bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenoidectomy in a child with Crouzon syndrome complicated with severe obstructive sleep apnea: Case report and review of literature
Authors: Yu Lei , Zhao Yuliang 
Published: June 2024

Rationale:
Crouzon syndrome is an extremely rare craniofacial dysplasia, which is mainly caused by the early ossification and closure of the coronal suture of the skull. Craniofacial deformities can cause stenosis of the nasal cavity and posterior nasal meatus, resulting in sleep apnea.

Patient concerns:
A 9-year-old boy with sleep snoring for 6 years, progressive aggravation in the past 1 month and accompanied by apnea during sleep.

Diagnoses:
This case was diagnosed with Crouzon syndrome complicated with severe obstructive sleep apnea and severe hypoxemia.

Interventions:
After adenoidectomy, he was admitted to the pediatric intensive care unit with ventilator-assisted respiration. During this period, the blood oxygen saturation fluctuated greatly. After trying to extubate, the blood oxygen was difficult to maintain and had to be intubated again. After active treatment, extubation was successful.

Outcomes:
The wound of nasopharynx recovered well and the sleep state was significantly improved 3 months postoperation.

Lessons:
It is suggested that the time of ventilator-assisted breathing should be prolonged and the perioperative airway management should be strengthened in order to reduce the risk of postoperative complications.
Effect of early initiation of noninvasive ventilation in patients transported by emergency medical service for acute heart failure
Authors: Gorlicki Judith , Masip Josep , Gil Víctor , Llorens Pere , Jacob Javier , Alquézar-Arbé Aitor , Domingo Baldrich Eva , Fortuny María José , Romero Marta , Esquivias Marco Antonio , Moyano García Rocío , Gómez García Yelenis , Noceda José , Rodríguez Pablo , Aguirre Alfons , López-Díez M. Pilar , Mir María , Serrano Leticia , Fuentes de Frutos Marta , Curtelín David , Freund Yonathan , Miró Òscar ,   on behalf of the ICA-SEMES research group
Published: June 2024

Background
While the indication for noninvasive ventilation (NIV) in severely hypoxemic patients with acute heart failure (AHF) is often indicated and may improve clinical course, the benefit of early initiation before patient arrival to the emergency department (ED) remains unknown.

Objective
This study aimed to assess the impact of early initiation of NIV during emergency medical service (EMS) transportation on outcomes in patients with AHF.

Design
A secondary retrospective analysis of the EAHFE (Epidemiology of AHF in EDs) registry.

Setting
Fifty-three Spanish EDs.

Participants
Patients with AHF transported by EMS physician-staffed ambulances who were treated with NIV at any time during of their emergency care were included and categorized into two groups based on the place of NIV initiation: prehospital (EMS group) or ED (ED group).

Outcome measures
Primary outcome was the composite of in-hospital mortality and 30-day postdischarge death, readmission to hospital or return visit to the ED due to AHF. Secondary outcomes included 30-day all-cause mortality after the index event (ED admission) and the different component of the composite primary endpoint considered individually. Multivariate logistic regressions were employed for analysis.

Results
Out of 2406 patients transported by EMS, 487 received NIV (EMS group: 31%; EMS group: 69%). Mean age was 79 years, 48% were women. The EMS group, characterized by younger age, more coronary artery disease, and less atrial fibrillation, received more prehospital treatments. The adjusted odds ratio (aOR) for composite endpoint was 0.66 (95% CI: 0.42–1.05). The aOR for secondary endpoints were 0.74 (95% CI: 0.38–1.45) for in-hospital mortality, 0.74 (95% CI: 0.40–1.37) for 30-day mortality, 0.70 (95% CI: 0.41–1.21) for 30-day postdischarge ED reconsultation, 0.80 (95% CI: 0.44–1.44) for 30-day postdischarge rehospitalization, and 0.72 (95% CI: 0.25–2.04) for 30-day postdischarge death.

Conclusion
In this ancillary analysis, prehospital initiation of NIV in patients with AHF was not associated with a significant reduction in short-term outcomes. The large confidence intervals, however, may preclude significant conclusion, and all point estimates consistently pointed toward a potential benefit from early NIV initiation.
Exploring Heterogeneity in Cost-Effectiveness Using Machine Learning Methods
Authors: Hattab Zaid , Doherty Edel , Sadique Zia , Ramnarayan Padmanabhan , O’Neill Stephen 
Published: June 2024

Objective:
The aim of this study was to explore heterogeneity in the cost-effectiveness of high-flow nasal cannula (HFNC) therapy compared with continuous positive airway pressure (CPAP) in children following extubation.

Design:
Using data from the FIRST-line support for Assistance in Breathing in Children (FIRST-ABC) trial, we explore heterogeneity at the individual and subgroup levels using a causal forest approach, alongside a seemingly unrelated regression (SUR) approach for comparison.

Settings:
FIRST-ABC is a noninferiority randomized controlled trial (ISRCTN60048867) including children in UK paediatric intensive care units, which compared HFNC with CPAP as the first-line mode of noninvasive respiratory support.

Patients:
In the step-down FIRST-ABC, 600 children clinically assessed to require noninvasive respiratory support were randomly assigned to HFNC and CPAP groups with 1:1 treatment allocation ratio. In this analysis, 118 patients were excluded because they did not consent to accessing their medical records, did not consent to follow-up questionnaire or did not receive respiratory support.

Measurements and Main Results:
The primary outcome of this study is the incremental net monetary benefit (INB) of HFNC compared with CPAP using a willingness-to-pay threshold of £20,000 per QALY gain. INB is calculated based on total costs and quality adjusted life years (QALYs) at 6 months. The findings suggest modest heterogeneity in cost-effectiveness of HFNC compared with CPAP at the subgroup level, while greater heterogeneity is detected at the individual level.

Conclusions:
The estimated overall INB of HFNC is smaller than the INB for patients with better baseline status suggesting that HFNC can be more cost-effective among less severely ill patients.
Central Positional Nystagmus Can Be the Sole Presentation of Cerebellar Nodulus Infarction
Authors: Baskan Gülcan Neşem , Çelebisoy Neşe 
Published: June 2024

Objectives:
To draw attention to acute positional vertigo and central positional nystagmus (CPN) developing as the sole features of cerebellar nodulus infarction.

Background:
The cerebellar nodulus is vascularized by the medial branch of the posterior inferior cerebellar artery, which also supplies the uvula, tonsil, tuber, and pyramid of the vermis, and the inferior part of the cerebellar hemisphere, making isolated cerebellar nodulus infarction extremely rare. CPN occurs after a change in head position with respect to gravity and is caused by pathologies involving the vestibulo-cerebellar pathways. CPN is rarely seen in isolation. Additional neurological signs and ocular motor abnormalities are generally present.

Methods:
A 62-year-old man was admitted to the emergency department with acute-onset positional vertigo and CPN as the sole finding on examination. Cranial magnetic resonance imaging revealed an acute infarction involving the nodulus. Results: Infarcts restricted to nodulus can cause positional vertigo and CPN without any associated neurological signs or ocul ar motor abnormalities.

Conclusion:
Though very rare, cerebellar nodulus stroke must be searched in patients with positional vertigo of acute onset and isolated CPN on examination.
Objective Assessment of Cognitive Workload in Surgery
Authors: Almukhtar Aws , Caddick Virginia , Naik Ravi , Goble Mary , Mylonas George , Darzi Ara , Orihuela-Espina Felipe , Leff Daniel R. 
Published: June 2024

Objective:
To systematically review technologies that objectively measure CWL in surgery, assessing their psychometric and methodological characteristics.

Summary Background Data:
Surgical tasks involving concurrent clinical decision-making and the safe application of technical and non-technical skills require a substantial cognitive demand and resource utilization. Cognitive overload leads to impaired clinical decision-making and performance decline. Assessing cognitive workload (CWL) could enable interventions to alleviate burden and improve patient safety.

Methods:
Ovid MEDLINE, OVID Embase, the Cochrane Library and IEEE Xplore databases were searched from inception to August 2023. Full-text, peer-reviewed original studies in a population of surgeons, anesthesiologists or interventional radiologists were considered, with no publication date constraints. Study population, task paradigm, stressor, Cognitive Load Theory (CLT) domain, objective and subjective parameters, statistical analysis and results were extracted. Studies were assessed for a) definition of CWL, b) details of the clinical task paradigm, and c) objective CWL assessment tool. Assessment tools were evaluated using psychometric and methodological characteristics.

Results:
10790 studies were identified; 9004 were screened; 269 full studies were assessed for eligibility, of which 67 met inclusion criteria. The most widely used assessment modalities were autonomic (32 eye studies and 24 cardiac). Intrinsic workload (e.g. task complexity) and germane workload (effect of training or expertize) were the most prevalent designs investigated. CWL was not defined in 30 of 67 studies (44.8%). Sensitivity was greatest for neurophysiological instruments (100% EEG, 80% fNIRS); and across modalities accuracy increased with multi-sensor recordings. Specificity was limited to cardiac and ocular metrics, and was found to be sub-optimal (50% and 66.67%). Cardiac sensors were the least intrusive, with 54.2% of studies conducted in naturalistic clinical environments (higher ecological validity).

Conclusion:
Physiological metrics provide an accessible, objective assessment of CWL, but dependence on autonomic function negates selectivity and diagnosticity. Neurophysiological measures demonstrate favorable sensitivity, directly measuring brain activation as a correlate of cognitive state. Lacking an objective gold standard at present, we recommend the concurrent use of multimodal objective sensors and subjective tools for cross-validation. A theoretical and technical framework for objective assessment of CWL is required to overcome the heterogeneity of methodological reporting, data processing, and analysis.
Basic life support training for intensive care unit nurses at a general hospital in Tabriz, Iran: a best practice implementation project
Authors: Kabiri Neda , Hajebrahimi Sakineh , Soleimanpour Maryam , Ardebili Roghayeh Asghari , Kashgsaray Nasim Hajipoor , Soleimanpour Hassan 
Published: June 2024

ABSTRACTIntroduction and objectives:Basic life support (BLS) is foundational to the care delivered to cardiac arrest victims. This study evaluated current practices and implemented best practices related to BLS training for intensive care unit (ICU) nurses in a general hospital in Tabriz, Iran.Methods:This interventional before-after study was informed by the JBI Evidence Implementation Framework. An audit, feedback, and re-audit strategy was used to measure baseline compliance with best practices, develop an implementation strategy to address gaps in compliance, and undertake a final evaluation to measure changes in compliance. The JBI Practical Application of Clinical Evidence System (JBI PACES) and situational analysis Getting Research into Practice (GRiP) tool were used to support data collection and implementation planning. There were 13 evidence-based criteria and a sample of 9 ICU nurses.Results:The baseline audit revealed gaps between current practice and best practice in 9 of the 13 criteria. Barriers included insufficient education tools and programs, insufficient supervision, lack of skills laboratories, and a lack of continuous BLS education. Improvement strategies included providing a human stimulator manikin, developing an education program for nurses, as well as establishing a cardiopulmonary-cerebral resuscitation department, a skills laboratory, and continuous BLS education based on the American Heart Association guidelines. The follow-up audit revealed improvement of 100% across all criteria.Conclusions:This project indicates that a clinical audit is effective for assessing evidence-based BLS education for ICU nurses, thereby improving resuscitation performance and patient outcomes.Spanish abstract:http://links.lww.com/IJEBH/A213
The Effects of Functional Training on Muscle Strength in Athletes: A Meta-Analysis
Authors: Liu Junyan , Lei Shang , Yu Hongjun 
Published: June 2024

The study aimed to analyze the effects of functional training (FT) on athletes muscle strength compared to traditional resistance training (TRT). A systematic search was conducted in 6 databases from inception to January 2024. Baseline and outcome measures from randomized controlled trials (RCT) were assessed for the impact of FT on athlete muscle strength, across sex, age, and sports levels. Hedge's g effect sizes were calculated using a random-effects model, and subgroup and single training factor analyses were performed to address potential sources of heterogeneity, along with a meta-regression analysis. The inclusion of 67 studies involving 1718 athletes revealed significant moderate to large effects of FT on maximum strength (k=11; ES=2.68; ≤0.001) , power (k=12; ES=0.68; p?0.001), as well as muscle endurance(k=12; ES=4.13; p?0.001).In conclusion, FT appears to offer potential benefits for enhancing muscle strength in athletes, with considerations for individual differences in sex, age, and training programs. Findings suggest that longer training sessions may be associated with improvements in maximum strength and muscle endurance, whereas shorter sessions might be more conducive to power development. Additionally, preliminary evidence hints that younger athletes may experience more pronounced training benefits, though this observation requires further investigation to establish a more definitive correlation.
A Non-Invasive and Non-Contact Jugular Venous Pulse Measurement: A Feasibility Study
Authors: Das Shatabdi , Dwivedi Girish , Afsharan Hadi , Kavehei Omid 
Published: June 2024

AbstractThe Jugular Venous Pulse (JVP) is a vital gauge of proper heart health, reflecting the venous pressure via the Jugular Vein observation. It offers crucial insights for discerning numerous cardiac and pulmonary conditions. Yet, its evaluation is often over-shadowed by the challenges in its process, especially in patients with neck obesity obstructing visibility. Although central venous catheterization provides an alternative, it is invasive and typically reserved for critical cases. Traditional JVP monitoring methods, both visual and via catheterization, present significant hurdles, limiting their frequent application despite their clinical significance. Therefore, there is a pressing need for a non-invasive, efficient JVP monitoring method accessible for home-based and hospitalized patients. Such a method could preempt numerous hospital admissions by offering early indicators. We introduce a non-invasive method using a frequency-modulated continuous wave (FMCW) radar for JVP estimation directly from the skin surface. Our signal processing technique involves an eigen beamforming method to enhance the signal-to-noise ratio for better estimation of JVP. By meticulously fine-tuning various parameters, we identified the optimal settings to enhance the JVP signal quality. In addition, we performed a detailed morphological analysis comparing the JVP and photoplethysmography signals. Our investigation effectively achieved signal localization within a Direction of Arrival (DoA) range from -20° to 20°. This initial study validates the effectiveness of using a 60 GHz far-field radar in measuring JVP.Abstract Figure
Characterization of Viroplasm-Like Structures by Co-Expression of NSP5 and NSP2 Across Rotavirus Species A to J
Authors: Lee Melissa , Cosic Ariana , Tobler Kurt , Aguilar Claudio , Fraefel Cornel , Eichwald Catherine 
Published: June 2024

AbstractRotaviruses (RV) are classified into nine species, A-C and D-J, with species A being the most studied. In rotavirus of species A (RVA), replication occurs in viroplasms, which are cytosolic globular inclusions primarily composed of the proteins NSP5, NSP2, and VP2. The co-expression of NSP5 with either NSP2 or VP2 leads to the formation of viroplasm-like structures (VLS). Although morphologically identical to viroplasms, VLSs cannot replicate, but they serve as excellent simplified tools for studying complex viroplasms.There is a knowledge gap regarding viroplasms of non-RVA species due to a lack of research tools, such as specific antibodies and tissue culture systems. In this study, we explored the ability of NSP5 and NSP2 from non-RVA species to form VLSs. The co-expression of these two proteins led to globular VLSs in RV species A, B, D, F, G, and I, while RVC formed filamentous VLSs. The co-expression of NSP5 and NSP2 of RV species H and J did not result in VLS formation.Interestingly, NSP5 of all RV species self-oligomerizes, with the ordered C-terminal region, termed the tail, being necessary for self-oligomerization of RV species A-C and G-J. Except for NSP5 from species J, all NSP5 bound with their respective NSP2. We also found that interspecies VLS are formed between closely related RV species B with G and D with F. Additionally, VLS from RVH and RVJ formed when the tail of NSP5 RVH and RVJ was replaced by the tail of NSP5 from RVA and co-expressed with their respective NSP2.ImportanceRotaviruses (RV) are classified into nine species, A-D and F-J, infecting mammals and birds. Due to the lack of research tools, all cumulative knowledge on RV replication is based on RV species A (RVA). The RV replication compartments are globular cytosolic structures named viroplasms, which have only been identified in RV species A. In this study, we examined the formation of viroplasm-like structures (VLS) by the expression of NSP5 with NSP2 across RV species A to J. Globular VLSs formed for RV species A, B, D, F, G, and I, while RV species C formed filamentous structures. The RV species H and J did not form VLS with NSP5 and NSP2. Similar to RVA, NSP5 self-oligomerizes in all RV species, which is a requirement for VLS formation. This study provides basic knowledge of the non-RVA replication mechanisms, which could help develop strategies to halt virus infection across RV species.
Understanding brewing trait inheritance inde novolager yeast hybrids
Authors: Zavaleta Vasni , Pérez-Través Laura , Saona Luis A. , Villarroel Carlos A. , Querol Amparo , Cubillos Francisco A. 
Published: June 2024

ABSTRACTHybridization betweenSaccharomyces cerevisiaeandSaccharomyces eubayanusresulted in the emergence ofS. pastorianus, a crucial yeast for lager fermentation. However, our understanding of hybridization success and hybrid vigour between these two species remains limited due to the scarcity ofS. eubayanusparental strains. Here, we explore hybridization success and the impact of hybridization on fermentation performance and volatile compound profiles in newly formed lager hybrids. By selecting parental candidates spanning a diverse array of lineages from both species, we reveal that the Beer and PB-2 lineages exhibit high rates of hybridization success inS. cerevisiaeandS. eubayanus, respectively. Polyploid hybrids were generated through rare mating techniques, revealing a prevalence of triploids and diploids over tetraploids. Despite the absence of heterosis in fermentative capacity, hybrids displayed phenotypic variability, notably influenced by maltotriose consumption. Interestingly, ploidy levels did not significantly correlate with fermentative capacity, although triploids exhibited greater phenotypic variability. TheS. cerevisiaeparental lineages primarily influenced volatile compound profiles, with significant differences in aroma production. Interestingly, hybrids emerging from the BeerS. cerevisiaeparental lineages exhibited a volatile compound profile resembling the correspondingS. eubayanusparent. This pattern may result from the dominant inheritance of theS. eubayanusaroma profile, as suggested by the over-expression of genes related to alcohol metabolism and acetate synthesis in hybrids including the BeerS. cerevisiaelineage. Our findings suggest complex interactions between parental lineages and hybridization outcomes, highlighting the potential for creating yeasts with distinct brewing traits through hybridization strategies.
Effect of PCI on Clinical Prognosis of Chronic Coronary Artery Occlusion
Authors: Jiang Lei , Wang Mei , Liu Pu , Liang Dong , Wang Jiangpeng , Meng Haoyu , Kong Xiangqing , Chen Leilei 
Published: June 2024

AbstractBackgroundCoronary chronic total occlusions (CTOs) are considered to increase the risk of adverse clinical outcomes. The purpose of this study was to evaluate whether long-term clinical outcomes could be improved by successful percutaneous coronary intervention (PCI) over optimal medical therapy (OMT) in CTO patients.Methods258 consecutive patients with CTO lesions undergoing PCI at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2017 were enrolled. After 25 were excluded due to CABG surgery, a total of 233 patients who met the enrollment criteria were divided into successful CTO-PCI group (n=187) and CTO-OMT group (n=46) based on the treatment received. The study primary endpoint was major adverse cardiac cerebrovascular events (MACCE), including cardiac death, recurrent myocardial infarction, unplanned revascularization, and stroke. The secondary endpoint was all-cause death.ResultsDuring a median follow-up of 78 months, PCI treatment significantly improved MACCE incidence survival probability compared with OMT (29.55% vs 21.95% p=0.028). There was no difference between these two groups in secondary endpoint (p=0.93). There was also no significant difference in MACCE between single vessel CTO lesions and single vessel CTO combined with multiple vessel lesions(p=0.54). The cumulative survival of LAD is the highest among different branch lesion groups(p=0.044). Elderly patients (≥65 years) in PCI group showed a significant decrease of MACCE incidence compared with OMT (35.00% vs 21.33% p=0.001).ConclusionsSuccessful PCI in CTO patients is associated with a significant decrease of MACCE compared with OMT.
In-Scanner Thoughts shape Resting-state Functional Connectivity: how participants “rest” matters
Authors: Gonzalez-Castillo J , Spurney MA , Lam KC , Gephart IS , Pereira F , Handwerker DA , Kam JWY , Bandettini PA 
Published: June 2024

AbstractResting-state fMRI (rs-fMRI) scans—namely those lacking experimentally-controlled stimuli or cognitive demands—are often used to identify aberrant patterns of functional connectivity (FC) in clinical populations. To minimize interpretational uncertainty, researchers control for across-cohort disparities in age, gender, co-morbidities, and head motion. Yet, studies rarely, if ever, consider the possibility that systematic differences in inner experience (i.e., what subjects think and feel during the scan) may directly affect FC measures. Here we demonstrate that is the case using a rs-fMRI dataset comprising 471 scans annotated with experiential data. Wide-spread significant differences in FC are observed between scans that systematically differ in terms of reported in-scanner experience. Additionally, we show that FC can successfully predict specific aspects of in-scanner experience in a manner similar to how it predicts demographics, cognitive abilities, clinical outcomes and labels. Together, these results highlight the key role of in-scanner experience in shaping rs-fMRI estimates of FC.