bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Post-Stroke Post-Traumatic Stress Disorder
Authors: Renati Swetha , Raju Sanita , Makarova Alena , Hairston Marla , Beba Abadal Kanita , Bozeman Andrea , Chen Henian , Cen Weiliang , Rose David Z. , Burgin W. Scott 
Published: January 2025

Introduction Post-Traumatic Stress Disorder (PTSD) is associated with exposure to traumatic events, especially in the military setting. However, patients who experience stroke may develop anxiety about their stroke event and may re-experience transient neurological symptoms as a result. A significant portion develop the persistent and disabling symptoms of PTSD. Methods At the University of South Florida, we conducted a single-center, IRB-approved, observational pilot study of 20 adult patients who were diagnosed with stroke or transient ischemic attack (TIA) in the previous 31 days to 1 year. Patients completed the post-traumatic stress disorder checklist-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Stroke specific Quality of Life Scale (SS-QOL-12), Modified Rankin Scale of disability (mRS), and National Institutes of Health Stroke Scale (NIHSS) and provided blood and saliva samples. Results All 20 subjects completed the PCL-5 and 19 subjects completed the follow up scales. Seven patients (35%) were found to have Post-Stroke Post-Traumatic Stress Disorder (PS-PTSD). Higher PCL-5 scores were significantly correlated with lower SS-QOL scores indicating worse quality of life (r = −0.709, P = .001) and higher PHQ-9 scores representing symptoms of depression (r = 0.727, P < 0.001). Conclusion Post-Stroke Post-Traumatic Stress Disorder (PS-PTSD) is prevalent after stroke and TIA with patients experiencing concurrent depressive symptoms, correlating with a worsened quality of life.
Long-Term Effectiveness of Dupilumab in Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyps: A Multicenter Retrospective Study
Authors: Russo Paolo , Bassano Edoardo , Menichetti Marcella , Lucidi Daniela , Minniti Rosa Maria , Cigarini Elisa , Menabue Silvia , Marchioni Daniele , Perano Daniele , Ghidini Angelo 
Published: January 2025

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex immunological disease associated with significant morbidity and reduced health-related quality of life. Dupilumab is an anti-T2-inflammatory biological drug registered for chronic rhinosinusitis with nasal polyps, indicated by integrated care pathways when optimal medico-surgical treatment yields insufficient control of sinonasal symptoms. Objective The purpose of this study was to confirm the long-term efficacy of dupilumab in the treatment of severe uncontrolled CRSwNP. Methods Multicentric data collection of patients with severe uncontrolled CRSwNP treated with Dupilumab was retrospectively performed. Mixed Model Anova test was used to evaluate the effect of the biological therapy in the improvement of nasal polyp score and quality of life measured with Sinonasal Outcome Test-22 (SNOT-22) and visual analog scale (VAS) scores. Results The study showed a statistically significant and progressive improvement in the Nasal Polyp Score with a decrease from a median baseline value of 6 (IQR 5-6) to 0 (IQR 0-2) at 24 months. Furtherly, optimal results were found for SNOT-22 scores from baseline (62 ± 19) to 6 months (15± 11), with further variations on each successive timepoint remaining below the minimal clinically important difference. VAS scores of nasal obstruction, rhinorrhea, sleep disorders, and craniofacial pain, demonstrated consistent and significant improvements over time until one year of treatment, confirming substantial relief for the most pertinent symptoms of the condition Conclusions The results of this study show high therapeutic efficacy and safety of dupilumab for severe CRswNP particularly in the first 6-12 months, with sustained benefits up to 24 months.
The Significance of Fractional Exhaled Nitric Oxide, Fractional Nasal Exhaled Nitric Oxide and Lung Function Tests in Children with Moderate-to-Severe Allergic Rhinitis
Authors: Li Wanying , Jia Wanyu , Yi Xiaowen , Li Peng , Song Chunlan 
Published: January 2025

Purpose Fractional nasal exhaled NO (FnNO), fractional exhaled NO (FeNO) and lung function tests were performed in children with moderate-to-severe persistent allergic rhinitis (AR) to investigate the significance of the above indices in the assessment and diagnosis of children with AR. Methods A total of 135 children with persistent AR were selected and divided into moderate-to-severe and mild groups; serum total immunoglobulin E (IgE), peripheral blood eosinophil counts (EOS), FnNO, FeNO, and lung function tests were performed. Results Children in the moderate-to-severe group had increased levels of FnNO and FeNO and decreased levels of forced expiratory flow at 75% of forced vital capacity as a percentage of the predicted value (FEF75%) and maximum mid-term expiratory flow as a percentage of the predicted value (MMEF%) . IgE in children with AR was positively correlated with FeNO and FnNO and negatively correlated with FEF75% . EOS was positively correlated with FnNO. FeNO was negatively correlated with FEF75% and forced expiratory flow at 50% of forced vital capacity as a percentage of the predicted value (FEF50%). FnNO was negatively correlated with FEF75%, FEF50%, and MMEF%. Conclusion FnNO, FeNO, and pulmonary function tests may help assess disease severity and level of disease control in children with persistent AR.
Evolution of a patient safety program in an academic medical center
Authors: Bishop Phyllis , Didion Lisa , Whitfield Candice , Henderson J Michael 
Published: January 2025

Background The Academic Medical Center earned a 1-Star CMS designation and received an F on the Leapfrog Safety Grade in 2015, which led to leadership setting Clinical Quality Improvement as the #1 Strategic Priority. This paper presents the evolution of a structured patient safety program as a component of this plan to direct and motivate employees to succeed in reducing patient harm. Methods Data-driven quality improvement using simple, timely, actionable data drillable scorecards available to all employees was the cornerstone of the above strategic priority. A comprehensive patient safety program was developed utilizing three phases: Error Prevention Training, Improved Event Reporting, and the Chasing Zero Harm initiative. Results Improvement was achieved in Culture of Safety Survey domains of overall safety, event reporting, nonpunitive response to errors, and hand-off communication. Patient safety indicators and hospital-acquired infections improved on the Medical Center's internal scorecard and public reported data by >60%. These resulted in improvement in Leapfrog Safety Score from an F in 2015 to a B in 2023, and increase from CMS 1-Star to 2-Star rank in 2023. Adverse event reports and review with follow up increased by 45% between 2018 and 2023. A Chasing Zero harm program was initiated following establishment of these steps. Discussion A successful patient safety program, predicated on high reliability, can successfully be built with leadership commitment, development of safety culture, and performance improvement.
Longitudinal Recovery Trajectories and Ventilatory Modalities in Covid-19 ARDS Survivors
Authors: González Jessica , Benítez Iván D. , Santisteve Sally , Vila Anna , Aguilà Maria , Torres Gerard , Sánchez-Cucó Anna , Malla-Bañeres Mar , Moncusí-Moix Anna , de Batlle Jordi , Gracia-Lavedan Esther , Ceccato Adrián , Ferrer Ricard , Motos Anna , Riera Jordi , Fernández Laia , Menéndez Rosario , Lorente José Ángel , Peñuelas Oscar , García Dario , Roca Oriol , Peñasco Yhivian , Ricart Pilar , Martin Delgado Maria Cruz , Aguilera Luciano , Rodríguez Alejandro , Boado Varela Maria Victoria , Pérez-García Felipe , Pozo-Laderas Juan Carlos , Solé-Violan Jordi , Adell-Serrano Berta , Novo Mariana Andrea , Barberán José , Amaya Villar Rosario , de Gonzalo-Calvo David , Torres Antoni , Barbé Ferran , Roche-Campo Ferran ,   on behalf of the CIBERESUCICOVID Group
Published: January 2025

IntroductionThe impact of the different ventilatory support modalities and the timing of intubation on longitudinal lung recovery trajectories in patients with severe COVID-19 is unknown.MethodsA multicenter, prospective observational study conducted in 52 Spanish intensive care units (ICUs) involving critically ill COVID-19 patients admitted between February 25th, 2020, to February 28th, 2021. 1854 COVID-19 patients were followed after hospital discharge at 3, 6 and 12 months with lung diffusing capacity (DLCO) and a chest imaging. Patients were classified regarding the ventilatory support received during the ICU stay: noninvasive mechanical ventilation (NIMV), high-flow nasal cannula (HFNC) and invasive mechanical ventilation (IMV) divided into early IMV (intubation <24 h) and late IMV (intubation >24 h). The primary objective is to evaluate the impact of the different respiratory support modalities during the ICU stay and time of intubation on DLCOmeasurements and their recovery trajectories over a one-year follow-up. Secondary outcomes include other pulmonary function parameters and chest imaging findings.ResultsA total of 360 (19.4%) and 290 (15.6%) patients received HFNC and NIMV, respectively. 1204 (64.9%) patients underwent IMV; 966 received early IMV and 238 late IMV. The latter exhibited a significantly worse percentage of predicted DLCOduring the one-year follow-up with adjusted differences (95%CI; p-value) of 6.9 (3.9 to 10; p<0.001), 4.2 (1.1 to 7.2; p=0.007) and 4.9 (1.7 to 8.2; p=0.003) at 3, 6 and 12 months compared with early IMV. NIMV patients exhibited greater lung damage at follow-up than those under HFNC with an adjusted difference of DLCOvalues of 5.2 (1.7 to 8.7; p=0.003) at 6 months and greater presence of radiological abnormalities during the follow-up. Matched and sensitivity analysis showed results consistent with those reported.ConclusionsDelay in intubation implies the worst outcomes; however, patients with NIMV exhibited a slower lung recovery in terms of DLCOmeasurements and more radiological abnormalities compared with HFNC patients. These results should be used to optimize follow-up protocols for COVID-19 ARDS survivors. These findings may serve as a valuable consideration for optimizing follow-up protocols for survivors of COVID-19 ARDS.
Predicting rifampicin resistance inM. tuberculosisusing machine learning informed by protein structural and chemical features
Authors: Lynch Charlotte I , Adlard Dylan , Fowler Philip W 
Published: January 2025

BackgroundRifampicin remains a key antibiotic in the treatment of tuberculosis. Despite advances in cataloguing resistance-associated variants (RAVs), novel and rare mutations in the relevent gene,rpoB, will be encountered in clinical samples, complicating the task of using genetics to predict whether a sample is resistant or not to rifampicin. We have trained a series of machine learning models with the aim of complementing genetics-based drug susceptibility testing.MethodsWe built a Test+Train dataset comprising 219 susceptible mutations and 46 RAVs. Features derived from the structure of the RNA polymerase or the change in chemistry introduced by the mutation were considered, however, only a few, notably the distance from the rifampicin binding site, were found to be predictive on their own. Due to the paucity of RAVs we used Monte Carlo cross-validation with 50 repeats to train four different machine learning models.ResultsAll four models behaved similarly with sensitivities and specificities in the range 0.84–0.88 and 0.94–0.97 although we preferred the ensemble of Decision Tree models as they are easy to inspect and understand. We showed that measuring distances from molecular dynamics simulations did not improve performance.ConclusionsIt is possible to predict whether a mutation inrpoBconfers resistance to rifampicin using a machine learning model trained on a combination of structural, chemical and evolutionary features, however performance is moderate and training is complicated by the lack of data.
Effects of eHealth exercise on paediatric suppurative lung diseases: a systematic review and meta-analysis
Authors: Mavronasou Aspasia , Kortianou Eleni A. , Sapouna Vaia , Douros Konstantinos , Spinou Arietta 
Published: January 2025

BackgroundUtilizing information and communication technologies through eHealth in exercise programs could support their delivery and improve clinical outcomes in children and adolescents with chronic suppurative lung diseases (CSLDs). This study aimed to systematically investigate the effects of eHealth exercise programs on clinical outcomes for this population.MethodsFive databases were searched from inception to April 12, 2024. Two researchers independently screened the retrieved results and rated the methodological quality of the included studies using the revised Cochrane Risk of Bias tool for randomized trials and the Risk of Bias in Non-Randomized Studies – of Interventions tool. The quality of evidence was graded using the GRADE approach. A narrative synthesis of findings was performed, and a meta-analysis was conducted to evaluate the effects of eHealth exercise programs on clinical outcomes that had data from ≥2 studies.ResultsSeven studies used eHealth exercise programs through active video games (n=3), videoconferencing (n=3), and a digital spirometer (n=1) lasting from 3 to 12 weeks. Five studies had participants with cystic fibrosis (CF). Results showed a greater improvement in the 6-minute walk test following the intervention compared to the control group; pooled estimate mean difference [37.2 meters (95%CI: 7.91 to 66.48), p=0.013]. Pulmonary function, exercise capacity, balance, peripheral and respiratory muscle strength, and HRQoL were also improved. Still, most studies involved a considerable risk of bias.ConclusionseHealth exercise programs can improve clinical outcomes in children and adolescents with CF. Further research is needed for other pediatric populations with CSLDs and also for comparisons with conventional exercise programs.
Feasibility and inter-reporter variability of submaximal outcomes derived from cardiopulmonary exercise testing in people with advanced cystic fibrosis lung disease
Authors: Urquhart Don S , Jamieson Patrick , Burns Paul , Braun Julia , Hebestreit Helge , Radtke Thomas 
Published: January 2025

BackgroundCardiopulmonary exercise testing (CPET) provides prognostic information in people with advanced cystic fibrosis lung disease (pwACFLD). This project aimed to ascertain feasibility and inter-reporter variability in the identification of submaximal CPET outcomes for pwACFLD as potential predictors of prognosis where no peak exercise data are available.MethodsWe utilised data from an international retrospective multicentre study involving pwACFLD, for whom raw CPET data were available. Two experienced operators independently reviewed and analysed CPET tests with a focus on three pre-defined measures: oxygen uptake (V̇O2) at the anaerobic threshold (AT), the breathing reserve index at the AT (BRIAT), and the slope of the minute ventilation to carbon dioxide production ratio (V̇E/V̇CO2-slope). We calculated intra-class correlation coefficients (ICC) with their 95% confidence intervals (CI), and limits of agreement using the Bland-Altman method.ResultsThe original cohort included 174 pwACFLD. Among those, raw CPET data were available for 101 individuals, of which 89 tests were of sufficient technical quality for submaximal analysis. In 72 out of 89 technically-acceptable tests (81%), the AT could be confidently identified by both operators. Furthermore, ICCs indicated good-to-excellent inter-reporter agreement for V̇O2at the AT [ICC (95% CI) 0.79 (0.62 to 0.88)], the V̇E/V̇CO2-slope [0.95, 0.93 to 0.97)], and BRIAT [0.76, 0.63 to 0.85].ConclusionsSubmaximal CPET data can be reliably obtained in most pwACFLD by trained CPET operators. Future studies may ascertain the prognostic value of submaximal CPET outcomes in pwACFLD.
Utility of Diaphragm Dome Height as a Marker of Operational Lung Volume Changes, Disease Burden and Exacerbations in Patients with Mild-to-Moderate COPD: An Observational Study Within the CanCOLD Cohort
Authors: Beydoun Sarah A. , Iorio Olivia C. , Genkin Daniel , Li Pei Z , Doiron Dany , Maltais François , Bourbeau Jean , Tan Wan , Sin Don D. , Aaron Shawn D. , Chapman Kenneth R. , Hernandez Paul , Marciniuk Darcy D. , O'Donnell Denis E. , Walker Brandie L. , Kirby Miranda , Ross Bryan A. 
Published: January 2025

BackgroundDynamic hyperinflation is central to dyspnoea, exercise limitation, and exacerbations in chronic obstructive pulmonary disease (COPD). While studied previously in moderate-severe COPD, the relevance of diaphragm dome height on clinically important outcomes has been under-investigated in mild-to-moderate COPD.MethodsCanadian Cohort Obstructive Lung Disease participants with spirometry-confirmed COPD, symptom-limited incremental cardiopulmonary exercise testing, and computed tomography image data were included. Base-to-apex left and right diaphragm dome height (DDH) was automatically segmented, with increased height implying less flattening and thus less hyperinflation. Dynamic hyperinflation was defined as ≥150 mL reduction in inspiratory capacity (IC) from rest to peak-exercise. Cross-sectional linear regression models were fitted between left and right DDH (predictor variables) with peak IC (ICpeak), peak workload (Wpeak), FEV1, and CAT score (outcome variables), and in longitudinal (Anderson-Gill) models with “symptom-based” and “event-based” exacerbations. Results are reported as parameter estimates or hazard ratios with 95%CIs per interquartile range dome height increment.ResultsAmong 304 participants (mean age 64.7±10.3, 41.8% female, 44.4% with mild COPD), each left and right DDH increment, respectively, was associated with ICpeak(0.21[0.13,0.29]L, 0.13[0.07,0.19]L), Wpeak(9.54[5.03,14.04]W, 6.04[2.45,9.62]W), FEV1(0.17[0.10,0.25]L, 0.08[0.02,0.14]L), and CAT score (−1.36[−2.39,−0.33], −0.82[−1.63,0.00]). Left DDH alone was associated with both symptom-based (HR: 0.82[0.74,0.91]) and event-based (0.83[0.73,0.95]) exacerbations. Of 167/304 participants with confirmed dynamic hyperinflation (ΔIC=−0.47±0.25 L), left DDH alone was associated with all outcomes (ICpeak, Wpeak, FEV1, CAT, and symptom-based/event-based exacerbations).ConclusionsLeft DDH appears to be a clinically important marker for operational lung volume changes, lung function, exercise performance, disease burden, and exacerbations in mild-to-moderate COPD.
Value of combining lung ultrasound score with oxygenation and functional indices in determining weaning timing for critically ill pediatric patients
Authors: Hao Ximeng , Duan Hongnian , Li Qiushuang , Wang Dan , Yin Xin , Di Zhiyan , Du Shanshan 
Published: January 2025

Abstract

Objective
This study aims to investigate the predictive effectiveness of bedside lung ultrasound score (LUS) in conjunction with rapid shallow breathing index (RSBI) and oxygenation index (P/F ratio) for weaning pediatric patients from mechanical ventilation.

Methods
This was a retrospective study. Eighty-two critically ill pediatric patients, who were admitted to the Pediatric Intensive Care Unit (PICU) and underwent mechanical ventilation from January 2023 to April 2024, were enrolled in this study. Prior to weaning, all patients underwent bedside LUS, with concurrent measurements of their RSBI and P/F ratio. Patients were followed up for weaning outcomes and categorized into successful and failed weaning groups based on these outcomes. Differences in clinical baseline data, LUS scores, RSBI and P/F ratios between the two groups were compared. The predictive value of LUS scores, RSBI and P/F ratios for weaning outcomes was assessed using receiver operating characteristic (ROC) curves and the area under the curve (AUC).

Results
Out of the 82 subjects, 73 (89.02%) successfully weaned, while 9 (10.98%) failed. No statistically significant differences were observed in age, gender, BMI, and respiratory failure-related comorbidities between the successful and failed weaning groups (P > 0.05). Compared to the successful weaning group, the failed weaning group exhibited longer hospital and intubation durations, higher LUS and RSBI, and lower P/F ratios, with statistically significant differences (P < 0.05). An LUS score ≥ 15.5 was identified as the optimal cutoff for predicting weaning failure, with superior predictive power compared to RSBI and P/F ratios. The combined use of LUS, RSBI and P/F ratios for predicting weaning outcomes yielded a larger area under the curve, indicating higher predictive efficacy.

Conclusion
The LUS demonstrates a high predictive value for the weaning outcomes of pediatric patients on mechanical ventilation.
Chronic and infectious respiratory mortality and short-term exposures to four types of pollen taxa in older adults in Michigan, 2006-2017
Authors: Larson Peter S. , Steiner Allison L. , O’Neill Marie S. , Baptist Alan P. , Gronlund Carina J. 
Published: January 2025

Abstract

Introduction
Levels of plant-based aeroallergens are rising as growing seasons lengthen and intensify with anthropogenic climate change. Increased exposure to pollens could increase risk for mortality from respiratory causes, particularly among older adults. We determined short-term, lag associations of four species classes of pollen (ragweed, deciduous trees, grass pollen and evergreen trees) with respiratory mortality (all cause, chronic and infectious related) in Michigan, USA.

Methods
We obtained records for all Michigan deaths from 2006-2017 from the Michigan Department of Health and Human Services (MDHHS). Deaths from infectious and chronic respiratory-related causes were selected using International Classification of Diseases (ICD-10) codes. Pollen data were obtained from a prognostic model of daily pollen concentrations at 25 km resolution. Case-crossover models with distributed lag non-linear crossbases for pollen were used to estimate associations between lags of daily pollen concentrations with mortality and to explore effect modification by sex and racial groups.

Results
127,163 deaths were included in the study. Cumulative daily high concentrations (90th percentile) of deciduous broadleaf, grass and ragweed were associated with all-cause respiratory mortality at early lags with e.g., a 1.81 times higher risk of all respiratory deaths at cumulative 7 day lag exposure to deciduous broadleaf pollen at the 90th percentile (95% confidence interval: 1.04, 3.15). Exposure to high concentrations of grass and ragweed pollens was associated with increased risk for death from chronic respiratory causes. No association was found for any pollen species with death from infectious respiratory causes though there was a positive but non-significant association of exposure to deciduous broadleaf and ragweed pollens. We found no evidence to suggest effect modification by race or sex.

Conclusions
Modelled exposures to high concentrations of pollen taxa were associated with increased all-cause and chronic respiratory mortality among older adults. Results suggest that pollen exposure may become more important to respiratory mortality as the temperatures increase and pollen seasons lengthen.