bluuebunny/crossref_metadata_2025_split huggingface dataset:
VE-CAM-S: Visual EEG-Based Grading of Delirium Severity and Associations With Clinical Outcomes
Authors: Tesh Ryan A. , Sun Haoqi , Jing Jin , Westmeijer Mike , Neelagiri Anudeepthi , Rajan Subapriya , Krishnamurthy Parimala V. , Sikka Pooja , Quadri Syed A. , Leone Michael J. , Paixao Luis , Panneerselvam Ezhil , Eckhardt Christine , Struck Aaron F. , Kaplan Peter W. , Akeju Oluwaseun , Jones Daniel , Kimchi Eyal Y. , Westover M. Brandon 
Published: January 2022

OBJECTIVES:
To develop a physiologic grading system for the severity of acute encephalopathy manifesting as delirium or coma, based on EEG, and to investigate its association with clinical outcomes.

DESIGN:
This prospective, single-center, observational cohort study was conducted from August 2015 to December 2016 and October 2018 to December 2019.

SETTING:
Academic medical center, all inpatient wards.

PATIENTS/SUBJECTS:
Adult inpatients undergoing a clinical EEG recording; excluded if deaf, severely aphasic, developmentally delayed, non-English speaking (if noncomatose), or if goals of care focused primarily on comfort measures. Four-hundred six subjects were assessed; two were excluded due to technical EEG difficulties.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A machine learning model, with visually coded EEG features as inputs, was developed to produce scores that correlate with behavioral assessments of delirium severity (Confusion Assessment Method-Severity [CAM-S] Long Form [LF] scores) or coma; evaluated using Spearman R correlation; area under the receiver operating characteristic curve (AUC); and calibration curves. Associations of Visual EEG Confusion Assessment Method Severity (VE-CAM-S) were measured for three outcomes: functional status at discharge (via Glasgow Outcome Score [GOS]), inhospital mortality, and 3-month mortality. Four-hundred four subjects were analyzed (mean [sd] age, 59.8 yr [17.6 yr]; 232 [57%] male; 320 [79%] White; 339 [84%] non-Hispanic); 132 (33%) without delirium or coma, 143 (35%) with delirium, and 129 (32%) with coma. VE-CAM-S scores correlated strongly with CAM-S scores (Spearman correlation 0.67 [0.62–0.73]; p < 0.001) and showed excellent discrimination between levels of delirium (CAM-S LF = 0 vs ≥ 4, AUC 0.85 [0.78–0.92], calibration slope of 1.04 [0.87–1.19] for CAM-S LF ≤ 4 vs ≥ 5). VE-CAM-S scores were strongly associated with important clinical outcomes including inhospital mortality (AUC 0.79 [0.72–0.84]), 3-month mortality (AUC 0.78 [0.71–0.83]), and GOS at discharge (0.76 [0.69–0.82]).

CONCLUSIONS:
VE-CAM-S is a physiologic grading scale for the severity of symptoms in the setting of delirium and coma, based on visually assessed electroencephalography features. VE-CAM-S scores are strongly associated with clinical outcomes.
Association of Nonrecovery of Kidney Function After Pediatric Acute Kidney Injury With 5-Year Kidney and Nonkidney Outcomes
Authors: Ulrich Emma H. , Hessey Erin , Perreault Sylvie , Dorais Marc , Jouvet Philippe , Phan Veronique , Zappitelli Michael 
Published: January 2022

IMPORTANCE:
Acute kidney injury is common in critically ill children, but the long-term outcomes are not well defined.

OBJECTIVES:
Evaluated whether nonrecovery of kidney function, following acute kidney injury, was associated with postdischarge mortality, healthcare utilization, and chronic kidney disease.

DESIGN:
Retrospective, two-center, observational study.

SETTING:
Two ICUs at tertiary children’s hospitals in Montreal, QC.

PARTICIPANTS:
Pediatric patients (age ≤ 18 yr) with index admission to intensive care between January 1, 2003, and March 31, 2005. Children were excluded if they 1) died during admission, 2) did not have serum creatinine or urine output measured, 3) did not develop acute kidney injury, 4) could not be linked to administrative health data, and 5) (for chronic kidney disease outcome) had pre-existing renal disease by chart review, baseline estimated glomerular filtration rate measurement, or administrative health data codes.

MAIN OUTCOMES AND MEASURES:
Three-hundred seventy-eight patients’ data were included for long-term mortality and healthcare utilization outcomes; 316 patients for long-term chronic kidney disease outcome. Outcomes were defined using provincial administrative healthcare data diagnosis, procedure, and billing codes.

MAIN RESULTS:
Nonrecovery of kidney function, defined as serum creatinine greater than or equal to 1.5× baseline at ICU discharge, occurred in 51 patients (13%). Nonrecovery of kidney function was not associated with long-term mortality (at 5–7 yr following hospital discharge), increased hospitalizations or emergency department visits (at 30-days, 1-year, and 5-yr follow-up), or increased physician visits (at 1- and 5-yr follow-up). Nonrecovery was associated with increased 30-day physician visits (adjusted relative risk, 1.40; 95% CI, 1.13–1.73) and chronic kidney disease diagnosis within 5 years of discharge (adjusted hazard ratio, 4.92, 95% CI, 1.77–13.70).

CONCLUSIONS AND RELEVANCE:
Nonrecovery of kidney function following an episode of acute kidney injury in critically ill children is associated with nearly five-fold increased risk for long-term chronic kidney disease. Acute kidney injury nonrecovery may be a useful marker to identify patients that are particularly important to follow-up post discharge for chronic kidney disease detection.
Systolic Strain by Speckle-Tracking Echocardiography Is a Feasible and Sensitive Measure of Right Ventricular Dysfunction in Acute Respiratory Failure Patients on Mechanical Ventilation
Authors: Simmons James , Haines Philip , Extein Jonathan , Bashir Zubair , Aliotta Jason , Ventetuolo Corey E. 
Published: January 2022

OBJECTIVES:
Right ventricular (RV) dysfunction is common in acute respiratory failure and associated with worse outcomes, but it can be difficult to detect in the ICU setting. Speckle-tracking echocardiography (STE) can identify early changes in RV systolic function and be quantified as systolic strain. We measured the feasibility of RV global longitudinal systolic strain (RV GLS) in respiratory failure patients and its association with clinical outcomes.

DESIGN:
Retrospective cohort.

SETTING:
Two tertiary hospital medical ICUs in Providence, RI, from March 2015 to January 2018.

PATIENTS:
Two hundred twenty-three patients with acute respiratory failure requiring mechanical ventilation (MV) with available echocardiograms.

MEASUREMENTS AND MAIN RESULTS:
Clinical data were extracted from medical records. RV GLS was measured via STE (TOMTEC, Chicago, IL), along with standard echocardiographic measurements by two independent readers blinded to outcomes. The average age was 65 years (range, 21–90 yr), 121 (54%) were men, and the most common etiology of respiratory failure was pneumonia (n = 83, 37%). The average RV GLS was –16% (sd ± 7). The intraobserver correlation coefficients were 0.78 and 0.94, whereas the interobserver correlation coefficient was 0.61 for RV GLS. In the majority of echocardiograms (n = 178, 80%), all wall segments were tracked appropriately by operator visual inspection. Worse RV GLS was associated with greater hospital mortality (odds ratio, 1.03; 95% CI, 1.00–1.07; p = 0.03), such that every 1% decrement in RV GLS was associated with up to a 7% increase in the risk of death. RV GLS was 90% sensitive for the detection of RV dysfunction compared with tricuspid annular plane systolic excursion.

CONCLUSIONS:
The measurement of RV GLS by STE in subjects on MV is feasible, reproducible, and sensitive for the detection of RV dysfunction. RV GLS may predict poor outcomes in acute respiratory failure.
Long-Term Beta-Blocker Therapy After Myocardial Infarction Without Heart Failure in the Reperfusion Era—Systemic Review and Meta-analysis
Authors: Kim Youngju , Byun Sungwook , Kim Hee-Yeol , Kim Dong-Bin 
Published: January 2022

Abstract:
Beta-blockers are recommended as a standard treatment for patients who experience a myocardial infarction (MI). However, the evidence supporting this recommendation is based on the prereperfusion era data. This review aims to evaluate the effectiveness of long-term (≥1 year) beta-blocker therapy in post-MI patients without clinical heart failure (HF) in the reperfusion era. We included observational cohort studies, which compared at least 1 year use of beta-blockers to no beta-blockers in patients with an acute MI, but without HF. The clinical endpoint considered was all-cause mortality, except for cardiovascular death in one study. Five cohort studies and 217,532 patients were included. One study demonstrated a reduction in all-cause mortality with beta-blockers, whereas, in 4 studies, there was no difference in the death rate. The pooled estimate by random effect showed that beta-blocker treatment does not reduce mortality (odds ratio 0.800, 95% confidence interval 0.559–1.145) with high heterogeneity (I2 = 94%). This meta-analysis shows that the use of oral beta-blockers for 1 year or more does not reduce the mortality of MI patients without HF. Large randomized trials need to evaluate beta-blocker discontinuation after an acute MI.
Are High- or Low-dose SGLT2 Inhibitors Associated With Cardiovascular and Respiratory Adverse Events? A Meta-analysis
Authors: Zou Hai-Tao , Yang Guo-Huan , Cai Yu-Jun , Chen Hao , Zheng Xiao-Qin , Hu Rong 
Published: January 2022

Abstract:
The association between high-dose or low-dose sodium-glucose cotransporter 2 (SGLT2) inhibitors and various cardiovascular and respiratory serious adverse events (SAE) is unclear. Our meta-analysis aimed to define the association between high-dose or low-dose SGLT2 inhibitors and 86 kinds of cardiovascular SAE and 58 kinds of respiratory SAE. We included large cardiorenal outcome trials of SGLT2 inhibitors. Meta-analysis was conducted and stratified by the dose of SGLT2 inhibitors (high dose or low dose) to synthesize risk ratio (RR) and 95% confidence interval (CI). We included 9 trials. Compared with placebo, SGLT2 inhibitors used at high dose or low dose were associated with the decreased risks of 6 kinds of cardiovascular SAE [eg, bradycardia (RR, 0.60; 95% CI, 0.41–0.89), atrial fibrillation (RR, 0.79; 95% CI, 0.69–0.92), and hypertensive emergency (RR, 0.34; 95% CI, 0.15–0.78)] and 6 kinds of respiratory SAE [eg, asthma (RR, 0.59; 95% CI, 0.37–0.93), chronic obstructive pulmonary disease (RR 0.77, 95% CI 0.62–0.96), and sleep apnea syndrome (RR 0.37, 95% CI 0.17–0.81)]. SGLT2 inhibitors used at high dose or low dose did not show significant associations with 132 other cardiopulmonary SAE. For any outcome of interest, the subgroup difference according to the dose of SGLT2 inhibitors was not significant (P
subgroup > 0.05). SGLT2 inhibitors used at whether high dose or low dose are associated with the decreased risks of 12 cardiopulmonary disorders (eg, bradycardia, atrial fibrillation, hypertensive emergency, asthma, chronic obstructive pulmonary disease, and sleep apnea syndrome). These findings may suggest the potential efficacy of high- or low-dose SGLT2 inhibitors for the prevention and treatment of these cardiopulmonary disorders.
Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study
Authors: Ahmed Seid A. 
Published: January 2022

Background:
Intensive care unit is special unit primarily concerned with the care of patients with critical illness. Caring of critically ill children remains one of the most demanding and challenging aspects of the field of pediatrics.

Methods:
A retrospective study design was conducted. All children from 1 month to 14 years of age who were admitted to the pediatric intensive care unit from September 2017 to September 2018 were included. Descriptive statistics was used to describe different characters.

Results:
A total of 305 children were admitted over the study period. Most of patients were males (57.4%) with a male-to-female ratio of 1.3:1. The overall mortality rate was 23.6%. The majority of the children were in the age range of 10–14 years (27.9%). Out of all patients, 23.6% were neurological cases and from these, 22.2% of patients were died. The highest percentages (12.8%) of neurological patients were admitted because of meningitis. Respiratory (19%) and cardiac (11.8%) cases were the second and the third causes of admission, respectively.

Conclusion:
The leading cause of admission and death was neurological causes. Respiratory and cardiac causes were also significant. The mortality rate was very high. Further interventions are recommended to reduce mortality and increase quality of care.
Lipid Keratopathy Management With Therapeutic Scleral Lens Wear
Authors: Gelles John D. , Hillier Kyla E. , Krisa Sydney , Greenstein Steven A. , Hersh Peter S. 
Published: January 2022

Purpose:
To report on the use of scleral lens therapy for a patient with lipid keratopathy secondary to rigid gas permeable contact lens wear and ocular surface disease.

Methods:
Case report and literature review.

Results:
A 40-year-old man with a history of keratoconus and rigid gas permeable contact lens wear, resulting in corneal neovascularization and lipid keratopathy. The patient reported to our clinic with central lipid keratopathy secondary to rigid gas permeable lens wear and ocular surface disease. Given the density, central location, and subsequent visual limitations induced by lipid deposition and topographical irregularity, penetrating keratoplasty and scleral contact lens wear were discussed as possible treatment options. In this case, scleral lens wear provided both visual improvement and resolution of lipid keratopathy. After 3 years, the patient has remained stable, with significant visual improvement and near-complete resolution of lipid keratopathy.

Conclusions:
This case illustrates the use of scleral lens wear in the therapeutic management of lipid keratopathy secondary to rigid gas permeable lens wear and ocular surface disease. For patients limited by lipid keratopathy and topographical irregularity, scleral lens wear may be used to achieve both visual and therapeutic outcomes.
Physical Activity, Sedentary Time, and Cardiometabolic Health in Heavy Goods Vehicle Drivers
Authors: Ruettger Katharina , Varela-Mato Veronica , Chen Yu-Ling , Edwardson Charlotte L. , Guest Amber , Gilson Nicholas D. , Gray Laura J. , Paine Nicola J. , Sherry Aron P. , Sayyah Mohsen , Yates Thomas , King James A. , Clemes Stacy A. 
Published: January 2022

Objective:
: Physical inactivity, prolonged sitting, and unhealthy dietary habits are common in Heavy Goods Vehicle (HGV) drivers. These factors increase risk of long-term health conditions

Methods:
: 329 HGV drivers across 25 UK depots completed a health assessment, including questionnaire completion, and objectively measured anthropometrics, blood biomarkers, physical activity (PA), and sedentary behavior.

Results:
: The sample demonstrated a high-risk cardiometabolic health profile. 88.1% were overweight or had obesity, and 11.9% had pre-diabetes or diabetes. 28.3% had hypertension, 83.6% had clinically elevated circulating low-density lipoprotein-cholesterol concentrations (>2mmol/l), and 66.6% had high total cholesterol levels (>4mmol/l). On workdays drivers accumulated 12 hours/day of sitting, 1.7 hours/day of light PA, and 9.8 mins/day of moderate-to-vigorous PA. Associations between light PA and cardiometabolic markers were observed.

Conclusion:
This sample presents high levels of inactivity, overweight, and obesity, and unhealthy cardiometabolic health profiles.
Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States
Authors: Carlson Matthew L. , Nassiri Ashley M. , Marinelli John P. , Lohse Christine M. , Sydlowski Sarah A. 
Published: January 2022

Objective:
To characterize current awareness, perceptions, and literacy surrounding hearing loss among the adult population in the United States.

Study Design:
National cross-sectional survey study.

Setting:
United States.

Patients:
Adults between 50 and 80 years of age in the United States.

Results:
Survey respondents included 1,250 adults between the ages of 50 and 80 years, including 500 who indicated at least moderate hearing loss and were using hearing aids and 750 who denied having hearing loss and were not using hearing aids.
Only 9% of patients were able to correctly identify what constitutes a “normal” or “average” range for hearing. By comparison, a “normal” range of values for vision, blood pressure, and total cholesterol were identified correctly by 93%, 85%, and 52% of the 1,250 surveyed adults, respectively. When asked to rank the importance of addressing hearing loss within the context of 10 other common health conditions, hearing loss was ranked third to least important. When considering annual health maintenance, respondents indicated they were “very likely” to have an annual physical exam (72%), a cholesterol test (70%), an eye exam (66%), and bring their pet to a veterinarian (59%) over twice as frequently as having their hearing evaluated (27%).
When evaluating awareness surrounding associations between hearing loss and other health and social issues, less than one-fourth indicated strong awareness about links between hearing loss and depression, employability and income, fall risk, dementia, and type 2 diabetes. While most patients acknowledge the potential impacts of hearing loss on safety, quality of life, and health, less than half believe that hearing loss is treatable and less than 20% believe that hearing loss is preventable.

Conclusion:
Despite widespread literacy of what constitutes normal vision, blood pressure, and total cholesterol levels, respondents exhibit substantially poorer understanding of “normal” hearing levels. Most adults believe that few treatment options exist for the management of hearing loss. Underlying the uniformly limited literacy surrounding hearing loss and its treatment options is the adult population's lack of appreciation for the long-term health sequelae of untreated hearing loss.
Treating the body to prevent brain injury: lessons learned from the coronavirus disease 2019 pandemic
Authors: Fan Tracey H. , Solnicky Veronika , Cho Sung-Min 
Published: January 2022

Purpose of review
We aim to provide the current evidence on utility and application of neuromonitoring tools including electroencephalography (EEG), transcranial Doppler (TCD), pupillometry, optic nerve sheath diameter (ONSD), cerebral near-infrared spectroscopy (cNIRS), somatosensory-evoked potentials (SSEPs), and invasive intracranial monitoring in COVID-19. We also provide recent evidence on management strategy of COVID-19-associated neurological complications.

Recent findings
Despite the common occurrence of neurological complications, we found limited use of standard neurologic monitoring in patients with COVID-19. No specific EEG pattern was identified in COVID-19. Frontal epileptic discharge was proposed to be a potential marker of COVID-19 encephalopathy. TCD, ONSD, and pupillometry can provide real-time data on intracranial pressure. Additionally, TCD may be useful for detection of acute large vessel occlusions, abnormal cerebral hemodynamics, cerebral emboli, and evolving cerebral edema at bedside. cNIRS was under-utilized in COVID-19 population and there are ongoing studies to investigate whether cerebral oxygenation could be a more useful parameter than peripheral oxygen saturation to guide clinical titration of permissive hypoxemia. Limited data exists on SSEPs and invasive intracranial monitoring.

Summary
Early recognition using standardized neuromonitoring and timely intervention is important to reduce morbidity and mortality. The management strategy for neurological complications is similar to those without COVID-19.
Intracranial pressure management: moving beyond guidelines
Authors: Rubiano Andres M. , Figaji Anthony , Hawryluk Gregory W. 
Published: January 2022

Purpose of review
The aim of this study was to provide an overview on advances in intracranial pressure (ICP) protocols for care, moving from traditional to more recent concepts.

Recent findings
Deep understanding of mechanics and dynamics of fluids and solids have been introduced for intracranial physiology. The amplitude or the harmonics of the cerebral-spinal fluid and the cerebral blood waves shows more information about ICP than just a numeric threshold. When the ICP overcome the compensatory mechanisms that maintain the compliance within the skull, an intracranial compartment syndrome (ICCS) is defined. Autoregulation monitoring emerge as critical tool to recognize CPP management. Measurement of brain tissue oxygen will be a critical intervention for diagnosing an ICCS. Surgical procedures focused on increasing the physiological compliance and increasing the volume of the compartments of the skull.

Summary
ICP management is a complex task, moving far than numeric thresholds for activation of interventions. The interactions of intracranial elements requires new interpretations moving beyond classical theories. Most of the traditional clinical studies supporting ICP management are not generating high class evidence. Recommendations for ICP management requires better designed clinical studies using new concepts to generate interventions according to the new era of personalized medicine.
Factors related to the risk of stroke in the population with type 2 diabetes
Authors: Wang Kai , Lv Zhiguo , Xu Peng , Cui Yabin , Zang Xiaoyu , Zhang DongMei , Wang Jian 
Published: January 2022

Abstract

Background:
Type 2 diabetes is an independent risk factor for stroke. The main role of the current study is to study the mechanism of stroke induced by diabetes, but there is no systematic summary of daily management and stroke prevention for patients with type 2 diabetes. In order to provide a more detailed stroke prevention program for patients with type 2 diabetes, we included in the study and looked forward to analyzing the risk factors that were more in line with the clinical characteristics of type 2 diabetes.

Methods:
We will search the following Chinese and English databases: PubMed, Web of science, Cochrane Library, Medline, and China National Knowledge Infrastructure database. All of the above electronic databases will be searched from inception to June 30, 2021. In addition, we will manually search for conference papers, ongoing experiments, and internal reports to supplement the studies retrieved via electronic search. We will use the STATA 16.0 provided by Cochrane Collaboration Network for statistical analysis.

Results:
The study will prove a collective view on the relationship between related factors and stroke in the type 2 diabetes population.

Conclusion:
We plan to submit this systematic review to a peer-reviewed journal.

INPLASY registration number: INPLASY2021100046