bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echo is a good, not perfect, measure of cardiac output in critically ill surgical patients
Authors: Olivieri Peter P. , Patel Rajan , Kolb Stephanie , Fatima Syeda , Galvagno Samuel M. , Haase Daniel J. , Ramani Gautam V. , Ludmir Jonathan , Alkhatib Hani , Herr Daniel , Bruno David A. , Scalea Thomas M. , Murthi Sarah B. 
Published: April 2019

BACKGROUND
Compared with a pulmonary artery catheter (PAC), transthoracic echocardiography (TTE) has been shown to have good agreement in cardiac output (CO) measurement in nonsurgical populations. Our hypothesis is that the feasibility and accuracy of CO measured by TTE (CO-TTE), relative to CO measured by PAC thermodilution (CO-PAC), is different in surgical intensive care unit patients (SP) and nonsurgical patients (NSP).

METHODS
Surgical patients with PAC for hemodynamic monitoring and NSP undergoing right heart catheterization were prospectively enrolled. Cardiac output was measured by CO-PAC and CO-TTE. Pearson coefficients were used to assess correlation. Bland-Altman analysis was used to determine agreement.

RESULTS
Over 18 months, 84 patients were enrolled (51 SP, 33 NSP). Cardiac output TTE could be measured in 65% (33/51) of SP versus 79% (26/33) of NSP; p = 0.17. Inability to measure the left ventricular outflow tract diameter was the primary reason for failure in both groups; 94% (17/18) in SP versus 86% (6/7) NSP; p = 0.47. Velocity time integral could be measured in all patients. In both groups, correlation between PAC and TTE measurement was strong; SP (r = 0.76; p < 0.0001), NSP (r = 0.86; p < 0.0001). Bland-Altman analysis demonstrated bias of −0.1 L/min, limits of agreement of −2.5 and +2.3 L/min, percentage error (PE) of 40% for SP, and bias of +0.4 L/min, limits of agreement of −1.8 and +2.5 L/min, and PE of 40% for NSP.

CONCLUSION
There was strong correlation and moderate agreement between TTE and PAC in both SP and NSP. In both patient populations, inability to measure the left ventricular outflow tract diameter was a limiting factor.

LEVEL OF EVIDENCE
Diagnostic tests or criteria, level III.
Pediatric resuscitation: Weight-based packed red blood cell volume is a reliable predictor of mortality
Authors: Hanna Kamil , Hamidi Mohammad , Anderson Kathryn Tinsley , Ditillo Michael , Zeeshan Muhammad , Tang Andrew , Henry Marion , Kulvatunyou Narong , Joseph Bellal 
Published: April 2019

BACKGROUND
The definition of massive transfusion (MT) in civilian pediatric trauma patients is not established. In combat-injured pediatric patients, the definition of MT is based on the volume of total blood products transfused. The aim of this study is to define MT in civilian pediatric trauma patients based on a packed red blood cell (PRBC) volume threshold and compare its predictive power to a total blood products volume threshold.

METHODS
An analysis of the pediatric American College of Surgeons Trauma Quality Improvement Program database was performed (2014–2016) including pediatric trauma patients (4–18 years) who received blood products within 24 hours. Receiver operator characteristic curves for predicting mortality determined the optimal PRBC MT threshold. Area under receiver operating characteristic curve (AUROC) curve analysis was performed to compare the predictive power of a PRBC threshold to a total blood product threshold.

RESULTS
A total of 1,495 patients were included. Sensitivity and specificity for 24-hour and in-hospital mortality were optimal at a PRBC threshold of 20 mL/kg. As compared with total blood products threshold, 20 mL/kg PRBCs volume achieved higher discriminatory power for predicting 24-hour (AUROC, 0.803 vs. 0.672; p < 0.001) and in-hospital mortality (AUROC, 0.815 vs. 0.686, p < 0.001). Patients who received an MT had higher Injury Severity Score (p < 0.001) and were more likely to receive mechanical ventilation (p < 0.001) and intensive care unit admission (p < 0.001). Overall 24-hour mortality (23.1% vs. 7.6%, p < 0.001) and in-hospital mortality (44.9% vs. 15.8%, p < 0.001) were higher in the MT group. On regression analysis, MT significantly predicted in-hospital mortality (odds ratio, 3.8 [2.9–4.9, 95% CI]) and 24-hour mortality (odds ratio, 3.3 [2.4–4.7, 95% CI]).

CONCLUSION
The use of a PRBCs MT definition in civilian pediatric patients is a better predictor of mortality compared with total blood products threshold. These results provide a framework for MT protocol development.

LEVEL OF EVIDENCE
Prognostic study, level III.
Efficacy of intermittent versus standard resuscitative endovascular balloon occlusion of the aorta in a lethal solid organ injury model
Authors: Kuckelman John , Derickson Michael , Barron Morgan , Phillips Cody J. , Moe Donald , Levine Tiffany , Kononchik Joseph P. , Marko Shannon T. , Eckert Matthew , Martin Matthew J. 
Published: April 2019

BACKGROUND
High-grade solid organ injury is a major cause of mortality in trauma. Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) can be effective but is limited by ischemia-reperfusion injury. Intermittent balloon inflation/deflation has been proposed as an alternative, but the safety and efficacy prior to operative hemorrhage control is unknown.

METHODS
Twenty male swine underwent standardized high-grade liver injury, then randomization to controls (N = 5), 60-min continuous REBOA (cR, n = 5), and either a time-based (10-minute inflation/3-minute deflation, iRT = 5) or pressure-based (mean arterial pressure<40 during deflation, iRP = 5) intermittent schedule. Experiments were concluded after 120 minutes or death.

RESULTS
Improved overall survival was seen in the iRT group when compared to cR (p < 0.01). Bleeding rate in iRT (5.9 mL/min) was significantly lower versus cR and iRP (p = 0.02). Both iR groups had higher final hematocrit (26% vs. 21%) compared to cR (p = 0.03). Although overall survival was lower in the iRP group, animals surviving to 120 minutes with iRP had decreased end organ injury (Alanine aminotransferase [ALT] 33 vs. 40 in the iRT group, p = 0.03) and lower lactate levels (13 vs. 17) compared with the iRT group (p = 0.03). No differences were seen between groups in terms of coagulopathy based on rotational thromboelastometry.

CONCLUSION
Intermittent REBOA is a potential viable adjunct to improve survival in lethal solid organ injury while minimizing the ischemia-reperfusion seen with full REBOA. The time-based intermittent schedule had the best survival and prolonged duration of tolerable zone 1 placement. Although the pressure-based schedule was less reliable in terms of survival, when effective, it was associated with decreased acidosis and end-organ injury.
Artificial neural networks can predict trauma volume and acuity regardless of center size and geography: A multicenter study
Authors: Dennis Bradley M. , Stonko David P. , Callcut Rachael A. , Sidwell Richard A. , Stassen Nicole A. , Cohen Mitchell J. , Cotton Bryan A. , Guillamondegui Oscar D. 
Published: April 2019

BACKGROUND
Trauma has long been considered unpredictable. Artificial neural networks (ANN) have recently shown the ability to predict admission volume, acuity, and operative needs at a single trauma center with very high reliability. This model has not been tested in a multicenter model with differing climate and geography. We hypothesize that an ANN can accurately predict trauma admission volume, penetrating trauma admissions, and mean Injury Severity Score (ISS) with a high degree of reliability across multiple trauma centers.

METHODS
Three years of admission data were collected from five geographically distinct US Level I trauma centers. Patients with incomplete data, pediatric patients, and primary thermal injuries were excluded. Daily number of traumas, number of penetrating cases, and mean ISS were tabulated from each center along with National Oceanic and Atmospheric Administration data from local airports. We trained a single two-layer feed-forward ANN on a random majority (70%) partitioning of data from all centers using Bayesian Regularization and minimizing mean squared error. Pearson's product-moment correlation coefficient was calculated for each partition, each trauma center, and for high- and low-volume days (>1 standard deviation above or below mean total number of traumas).

RESULTS
There were 5,410 days included. There were 43,380 traumas, including 4,982 penetrating traumas. The mean ISS was 11.78 (SD = 6.12). On the training partition, we achieved R = 0.8733. On the testing partition (new data to the model), we achieved R = 0.8732, with a combined R = 0.8732. For high- and low-volume days, we achieved R = 0.8934 and R = 0.7963, respectively.

CONCLUSION
An ANN successfully predicted trauma volumes and acuity across multiple trauma centers with very high levels of reliability. The correlation was highest during periods of peak volume. This can potentially provide a framework for determining resource allocation at both the trauma system level and the individual hospital level.

LEVEL OF EVIDENCE
Care Management, level IV.
Relationship Between Energy Expenditure During Walking and Step Length in Patients With Heart Failure
Authors: Yoshimura Kae , Urabe Yukio , Maeda Noriaki , Yoshida Toshinobu 
Published: April 2019

Objective:
Step length (SL) is an important indicator of physical function in older individuals and patients with heart failure (HF). The aim of this study was to investigate correlations between energy expenditure during walking and SL in patients with HF in different age groups.

Subjects and Methods:
A total of 44 patients participated in this study. The patients were divided into 2 groups with age younger than 65 years (the nonelderly group) and 65 years or older (the elderly group). Oxygen uptake (

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2) during walking was measured for 6 minutes at a self-selected speed using the FitMate Pro (COSMED, Rome, Italy). The highest values of

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2 (h

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2) and O2 cost during walking were determined. Step length (m), SL/height ratio (%), walking speed, and handgrip strength (HS) were also measured. All patients underwent a symptom-limited, graded exercise test on a cycle ergometer to derive peak

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2.

Results and Conclusions:
Height was significantly correlated with SL in the nonelderly group (r = 0.56, P = .010) but not in the elderly group. h

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2 was not correlated with SL or SL/height ratio. In the elderly group, O2 cost was negatively correlated with SL (r =−0.61, P = .027) but not with SL/height ratio. There was a significant correlation between HS and SL only in the elderly group (r = 0.58, P = .001). These results suggest that SL might be a useful index that reflects energy expenditure during walking in elderly patients with HF.
Effect of Diaphragm Postisometric Relaxation in Older Adults
Authors: Fronczek-Wojciechowska Magdalena , Mysłek Karolina , Sajek Aleksandra , Padula Gianluca , Kopacz Karolina 
Published: April 2019

Objective:
To analyze the diaphragm postisometric relaxation (PIR) effect in older people.

Subjects and Methods:
The study group comprised 23 people with a mean age of 65 (5) years. Examinations consisted of spirometry, pulse oximetry, chest circumference test, and palpation of diaphragm. Examination was done twice, before and after the program of exercises related to diaphragm PIR.

Results and Conclusions:
Slow vital capacity, maximal voluntary ventilation, chest mobility, and oxygen saturation were significantly higher after diaphragm PIR. Diaphragm tension improved in 30% of participants. PIR of diaphragm can improve respiratory parameters, chest mobility, and diaphragm tension without influence on the heart rate.
Influence of the Nordic Walking Intervention Program on the Improvement of Functional Parameters in Older Women
Authors: Panou Helen , Giovanis Vasilios , Tsougos Elias , Angelidis George 
Published: April 2019

Background:
Nordic Walking is a total body type of exercise that can be performed by nonathletes as a health-promoting physical activity.

Aims:
In the present study, we aimed to evaluate the impact of a Nordic Walking interventional program in older adults, with regard to the potential improvements in functional parameters.

Methods:
Thirty-five women (mean age: 67.86 years, SD: 4.44 years) participated in a 25-week Nordic Walking program, while 25 women (control group, mean age: 76.97 years, SD: 8.14 years) did not engage to any type of exercise during the same period. Functional parameters were assessed using the Senior Fitness Test and the Bosco Counter-Movement Jump Test at baseline and after the completion of the program.

Results:
In the experimental group, improvements were observed in all functional parameters assessed by the Senior Fitness Test, including strength, flexibility, movement coordination, dynamic balance, and aerobic capacity. No such correlations were found in the control group. Similarly, with regard to the parameters recorded using the Counter-Movement Jump Test, there was an improvement in strength from baseline to the final measurements.

Conclusions:
Our findings confirmed previous evidence regarding the beneficial effects of Nordic Walking on functional parameters in older adults.
Dynapenic Abdominal Obesity as a Risk Factor for Falls in Older Women
Authors: Pereira Juscelia Cristina , de Moraes Elias Julia , Neri Silvia G. R. , Gadelha André Bonadias , Lemos Rafael Raposo , Lima Ricardo M. 
Published: April 2019

Background:
The combination of dynapenia and central obesity has been introduced as dynapenic abdominal obesity (D/AO), but its relationship with falls-related phenotypes is unclear.

Objectives:
To investigate the association between D/AO, risk of falls, dynamic balance, and fear of falling in older women.

Design:
Cross-sectional study.

Methods:
A total of 217 women (68.03 ± 6.21 years) underwent waist circumference and handgrip measurements. Risk of falls (QuickScreen), the Timed Up and Go test, and fear of falling were also evaluated. Dynapenia was classified using the lower tertile of handgrip strength as cutoff value (20.67 kgf), while obesity was considered a waist circumference of greater than 88 cm; D/AO was the combination of both criteria.

Results:
Dynapenic abdominal obesity was associated with increased probability of falls (χ2 = 32.392; P < .001), reflecting decreased sit-to-stand performance (P = .001), reaction time (P < .001), peripheral sensation (P = .05), and postural balance (P = .05). Time to complete the Timed Up and Go test was significantly higher in D/AO group (P < .001). Finally, D/AO (30.08 ± 7.81) and abdominal obesity (27.77 ± 7.40) women presented increased fear of falling than normal (23.22 ± 5.50) and dynapenic (26.61 ± 8.33) groups (P < .05).

Conclusion:
Dynapenic abdominal obesity is associated with increased risk and fear of falls and reduced dynamic balance in older women. These relationships are stronger than those observed for obesity or dynapenia alone.
Transcranial Direct Current Stimulation Improves Cognitive Function in Mild to Moderate Alzheimer Disease
Authors: Cai Mengjie , Guo Zhiwei , Xing Guoqiang , Peng Haitao , Zhou Liang , Chen Huaping , McClure Morgan A. , He Lin , Xiong Liangwen , He Bin , Du Fei , Mu Qiwen 
Published: April 2019

Objective:
The purpose of this meta-analysis was to evaluate the therapeutic effect of transcranial direct current stimulation (tDCS) on mild to moderate Alzheimer disease (AD) patients.

Materials and Methods:
PubMed, Embase, Web of Science, and Cochrane Library were searched until April 2018. The primary cognitive outcomes were extracted from included articles. A crude standardized mean difference with 95% CI was calculated by using fixed or random effect models.

Results:
Seven studies with 146 patients were included in this meta-analysis. The pooled result showed that tDCS significantly improved cognitive function of AD patients (standardized mean difference=0.37; 95% CI, 0.09-0.65; P=0.01). Subgroup analyses showed that: a single session of tDCS was significantly effective (P<0.05) whereas repeated sessions of tDCS was not lower current density (0.06 mA/cm2) (P>0.05) but not higher current density (0.08 mA/cm2) significantly improved cognitive performance; stimulating the temporal cortex (P<0.05) but not the left dorsal lateral prefrontal cortex significantly improved cognitive function of AD patients; and improved cognitive function occurred in the group with higher education (P<0.05) but not in the group with lower education.

Conclusions:
Current evidence suggests that tDCS has a beneficial effect in mild to moderate AD patients. We must be cautious about the results of subgroup analysis given small sample sizes, and further well-designed studies with larger sample size are required to verify these results.
GenMap: Fast and Exact Computation of Genome Mappability
Authors: Pockrandt Christopher , Alzamel Mai , Iliopoulos Costas S. , Reinert Knut 
Published: April 2019

AbstractWe present a fast and exact algorithm to compute the (k, e)-mappability. Its inverse, the (k, e)-frequency counts the number of occurrences of each k-mer with up to e errors in a sequence. The algorithm we present is a magnitude faster than the algorithm in the widely used GEM suite while not relying on heuristics, and can even compute the mappability for short k-mers on highly repetitive plant genomes. We also show that mappability can be computed on multiple sequences to identify marker genes illustrated by the example of E. coli strains. GenMap allows exporting the mappability information into different formats such as raw output, wig and bed files. The application and its C++ source code is available on https://github.com/cpockrandt/genmap.
Thede novoreference genome and transcriptome assemblies of the wild tomato speciesSolanum chilense
Authors: Stam Remco , Nosenko Tetyana , Hörger Anja C. , Stephan Wolfgang , Seidel Michael , Kuhn José M.M. , Haberer Georg , Tellier Aurelien 
Published: April 2019

ABSTRACTBackgroundWild tomato species, likeSolanum chilense, are important germplasm resources for enhanced biotic and abiotic stress resistance in tomato breeding. In addition,S. chilenseserves as a model system to study adaptation of plants to drought and to investigate the evolution of seed banks. However to date, the absence of a well annotated reference genome in this compulsory outcrossing, very diverse species limits in-depth studies on the genes involved.FindingsWe generated ∼134 Gb of DNA and 157 Gb of RNA sequence data ofS chilense, which yielded a draft genome with an estimated length of 914 Mb in total encoding 25,885 high-confidence (hc) predicted gene models, which show homology to known protein-coding genes of other tomato species. Approximately 71% (18,290) of the hc gene models are additionally supported by RNA-seq data derived from leaf tissue samples. A benchmarking with Universal Single-Copy Orthologs (BUSCO) analysis of predicted gene models retrieved 93.3% BUSCO genes, which is in the current range of high-quality genomes for non-inbred plants. To further verify the genome annotation completeness and accuracy, we manually inspected the NLR resistance gene family and assessed its assembly quality. We revealed the existence of unique gene families of NLRs toS. chilense. Comparative genomics analyses ofS. chilense, cultivated tomatoS. lycopersicumand its wild relativeS. pennelliirevealed similar levels of highly syntenic gene clusters between the three species.ConclusionsWe generated the first genome and transcriptome sequence assembly for the wild tomato speciesSolanum chilenseand demonstrated its value in comparative genomics analyses. We make these genomes available for the scientific community as an important resource for studies on adaptation to biotic and abiotic stress inSolanaceae, on evolution of self-incompatibility, and for tomato breeding.
Estimating the Relative Probability of Direct Transmission between Infectious Disease Patients
Authors: Leavitt Sarah V , Lee Robyn S , Sebastiani Paola , Horsburgh Charles R. , Jenkins Helen E , White Laura F 
Published: April 2019

ABSTRACTBackgroundEstimating infectious disease parameters such as the serial interval (time between symptom onset in primary and secondary cases) and reproductive number (average number of secondary cases produced by a primary case) are important to understand infectious disease dynamics. Many estimation methods require linking cases by direct transmission, a difficult task for most diseases.MethodsUsing a subset of cases with detailed genetic or contact investigation data to develop a training set of probable transmission events, we build a model to estimate the relative transmission probability for all case-pairs from demographic, spatial and clinical data. Our method is based on naive Bayes, a machine learning classification algorithm which uses the observed frequencies in the training dataset to estimate the probability that a pair is linked given a set of covariates.ResultsIn simulations we find that the probabilities estimated using genetic distance between cases to define training transmission events are able to distinguish between truly linked and unlinked pairs with high accuracy (area under the receiver operating curve value of 95%). Additionally only a subset of the cases, 10-50% depending on sample size, need to have detailed genetic data for our method to perform well. We show how these probabilities can be used to estimate the average effective reproductive number and apply our method to a tuberculosis outbreak in Hamburg, Germany.ConclusionsOur method is a novel way to infer transmission dynamics in any dataset when only a subset of cases has rich contact investigation and/or genetic data.KEY MESSAGESThis method provides a way to calculate the relative probability that two infectious disease patients are connected by direct transmission using clinical, demographic, geographic, and genetic characteristics.We use a naïve Bayes, a machine learning technique to estimate these probabilities using a training set of probable links defined by contact investigation or pathogen WGS data on a subset of cases.These probabilities can be used to explore possible transmission chains, rule out transmission events, and estimate the reproductive number.