bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study
Authors: Mathew Jithin , Jain Siddharth , Susngi Terence , Naidu Shankar , Dhir Varun , Sharma Aman , Jain Sanjay , Sharma Shefali Khanna 
Published: February 2023

AbstractObjectiveThere is dearth of data regarding the outcomes of coronavirus disease 2019 (COVID-19) among rheumatic and musculoskeletal disease (RMD) patients from Southeast Asia. We report the clinicodemographic profile and identify predictors of COVID-19 outcomes in a large cohort of Indian RMD patients.MethodsThis prospective cohort study, carried out at the Postgraduate Institute of Medical Education and Research, Chandigarh (a tertiary care centre in India), included RMD patients affected with COVID-19 between April 2020 and October 2021. Demographic and clinical and laboratory details of COVID-19 and underlying RMD were noted. Predictors of mortality, hospitalization and severe COVID-19 were identified using stepwise multivariable logistic regression.ResultsA total of 64 severe acute respiratory syndrome coronavirus-2-infected RMD patients [age 41.5 (19–85) years; 46 (72%) females] were included. Eighteen (28%) patients had severe COVID-19. Twenty-three (36%) required respiratory support [11 (17%) required mechanical ventilation]. Thirty-six (56%) patients required hospitalization [median duration of stay 10 (1–42) days]; 17 (27%) required intensive care unit admission. Presence of co-morbidities [odds ratio (OR) = 4.5 (95% CI: 1.4, 14.7)] was found to be an independent predictor of COVID-19 severity. Co-morbidities [OR = 10.7 (95% CI: 2.5, 45.4)] and underlying lupus [OR = 7.0 (95% CI: 1.2, 40.8)] were independently associated with COVID-19 hospitalization. Ongoing rheumatic disease activity [OR = 6.8 (95% CI: 1.3, 35.4)] and underlying diagnosis of lupus [OR = 7.1 (95% CI: 1.2, 42.4)] and SSc [OR = 9.5 (95% CI: 1.5, 61.8)] were found to be strong independent predictors of mortality. Age, sex, underlying RMD-associated interstitial lung disease and choice of immunosuppressive therapy were not associated with COVID-19 severity or adverse outcomes.ConclusionThe presence of co-morbidities was independently associated with COVID-19 severity and hospitalization. Ongoing rheumatic disease activity and the presence of lupus or SSc independently predicted mortality. Age, sex, type of immunosuppressive therapy and presence of RMD-associated interstitial lung disease did not affect COVID-19 severity or outcomes in Indian RMD patients.
Mission-oriented innovation policy as a hybridisation process: the case of transforming a national fertilising system
Authors: Nylén Erkki-Jussi , Johanson Jan-Erik , Vakkuri Jarmo 
Published: February 2023

Abstract
Policymakers and researchers have discussed mission-oriented innovation policies (MIPs) as one way to tackle the grand challenges of modern societies. Our contribution to MIP research is to provide a case analysis of the unfolding of such a policy from a hybridity perspective. Hybridity refers to the amalgamation of public policies, private efforts, and voluntary activities when pursuing societal aims. In practice, hybridity integrates value propositions from governments, markets, and civil society. Our case study subject is the Finnish nutrient recycling (NR) policy. The NR policy aims to supersede the dominance of chemical fertilisers with organic fertilisers. We analysed forms of hybridity and hybrid constellations of actors that were initiated as part of the Finnish NR policy. Subsequently, we analysed how the value-creation mechanisms of legitimising, compromising, and mixing appear in the NR policy. As a result, we conceptualised what the process of hybridisation entails in the context of MIPs.
Cytotoxic and genotoxic effects of leaking chemicals from serum infusion sets: an in-vitro study
Authors: Özlü Ayşegül , Taner Gökçe 
Published: February 2023

Abstract
Safety concerns about medical devices playing important role in health sciences and bioengineering research are rising day by day. Although there are specific standards regarding disposable medical materials, the information is updating with the toxicological studies. In this study, cytotoxic/genotoxic effects of chemicals leaking from serum infusion sets that have an important place in the clinic were investigated. Media containing leakage chemicals were prepared from equal samples taken from the plastic line sections of 13 different brands of serum infusion sets containing phthalates and the effects on the cultured cells were compared with the untreated control groups. To obtain leaking chemicals, extracting period was selected as 72 h, a routine set-change time in the clinic as indicated in various publications. Neutral red uptake and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tests were performed in L929 cells to determine cytotoxicity, and cytokinesis blocked micronucleus technique was performed in lymphocytes to determine genotoxicity. Cytotoxic and genotoxic damage levels were compared by evaluating cell-viability rates relative to control, micronucleus frequency, and nuclear division index values. The results showed that all sets caused a decrease in cell viability revealing the effects both on lysosomal and mitochondrial activity and increase in micronucleus frequencies in general. The number of similar studies is extremely limited, and in this study in addition to the short-term effects of using the serum infusion sets, the information about the sample tests to determine the biosecurity of disposable medical materials is given.
Research on virtual coupling technology in rail transit train collision protection
Authors: Li Gaosong , Zou Jinbai , Ma Weijie , Lan Meng 
Published: February 2023

Abstract
In the research on the new generation of intelligent rail transit system, the prevention of train collision accidents is still a focus. Virtual coupling technology controls the running speed and interval distance of two or more trains cooperatively through Train-to-Train (T2T) direct communication technology. The aim is to form a coordinated logical system and jointly complete the train control and dispatching. In this paper, a virtual coupling train formation control method based on the model predictive control (MPC) framework is proposed. From the establishment of the virtual coupling system, the construction of an MPC model and decoupling method, how to integrate virtual coupling technology into the rail transit train collision protection is studied. The safety and reliability of the system are calculated through fault tree and the method of constructing reliability function. The research shows that if virtual coupling technology is used for train collision protection, the overall safety and reliability of the train control system is improved.
Elucidating the Obligate Nature and Biological Capacity of an Invasive Fungal Corn Pathogen
Authors: MacCready Joshua S. , Roggenkamp Emily M. , Gdanetz Kristi , Chilvers Martin I. 
Published: February 2023

Tar spot is a devasting corn disease caused by the obligate fungal pathogen Phyllachora maydis. Since its initial identification in the United States in 2015, P. maydis has become an increasing threat to corn production. Despite this, P. maydis has remained largely understudied at the molecular level, due to difficulties surrounding its obligate lifestyle. Here, we generated a significantly improved P. maydis nuclear and mitochondrial genome, using a combination of long- and short-read technologies, and also provide the first transcriptomic analysis of primary tar spot lesions. Our results show that P. maydis is deficient in inorganic nitrogen utilization, is likely heterothallic, and encodes for significantly more protein-coding genes, including secreted enzymes and effectors, than previous determined. Furthermore, our expression analysis suggests that, following primary tar spot lesion formation, P. maydis might reroute carbon flux away from DNA replication and cell division pathways and towards pathways previously implicated in having significant roles in pathogenicity, such as autophagy and secretion. Together, our results identified several highly expressed unique secreted factors that likely contribute to host recognition and subsequent infection, greatly increasing our knowledge of the biological capacity of P. maydis, which have much broader implications for mitigating tar spot of corn. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Early Factors Predictive of Extreme High and Low Life Satisfaction 10 Years Post–Moderate to Severe Traumatic Brain Injury
Authors: O'Neil-Pirozzi Therese M. , Sevigny Mitch , Pinto Shanti M. , Hammond Flora M. , Juengst Shannon B. 
Published: February 2023

Objective:
To identify demographic, injury-related, and 1-year postinjury clinical and functional predictors of high and low life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach.

Setting:
Multicenter longitudinal database study.

Participants:
A total of 3040 people from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Model Systems database with life satisfaction data at 10 years post-TBI.

Design:
Multicenter, cross-sectional, observational design.

Main Measures:
Satisfaction With Life Scale (outcome), Glasgow Coma Scale, Disability Rating Scale, Functional Independence Measure, Participation Assessment with Recombined Tools-Objective, Patient Health Questionnaire-9, and General Anxiety Disorder-7 (standardized predictors).

Results:
Greater cognitive and motor independence, more frequent community participation, and less depressive symptoms 1 year post–moderate to severe TBI predicted extreme high life satisfaction 10 years later. Non-Hispanic White and Hispanic individuals were significantly more likely than Black individuals to have extreme high life satisfaction 10 years post-TBI.

Conclusions:
Extreme phenotyping analysis complements existing knowledge regarding life satisfaction post–moderate to severe TBI. From a chronic disease management perspective, future studies are needed to examine the feasibility and impact of early postinjury medical and rehabilitative interventions targeting cognitive and motor function, community participation, and mood on the maintenance/enhancement of long-term life satisfaction post-TBI.
Neck Symptoms and Associated Clinical Outcomes in Patients Following Concussion
Authors: Oyekan Anthony A. , Eagle Shawn , Trbovich Alicia M. , Shaw Jeremy D. , Schneider Michael , Collins Michael , Lee Joon Y. , Kontos Anthony P. 
Published: February 2023

Objective:
To examine the frequency and association of neck pain symptoms in patients with a concussion.

Study Setting and Participants:
Three-hundred and thirty-one consecutively enrolled patients aged 9 to 68 years with a diagnosed concussion 1 to 384 days post-injury were enrolled at a concussion clinic from a single integrated healthcare system in Western Pennsylvania between 2019 and 2021.

Design:
Retrospective cohort analysis of prospectively collected concussion screening tool intake survey responses and clinical outcomes data. The primary outcome was self-reported neck pain or difficulty with neck movement on the Concussion Clinical Profiles Screening (CP Screen) tool, recovery time, and incidence of treatment referral. Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) composite scores, Vestibular/Ocular Motor Screening (VOMS) item scores, type and severity of neck symptoms, mechanism of injury, time from injury to clinic presentation, medical history, and concussion symptom profile were secondary outcomes.

Results:
Of the 306 consecutively enrolled eligible patients in the registry, 145 (47%) reported neck pain, 68 (22.2%) reported difficulty moving their neck, and 146 (47.7%) reported either symptom. A total of 47 (15.4%) participants reported more severe neck symptoms, and this group took longer to recover (40 ± 27 days) than those not reporting neck symptoms (30 ± 28 days; U = 8316, P < .001). Stepwise logistic regression predicting more severe neck symptoms was significant (Nagelkerke R
2 = 0.174, χ2 = 9.315, P = .316) with older age (P = .019) and mechanism of injury including motor vehicle collisions (MVCs) (P = .047) and falls (P = .044) as risk factors. MVCs and falls were associated with over 4 times and 2 times greater risk, respectively, for reporting more severe neck symptoms.

Conclusion:
Neck pain and stiffness symptoms are common in patients with a concussion following high-energy mechanisms of injury including MVCs or falls from height. These symptoms are associated with prolonged recovery. Providers should evaluate neck symptoms and consider targeted treatment strategies to limit their effects in patients with a concussion.
Research Letter: Rate of BPPV in Patients Diagnosed With Concussion
Authors: McCormick Kristen , Kolar Beth 
Published: February 2023

Objective:
The purpose of this study was to investigate the incidence of benign paroxysmal positional vertigo (BPPV) specifically among patients with dizziness in the rehabilitation phase of concussion recovery and to provide evidence regarding the importance of BPPV assessment in physical therapy concussion evaluations.

Setting:
Outpatient neurologic rehabilitation center at a suburban comprehensive rehabilitation hospital.

Participants:
Fifty patients diagnosed with concussion and referred to vestibular physical therapy with complaints of dizziness were tested for BPPV within their first 3 visits.

Design:
In this prospective cohort study, a positive Dix-Hallpike test or Horizontal Roll test indicated the presence of BPPV.

Main Measures:
The primary outcome measure was the presence of BPPV. Additional demographic and injury-specific variables were also considered. Among secondary outcomes, patient characteristics and Dizziness Handicap Inventory scores were compared on the basis of presence or absence of BPPV.

Results:
Eleven participants, 22%, tested positive for BPPV. Only fall, as the mechanism of injury, was statistically significant (P < .05), with 72.7% of those who tested positive for BPPV reporting having been injured in a fall compared with 30.8% in the negative group. Nearly half, 45%, of the participants who were positive for BPPV had resolution of their BPPV within 1 visit.

Conclusion:
This study is unique in its focus on mild traumatic brain injury in the rehabilitation phase of recovery. The results provide evidence regarding the importance of BPPV assessment in physical therapy concussion evaluations.
Pediatric Hepatitis and Respiratory Viruses: A Spatiotemporal Ecologic Analysis
Authors: Sawires Rana , Osowicki Joshua , Clothier Hazel , Fahey Michael , Buttery Jim 
Published: February 2023

Introduction:
Beginning in early 2022, clusters of severe pediatric hepatitis were reported in Europe and the United States. To date, no cause has been identified although human adenovirus 41 has been proposed in a proportion of cases. We examined population data >11 years for hepatitis clusters in Victoria, Australia, and whether any were spatiotemporally associated with community transmission of common respiratory viruses.

Methods:
We used SaTScan to analyze for clusters of pediatric hepatitis and respiratory adenoviruses in Victoria. Negative binomial regression analysis was performed to determine any associations between hepatitis and respiratory viruses across Victoria between July 1, 2011, and June 30, 2022.

Results:
A number of positive associations were observed in Victoria between pediatric hepatitis clusters and respiratory viruses in our spatiotemporal analysis. A positive association was not found with respiratory adenoviruses or SARS-CoV-2. Increased hepatitis clusters were observed in 2021 and 2022 as noted internationally.

Conclusion:
The current hepatitis outbreak is novel and, although respiratory viruses are broadly associated with hepatitis, SARS-CoV-2 and respiratory adenoviruses are unlikely to be related.
Reduction in Extraocular Muscle Cross-sectional Area and Correlation With Extraocular Motility and Diplopia Following Teprotumumab for Thyroid Eye Disease
Authors: Reshef Edith R. , Marsiglia Marcela , Bouhadjer Karim , Chiou Carolina A. , O’Brien-Coon Devin , Reinshagen Katherine L. , Freitag Suzanne K. 
Published: February 2023

Purpose:
To quantify changes in extraocular muscle (EOM) cross-sectional areas (CSA) on orbital imaging in patients with thyroid eye disease before and after teprotumumab treatment, and assess for correlation with clinical outcomes.

Methods:
This retrospective study included thyroid eye disease patients treated with teprotumumab who had pre- and post-treatment CT imaging. Reformatted oblique coronal images were created for each orbit in a plane perpendicular to the optic nerve. EOM CSA measurements were performed by 2 radiographic reviewers and averaged. Primary outcomes included change in ratio of total EOM to orbit CSA, and of each individual muscle group to orbit CSA, before and after treatment. Secondary outcomes included subanalysis based on age (≥40, <40 years) and Clinical Activity Score (CAS) (≥4, <4), and comparison with clinical outcomes including CAS, Hertel exophthalmometry, Gorman diplopia score, and extraocular motility.

Results:
Forty-eight orbits of 24 patients (16 female, mean age 57.9 years) were included. There was a significant reduction in the total EOM to orbit CSA ratio (p < 0.01) and for each individual rectus muscle to orbit CSA ratio (p < 0.01 for all groups). Total EOM to orbit CSA ratios were reduced for 21 patients (87.5%); this was statistically significant in 13 patients (54.2%). There was significant improvement in CAS, proptosis, diplopia, and EOM motility (p < 0.01 for all categories). There was a significant correlation between reduction of EOM CSA, and reduction of diplopia (p < 0.01) and EOM motility (p < 0.01).

Conclusions:
EOM CSA is significantly reduced following treatment with teprotumumab, and correlates with clinical findings including improvement in extraocular motility and diplopia.
Preliminary outcomes of accelerated partial breast irradiation by interstitial multicatheter brachytherapy with intraoperative free-hand catheter implantation in early breast cancer
Authors: Cheng Hao-Shen , Hung Chih-Chiang , Wang Kuo-Chung , Tsai I-Chen , Lin Jia-Fu , Yeh Hui-Ling 
Published: February 2023

Background:
To evaluate the clinical feasibility of interstitial brachytherapy by intraoperative free-hand catheter implantation in the treatment of early breast cancer after breast-conserving surgery (BCS).

Methods:
Between January 2018 and December 2019, 44 patients with early breast cancer after BCS who met the inclusion criteria ≥45 years old, invasive carcinoma ≤3 cm or ductal carcinoma in situ <2.5 cm, estrogen receptor positive, lymph node negative, surgical margin negative, no distant metastasis, and an ECOG performance score ≤1 were enrolled in this phase II single-arm study. The postoperative irradiation field includes the tumor bed plus 2-cm margin in all directions, except in the anterior–posterior direction. The total prescribed tumor dose was 3400 cGy delivered in 10 fractions twice daily at 6-hour intervals. The primary endpoints were acute side effects, late treatment-related toxicity, and cosmetic outcome. The secondary endpoints were local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), and overall survival (OS).

Results:
The median follow-up time was 33.5 months (mean, 32.9 months; range, 20-43 months). The cosmetic results were good to very good in 92.3% of the questionnaire respondents. The acute toxicities were mild, and no acute grade 3-4 toxicity was noted. Wound infection was noted in two patients (4.5%). There was only one event of regional lymph node recurrence in one patient. The 3-year LRFS, DMFS, and OS were 100%, and RRFS was 94.7%. For two patients who had a positive lymph node based on their final pathology reports, postoperative irradiation, including whole breast and regional lymph nodes, was added.

Conclusion:
Accelerated partial breast irradiation using interstitial brachytherapy with the intraoperative free-hand catheter implantation technique provides an alternative method of postoperative radiotherapy for selected patients with early breast cancer after BCS with acceptable toxicities.
Hidden behind thromboinflammation: revealing the roles of von Willebrand factor in sickle cell disease pathophysiology
Authors: Vital Eudorah F. , Lam Wilbur A. 
Published: February 2023

Purpose of review
This review provides an update on the pathophysiology of sickle cell disease (SCD) with a particular focus on the dysregulation of the von Willebrand factor (VWF) - ADAMTS13 axis that contributes to its pathogenesis. In discussing recent developments, we hope to encourage new and ongoing discussions surrounding therapeutic targets for SCD.

Recent findings
Within the last 5 years, the role of VWF in the pathophysiology of SCD has been further elucidated and is now a target of study in ongoing clinical trials.

Summary
The pathophysiology of SCD is multifaceted, as it involves systemwide vascular activation, altered blood rheology, and the activation of immune responses and coagulative pathways. The presence of VWF in excess in SCD, particularly in its largest multimeric form, greatly contributes to its pathogenesis. Understanding the molecular mechanisms that underly the presence of large VWF multimers in SCD will provide further insight into the pathogenesis of SCD and provide specific targets for therapy.
Using a Learning System Approach to Improve Safety for Prone-Position Ventilation Patients
Authors: Thomas Anna L. , Graham Kelly , Davila Shannon , Giuffrida Patricia 
Published: February 2023

Objectives
This study aimed to describe how a Patient Safety Organization, to which healthcare organizations submit patient safety event data for both protections and analysis, used a learning system approach to analyze and interpret trends in member data. The data analysis informed evidence-based practice recommendations for improvement of patient outcomes for patients receiving prone-position ventilation.

Methods
Patient safety analysts with critical care nursing backgrounds identified a need for increased support of Patient Safety Organization members who were proning patients during the COVID-19 pandemic. Patient safety events from member organizations across the United States were analyzed and aggregated. Primary and secondary taxonomies for safety events experienced by patients receiving prone-position ventilation were created, which provided insight into harm trends in this patient population.

Results
Analysis of 392 patient safety events resulted in the identification of gaps in the care of these fragile patients, including but not limited to medical device–related pressure injuries, concerns with care delivery, staffing and acuity issues, and medical device dislodgement. Event themes in prone-position ventilation safety events informed a literature search from which an evidence-based action plan was developed and disseminated to Patient Safety Organization members for use in harm reduction efforts.

Conclusions
Using a learning system approach, patient safety event data related to prone-position ventilation or any other type of patient safety event can be aggregated and analyzed to identify key areas of safety concerns and gaps in practice, allowing organizations to affect improvement efforts.