bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic value of ultrasound elastography in triple negative breast cancer: A meta-analysis
Authors: Wang Fei , Wang Hongjiang 
Published: February 2023

Background:
The purpose of this study was to determine the value of ultrasound elastic imaging (UE) in the differential diagnosis of the 3 negative breast cancer (TNBC) and non-TNBC.

Methods:
We searched the PubMed, Cochrane Library, and CBM databases from inception to July 20, 2022 and used STATA version 14.0 and Meta-Disc version 1.4 software. We computed summary statistics for sensitivity (Sen), specificity, positive and negative likelihood ratio (LR+/LR−), diagnostic odds ratio, and summary receiver operating characteristic curves. Cochran Q-statistic and I2 test were used to assess potential heterogeneity between studies. Sen analysis was carried out to evaluate the effect of a single study on overall estimation. We also conducted a meta regression analysis to investigate potential sources of heterogeneity.

Results:
Nine studies that fulfilled all the criteria for acceptance were incorporated into the meta-analysis. TNBC 317 and non-TNBC 1055 cases were evaluated. All breast tumors were histologically confirmed. The pooled Sen was 0.78 (95% confidence interval [CI] = 0.58–0.90); the pooled specificity was 0.86 (95%CI = 0.78–0.91). The pooled LR+ was 5.46 (95%CI = 3.07–9.73); the pooled negative LR− was 0.26 (95%CI = 0.12–0.55). The pooled diagnostic odds ratio of UE was 21.00 (95% CI = 6.14–71.78). The area under the summary receiver operating characteristic curve was 0.89 (SE = 0.0378). No evidence was found to reveal bias (t = 0.10, P = .92).

Conclusion:
Our meta-analysis showed that UE could have high diagnostic accuracy in distinguishing TNBC and non-TNBC.
Balanced resuscitation: application to the paediatric trauma population
Authors: Georgette Nathan , Lipton Galina , Li Joyce 
Published: February 2023

Purpose of review
Trauma is the leading cause of death in children over 5 years old. Early mortality is associated with trauma-induced coagulopathy (TIC), with balanced resuscitation potentially mitigating the effects of TIC. We review TIC, balanced resuscitation and the best evidence for crystalloid fluid versus early blood products, massive transfusion protocol (MTP) and the optimal ratio for blood products.

Recent findings
Crystalloid fluids have been associated with adverse events in paediatric trauma patients. However, the best way to implement early blood products remains unclear; MTP has only shown improved time to blood products without clear clinical improvement. The indications to start blood products are also currently under investigation with several scoring systems and clinical indications being studied. Current studies on the blood product ratio suggest a 1 : 1 ratio for plasma:pRBC is likely ideal, but prospective studies are needed to further support its use.

Summary
Balanced resuscitation strategies of minimal crystalloid use and early administration of blood products are associated with improved morbidity in paediatric trauma patients but unclear mortality benefit. Current evidence suggests that the utilization of MTPs with 1 : 1 plasma:pRBC ratio may improve morbidity, but more research is needed.
Recommendations and effects of rehabilitation programs in older adults after hospitalization for COVID-19: A scoping review
Authors: Araya-Quintanilla Felipe , Sepulveda-Loyola Walter , Cuyul-Vásquez Ivan , Alvarez-Bustos Alejandro , Gutiérrez-Espinoza Héctor , Suziane Probst Vanessa , Camp Pat G. , Rodríguez-Mañas Leocadio 
Published: February 2023

Abstract
The aim of this review was to identify studies on physical rehabilitation programs, and to describe the potential effects on functional outcomes in patients older than 60 years at discharge from acute care post-COVID-19. The literature search was conducted in the MEDLINE, Cochrane CENTRAL, EMBASE, PEDro, LILACS, CINAHL, SPORTDiscus, Web of Science, and The Living OVerview of Evidence (L-OVE) COVID-19 databases. Studies with patients older than >60 years, hospitalized with COVID-19, and admitted to a rehabilitation program after discharge from acute care were included. Ten studies were included with a total of 572 patients. The prevalence of patients that received post-intensive care rehabilitation was 53% (CI 95% 0.27–0.79; p = 0.001). The rehabilitation program included physiotherapy in nine studies, occupational therapy in three studies, and psychotherapy in two studies. The rehabilitation programs increased the aerobic capacity, functional independence in basic activities of daily living, muscle strength, muscle mass, dynamic balance, physical performance, pulmonary function, quality of life, cognitive capacity and mental health. Multidisciplinary rehabilitation programs are necessary for older adults after hospitalization for COVID-19, especially those coming from intensive care units, as rehabilitation has a positive effect on important clinical outcomes.

PROSPERO registration number: CRD42021259740
Key Modifiable Factors in Community Participation Among Adults With Lower Limb Amputation
Authors: Sions Jaclyn Megan , Seth Mayank , Pohlig Ryan Todd , Stauffer Samantha Jeanne , Horne John Robert , Sarlo Frank Bernard 
Published: February 2023

Objective
The aim of the study is to identify factors that may predict community participation among adults with lower limb amputation.

Design
This study is a secondary analysis of a cross-sectional data set, including 126 community-dwelling adults, ≥1 yr after unilateral transfemoral- (n = 44; mean age = 59 ± 14 yrs) or transtibial-level amputation (n = 82; mean age = 59 ± 14 yrs) seen in an outpatient limb loss clinic. Participation was assessed with the Community Integration Questionnaire. Factors, that is, demographics, comorbidities, prosthesis use per the Houghton Scale, Socket Comfort Score, assistive device use, falls history, and activity level per General Practice Physical Activity Questionnaire were evaluated. Moreover, balance confidence per the Activities-Specific Balance Confidence Scale, mobility per the Locomotor Capabilities Index, fast and self-selected gait speed per 10-meter walk tests, and functional mobility via Timed Up and Go were also included.

Results
Community participation was correlated with several factors (P ≤ 0.050). Stepwise regression of correlated factors found absence of peripheral neuropathy and greater self-reported physical activity, balance confidence, and prosthesis use, as the strongest correlates, collectively explaining 50.1% of the variance in community participation post–lower limb amputation.

Conclusions
Findings identify key modifiable factors for consideration in future prospective research seeking to enhance community reintegration and participation among adults living with a unilateral transfemoral- or transtibial-level amputation.
Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study
Authors: Kent Michael S. , Hartwig Matthew G. , Vallières Eric , Abbas Abbas E. , Cerfolio Robert J. , Dylewski Mark R. , Fabian Thomas , Herrera Luis J. , Jett Kimble G. , Lazzaro Richard S. , Meyers Bryan , Reddy Rishindra M. , Reed Michael F. , Rice David C. , Ross Patrick , Sarkaria Inderpal S. , Schumacher Lana Y. , Spier Lawrence N. , Tisol William B. , Wigle Dennis A. , Zervos Michael 
Published: February 2023

Objective:
The aim of this study was to analyze overall survival (OS) of robotic-assisted lobectomy (RL), video-assisted thoracoscopic lobectomy (VATS), and open lobectomy (OL) performed by experienced thoracic surgeons across multiple institutions.

Summary Background Data:
Surgeons have increasingly adopted RL for resection of early-stage lung cancer. Comparative survival data following these approaches is largely from single-institution case series or administrative data sets.

Methods:
Retrospective data was collected from 21 institutions from 2013 to 2019. Consecutive cases performed for clinical stage IA–IIIA lung cancer were included. Induction therapy patients were excluded. The propensity-score method of inverse-probability of treatment weighting was used to balance baseline characteristics. OS was estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard models were used to evaluate association among OS and relevant risk factors.

Results:
A total of 2789 RL, 2661 VATS, and 1196 OL cases were included. The unadjusted 5-year OS rate was highest for OL (84%) followed by RL (81%) and VATS (74%); P=0.008. Similar trends were also observed after inverse-probability of treatment weighting adjustment (RL 81%; VATS 73%, OL 85%, P=0.001). Multivariable Cox regression analyses revealed that OL and RL were associated with significantly higher OS compared with VATS (OL vs. VATS: hazard ratio=0.64, P<0.001 and RL vs. VATS: hazard ratio=0.79; P=0.007).

Conclusions:
Our finding from this large multicenter study suggests that patients undergoing RL and OL have statistically similar OS, while the VATS group was associated with shorter OS. Further studies with longer follow-up are necessary to help evaluate these observations.
Recent advances in pharmacotherapy for epilepsy
Authors: Pong Amanda W. , Xu Kevin J. , Klein Pavel 
Published: February 2023

Purpose of review
Epilepsy affects 70 million people worldwide and is a significant cause of morbidity and early mortality. The mainstay of therapy is oral medications. Epilepsy drug development is escalating, driven by continued drug resistance in up to a third of epilepsy patients. Treatment development now focuses on discovery of novel mechanisms of action and syndrome-specific therapies

Recent findings
Difficult-to-treat epilepsy related to conditions including tuberous sclerosis complex (TSC), Lennox Gastaut syndrome (LGS) and Dravet syndrome (DS) have been the target of recent developments. Disease-modifying therapy for epilepsy related to TSC with vigabatrin at onset of first electroencephalographic epileptiform changes, rather than after first clinical seizure, has demonstrated strongly positive seizure and developmental outcomes. Fenfluramine, approved for DS and, more recently, LGS, has robust data supporting efficacy, safety/tolerability, as well as mortality, quality of life and cognitive function. Rescue therapy has expanded to include better tolerated benzodiazepines in the form of nasal midazolam and valium. Cenobamate, a first-in-class inactivator of the persistent voltage-gated sodium channel and approved for adult partial onset epilepsy, has exceptional efficacy and tolerability and will be expanded to children and to generalized onset epilepsy in adults.

Summary
The repertoire of available and developmental therapies for epilepsy is rapidly expanding, and now includes disease-modifying vigabatrin in TSC and agents with extraordinary efficacy, fenfluramine and cenobamate.
Update on current animal models for schizophrenia: are they still useful?
Authors: Uliana Daniela L. , Gomes Felipe V. , Grace Anthony A. 
Published: February 2023

Purpose of review
Schizophrenia is a psychiatric disorder that has a significant socioeconomic impact worldwide. Antipsychotic drugs targeting dopamine transmission alleviate psychotic symptoms but with limited efficacy and tolerability. Animal models have long proven useful for drug discovery. The continued need for new treatment highlights the importance of animal models to study schizophrenia. The lack of new therapeutic compounds combined with the shortcomings of clinical design studies potentially decreased the enthusiasm for animal model use.

Recent findings
In the current review, we discuss the central role of animal models for schizophrenia in providing new insights into neurobiological features and therapeutic development. The US National Institute of Mental Health released the Research Domain Criteria to guide preclinical model studies. Here, we point out the advances of this approach and debate its potential limitations when using animal models to study schizophrenia from the drug discovery perspective.

Summary
Cross-validated animal models for schizophrenia are crucial to comprehend the cause, pathophysiology, and behavioral and biological features of the disease, to advance prevention and treatment, and the need to carefully evaluate and select appropriate paradigms when investigating novel therapeutic targets.
Race, criminalization and urban mental health in the United States
Authors: Pamplin John R. , Kelsall Nora Clancy , Keyes Katherine M. , Bates Lisa M. , Prins Seth J. 
Published: February 2023

Purpose of review
As efforts to increase policing and roll back criminal legal system reforms in major U.S. cities rise, the collateral consequences of increased criminalization remain critical to document. Although the criminalization of mental illness has been well studied in the U.S., the mental health effects of criminalization are comparatively under-researched. In addition, despite extreme racial disparities in U.S. policing, there is limited understanding of how criminalization may contribute to racial disparities in mental health.

Recent findings
Literature included in this review covers various types of criminalization, including direct and indirect impacts of incarceration, criminalization of immigration, first-hand and witnessed encounters with police, and the effects of widely publicized police brutality incidents. All forms of criminalization were shown to negatively impact mental health (depression, anxiety and suicidality), with evidence suggestive of disproportionate impact on Black people.

Summary
There is evidence of significant negative impact of criminalization on mental health; however, more robust research is needed to address the limitations of the current literature. These limitations include few analyses stratified by race, a lack of focus on nonincarceration forms of criminalization, few longitudinal studies limiting causal inference, highly selected samples limiting generalizability and few studies with validated mental health measures.
Fingerstick blood assay maps real-world NAD+ disparity across gender and age
Authors: Wang Pei , Chen Meiting , Hou Yaying , Luan Jun , Liu Ruili , Chen Liuqing , Hu Min , Yu Qiuliyang 
Published: February 2023

AbstractNAD+level has been associated with various age-related diseases and its pharmacological modulation emerges as a potential approach for aging intervention. But human NAD+landscape exhibits large heterogeneity, and the lack of rapid, low-cost assays limits the establishment of NAD+baseline and the development of personalized therapies, especially for those with poor responses towards conventional NAD+supplementation. Here, we developed an automated NAD+analyzer for the rapid measurement of NAD+with 5 μL of capillary blood using a recombinant bioluminescent sensor protein and an automated optical reader. The minimal invasiveness of the assay allowed a frequent and decentralized mapping of real-world NAD+dynamics. We showed that sports and NMN supplementation can increase blood NAD+levels and that male on average has higher NAD+than female before the age of 50. We further revealed the long-term stability of human NAD+baseline over 100 days and identified the major real-world NAD+-modulating behaviors.
Higher Frequency and Mortality Rate of Antimicrobial-resistant Bloodstream Infections in Tertiary-care Hospitals Compared with Secondary-care Hospitals in Thailand
Authors: Lim Cherry , Hantrakun Viriya , Klaytong Preeyarach , Rangsiwutisak Chalida , Tangwangvivat Ratanaporn , phiancharoen Chadaporn , Doung-ngern Pawinee , Kripattanapong Somkid , Hinjoy Soawapak , Yingyong Thitipong , Rojanawiwat Archawin , Unahalekhaka Aekkawat , Kamjumphol Watcharaporn , Khobanan Kulsumpun , Leethongdee Phimrata , Lorchirachoonkul Narisorn , Khusuwan Suwimon , Siriboon Suwatthiya , Chamnan Parinya , Vijitleela Amornrat , Fongthong Traithep , Noiprapai Krittiya , Boonyarit Phairam , Srisuphan Voranadda , Sartorius Benn , Stelling John , Turner Paul , Day Nicholas PJ , Limmathurotsakul Direk 
Published: February 2023

AbstractThere are few studies comparing proportion, frequency, mortality and mortality rate of antimicrobial-resistant (AMR) bacterial infections between tertiary-care hospitals (TCHs) and secondary-care hospitals (SCHs) in low and middle-income countries (LMICs) to inform infection control strategies. We evaluated bloodstream infections (BSIs) from 2012 to 2015 in 15 TCHs and 34 SCHs in Thailand. There were differences in the proportions (%) of BSI caused by AMR strains for some pathogens between TCHs and SCHs. Of 19,665 patients with AMR BSI, 6,746 (34.3%) died. Among patients with AMR BSI, there were no or minimal differences in mortality proportion for all AMR pathogens between TCHs and SCHs. However, the frequency and mortality rates of AMR BSI were considerably higher in TCHs for most pathogens. For example, the mortality rate of hospital-origin carbapenem-resistantAcinetobacter baumanniiBSI in TCHs was nearly three times higher than that in SCHs (10.2 vs. 3.6 per 100,000 patient-days at risk, mortality rate ratio 2.77; 95% confidence interval 1.71 to 4.48, p<0.0001). Targets of and resources for antimicrobial stewardship and infection control programs in LMICs may need to be tailored based on hospital type and size, as burden of AMR infections could differ by hospital setting.
Association between calcium and vitamin D in geriatric patients hospitalized for Covid-19: Results from the GERIA-COVID study
Authors: Bourgeais Alexis , Gautier Jennifer , Sacco Guillaume , Annweiler Cédric , Asfar Marine 
Published: February 2023

ABSTRACTThe deficiency of 25OH vitamin D (25[OH]D) is common in the older population. It physiologically triggers secondary hyperparathyroidism resulting in normal circulating calcium levels. Adjusted calcium (CaA) is estimated by the PAYNE method and several studies report a misclassification of calcium status by corrected calcium compared to ionized calcium (CaI) in older patients. Hypocalcemia is common in older COVID-19 patients. Blunted secondary hyperparathyroidism explain this high prevalence of hypocalcemia in COVID-19. However, no studies have focused on patients older than 75 years despite the high mortality rate in this population. In the present study, the association between the different types of calcium (CaI, CaA, and total calcium [CaT]) and 25(OH)D deficiency (below 50 nmol/L) was investigated. The study of the correlation between each type of calcium was performed secondarily. Observational monocentric study focused on the GERIA-COVID database during the second wave of COVID-19 in France from October 2020 to March 2021. COVID-19 was diagnosed with RT-PCR and/or chest CT-scan. A population of 181 older COVID-19 patients (86.4 years ± 5.7) was analyzed. Sixty-three patients (34.8%) were deficient in 25(OH)D. The prevalence of total and ionized hypocalcemia was 44.1% and 39.2%, respectively. A negative association was reported in linear regression between 25(OH)D deficiency and CaA (β =-0.052 [- 0.093; -0.010], p = 0.015) as well as with CaT (β = -0.05 [-0.09; -0.01], p =0.034) in the multivariate model. No association was found between vitamin D deficiency and CaI. In the multivariate models, there was no association between each type of calcium and PTH. CaI was correlated with CaT (r = 0.39, p < 0.001) and with CaA (r = 0.15, p = 0.043). Secondary hyperparathyroidism was not activated in the context of COVID-19 in this study. After reviewing the literature, this appears to be the first study in older patients to expose such results.
Poor evidence for an effect of tecovirimat in shortening recovery time in hospitalized mpox cases from real-world data
Authors: Mazzotta V , Cozzi-Lepri A , Lanini S , Mondi A , Carletti F , Tavelli A , Gagliardini R , Vita S , Pinnetti C , Aguglia C , Faccendini P , Colavita F , Faraglia F , Beccacece A , Paulicelli J , Girardi E , Nicastri E , Vaia F , Maggi F , Antinori A 
Published: February 2023

AbstractObjectivesTo assess the effectiveness of tecovirimat (TPOXX) for treating mpox in terms of difference in healing time and extent of viral clearance.DesignEmulation of a target trial based on observational data.SettingItalyParticipantsForty-one men hospitalized for mpox as of September 29th, 2022.Main outcome measuresMain outcome was the time to clinical recovery. Secondary outcome was the variation in viral load in the upper respiratory tract (URT) after treatment.ResultsThe median time from symptoms onset to hospital admission and to initiation of TPOXX was 4 days (IQR 2-6) and 10 days (IQR 8-11), respectively. Fifteen patients completed a course of therapy. No deaths were observed; the overall median healing time was 21 days (IQR 17-26). We found no evidence for a significant improvement in recovery time in treated vs. untreated patients, with an estimated mean of 14.7 days for both groups. A subset of 13 patients had URT samples at T1 (median of 5 days (IQR 3-7) from symptoms onset) and T2 (median 7 days (IQR 7-9) from T1). Overall, mean viral load was 4.65 (0.30) vs. 4.91 (0.35) (log2 scale of cycle threshold) at T1 and T2, respectively. In the unadjusted analysis, variation over T1-T2 was lower in the treated 0.13 log2 (SD=0.53) vs. untreated 0.37 (0.50), although not statistically significant (unpaired t-test p=0.41). After controlling for confounding, there was no evidence for a difference in the potential changes over T1-T2 by treatment arm, and our estimate of the average treatment effect (ATE) was consistent with no difference by treatment group, although with large 95% CI around these estimates.ConclusionsOur analysis seems to exclude a clinically important effect of TPOXX in hospitalized mpox patients when compared to no treatment. These data are one of the valuable currently available sources of evidence to guide treatment decisions in patients hospitalized with TPOXX. Pending more robust data from randomized comparisons, the use of TPOXX should be restricted to the clinical trials setting.Trial registration“MpoxCohort” observational study protocol: approval number 40z, Register of Non-Covid Trials 2022.
A Compound Model of Multiple Treatment Selection with Applications to Marginal Structural Modeling
Authors: Stein David , D’Arinzo Lauren , Gaspar Fraser , Oliver Max , Fitzgerald Kristin , Lu Di , Piantadosi Steven , Amin Alpesh , Webb Brandon 
Published: February 2023

AbstractMethods of causal inference are used to estimate treatment effectiveness for non-randomized study designs. The propensity score (i.e., the probability that a subject receives the study treatment conditioned on a set of variables related to treatment and/or outcome) is often used with matching or sample weighting techniques to, ideally, eliminate bias in the estimates of treatment effect due to treatment decisions. If multiple treatments are available, the propensity score is a function of the adjustment set and the set of possible treatments. This paper develops a compound model that separates the treatment decision into a binary decision: treat or don’t treat; and a potential treatment decision: choose the treatment that would be given if the subject is treated. It is applicable if the treatment set is finite, treatments are given at one time point, and the outcome is observed at a fixed time point. This representation can reduce bias when not all treatments are available to all patients. Multiple treatment stabilized marginal structural weights were calculated with this approach, and the method was applied to an observational study to evaluate the effectiveness of different neutralizing monoclonal antibodies to treat infection with various severe acute respiratory syndrome coronavirus 2 variants.