundred and seventy-eight unilateral knees that have greater Kellgren and Lawrence (KL) grade than the contralateral knees at baseline and in all follow-up 48 months were included. Measurements of biomarkers at baseline were chosen. Subtype and Stage Inference model (SuStaIn) was applied as a subtype-progression model to identify subtypes, subtype biomarker progress sequences and stages of KOA.Results: This study identified three subtypes which account for 15, 61, and 24% of knees, respectively. Each subtype has distinct subtype biomarker progress sequence. For knees with KL grade 0/1, 2, 3, and 4, they have different distributions on stage and 26, 53, 89, and 95% of them are strongly assigned to subtypes. When assessing whether a knee has KL (grade ≥ 2), subtypes and stages from subtypes-progression model (SuStaIn) are significantly better fitting than those from subtypes-only (mixture of Gaussians) (likelihood ratio = 105.59, p = 2.2 × 10−16) or stages-only (SuStaIn where setting c = 1) (likelihood ratio = 58.04, p = 2.57 × 10−14) model. Stages in subtypes-progression model has greater β than stages-only model. Subtypes from subtypes-progression model have no statistical significance.Conclusions: For subtypes-progression model, stages contain more complete temporal information and subtypes are closer to real OA subtypes.
Estimation and Discriminability of Doppler Ultrasound Fetal Heart Rate Variability Measures
Authors: Vargas-Calixto Johann , Warrick Philip , Kearney Robert 
Published: August 2021

Continuous electronic fetal monitoring and the access to databases of fetal heart rate (FHR) data have sparked the application of machine learning classifiers to identify fetal pathologies. However, most fetal heart rate data are acquired using Doppler ultrasound (DUS). DUS signals use autocorrelation (AC) to estimate the average heartbeat period within a window. In consequence, DUS FHR signals loses high frequency information to an extent that depends on the length of the AC window. We examined the effect of this on the estimation bias and discriminability of frequency domain features: low frequency power (LF: 0.03–0.15 Hz), movement frequency power (MF: 0.15–0.5 Hz), high frequency power (HF: 0.5–1 Hz), the LF/(MF + HF) ratio, and the nonlinear approximate entropy (ApEn) as a function of AC window length and signal to noise ratio. We found that the average discriminability loss across all evaluated AC window lengths and SNRs was 10.99% for LF 14.23% for MF, 13.33% for the HF, 10.39% for the LF/(MF + HF) ratio, and 24.17% for ApEn. This indicates that the frequency domain features are more robust to the AC method and additive noise than the ApEn. This is likely because additive noise increases the irregularity of the signals, which results in an overestimation of ApEn. In conclusion, our study found that the LF features are the most robust to the effects of the AC method and noise. Future studies should investigate the effect of other variables such as signal drop, gestational age, and the length of the analysis window on the estimation of fHRV features and their discriminability.
Primary Peritoneal Carcinosarcoma: A Case Report
Authors: Erz Logan , Smith Brandon , Larson Brandon , Ma Truong 
Published: August 2021

Introduction: Carcinosarcoma, also known as malignant mixed Mullerian tumor (MMMT) is a malignant biphasic neoplasm consisting of carcinomatous and malignant non-epithelial components of mesenchymal origin. MMMTs typically arise from the female genital tract in patients over 40 years old. Primary extragenital MMMTs are extremely rare with published literature totaling 40 reported cases. The primary peritoneal carcinosarcoma is an aggressive tumor as patients with this tumor have an average survival of 7.6 months. Surgical debulking is the mainstay of treatment for these tumors and systemic chemotherapy is advised in all cases.Case: A 48-year-old Amish female presented with 5 day history of bloating and abdominal pain superimposed on a 1 year history of worsening fatigue and intermittent bloody bowel movements. She was found to have a pelvic mass on physical exam. Computed tomography scan of the abdomen and pelvis that demonstrated stricturing of the sigmoid colon, and a large multi-cystic mass in the midline pelvis measuring 12.5 × 9.9 × 11.7 cm. Colonoscopy showed stenosis due to external compression without intraluminal lesion. CEA and CA 125 levels were elevated and CA 19-9 was normal. Exploratory laparotomy was performed with en-bloc resection of a 15 cm mass originating from the sigmoid colon mesentery with several other small tumor deposits throughout the mesentery. Pathology diagnosed primary peritoneal carcinosarcoma Mullerian-type with three positive lymph nodes.Conclusion: Malignant mixed Mullerian tumor (carcinosarcoma) caries a universally grim prognosis. Herein, we report a unique case of primary peritoneal carcinosarcoma and discuss the work-up and surgical management of this rare tumor.
La paradoja neurótica en la perspectiva constructivista
Authors: Mancini Francesco 
Published: August 2021

El objetivo del articulo era demostrar que las paradojas neuroticas se generan en situaciones que por su naturaleza tienden a la intolerancia. Hemos visto un caso clinico de un conflicto acercamiento- evitacion. Hemos visto el caso de un paciente que oscilaba durante años establecer un vinculo acercamiento- evitacion , porque no era capaz de apreciar las diferencias entre perdidas mas o menos severas. Luego analizando el motivo por el cual el paciente no ha logrado,con el curso de los años, articular sus objetivos afectivos con el fin de poder discriminar el valor de las distintas perdidas.
Estados de animo: polaridades básicas y relaciones con el trastorno depresivo
Authors: Preciado Ignacio 
Published: August 2021

El estado de animo es un estado afectivo cotidiano, costituido por sentimientos duraderos y aparentemente inespecificos. El proposito de este articulo es la revision los estudios centrados en sus principales polaridades : positividad/ negatividad,energia alta/ energia baja , tension/ calma y tambien su grado de inhibicion/ expresion. Finalmente establecemos algunas relaciones con el trastorno depresivo.
La terapia cognitiva desde una perspectiva evolutivo-constructivista
Authors: Guidano Vittorio F. 
Published: August 2021

En este articulo se presenta la Terapia Cognitiva desde una perspectiva evolutivo- constructivista. De acuerdo con esta perspectiva la finalidad principal de la Terapia Constructivista es reconstruir el proceso de formacion ontogenética del Self. Para poder llevar a buen término este proceso reconstructivo se enfoca las intervenciones terapéuticas hacia las etapas del desarrollo evolutivo a mas de un estadio de autoobservacion del Self.
Figura de la hija madre en la familia venezolana. Relato de vida de Simonne Gennaro
Authors: De La Torre Elsa , Gennaro Simonne 
Published: August 2021

Partiendo del relato de vida; “Mi padre me dijo que estaría a cargo de mis dos hermanas, no logre tener una explicación, solo sé que nos llevaron a la casa de mi Nonna (la madre de mi papá). No comprendía lo que sucedía, pero la agonía cada día se hacía grande porque yo quería estar con mi Mamá”. Esta investigación tuvo como intencionalidad hacer un estudio comprensivo sobre la figura de la hija madre en el contexto de la familia venezolana. Metodológicamente fue cualitativa de investigación convivida con enfoque biográfico de relato-de- vida (Moreno, 2016). El relato-d-vida, produjo 3 bloques respectivamente. A la luz de ello se habla de dos grandes temáticas, la resolución del problema por medio de la familia matricentrada los dispositivos culturales. Aportes a la orientación es haber develado como los dispositivos culturales se hacen presente para preservar la familia matricentrada.