bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prehospital Tranexamic Acid Administration in Pediatric Trauma Patients: A Propensity-Matched Analysis of the Israeli Defense Forces Registry
Authors: Gendler Sami , Gelikas Shaul , Talmy Tomer , Lipsky Ari M. , Avital Guy , Nadler Roy , Radomislensky Irina , Ahimor Alon , Glassberg Elon , Mozer Glassberg Yael , Almog Ofer , Yazer Mark H. , Benov Avi 
Published: February 2023

OBJECTIVES:Tranexamic acid (TXA) administration confers a survival benefit in bleeding trauma patients; however, data regarding its use in pediatric patients are limited. This study evaluates the prehospital treatment with TXA in pediatric trauma patients treated by the Israel Defense Forces Medical Corps (IDF-MC).DESIGN:Retrospective, cohort study using the Israel Defense Forces registry, 2011–2021.PATIENTS:Pediatric trauma patients less than 18 years old. We excluded patients pronounced dead at the scene.INTERVENTIONS:None.SETTING:All cases of pediatric trauma in the registry were assessed for treatment with TXA. Propensity score matching was used to assess the association between prehospital TXA administration and mortality.MEASUREMENTS AND MAIN RESULTS:Overall, 911 pediatric trauma patients were treated with TXA by the IDF-MC teams; the median (interquartile) age was 10 years (5–15 yr), and 72.8% were male. Seventy patients (7.6%) received TXA, with 52 of 70 (74%) receiving a 1,000 mg dose (range 200–1,000 mg). There were no prehospital adverse events associated with the use of TXA (upper limit of 95% CI for 0/70 is 4.3%). Compared with pediatric patients who did not receive TXA, patients receiving TXA were more likely to suffer from shock (40% vs 10.7%;p< 0.001), sustain more penetrating injuries (72.9% vs 31.7%;p< 0.001), be treated with plasma or crystalloids (62.9% vs 11.4%;p< 0.001), and undergo more lifesaving interventions (24.3% vs 6.2%;p< 0.001). The propensity score matching failed to identify an association between TXA and lesser odds of mortality, although a lack of effect (or even adverse effect) could not be excluded (non-TXA: 7.1% vs TXA: 4.3%, odds ratio = 0.584; 95% CI 0.084–3.143;p= 0.718).CONCLUSIONS:Although prehospital TXA administration in the pediatric population is feasible with adverse event rate under 5%, more research is needed to determine the appropriate approach to pediatric hemostatic resuscitation and the role of TXA in this population.
Strength-based rehabilitation on clinical outcomes in patients post-partial meniscectomy: a systematic review and meta-analysis
Authors: Vivekanantha Prushoth , Diao David , Cohen Dan , Murphy Ben , de SA Darren 
Published: February 2023

ABSTRACTObjectiveTo determine the effect of strength-based rehabilitation programs on patients who underwent partial meniscectomy proceduresDesignThree databases MEDLINE, PubMed and EMBASE were searched from inception to May 9th, 2022. Data on functional outcomes such as quadriceps and hamstring strengths, as well as patient-reported outcomes such as Knee Osteoarthritis and Outcome Score (KOOS) and Visual-Analogue Scale (VAS) were recorded.ResultsA total of nine studies comprising 417 patients were included in this review. There were no significant differences in quadriceps or hamstring strength measures between pre and post-intervention for both groups. KOOS scores significantly increased from pre and post-intervention in both control and exercise groups. VAS scores changed from 5.0 cm to 1.4 cm in the exercise arm and 3.1 cm to 1.9 cm in the control arm.ConclusionStrength-based exercise programs for patients post-partial meniscectomy did not result in significantly different improvements in quadriceps or hamstring strength compared to control programs. However, strength-based exercise programs resulted in significantly higher KOOS scores and a greater decrease in VAS scores. Further studies, specifically well-designed systematic randomized controlled trials are necessary in order to elucidate the specifics behind what type of exercises to use in addition to load progression and frequency of training.
Changes in mild neurocognitive disorder status in mobility limited older primary care patients— implications for rehabilitative care
Authors: Ogawa Elisa F. , Ward Rachel E. , Milberg William P. , Dufour Alyssa B. , Moye Jennifer , Driver Jane A. , Bean Jonathan F. 
Published: February 2023

Abstract

Objective
To identify potential rehabilitative treatment targets associated with participants’ annual cognitive status.

Design
A cohort study patients with self-reported mobility limitation who completed neuropsychological, physical performance testing, and questionnaires at baseline to 2-year follow-up were categorized into three groups (persistently cognitively normal (mNCD-), non-persistent mild neurocognitive disorder (mNCD) and persistently mNCD+) based on their annual cognitive status using baseline, years 1 and 2 performance on Hopkins Verbal Learning, Trail Making, and Digit Symbol Substitution Tests. Repeated measures multinomial regression analysis was used to examine the differences between groups and associated characteristics.

Results
Study included 349 participants (mean age 76 ± 7) with 57% of participants were persistently mNCD-, 16% persistently mNCD+, and 27% non-persistent mNCD over 2 years of follow-up. Faster gait speed (Relative Risk Reduction (RRR):0.64-0.89) was associated with risk reduction and increase in depressive symptoms (RRR:1.09-1.12) was associated with greater risk of being classified into the non-persistent or persistently mNCD+ compared to persistently mNCD-.

Conclusion
Variability across cognitive status over time was observed. Gait speed and depressive symptoms were modifiable risk factors associated with non-persistent and persistent mNCD status. This study reinforces the potential benefit of multifaceted rehabilitation for preventing and treating older adults with mobility and/or cognitive problems.
Antiviral therapies for influenza
Authors: Chan Ken K.P. , Hui David S.C. 
Published: February 2023

Purpose of review
The heavily suppressed global influenza activity during the coronavirus disease 2019 (COVID-19) pandemic is expected to return upon relaxation of travel restriction and nonpharmaceutical interventions (NPI). We reviewed the four marketed neuraminidase inhibitors (NAI e.g., oseltamivir, zanamivir, peramivir, laninamivir) and the only endonuclease inhibitor (baloxavir) on their clinical therapeutic effects and the ability of viral suppression in various groups of patients of different clinical settings based on the latest evidence.

Recent findings
Early initiation, preferably within 48 h of symptom onsets, of antiviral treatments with NAI and baloxavir, is crucial to produce favourable outcomes in patients with influenza infection. Updated evidence does not suggest routine use of combined antiviral agents in patients with influenza infection. Treatment-emergent resistant influenza variants may occur during NAI and baloxavir use, but it has no major impact on subsequent recovery. Early treatment of index patients with influenza infection and post-exposure prophylaxis in specific populations is crucial in preventing influenza transmission.

Summary
Antiviral therapy is the major defence therapeutically in the community and hospital settings to expedite early recovery and reduce influenza-related complications. Early treatment of index patients and post-exposure prophylaxis in susceptible close contacts may mitigate the spread of infection.
Malignant Peripheral Nerve Sheath Tumors of the Brachial Plexus
Authors: Donaldson Elsa K. , Winter Jessica M. , Chandler Rowan M. , Clark Tod A. , Giuffre Jennifer L. 
Published: February 2023

Introduction
The incidence of malignant peripheral nerve sheath tumors (MPNSTs) is 0.001%. Commonly, MPNST arise in neurofibromatosis; however, they can occur sporadically, de novo or from a preexisting neurofibroma. Malignant peripheral nerve sheath tumors are aggressive tumors with high rates of local recurrence and metastasis. The prognosis is poor with 5-year survival rates of 15% to 50%. Unfortunately, given the rarity of these tumors, it is not clear how to best manage these patients. The purposes of this study were (1) to discuss our experience with MPNST and particularly our difficulties with diagnosis and management, and (2) to review the literature.

Materials and Methods
We report on all tumors of the brachial plexus excised between 2013 and 2019. We report 3 cases of MPNST, their treatment, and their outcomes.

Results
Thirteen patients underwent surgical excision of an intrinsic brachial plexus mass. Three of these patients (2 male, 1 female; average age, 36 years) were diagnosed with an MPNST. Two patients with an MPNST had neurofibromatosis type 1. All patients with an MPNST had a tumor >8 cm, motor and sensory deficits, and pain. All 3 patients with MPNST underwent a magnetic resonance imaging (MRI) before diagnosis. The average time from initial symptom onset to MRI was 12.3 months. Only 1 of the MRIs suggested a malignant tumor, with no MRI identifying an MPNST. One patient underwent an excisional biopsy, and 2 had incisional biopsies. Because of the lack of diagnosis preoperatively, all patients had positive margins given the limited extent of surgery. Returning for excision in an attempt to achieve negative margins in a large oncologically contaminated field was not possible because defining the boundaries of the initial surgical field was unachievable; therefore, the initial surgery was their definitive surgical management. All patients were referred to oncology and received radiation therapy.

Conclusions
Malignant peripheral nerve sheath tumors must be suspected in enlarging masses (>5 cm) with the constellation of pain, motor, and sensory deficits. Computed tomography– or ultrasound-guided core needle biopsy under brachial plexus block or sedation is required for definitive diagnosis to allow for a comprehensive approach to the patient's tumor with a higher likelihood of disease-free survival.
Addressing a climate emergency amidst the COVID-19 pandemic: A mixed-methods study on a hospital evacuation during the 2021 European floods
Authors: Wal Willemijn vd , Barten Dennis G. , Ketelings Linsay , Osch Frits v , Rao Madhura , Mortelmans Luc , Bierens Joost 
Published: February 2023

ABSTRACTIntroductionIn July 2021, several European countries were affected by severe floods with water levels of the river Meuse reaching a record high. VieCuri Medical Center (Venlo, the Netherlands) is a hospital located directly adjacent to this river, and in response to the flood threat it was decided to completely evacuate the hospital. The aim of this study was to explore the decision-making process of this emergent evacuation.MethodsA mixed-method approach was used. Qualitative data were collected through semi-structured interviews with 11 key participants closely involved in the evacuation. Quantitative data on the patients that were admitted at the time of the evacuation decision were collected, and included 30-day mortality, 7-day readmission rates and Charlson Comorbidity Index.ResultsThree themes were constructed from the interviews: risk-assessment, COVID-19 experience and collaboration. Participants highlighted the role of previous experiences from the COVID-19 pandemic. The use of a national patient coordination center enabled to rapidly assess capacity of potential destination hospitals. Furthermore, the hospital’s preparedness for evacuation could be improved by a thorough analysis of locoregional hazards and preparing for loss of regional healthcare capacity. Findings unrelated to decision-making included the inefficiency of large-scale ambulance dispatches and the expansion of business continuity plans. No patients died unanticipated during this hospital evacuation or within 30 days.ConclusionExperiences of the COVID-19 pandemic and the availability of a national patient coordination center were found to be decisive in performing this evacuation. This allowed for the swift identification of available capacity in appropriate destination hospitals.
IVUS Improves Outcomes with SUPERA Stents for the Treatment of Superficial Femoral-popliteal Artery Disease
Authors: Krishnan Prakash , Sharma Raman , Avadhani Sriya , Tarricone Arthur , Gee Allen , Farhan Serdar , Kamran Haroon , Kini Annapoorna , Sharma Samin 
Published: February 2023

AbstractObjectivesTo determine the effect of intravenous ultrasound (IVUS) when used adjunctively with nitinol interwoven bare metal stents in the management of femoropopliteal lesions.BackgroundNitinol interwoven bare metal stents represent an advancement in stent technology; however nominal deployment remains an area of focus. Intravascular Ultrasound (IVUS) has been shown to improve outcomes in both the coronary and peripheral vasculature by providing the operator with greater vessel detail. The use of adjunctive IVUS with Nitinol bare metal stents has not been widely studied.MethodsThis study included a cohort of 200 consecutive patients with peripheral artery disease. All patients were treated with ≥1 Supera bare metal stent, and 91 received adjunctive IVUS imaging prior to stent deployment. Deployment conditions of nominal, compressed, and elongated were measured and the primary clinical outcomes included target lesion reintervention, major and minor, below the knee amputation, and mortality.ResultsThe patients who received IVUS had a significantly greater number of nominally deployed stents (p<0.001). Patients who had IVUS imaging also had significantly lower reintervention rates compared to those who did not receive IVUS imaging (p=0.047).ConclusionIVUS and angiography decreases clinically driven target lesion reintervention and increases nominal deployment compared to angiography alone in femoropopliteal lesions treated with interwoven bare metal nitinol stents.Condensed AbstractThis retrospective study was done to examine the utility of intravenous ultrasound when used adjunctively for visualization in the management of femoropopliteal lesions in peripheral artery disease patients. There was total of 200 subjects and all were treated using the Supera nitinol self-expanding stent. By the end of the study, the group of subjects treated with intravenous ultrasound had significantly fewer reinterventions and had a greater rate of nominally deployed stents. These findings suggest the beneficial role intravenous ultrasound has compared to angiography alone in the management of femoropopliteal lesions with Supera stents.
Impact of Immune Evasion, Waning and Boosting on Dynamics of Population Mixing Between a Vaccinated Majority and Unvaccinated Minority
Authors: Fisman David N. , Amoako Afia , Simmons Allison , Tuite Ashleigh R. 
Published: February 2023

AbstractBackgroundWe previously demonstrated that when vaccines prevent infection, the dynamics of mixing between vaccinated and unvaccinated sub-populations is such that use of imperfect vaccines markedly decreases risk for vaccinated people, and for the population overall. Risks to vaccinated people accrue disproportionately from contact with unvaccinated people. In the context of the emergence of Omicron SARS-CoV-2 and evolving understanding of SARS-CoV-2 epidemiology, we updated our analysis to evaluate whether our earlier conclusions remained valid.MethodsWe modified a previously published Susceptible-Infectious-Recovered (SIR) compartmental model of SARS-CoV-2 with two connected sub-populations: vaccinated and unvaccinated, with non-random mixing between groups. Our expanded model incorporates diminished vaccine efficacy for preventing infection with the emergence of Omicron SARS-CoV-2 variants, waning immunity, the impact of prior immune experience on infectivity, “hybrid” effects of infection in previously vaccinated individuals, and booster vaccination. We evaluated the dynamics of an epidemic within each subgroup and in the overall population over a 10-year time horizon.ResultsEven with vaccine efficacy as low as 20%, and in the presence of waning immunity, the incidence of COVID-19 in the vaccinated subpopulation was lower than that among the unvaccinated population across the full 10-year time horizon. The cumulative risk of infection was 3-4 fold higher among unvaccinated people than among vaccinated people, and unvaccinated people contributed to infection risk among vaccinated individuals at twice the rate that would have been expected based on the frequency of contacts. These findings were robust across a range of assumptions around the rate of waning immunity, the impact of “hybrid immunity”, frequency of boosting, and the impact of prior infection on infectivity in unvaccinated people.InterpretationAlthough the emergence of the Omicron variants of SARS-CoV-2 has diminished the protective effects of vaccination against infection with SARS-CoV-2, updating our earlier model to incorporate loss of immunity, diminished vaccine efficacy and a longer time horizon, does not qualitatively change our earlier conclusions. Vaccination against SARS-CoV-2 continues to diminish the risk of infection among vaccinated people and in the population as a whole. By contrast, the risk of infection among vaccinated people accrues disproportionately from contact with unvaccinated people.
EphrinA4/EphA4 controls blood pressure via arterial sympathetic innervation
Authors: Simonnet Emilie , Martin Sabrina , Vilar José , Vessieres Emilie , Taib Sonia , Monceau Virginie , Pardanaud Luc , Bouby Nadine , Eichmann Anne , Silvestre Jean-Sébastien , Henrion Daniel , Brunet Isabelle 
Published: February 2023

AbstractThe autonomic sympathetic nervous system innervates peripheral resistance arteries, thereby controlling arterial diameter and modulating blood supply to organs and arterial tone. Despite its fundamental role in blood flow regulation and adaptive response of the cardiovascular system to challenging situations, how sympathetic arterial innervation develops remains poorly understood.We here show that sympathetic arterial innervation is regulated by the axonal guidance molecule EphrinA4 in arterial Smooth Muscle Cells (SMCs), which repels sympathetic axons via the EphA4 receptor. Specific inactivation of EphA4 in sympathetic axons induced a loss of repulsion and increased sympathetic innervation of peripheral arteries throughout life. Functional consequences were a significant increase in arterial tone (resistivity and vasoconstriction), leading to an elevated systemic arterial blood pressure that reached to hypertension under stressful circumstances. These findings identify a novel pathway that negatively regulates sympathetic arterial innervation, and could participate to the appearance of idiopathic resistant hypertension.
An integrated map of cell type-specific gene expression in pancreatic islets
Authors: Elgamal Ruth M , Kudtarkar Parul , Melton Rebecca L , Mummey Hannah M , Benaglio Paola , Okino Mei-Lin , Gaulton Kyle J 
Published: February 2023

AbstractPancreatic islets are comprised of multiple endocrine cell types that produce hormones required for glucose homeostasis, and islet dysfunction is a major factor in the development of type 1 and type 2 diabetes (T1D, T2D). Numerous studies have generated gene expression profiles in individual islet cell types using single cell assays. However, there is no canonical reference of gene expression in islet cell types in both health and disease that is also easily accessible for researchers to access, query, and use in bioinformatics pipelines. Here we present an integrated reference map of islet cell type-specific gene expression from 192,203 cells derived from single cell RNA-seq assays of 65 non-diabetic, T1D autoantibody positive (Aab+), T1D, and T2D donors from the Human Pancreas Analysis Program. We identified 10 endocrine and non-endocrine cell types as well as sub-populations of several cell types, and defined sets of marker genes for each cell type and sub-population. We tested for differential expression within each cell type in T1D Aab+, T1D, and T2D states, and identified 1,701 genes with significant changes in expression in any cell type. Most changes were observed in beta cells in T1D, and, by comparison, there were almost no genes with changes in T1D Aab+. To facilitate user interaction with this reference, we provide the data using several single cell visualization and reference mapping tools as well as open-access analytical pipelines used to create this reference. The results will serve as a valuable resource to investigators studying islet biology and diabetes.
μCas, a novel class of miniature type-V Cas12f nucleases with diverse PAM
Authors: Sharrar Allison , Arake de Tacca Luisa , Collingwood Trevor , Meacham Zuriah , Rabuka David , Staples-Ager Johanna , Schelle Michael 
Published: February 2023

AbstractSmall CRISPR-Cas effectors are key to developing gene editing therapies due to the packaging constraints in viral vectors. While Cas9 and Cas12a CRISPR-Cas effectors have advanced into select clinical applications, their size is prohibitive for efficient delivery of both nuclease and guide RNA in a single viral vector. Type-V Cas12f effectors present a solution given their small size. Here we describe μCas, a novel class of miniature (<490AA) type-V Cas12f nucleases that cleave double stranded DNA in human cells. We determined their optimal trans-activating RNA (tracrRNA) empirically through rational modifications which resulted in an optimal single guide RNA (sgRNA). We show that the μCas nucleases have broader PAM preferences than previously known Cas12f effectors. The unique characteristics of these novel nucleases add to the diversity of the miniature CRISPR-Cas toolbox while the expanded PAM allows for the editing of genomic locations that could not be accessed with existing Cas12f nucleases.
Seroreversion toChlamydia trachomatisPgp3 antigen among children in a hyperendemic region of Amhara, Ethiopia
Authors: Tedijanto Christine , Aragie Solomon , Gwyn Sarah , Wittberg Dionna M. , Zeru Taye , Tadesse Zerihun , Chernet Ambahun , Thompson Isabel J.B. , Nash Scott D. , Lietman Thomas M. , Martin Diana L. , Keenan Jeremy D. , Arnold Benjamin F. 
Published: February 2023

ABSTRACTMonitoring trachoma transmission with antibody data requires characterization of decay in IgG toChlamydia trachomatisantigens. In a three-year longitudinal cohort in a high transmission setting, we estimated a median IgG half-life of 3 years and a seroreversion rate of 2.5 (95% CI: 1.6, 3.5) per 100 person-years.