bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Readmission for Postpartum Preeclampsia [ID: 1378401]
Authors: Nienow-Birch Mary , Class Quetzal A. , Harrison Rachel , Owens Thomas 
Published: May 2023

INTRODUCTION:
Factors associated with preeclampsia with severe features (PSF) diagnosed on postpartum readmission are understudied, although important.

METHODS:
Patients were identified using ICD-9/10 codes of PSF diagnosed antenatally or postnatally between 2010 and 2019. We collected background and pregnancy characteristics via electronic medical records and used the Chicago Health Atlas to assign zip code-based socioeconomic hardship and education scores. Descriptive statistics and logistic regressions evaluated whether individual, pregnancy, and neighborhood factors predicted odds of readmission. Model 1 included age, body mass index (BMI), fetal growth restriction, urine protein, preterm delivery, and cesarean section. Model 2 added neighborhood factors, number of hypertensive medications at discharge, and length of delivery inpatient stay.

RESULTS:
Seven hundred forty-seven participants with PSF were identified, and 108 (14.8%) were diagnosed on postnatal readmission. Our sample was 68.8% Black, aged 29.0±6.8 years, with a mean BMI of 34.7±9.7 kg/m2. In model 1, older age was associated with an increased risk for readmission (adjusted odds ratio [aOR] 1.07, 95% CI 1.03–1.11) while the presence of proteinuria (aOR 0.38, 95% CI 0.24–0.61) and preterm birth (aOR 0.52, 95% CI 0.30–0.91) were associated with decreased risk for readmission. In model 2, older age (aOR 1.09, 95% CI 1.04–1.14) remained significantly associated with increased risk of readmission while the presence of proteinuria (aOR 0.24, 95% CI 0.12–0.45), more hypertensive medications given at discharge (aOR 0.44, 95% CI 0.24–0.82), and longer inpatient stay (aOR 0.60, 95% CI 0.40–0.92) showed decreased odds of readmission. No other studied factors were associated with readmission.

CONCLUSION:
Older mothers were consistently more at risk for readmission, while more intensive hypertensive treatment (higher number of medications, longer inpatient stay at delivery) protected against readmission.
High-Dose Steroids for Nonresolving Acute Respiratory Distress Syndrome in Critically Ill COVID-19 Patients Treated With Dexamethasone: A Multicenter Cohort Study*
Authors: Lopinto Julien , Arrestier Romain , Peiffer Bastien , Gaillet Antoine , Voiriot Guillaume , Urbina Tomas , Luyt Charles-Edouard , Bellaïche Raphaël , Pham Tái , Ait-Hamou Zakaria , Roux Damien , Clere-Jehl Raphaël , Azoulay Elie , Gaudry Stéphane , Mayaux Julien , Mekontso Dessap Armand , Canoui-Poitrine Florence , de Prost Nicolas 
Published: May 2023

OBJECTIVES:
To determine the impact of high doses of corticosteroids (HDCT) in critically ill COVID-19 patients with nonresolving acute respiratory distress syndrome (ARDS) who had been previously treated with dexamethasone as a standard of care.

DESIGN:
Prospective observational cohort study. Eligible patients presented nonresolving ARDS related to severe acute respiratory syndrome coronavirus 2 infection and had received initial treatment with dexamethasone. We compared patients who had received or not HDCT during ICU stay, consisting of greater than or equal to 1 mg/kg of methylprednisolone or equivalent for treatment of nonresolving ARDS. The primary outcome was 90-day mortality. We assessed the impact of HDCT on 90-day mortality using univariable and multivariable Cox regression analysis. Further adjustment for confounding variables was performed using overlap weighting propensity score. The association between HDCT and the risk of ventilator-associated pneumonia was estimated using multivariable cause-specific Cox proportional hazard model adjusting for pre-specified confounders.

SETTING:
We included consecutive patients admitted in 11 ICUs of Great Paris area from September 2020 to February 2021.

PATIENTS:
Three hundred eighty-three patients were included (59 in the HDCT group, 324 in the no HDCT group).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
At day 90, 30 of 59 patients (51%) in the HDCT group and 116 of 324 patients (35.8%) in the no HDCT group had died. HDCT was significantly associated with 90-day mortality in unadjusted (hazard ratio [HR], 1.60; 95% CI, 1.04–2.47; p = 0.033) and adjusted analysis with overlap weighting (adjusted HR, 1.65; 95% CI, 1.03–2.63; p = 0.036). HDCT was not associated with an increased risk of ventilator-associated pneumonia (adjusted cause-specific HR, 0.42; 95% CI, 0.15–1.16; p = 0.09).

CONCLUSIONS:
In critically ill COVID-19 patients with nonresolving ARDS, HDCT result in a higher 90-day mortality.
Determination of Orelabrutinib in Human Plasma Using LC-MS/MS
Authors: Zhao Yang , Guo Yu-Jiao , Chen Xiang-Long , Yang Yan-Ling , Ma Hong , Wang Yong-Qing , Sun Lu-Ning 
Published: May 2023

Background:
Orelabrutinib is a second-generation Bruton tyrosine kinase inhibitor that improves the management of B-cell malignancies. The objective of this study was to develop and validate an LC-MS/MS method for quantifying orelabrutinib in human plasma.

Methods:
Plasma samples were processed using acetonitrile to precipitate proteins. Ibrutinib-d5 was used as the internal standard. The mobile phase comprised 10 mM ammonium formate containing 0.1% formic acid and acetonitrile (62:38, vol/vol). The multiple reaction monitoring transitions at m/z = 428.1 → 411.2 and 446.2 → 309.2 were selected for orelabrutinib and ibrutinib-d5, respectively, after ionization in the positive mode.

Results:
Total runtime was 4.5 minutes. The validated curve ranges were 1.00–500 ng/mL. This method exhibited acceptable selectivity, dilution integrity, matrix effects, and recovery. Interrun and intrarun accuracy ranged from −3.4% to 6.5%, and interrun and intrarun precision was between 2.8% and 12.8%. Stability was studied under different conditions. The incurred sample reanalysis demonstrated good reproducibility.

Conclusions:
The LC-MS/MS method provided a simple, specific, and rapid quantification of orelabrutinib in the plasma of patients with mantle cell lymphoma or chronic lymphocytic leukemia/small lymphocytic lymphoma. The results indicated that orelabrutinib exhibits large variability between individuals and should be prudently used in combination with CYP3A4 inhibitors.
Long non-coding RNA TLR8-AS1 induces preeclampsia through increasing TLR8/STAT1 axis
Authors: Peng Chuyu , Zhu Jianbin , Guo Hong , Zhao Ling , Wu Feifei , Liu Bo 
Published: May 2023

Objective:
Our current study tried to assay the role of long noncoding RNAs (lncRNAs) TLR8-AS1 in regulating preeclampsia.

Methods:
TLR8-AS1 expression was examined in the clinical placental tissues of preeclampsia patients and the trophoblast cells induced by lipopolysaccharide (LPS). Then, different lentivirus was infected into trophoblast cells to study the role of TLR8-AS1 in cell functions. Furthermore, interactions among TLR8-AS1, signal transducer and activator of transcription 1 (STAT1) and toll-like receptor 8 (TLR8) were determined. A rat model of preeclampsia induced by N(omega)-nitro-L-arginine methyl ester was developed to validate the in-vitro findings.

Results:
High expression of TLR8-AS1 was detected in placental tissues of preeclampsia patients and LPS-induced trophoblast cells. In addition, overexpression of TLR8-AS1 arrested the proliferation, migration and invasion of trophoblast cells, which was related to the upregulation of TLR8 expression. Mechanistically, TLR8-AS1 recruited STAT1 to bind to the TLR8 promoter region, and thus promoted the transcription of TLR8. Meanwhile, overexpression of TLR8-AS1 was shown to aggravate preeclampsia by elevating TLR8 in vivo.

Conclusion:
Our study confirmed that TLR8-AS1 aggravated the progression of preeclampsia through increasing the expression of STAT1 and TLR8.
Blood pressure excursion on admission and intravenous thrombolysis in ischemic stroke
Authors: Du Linzhe , Zhang Yuqiao , Li Xiaohui , Liu Chengfang , Li Zhongyuan , Zhou Junshan , Liu Yukai 
Published: May 2023

Background:
Blood pressure (BP) excursion on admission was common in patients with acute ischemic stroke, but its influence on thrombolysis effect was not fully evaluated.

Methods:
Patients with acute ischemic stroke who received thrombolysis without subsequent thrombectomy were included. Admission BP excursion was defined as higher than 185/110 mmHg. Multivariate logistic regression analysis was used to evaluate the relationship between admission BP excursion and poor outcome as well as hemorrhage rates and mortality. Poor outcome was defined as a 90-day modified Rankin Scale score 3–6. Subgroup analysis was performed according to stroke severity, which was assessed by the National Institutes of Health Stroke Scale (NIHSS) score, and hypertension status.

Results:
A total of 633 patients were enrolled and 240 participants (37.9%) had admission BP excursion. Admission BP excursion was associated with poor outcome [adjusted odds ratio (OR) 0.64, 95% confidence interval 0.42–0.99, P = 0.046]. No significant difference was found regarding hemorrhage rates or mortality between patients with and without admission BP excursion. In subgroup analysis, admission BP excursion was related to poor outcome in patients with NIHSS score at least 7 (adjusted OR 1.89, 95% confidence interval 1.03–3.45, P = 0.038), but not in patients with NIHSS score less than 7 (P for interaction <0.001).

Conclusion:
Admission BP excursion above the guideline thresholds did not increase postthrombolysis hemorrhage risk or mortality, but was associated with poor outcome, especially in patients with severe stroke.
Overview of Guidelines for the Medical Treatment of Acute Kawasaki Disease in Japan (2020 Revised Version) and Positioning of Plasma Exchange Therapy in the Acute Phase
Authors: Mori Masaaki , Matsubara Tomoyo 
Published: May 2023

Background:
Kawasaki disease (KD) is a medium-sized vessel vasculitis of unknown origin that predominantly affects infants and young children. As KD causes cardiac complications such as coronary artery lesions, it is known as a disease that causes sudden death in children with acquired cardiac disease.

Methods:
The clinical trials of prednisolone, infliximab and cyclosporin A have led to the insurance coverage of these drugs in the treatment of KD, in addition to intravenous immunoglobulin therapy, which was already indicated for the treatment of KD. Despite not being a drug, plasma exchange therapy as a procedure was also approved for insurance coverage in Japan. Furthermore, new guidelines for KD treatment were published by the American Heart Association in 2017 and the Single Hub and Access Point for Paediatric Rheumatology in Europe in 2019. In light of these circumstances, the Japanese Society of Pediatric Cardiology and Cardiac Surgery guidelines were revised.

Conclusions:
Here, we provide an overview of the revised guidelines and mention the position and actual practice of plasma exchange therapy as one of the ultimate treatment modalities.
The 95% control lines on both confirmed cases and days of infection with COVID-19 were applied to compare the impact on public health between 2020 and 2021 using the hT-index
Authors: Chuang Hua-Ying , Kan Wei-Chih , Chien Tsair-Wei , Tsai Chia-Liang 
Published: May 2023

Background:
COVID-19, the disease caused by the novel coronavirus, is now a worldwide pandemic. The number of infected people has continually increased, and currently, this pandemic continues to present challenges to public health. Scatter plots are frequently used to interpret the impact in relation to confirmed cases. However, the 95% confidence intervals are rarely given to the scatter plot. The objective of this study was to; Develop 95% control lines on daily confirmed cases and infected days for countries/regions in COVID-19 (DCCIDC) and; Examine their impacts on public health (IPH) using the hT-index.

Methods:
All relevant COVID-19 data were downloaded from GitHub. The hT-index, taking all DCCIDCs into account, was applied to measure the IPHs for counties/regions. The 95% control lines were proposed to highlight the outliers of entities in COVID-19. The hT-based IPHs were compared among counties/regions between 2020 and 2021 using the choropleth map and the forest plot. The features of the hT-index were explained using the line chart and the box plot.

Results:
The top 2 countries measured by hT-based IPHs were India and Brazil in 2020 and 2021. The outliers beyond the 95% confidence intervals were Hubei (China), with a lower hT-index favoring 2021 ( = 6.4 in 2021 vs 15.55 in 2020) and higher hT indices favoring 2021 in Thailand (28.34 vs 14,77) and Vietnam (27.05 vs 10.88). Only 3 continents of Africa, Asia, and Europe had statistically and significantly fewer DCCIDCs (denoted by the hT-index) in 2021. The hT-index generalizes the h-index and overcomes the disadvantage without taking all elements (e.g., DCCIDCs) into account in features.

Conclusions:
The scatter plot combined with the 95% control lines was applied to compare the IPHs hit by COVID-19 and suggested for use with the hT-index in future studies, not limited to the field of public health as we did in this research.
Long-term results of huge deep-seated liposarcoma in the thigh: Two case reports
Authors: Wang Hyung Woo , Kim Youn Hwan , Park Seong Oh 
Published: May 2023

Rationale:
Liposarcoma is an uncommon malignant tumor that develops in the fatty tissue; thus, the long-term follow-up results of extremely large liposarcomas in the submuscular layer of the thigh have rarely been reported. Here we share the course and outcome of 2 cases of a huge deep-seated liposarcoma in the thigh.

Patient concerns:
Two patients visited our clinic, each with a deep-seated mass in the thigh. First, a 44-year-old man presented to the outpatient clinic with a left thigh mass. Approximately 1 year later, an 80-year-old man presented to the outpatient clinic with a right posterior thigh mass.

Diagnosis:
Magnetic resonance imaging revealed an approximately 14 × 8 × 21 cm well-differentiated liposarcoma between the sartorius and iliopsoas muscle and an approximately 14 × 12 × 31.5 cm lipomatous mass in the posterior compartment of the right thigh involving the right adductor muscles. After complete marginal resection, an excisional biopsy was performed to confirm the diagnosis.

Interventions:
Both patients underwent complete marginal resection without chemotherapy or radiotherapy.

Outcomes:
A biopsy showed a 20 × 17 × 7 cm well-differentiated, well-encapsulated liposarcoma in the 44-year-old man and a 30 × 17 × 10 cm well-differentiated liposarcoma in the 80-year-old man. These patients have achieved approximately 61 and 44 months of recurrence-free survival to date, respectively.

Lessons:
Here we described the long-term outcomes of 2 patients with a huge deep-seated liposarcoma in the lower extremity. Complete marginal excision of well-differentiated liposarcoma can achieve excellent recurrence-free survival.
Guillain-Barre syndrome and pulmonary embolism in an adult female with COVID-19 infection in Ghana: A case report
Authors: Tetteh-Wayoe Eugene , Duodu Fiifi , Pekyi-Boateng Prince Kwabla , Agyeman Badu Nana Boakye , Akpalu Albert , Adjei Patrick 
Published: May 2023

Introduction:
The coronavirus disease 2019 (COVID-19) pandemic began at the end of 2019 in Wuhan, the capital of Hubei Province, China. This novel coronavirus is classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurological manifestations are commonly associated with moderate to severe COVID-19 infection. Guillain-Barré syndrome (GBS) is a rare immune-mediated postinfectious neuropathy but there has been an increase in the number of cases of GBS associated with COVID-19, supporting the present body of global evidence of the notable association between the 2 conditions. We present the first proven case of GBS and pulmonary embolism associated with COVID-19 infection in Ghana, West Africa.

Case Presentation:
A 60-year-old apparently healthy female presented in August 2020 to the COVID-19 treatment center of the Korle-Bu Teaching Hospital in Accra, Ghana from a referral facility following a week’s history of low-grade fever, chills, rhinorrhoea, and generalized flaccid limb weakness. A positive SARS-CoV-2 test result was recorded 3 days after the onset of symptoms and the patient had no known chronic medical condition. Following cerebrospinal fluid analysis, neurophysiological studies and a chest computed tomography pulmonary angiogram, Guillain-Barre syndrome and pulmonary embolism were confirmed. The patient was however managed supportively and then discharged after 12 days on admission, as he made mild improvement in muscular power and function.

Conclusion:
This case report adds to the body of evidence of the association between GBS and SARS-CoV-2 infection, particularly from West Africa. It further highlights the need to anticipate potential neurological complications of SARS-CoV-2, particularly GBS even in mild respiratory symptoms for prompt diagnosis and initiation of appropriate therapy to improve outcomes and avert long-term deficits.
Contactin-associated protein-2 and anti-aquaporin-4 antibody positive autoimmune encephalitis secondary to herpes simplex encephalitis: A case report
Authors: Zhang Lin-Ming , Zhang Huan-Bo , Zou Yong-Fang , Liu Ming-Wei 
Published: May 2023

Rationale:
Recurrent herpes simplex encephalitis (HSE) can easily induce autoimmune encephalitis (AE). However, there are few reports of anti-contactin-associated protein-2 (CASPR2)-related encephalitis, especially with positive anti-aquaporin 4 (AQP4) antibodies.

Patient concerns:
A 14-year-old boy was admitted to the Department of Neurology of the First Affiliated Hospital of Kunming Medical University for “headache, dizziness, and fever for four days” with positive anti-CASPR2 and anti-AQP4 antibodies in the cerebrospinal fluid.

Diagnoses:
Cranial MRI showed lesions in the right hippocampus, amygdala, and insular lobe, with local sulcus enhancement in the right insular, temporal, and frontal lobes. The fluid-attenuated inversion recovery was significantly enhanced. Human herpes virus type I was detected by cerebrospinal fluid metagenomic testing. The patient was diagnosed with AE secondary to HSE, with positive anti-CASPR2 and anti-AQP4 antibodies.

Interventions:
After 2 weeks of immunoglobulin and methylprednisolone immunomodulatory therapy, acyclovir antivirus, mannitol dehydration, reducing intracranial pressure, and other symptomatic support therapy.

Outcomes:
The patient’s symptoms significantly improved, with no complaints of discomfort, and he was discharged for observation. The patient was followed up a month after discharge and had no complaints of discomfort.

Lessons:
CASPR2 and anti-aquaporin-4 antibody-positive AE have not been reported to be positive. This case will raise awareness of CASPR2 and anti-aquaporin-4 antibody-positive AE secondary to HSE, strengthen diagnostic capacities, and provide advice to treat it.
Effectiveness of techniques for insertion of nasoenteral probe in critical patients: Randomized clinical trial
Authors: Queiroz Cintia Galvão , Dantas Joyce Karolayne dos Santos , de Araújo Sara Cristina Matias , Rocha Mayara Araújo , Mendes Francisco De Cassio de Olivira , Medeiros Kleyton Santos , Dantas Daniele Vieira , Dantas Rodrigo Assis Neves 
Published: May 2023

Introduction:
despite being a common procedure, nasally placed small-bowel feeding tube insertion is not risk-free and can compromise patient safety. Due to the fact that nasally placed small-bowel feeding tube is commonly inserted ‘“blindly,” with the patient head in the neutral position, sometimes the process becomes difficult and traumatic, and may present higher level of complexity in physiological or induced coma and intubated patients. Therefore, adverse events (AEs) route errors can occur during this procedure. This study aimed to determine the effectiveness of different nasally placed small-bowel feeding tube insertion techniques in coma and intubated patients, in comparison with conventional method.

Methods:
A prospective, randomized and controlled clinical trial will be carried out with coma and intubated patients admitted to the Intensive Care Unit (ICU). Thirty-nine patients will be randomly divided into 3 groups: group who will have the tube inserted in a conventional manner with the head in the neutral position, group with the head positioned laterally to the right, and, finally, with the head in the neutral position, with assistance of a laryngoscope. The primary endpoint will be: first, second and total attempt success rate; and time required for the first successful attempt and the sum of all attempts. Complications during insertion included tube bending, twisting, knotting, mucosal bleeding, and insertion into the trachea. Patient vital signs will be measured.
Treatment of unstable C1 semi-ring fractures with direct C1 pedicle screw fixation using a navigational template: A case report and literature review
Authors: Dong Wei-Xin , Chu Zhen-Tao , Hu Yong 
Published: May 2023

Rationale:
Because of the risk of C1 to C2 instability, which would reduce the mobility of the occipito-atlanto-axis articulation, unstable C1 semi-ring fractures are typically treated with C1 to C2 or C0 to C2 fusion. The vertebral artery and spinal cord are at risk of harm during the installation of C1 pedicle screws. There is a need for a method that can maintain the occipito-atlanto-axis articulation’s mobility and increase the safety of C1 pedicle screw fixation, particularly for surgeons who have less experience inserting C1 pedicle screws freehand.

Patient concerns:
A 45-year-old man who had suffered a severe fall from a height of 2.5 m presented with pain in his cervical spine. Magnetic resonance imaging and computed tomography were used to diagnose unstable atlas fractures.

Diagnosis:
According to radiographic studies, the patient had a unilateral anterior and posterior arch fracture (semi-ring fracture, Landells type II), as well as fractures and transverse ligament avulsion at the attachment site.

Interventions:
We fixed the C1 directly with a pedicle screw using a navigational template.

Outcomes:
Both during and after the operation, there were no connected complications. Imaging at 12 months after surgery demonstrated that the fracture had united. The average visual analog scale score decreased from 8 before surgery to 2.

Lessons:
In particular for surgeons with less experience placing freehand C1 pedicle screws, direct C1 pedicle screw fixation with the aid of a navigational template was a good option because it can preserve the mobility of the occipito-atlanto-axis articulation and improve the safety of C1 pedicle screw.