bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving ICU Risk Predictive Models Through Automation Designed for Resiliency Against Documentation Bias
Authors: Liu Xinggang , Armaignac Donna Lee , Becker Christian , Hiddleson Cheryl , Dubouchet Eduardo Martinez , Rincon Teresa , Amelung Pamela J. , French Robin , Scurlock Corey , Atallah Louis , Badawi Omar 
Published: December 2022

Objectives:
Electronic health records enable automated data capture for risk models but may introduce bias. We present the Philips Critical Care Outcome Prediction Model (CCOPM) focused on addressing model features sensitive to data drift to improve benchmarking ICUs on mortality performance.

Design:
Retrospective, multicenter study of ICU patients randomized in 3:2 fashion into development and validation cohorts. Generalized additive models (GAM) with features designed to mitigate biases introduced from documentation of admission diagnosis, Glasgow Coma Scale (GCS), and extreme vital signs were developed using clinical features representing the first 24 hours of ICU admission.

Setting:
eICU Research Institute database derived from ICUs participating in the Philips eICU telecritical care program.

Patients:
A total of 572,985 adult ICU stays discharged from the hospital between January 1, 2017, and December 31, 2018, were included, yielding 509,586 stays in the final cohort; 305,590 and 203,996 in development and validation cohorts, respectively.

Interventions:
None.

Measurements and Main Results:
Model discrimination was compared against Acute Physiology and Chronic Health Evaluation (APACHE) IVa/IVb models on the validation cohort using the area under the receiver operating characteristic (AUROC) curve. Calibration assessed by actual/predicted ratios, calibration-in-the-large statistics, and visual analysis. Performance metrics were further stratified by subgroups of admission diagnosis and ICU characteristics. Historic data from two health systems with abrupt changes in Glasgow Coma Scale (GCS) documentation were assessed in the year prior to and after data shift. CCOPM outperformed APACHE IVa/IVb for ICU mortality (AUROC, 0.925 vs 0.88) and hospital mortality (AUROC, 0.90 vs 0.86). Better calibration performance was also attained among subgroups of different admission diagnoses, ICU types, and over unique ICU-years. The CCOPM provided more stable predictions compared with APACHE IVa within an external cohort of greater than 120,000 patients from two health systems with known changes in GCS documentation.

Conclusions:
These mortality risk models demonstrated excellent performance compared with APACHE while appearing to mitigate bias introduced through major shifts in GCS documentation at two large health systems. This provides evidence to support using automated capture rather than trained personnel for capture of GCS data used in benchmarking ICUs on mortality performance.
The association between diabetes type, age of onset, and age at natural menopause: a retrospective cohort study using the Canadian Longitudinal Study on Aging
Authors: Mehra Vrati M. , Costanian Christy , McCague Hugh , Riddell Michael C. , Tamim Hala 
Published: December 2022

Abstract

Objectives
With growing incidence of type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes, more women are expected to spend a larger proportion of their reproductive years living with a diabetes diagnosis. It is important to understand the long-term implications of premenopausal diabetes type on women's reproductive health including their age at natural menopause (ANM).

Methods
Baseline data from the Comprehensive Cohort of Canadian Longitudinal Study on Aging were used. Females who reported premenopausal diagnosis of diabetes were considered exposed. Kaplan-Meier cumulative survivorship estimates and multivariable Cox regression models were used to assess the association between diabetes types and ANM. Sociodemographic, lifestyle, and premenopausal clinical factors were adjusted in the final model as covariates.

Results
The sample comprised 11,436 participants, weighted to represent 1,474,412
Canadian females aged 45 to 85 years. The median ANM was 52 years. After adjusting for ethnicity, education, smoking, and premenopausal clinical factors, early age of diagnosis of both T1D (<30 years) and T2D (30-39 years) were associated with earlier menopause (T1D, <30: hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.05-2.28; T2D, 30-39: HR, 1.82; 95% CI, 1.12-2.94), as compared with nondiabetics. In addition, later age of diagnosis of T2D (≥40 years) was associated with later ANM (T2D: HR, 0.63; 95% CI, 0.50-0.80). No significant association between gestational diabetes and ANM was noted.

Conclusions
Our results point to early menopause among young women living with a diabetes diagnosis. These findings should allow for more focused research geared toward understanding the long-term health implications of diabetes on women's reproductive health and aging.
Estimation of placebo effect in randomized placebo-controlled trials for moderate or severe vasomotor symptoms: a meta-analysis
Authors: Zhou Tianyu 
Published: December 2022

Abstract

Objective
The Food and Drug Administration guidance recommended that for the indication of vasomotor symptoms (VMS), studies should enroll participants with minimum of seven to eight moderate to severe VMS per day at baseline, and coprimary endpoints should be the mean change in frequency/severity at weeks 4 and 12. This study aimed to estimate placebo effects in randomized controlled trials (RCTs) fulfilling this guidance.

Methods
PubMed was searched using the following terms: “vasomotor symptom or hot flash or hot flashes or hot flash or hot flashes [title/abstract],” “menopause or climacteric,” “RCT or randomized controlled or randomized controlled,” “placebo [title/abstract],” and “frequency or severity.” Inclusion criteria were as follows: (1) placebo controlled RCTs, (2) enrolling women with moderate or severe VMS with a minimal frequency more than seven to eight times per day or 50 times per week, and (3) efficacy measurements including mean change in VMS frequency from baseline at week 12. A random-effects model was used in the meta-analysis.

Results
Seventeen studies were included for the estimation of VMS frequency reduction and 13 studies for severity. Estimated change of VMS frequency in placebo arms was −5.44 times per day (95% CI, −5.81 to −5.07 times per day) at week 12. For VMS severity, the estimated change at week 12 was −0.36 (95% CI, −0.46 to −0.27).

Conclusion
Substantial and consistent placebo effects were observed in RCTs for VMS treatment. These data suggest a reduction of 5.44 times per day in frequency and 0.36 in severity might be observed as a placebo effect.
Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records
Authors: DePree Barbara , Houghton Katherine , Shiozawa Aki , Esterberg Elizabeth , King Deanna D. , Kim Janet , Mancuso Shayna 
Published: December 2022

Abstract

Objective
The aim of this study was to generate real-world evidence documenting use of prescription and nonprescription therapies recorded by health care providers for women experiencing vasomotor symptoms (VMS) associated with menopause.

Methods
This noninterventional, retrospective, observational cohort study used data from US patient medical records. Participating health care providers were gynecologists, internal medicine/family physicians, or advanced practice providers who typically saw three or more women per week presenting with menopausal symptoms and could identify eligible medical records; providers were recruited from local medical association directories and from listings from previously conducted research. Eligible women presented January 2016 through December 2019, were 40 to 60 years of age, and reported experiencing bothersome hot flashes at least twice within 24 hours.

Results
A total of 283 health care providers provided data for 1,016 women. The most common symptoms at initial presentation were hot flashes (91.2%), sleep problems (49.9%), and vaginal dryness (47.0%). At least one therapy for menopausal symptoms was recorded for 883 women (86.9%), and 611 (60.1%) had documentation of prescription medication, most commonly hormone therapy (70.4%). Nearly 40% of women had no prescription medication documented, and approximately 13% had no therapy documented. Despite experiencing bothersome menopausal symptoms, approximately 50% delayed seeking care for more than 6 months. Women had a mean of 2.1 (SD, 2.0) office visits related to menopause from initial presentation to completion of review, and health care resource utilization did not vary by treatment status. Subgroup analyses indicated nominal differences in treatment use across ethnic groups and varying prescribing patterns for menopausal symptoms by practitioner type and US region.

Conclusions
A high proportion of women with VMS remain untreated even when experiencing bothersome symptoms of menopause. Improved management of VMS is required to provide relief from the symptoms effectively and safely.
Building prediction models of clinically significant intraocular lens tilt and decentration for age-related cataract
Authors: Gu Xiaoxun , Zhang Miao , Liu Zhenzhen , Ruan Xiaoting , Tan Xuhua , Zhang Enen , Chen Xiaoyun , Luo Lixia , Liu Yizhi 
Published: December 2022

Purpose:To explore the risk factors and construct nomogram models to predict the risks of clinically significant intraocular lens (IOL) tilt and decentration after cataract surgery in patients with age-related cataract.Setting:Zhongshan Ophthalmic Center, Guangzhou, China.Design:Prospective cohort study.Methods:207 patients (207 eyes) who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Casia2 was used to measure the tilt and decentration of crystalline lenses and IOLs before and 3 months after surgery. Univariate and multivariate logistic regression analyses were used to determine the risk factors of clinically significant IOL tilt and decentration, and nomogram prediction models were constructed according to the results of the multivariate logistic regression analysis.Results:Two hundred and seven patients were included in analysis. 24 eyes (11.59%) and 16 eyes (7.73%) had clinically significant IOL tilt and decentration at 3 months after cataract surgery. Multivariate logistic regression analysis revealed that preoperative crystalline lens tilt and decentration were the risk factors for clinically significant IOL tilt (odds ratio [OR], 3.519,P< .001) and decentration (OR, 410.22,P= .001), respectively. Axial length was another association factor for clinically significant IOL decentration (OR, 2.155,P= .019). The risk models demonstrated good calibrations and discriminations for the predictions of clinically significant IOL tilt (receiver operating characteristic [ROC] area = 0.833, cutoff value = 6.5) and decentration (ROC area = 0.757, cutoff value = 0.08).Conclusions:The good performances of our models suggested that they may be useful risk prediction tools for postoperative IOL tilt and decentration. The measurement of preoperative crystalline lens tilt and decentration should be one of the routine examinations before cataract surgery, especially for toric and multifocal IOLs.
Cardiometabolic Diseases and Quality-of-Life Outcomes in Adults With HIV in the Deep South: A Cross-sectional Study
Authors: Enogela Ene M. , Jones Raymond , Buford Thomas W. , Vance David E. , Fazeli Pariya L. 
Published: December 2022

Abstract
The role of cardiometabolic diseases (CMDs) on physical health–related quality of life (P-HRQoL) and quality of sleep was examined among 261 PLWH ≥40 years, recruited from a university-affiliated HIV clinic in the Deep U.S. South. Using a cross-sectional study design, participants completed the Medical Outcomes Study HIV Health Survey (MOS-HIV; P-HRQoL) and Pittsburgh Sleep Quality Index. The overall prevalence of self-reporting ≥1 CMD was 64.4%. P-HRQoL scores were lower in PLWH with ≥1 CMD compared with those with no CMDs (45.53 ± 11.54 vs. 49.67 ± 10.77, p <.01). Poor sleep quality was higher among participants with ≥1 CMD compared with those with no CMDs (9.28 ± 4.42 vs. 7.26 ± 4.17, p<.01). Each additional CMD resulted in a 1.83-point decrease in P-HRQoL and 0.74-point increase in poor sleep quality scores. Interventions that focus on targeting these quality-of-life domains in PLWH with CMDs are needed.
Influence of Shift Work on Arterial Stiffness and Systemic Inflammation
Authors: Skogstad Marit , Aass Hans Christian D. , Sirnes Per Anton , Mamen Asgeir , Skare Øivind , Matre Dagfinn , Hammer Stine Eriksen , Goffeng Elisabeth , Lunde Lars-Kristian 
Published: December 2022

ObjectiveTo assess changes in cardiovascular disease risk factors during a 3-year follow-up among 57 rotating shift workers and 29 day workers in industry.MethodsWe collected demographics by questionnaire, examined blood pressure, heart rate, pulse wave velocity, carotid media thickness, and maximal oxygen uptake. We assessed blood samples for determination of lipids, glycosylated hemoglobin, C-reactive protein, markers of inflammation, and particle concentrations/respirable dust. Baseline comparisons were analyzed using logistic regression (plaque) and linear regression for all other outcomes. We applied mixed models to assess differences in change in health outcomes between the shift workers and the day workers.ResultsAt baseline, the adhesion molecules soluble vascular cell adhesion molecule 1 and soluble P-selectin were elevated among the shift workers compared with that of the day workers. There was a significant difference in change in pulse wave velocity between shift workers (1.29-m/s increase) and day workers (0.11-m/s increase) over the 3-year follow-up. Respirable dust levels were below the Norwegian occupational exposure limit.ConclusionsShift work in industry is associated with arterial stiffening reflecting increased risk for future cardiovascular disease. More uncertainly, we found some support for systemic inflammation.
Mediating and Moderating Effects of Psychological Detachment on the Association Between Stressors and Depression
Authors: Kiuchi Keita , Sasaki Takeshi , Takahashi Masaya , Kubo Tomohide , Yoshikawa Toru , Matsuo Tomoaki , Liu Xinxin 
Published: December 2022

Objectives
This study examines the mediating and moderating effects of psychological detachment (PD) based on the stressor-detachment model in the long term.

Methods
Two waves of Web-based surveys, 28 months apart, yielded 3556 responses from Japanese workers. Comparisons between models that included mediating and moderating effects of PD and reverse direction mediating effects (strain → PD → stressor) were made by structural equation modeling. Differences in depression as a strain between combinations of high and low stressors and PD were also examined.

Results
The best-fitting model was the moderation/reciprocal partial-mediation model. The effect of PD was significant in the group with stable or decreasing stressor.

Conclusion
According to the worker's level of stressors, PD, and depression, targeted interventions may effectively prevent physical and mental health problems caused by chronic stress.
PISCovid-1_final_preprint.docx
Authors: AbdelMassih Antoine , Hanafy Maram , ElAhmady Maryam , Kozman Sylvia , Diab Nourine , Husseiny Reem , Deyab Ashrakat M , Mady Aalaa , Yasser Alya , AbdelHalim Amira , Mohyeldin Aya , Serour Aya Sayed , AbdelGadir Ayat , Abdelaziz Eslam , ElGhamry Farida , Amr Hana , Milad Karim , Fouda Lamya , Hesham Mawada , Riad Mina Adly , Aoun Mohamed , AbdelTawab Rana , Sayed Rana , ElSenbawy Salma , Abdelkhalek Sara ElAhmady , Gamal Nada , Omar Yasmin 
Published: December 2022

<p> </p>
<h2>Introduction:</h2>
<p>Coronavirus Disease 2019 (COVID-19) is by far the most world-altering pandemic to ever hit modern humanity. Three years after the very first case emerged in December 2019, the virus continues to bring upon global disarray in the acute phase of the infection as well as months afterwards, causing the virus’s morbidity and mortality to further skyrocket. This systematic literature review was conducted up till December 2022, comprising all the case reports that thoroughly discuss a myriad of non-Multisystem Inflammatory Syndrome In Children (non-MIS-C) post-acute sequalae of COVID-19 (PASC) in the paediatric population, also known as Long COVID Syndrome. In this review, we aimed to highlight the prevalent time interval between COVID-19 infection and the development of various non-MISC post-infectious sequalae (PIS). </p>
<h2>Methods:</h2>
<p>We conducted a holistic literature search on PubMed, Google Scholar, Google Search, and Scopus. Data bases were searched for studies that met our inclusion and exclusion criteria. The systematic review was performed on all case reports containing relevant outcome parameters such as age, sex, the interval between COVID-19 infection and subsequent PASC and, lastly, the need for hospitalization during the course of the disease.</p>
<h2>Results: </h2>
<p>We collected a total of 78 case reports discussing the various post-infectious immune sequalae following COVID-19 infection in the paediatric population, consisting of a total of 109 patients. The final screening revealed an equal sex distribution, whereas the two commonest age intervals were school-aged children and adolescents, with 38% of the patients having been older than six years. Interestingly, hospital admission throughout the course of COVID-19 wasn’t a predictor of the subsequent PASC; forty-nine patients (44.9%) were hospitalized while sixty patients (55.1%) were not hospitalized. More importantly, the most predominant time interval between COVID-19 infection and the developing PASC was observed to be within 14 days since the start of COVID-19 infection, accounting for 61% of the cases. </p>
<h2>Conclusion: </h2>
<p>These findings suggest a crucial link is slowly but surely unfolding between COVID-19 and an abundance of systemic post-infectious immune sequalae in the paediatric population, especially amongst children older than six years. Accordingly, meticulous follow-up and prompt management is largely encouraged for the paediatric population in case of unusual symptoms and signs following COVID-19 infection, regardless of COVID-19’s severity. </p>
Optimizing Innervation in Radial Forearm Phalloplasty: Consider the Posterior Antebrachial Cutaneous Nerve
Authors: Peters Blair R. , Richards Holden W. , Berli Jens U. 
Published: December 2022

Summary:
One goal of an ideal phallic reconstruction is achieving tactile and erogenous sensation. Traditionally, the most common flap used in phalloplasty has been the radial forearm flap, where the medial and lateral antebrachial cutaneous nerves are coapted to meet this goal. The purpose of this article is to draw attention to the lesser-known posterior antebrachial cutaneous nerve (PABC) as an alternative or additional nerve for coaptation that innervates a majority of the shaft, where sensation is most desired. The presence, anatomical location, and territory of innervation of the antebrachial cutaneous nerves were assessed in a series of 12 consecutive in vivo radial forearm phalloplasties. A literature review was conducted to establish which nerves have traditionally been used for sensory reinnervation of the phallus. The PABC was the first nerve encountered on the radial border of the flap lying on the fascia in the interval between the brachioradialis and extensor carpi radials longus. The posterior and lateral antebrachial cutaneous nerves innervated the phallic shaft, whereas the anterior branch of the medial antebrachial cutaneous nerve innervated the phallic urethra. There were no articles in our review that used PABC for nerve coaptation in radial forearm phalloplasty. The skin innervated by the PABC represents a significant portion of the phallic shaft when using the standard template for radial forearm phalloplasty. Despite this, its use is not described in the literature. The authors introduce the PABC as an alternative or additional nerve for coaptation in radial forearm phalloplasty.
Speech Outcomes following Mandibular Distraction Osteogenesis for Robin Sequence: Midchildhood Results
Authors: Kosyk Mychajlo S. , Zapatero Zachary D. , Kalmar Christopher L. , Carlson Anna R. , Cohen Marilyn , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A. 
Published: December 2022

Background:
The aim of this study was to compare midchildhood speech outcomes in patients with nonsyndromic Robin sequence with cleft palate (RSCP) treated with mandibular distraction osteogenesis (MDO) to patients with nonsyndromic Veau class I and Veau class II cleft palate (CP).

Methods:
The authors performed a retrospective review of patients with nonsyndromic Robin sequence from 2000 to 2017, comparing those who underwent MDO to patients with nonsyndromic CP. Demographics, operative details, length of hospital stay, complications, and Pittsburgh Weighted Speech Scale scores were collected.

Results:
Thirty-three patients met inclusion criteria in the MDO group with 127 patients as controls. Despite similar median age (RSCP, 4.5 years; CP only, 4.6 years) and Veau cleft type at early evaluation, there was a significant increase in composite Pittsburgh Weighted Speech Scale score within the MDO cohort (P ≤ 0.002); specifically, with worse visible nasal emission (P ≤ 0.007), hypernasality (P ≤ 0.001), and compensatory articulation (P ≤ 0.015). However, these differences were not present at age-matched midchildhood evaluation (median, RSCP, 6.5; CP only, 7.1; P ≥ 0.092). Median age-matched follow-up was 6.4 years in the MDO group and 7.1 years in the control group (P ≥ 0.136). There was also no difference in the rate of secondary speech surgery at midchildhood evaluation (P ≥ 0.688).

Conclusions:
The authors’ retrospective comparison of speech outcomes in RSCP versus CP only demonstrates no difference in midchildhood speech, conflicting with recent reports. Although patients with Robin sequence treated with MDO had worse visible nasal emission, hypernasality, and compensatory articulation in early childhood, this appears to have resolved in the interim without additional intervention. Longitudinal follow-up is needed to fully understand the speech ramifications of RSCP.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.