bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitored anesthesia care and asleep-awake-asleep techniques combined with multiple monitoring for resection of gliomas in eloquent brain areas: a retrospective analysis of 225 patients
Authors: Li San-Zhong , Su Ning , Wu Shuang , Fei Xiao-Wei , He Xin , Zhang Jiu-Xiang , Wang Xiao-Hui , Zhang Hao-Peng , Bai Xiao-Guang , Cheng Guang , Fei Zhou 
Published: December 2022

Abstract
Background
Awake craniotomy (AC) has become gold standard in surgical resection of gliomas located in eloquent areas. The conscious sedation techniques in AC include both monitored anesthesia care (MAC) and asleep-awake-asleep (AAA). The choice of optimal anesthetic method depends on the preferences of the surgical team (mainly anesthesiologist and neurosurgeon). The aim of this study was to compare the difference in physiological and blood gas data, dosage of different drugs, the probability of switching to endotracheal intubation, and extent of tumor resection and dysfunction after operation between AAA and MAC anesthetic management for resection of gliomas in eloquent brain areas.

Methods
Two-hundred and twenty-five patients with super-tentorial tumor located in eloquent areas underwent AC from 2009 to 2021 in Xijing Hospital. Forty-one patients underwent AAA technique, and the rest one-hundred eighty-four patients underwent MAC technique. Anesthetic management, dosage of different drugs, intraoperative complications, postoperative outcomes, adverse events, extent of resection and motor, and sensory and language dysfunction after operation were compared between MAC and AAA.

Result
There was no significant difference in gender, KPS score, MMSE score, glioma grade, type, and growth site between the patients in the two groups, except the older age of patients in MAC group than that in AAA group. During the whole process of operation, there were greater pulse pressure difference (P = 0.046), shorter operation time (P = 0.039), less dosage of remifentanil (P = 0.000), more dosage of dexmedetomidine (P = 0.013), more use of antiemetics (81%, P = 0.0067), lower use of vasoactive agent (45.1%, P = 0.010), and lower probability of conversion to general anesthesia (GA, P = 0.027) in MAC group than that in AAA group. Blood gas analysis showed that PetCO2 (P = 0.000), Glu concentration (P = 0.000), and PaCO2 (P = 0.000) were higher, but SPO2 (P = 0.002) and PaO2 (P = 0.000) were lower in MAC group than that in AAA group. In the postoperative recovery stage, compared with that of AAA group, the probability of dysfunction in MAC group at 1, 3, 5, and 7 days after operation was lower, which were 27.8% vs 53.6% (P = 0.003), 31% vs 68.3% (P = 0.000), 28.8% vs 63.4% (P = 0.000), and 25.6% vs 58.5% (P = 0.000), respectively.

Conclusion
Compared with AAA, it seems that MAC has more advantages in the management for resection of gliomas in eloquent brain areas, and MAC combined with multiple monitoring such as cerebral cortical mapping, neuronavigation, and ultrasonic detection is worthy of popularization for the resection of gliomas in eloquent brain areas.
Surgical outcome after using negative pressure therapy in infected leg wounds in coronary bypass grafting surgery
Authors: Shaalan Ayman M. , El Wakeel Eman E. , Shaalan Khaled M. , Alhuthaifi Abdulkareem 
Published: December 2022

Abstract
Background
Infection of leg wounds is a common complication following great saphenous vein harvesting (GSV) for coronary bypass grafting (CABG). This complication can result in increased risk of patient morbidity and mortality by causing septicemia, and gangrene, subjecting the patients to amputation. This study aimed to assess the efficacy of negative pressure wound therapy (NPWT) compared to conventional wound care in infected leg wounds following GSV harvesting for myocardial revascularization.

Results
The NPWT group had a significantly lower rate of deep vein thrombosis (p = 0.013), osteomyelitis (p < 0.001), bed sores (p < 0.001), shorter duration of tissue edema (p < 0.001), and lesser discharge (p < 0.001). Also, the length of hospital stay was significantly shorter in the NPWT group (p < 0.001). Multivariable analysis revealed that traditional wound care (without NPWT, p < 0.001) and wound stage IV (p = 0.001) significantly and independently prolonged the length of hospital stay.

Conclusions
The use of NPWT in advanced complicated infected leg wounds could improve patients’ outcomes and satisfaction by decreasing the rate of complications and the length of hospital stay.
Feasibility of a novel ultra-low-cost bubble CPAP (bCPAP) System for neonatal respiratory support at Muhimbili National Hospital, Tanzania
Authors: Tayler Ashtyn , Ashworth Henry , Bou Saba Ghassan , Wadhwa Hena , Dundek Michelle , Ng Ellie , Opondo Kennedy , Mkony Martha , Moshiro Robert , Burke Thomas 
Published: December 2022

Objective
Continuous Positive Airway Pressure (CPAP) is recommended in the treatment of respiratory distress syndrome of premature newborns, however there are significant barriers to its implementation in low-resource settings. The objective of this study was to evaluate the feasibility of use and integration of Vayu bCPAP Systems into the newborn unit at Muhimbili National Hospital in Tanzania.

Study design
A prospective qualitative study was conducted from April 6 to October 6 2021. Demographic and clinical characteristics of patients treated with Vayu bCPAP Systems were collected and analyzed. Healthcare workers were interviewed until thematic saturation. Interviews were transcribed, coded, and analyzed using a framework analysis.

Results
370 patients were treated with Vayu bCPAP Systems during the study period. Mean birth weight was 1522 g (500–3800), mean duration of bCPAP treatment was 7.2 days (<1–39 d), and survival to wean was 81.4%. Twenty-four healthcare workers were interviewed and perceived Vayu bCPAP Systems as having become essential for treating neonatal respiratory distress at MNH. Key reasons were that Vayu bCPAP Systems improve patient outcomes, are easy to use, and more patients are now able to receive quality care. Barriers to integration included durability of oxygen tubing material and training.

Conclusions
It was feasible to implement and integrate Vayu bCPAP Systems into the care of neonates at Muhimbili National Hospital.
The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS
Authors: De Rosa Silvia , Sella Nicolò , Rezoagli Emanuele , Lorenzoni Giulia , Gregori Dario , Bellani Giacomo , Foti Giuseppe , Pettenuzzo Tommaso , Baratto Fabio , Fullin Giorgio , Papaccio Francesco , Peta Mario , Poole Daniele , Toffoletto Fabio , Maggiore Salvatore Maurizio , Navalesi Paolo ,   The SIAARTI Study Group
Published: December 2022

Background
The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality.

Methods and analysis
Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the “PROVENT-C19 Registry”, endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care…’(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice.

Conclusions
This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics.

Trial registration
The registry was registered (ClinicalTrial.Gov Trials Register NCT04905875) on May 28,2021.
A caveat to using wearable sensor data for COVID-19 detection: The role of behavioral change after receipt of test results
Authors: Cleary Jennifer L. , Fang Yu , Sen Srijan , Wu Zhenke 
Published: December 2022

Background
Recent studies indicate that wearable sensors can capture subtle within-person changes caused by SARS-CoV-2 infection and play a role in detecting COVID-19 infections. However, in addition to direct effects of infection, wearable sensor data may capture changes in behavior after the receipt of COVID test results. At present, it remains unclear to what extent the observed discriminative performance of the wearable sensor data is affected by behavioral changes upon receipt of the test results.

Methods
We conducted a retrospective study of wearable sensor data in a sample of medical interns who had symptoms and received COVID-19 test results from March to December 2020, and calculated wearable sensor metrics incorporating changes in step, sleep, and resting heart rate for interns who tested positive (cases, n = 22) and negative (controls, n = 83) after symptom onset. All these interns had wearable sensor data available for > 50% of the days in pre- and post-symptom onset periods. We assessed discriminative accuracy of the metrics via area under the curve (AUC) and tested the impact of behavior changes after receiving test results by comparing AUCs of three models: all data, pre-test-result-only data, and post-test-result-only data.

Results
Wearable sensor metrics differentiated between symptomatic COVID-19 positive and negative individuals with good accuracy (AUC = 0.75). However, the discriminative capacity of the model with pre-test-result-only data substantially decreased (AUC from 0.75 to 0.63; change = -0.12, p = 0.013). The model with post-test-result-only data did not produce similar reductions in discriminative capacity.

Conclusions
Changes in wearable sensor data, especially physical activity and sleep, are robust indicators of COVID-19 infection, though they may be reflective of a person’s behavior change after receiving a positive test result as opposed to a physiological signature of the virus. Thus, wearable sensor data could facilitate the monitoring of COVID-19 prevalence, but not yet replace SARS-CoV-2 testing.
Association between ustekinumab therapy and changes in specific anti-microbial response, serum biomarkers, and microbiota composition in patients with IBD: A pilot study
Authors: Rob Filip , Schierova Dagmar , Stehlikova Zuzana , Kreisinger Jakub , Roubalova Radka , Coufal Stepan , Mihula Martin , Jackova Zuzana , Kverka Miloslav , Thon Tomas , Kostovcikova Klara , Bajer Lukas , Drastich Pavel , Hercogova Jana Tresnak , Novakova Michaela , Kolar Martin , Vasatko Martin , Lukas Milan , Tlaskalova-Hogenova Helena , Jiraskova Zakostelska Zuzana 
Published: December 2022

BackgroundUstekinumab, is a new therapy for patients with IBD, especially for patients suffering from Crohn’s disease (CD) who did not respond to anti-TNF treatment. To shed light on the longitudinal effect of ustekinumab on the immune system, we investigated the effect on skin and gut microbiota composition, specific immune response to commensals, and various serum biomarkers.Methodology/Principal findingsWe recruited 11 patients with IBD who were monitored over 40 weeks of ustekinumab therapy and 39 healthy controls (HC). We found differences in the concentrations of serum levels of osteoprotegerin, TGF-β1, IL-33, and serum IgM antibodies againstLactobacillus plantarumbetween patients with IBD and HC. The levels of these biomarkers did not change in response to ustekinumab treatment or with disease improvement during the 40 weeks of observation. Additionally, we identified differences in stool abundance of unculturedSubdoligranulum,Faecalibacterium, andBacteroidesbetween patients with IBD and HC.Conclusion/SignificanceIn this preliminary study, we provide a unique overview of the longitudinal monitoring of fecal and skin microbial profiles as well as various serum biomarkers and humoral and cellular response to gut commensals in a small cohort of patients with IBD on ustekinumab therapy.
Estimating the population exposed to a risk factor over a time window: A microsimulation modelling approach from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
Authors: Náfrádi Bálint , Kiiver Hannah , Neupane Subas , Momen Natalie C. , Streicher Kai N. , Pega Frank 
Published: December 2022

Objectives
Burden of disease estimation commonly requires estimates of the population exposed to a risk factor over a time window (yeart to yeart+n). We present a microsimulation modelling approach for producing such estimates and apply it to calculate the population exposed to long working hours for one country (Italy).

Methods
We developed a three-model approach: Model 1, a multilevel model, estimates exposure to the risk factor at the first year of the time window (yeart). Model 2, a regression model, estimates transition probabilities between exposure categories during the time window (yeart to yeart+n). Model 3, a microsimulation model, estimates the exposed population over the time window, using the Monte Carlo method. The microsimulation is carried out in three steps: (a) a representative synthetic population is initiated in the first year of the time window using prevalence estimates from Model 1, (b) the exposed population is simulated over the time window using the transition probabilities from Model 2; and (c) the population is censored for deaths during the time window.

Results
We estimated the population exposed to long working hours (i.e. 41–48, 49–54 and ≥55 hours/week) over a 10-year time window (2002–11) in Italy. We populated all three models with official data from Labour Force Surveys, United Nations population estimates and World Health Organization life tables. Estimates were produced of populations exposed over the time window, disaggregated by sex and 5-year age group.

Conclusions
Our modelling approach for estimating the population exposed to a risk factor over a time window is simple, versatile, and flexible. It however requires longitudinal exposure data and Model 3 (the microsimulation model) is stochastic. The approach can improve accuracy and transparency in exposure and burden of disease estimations. To improve the approach, a logical next step is changing Model 3 to a deterministic microsimulation method, such as modelling of microflows.
Tuberculosis and risk of cancer: A systematic review and meta-analysis
Authors: Luczynski Pauline , Poulin Philip , Romanowski Kamila , Johnston James C. 
Published: December 2022

Introduction
Cancer is a major cause of death among people who experience tuberculosis (TB), but little is known about its timing and incidence following TB treatment. Our primary objectives were to estimate the pooled risk of all and site-specific malignancies in people with TB compared to the general population or suitable controls. Our secondary objective was to describe the pooled risk of cancer at different time points following TB diagnosis.

Methods
This study was prospectively registered (PROSPERO: CRD42021277819). We systematically searched MEDLINE, Embase, and the Cochrane Database for studies published between 1980 and 2021. We included original observational research articles that estimated cancer risk among people with TB compared to controls. Studies were excluded if they had a study population of fewer than 50 individuals; used cross-sectional, case series, or case report designs; and had a follow-up period of less than 12 months. Random-effects meta-analysis was used to obtain the pooled risk of cancer in the TB population.

Results
Of the 5,160 unique studies identified, data from 17 studies were included. When compared to controls, the pooled standardized incidence ratios (SIR) of all cancer (SIR 1.62, 95% CI 1.35–1.93, I2 = 97%) and lung cancer (SIR 3.20, 95% CI 2.21–4.63, I2 = 90%) was increased in the TB population. The pooled risk of all cancers and lung cancer was highest within the first year following TB diagnosis (SIR 4.70, 95% CI 1.80–12.27, I2 = 99%) but remained over five years of follow-up.

Conclusions
People with TB have an increased risk of both pulmonary and non-pulmonary cancers. Further research on cancer following TB diagnosis is needed to develop effective screening and early detection strategies. Clinicians should have a high index of suspicion for cancer in people with TB, particularly in the first year following TB diagnosis.
Exploring the relationship between pancreatic fat and insulin secretion in overweight or obese women without type 2 diabetes mellitus: A preliminary investigation of the TOFI_Asia cohort
Authors: Sequeira Ivana R. , Yip Wilson , Lu Louise W. , Jiang Yannan , Murphy Rinki , Plank Lindsay D. , Cooper Garth J. S. , Peters Carl N. , Aribsala Benjamin S. , Hollingsworth Kieren G. , Poppitt Sally D. 
Published: December 2022

Objective
While there is an emerging role of pancreatic fat in the aetiology of type 2 diabetes mellitus (T2DM), its impact on the associated decrease in insulin secretion remains controversial. We aimed to determine whether pancreatic fat negatively affects β-cell function and insulin secretion in women with overweight or obesity but without T2DM.

Methods
20 women, with normo- or dysglycaemia based on fasting plasma glucose levels, and low (< 4.5%) vs high (≥ 4.5%) magnetic resonance (MR) quantified pancreatic fat, completed a 1-hr intravenous glucose tolerance test (ivGTT) which included two consecutive 30-min square-wave steps of hyperglycaemia generated by using 25% dextrose. Plasma glucose, insulin and C-peptide were measured, and insulin secretion rate (ISR) calculated using regularisation deconvolution method from C-peptide kinetics. Repeated measures linear mixed models, adjusted for ethnicity and baseline analyte concentrations, were used to compare changes during the ivGTT between high and low percentage pancreatic fat (PPF) groups.

Results
No ethnic differences in anthropomorphic variables, body composition, visceral adipose tissue (MR-VAT) or PPF were measured and hence data were combined. Nine women (47%) were identified as having high PPF values. PPF was significantly associated with baseline C-peptide (p = 0.04) and ISR (p = 0.04) in all. During the 1-hr ivGTT, plasma glucose (p<0.0001), insulin (p<0.0001) and ISR (p = 0.02) increased significantly from baseline in both high and low PPF groups but did not differ between the two groups at any given time during the test (PPF x time, p > 0.05). Notably, the incremental areas under the curves for both first and second phase ISR were 0.04 units lower in the high than low PPF groups, but this was not significant (p > 0.05).

Conclusion
In women with overweight or obesity but without T2DM, PPF did not modify β-cell function as determined by ivGTT-assessed ISR. However, the salient feature in biphasic insulin secretion in those with ≥4.5% PPF may be of clinical importance, particularly in early stages of dysglycaemia may warrant further investigation.
Analysis of differential gene expression of pro-inflammatory cytokines in the nasopharyngeal milieu of mild & severe COVID-19 cases
Authors: Ghulam Unzela , Nazim Fizza , Farooqui Nida , Rizwan-ul-Hasan Syed , Anwar Muhammad Faraz , Ahmed Khalid , Jamal Abid , Kayani Hammad Afzal , Mughal Nouman , Hussain Azhar , Sarria-Santamera Antonio , Abidi Syed Hani 
Published: December 2022

Introduction
A subset of individuals with COVID-19 can suffer from a severe form of the disease requiring breathing support for respiratory failure and even death due to disease complications. COVID-19 disease severity can be attributed to numerous factors, where several studies have associated changes in the expression of serum pro-inflammatory cytokines with disease severity. However, very few studies have associated the changes in expression of pro-inflammatory changes in the nasopharyngeal milieu with disease severity. Therefore, in the current study, we performed differential gene expression analysis of various pro-inflammatory cytokines in the nasopharyngeal milieu of mild & severe COVID-19 cases.

Material and method
For this retrospective, cross-sectional study, a total of 118 nasopharyngeal swab samples, previously collected from mild and severe (based on the WHO criteria) COVID-19 patients were used. A real-time qPCR was performed to determine the viral loads and also evaluate the mRNA expression of eight cytokines (IL-1, IL-2, IL-4, IL-6, IL-10, IFN-γ, TGF-β1, and TNF-α). Subsequently, an unpaired T-test was applied to compare the statistical difference in mean expression of viral loads and each cytokine between the mild and severe groups, while the Pearson correlation test was applied to establish a correlation between disease severity, viral load, and cytokines expression. Similarly, a multivariable logistic regression analysis was performed to assess the relationship between different variables from the data and disease severity.

Results
Out of 118 samples, 71 were mild, while 47 were severe. The mean viral load between the mild and severe groups was comparable (mild group: 27.07± 5.22; severe group: 26.37 ±7.89). The mRNA expression of cytokines IL-2, IL-6, IFN- γ, and TNF-α was significantly different in the two groups (p<0.05), where the Log2 normalized expression of IL-2, IL-6, IFN- γ, and TNF-α was found to be 2.2–, 16–, 2.3–, and 1.73–fold less in the severe group as compared to the mild group. Furthermore, we also observed a significant positive correlation between all the cytokines in the severe group. The multivariate analysis showed a significant relationship between age, IL-6, and disease severity.

Conclusion
This decreased expression of certain cytokines (IL-2, IL-6, TNF-α, and IFN-γ) in the nasopharyngeal milieu may be considered early biomarkers for disease severity in COVID-19 patients.