bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-tidal Carbon Dioxide for Diagnosing Anaphylaxis in Patients with Severe Postinduction Hypotension
Authors: Erlich Clémence , Lamer Antoine , Moussa Mouhamed D. , Martin Julien , Rogeau Stéphanie , Tavernier Benoit 
Published: January 2022

Background
Perioperative hypersensitivity reactions may be difficult to diagnose during general anesthesia. Postinduction hypotension is the most common sign but is not specific. It was recently suggested that low end-tidal carbon dioxide (ETco
2) might be a marker of anaphylaxis (Ring and Messmer grades III to IV immediate hypersensitivity reactions) in hypotensive patients under mechanical ventilation. To test this hypothesis, the authors compared ETco
2 in patients with a diagnosis of anaphylaxis and in patients with severe hypotension from any other cause after the induction of anesthesia.

Methods
This was a retrospective single-center case-control study in which two groups were formed from an anesthesia data warehouse. The anaphylaxis group was formed on the basis of tryptase/histamine assay data and allergy workup data recorded over the period 2010 to 2018. The control (hypotension) group consisted of all patients having experienced severe hypotension (mean arterial pressure less than 50 mmHg for 5 min or longer) with a cause other than anaphylaxis after anesthesia induction in 2017.

Results
The anaphylaxis and hypotension groups comprised 49 patients (grade III: n = 38; grade IV: n = 11) and 555 patients, respectively. The minimum ETco
2 value was significantly lower in the anaphylaxis group (median [interquartile range]: 17 [12 to 23] mmHg) than in the hypotension group (32 [29 to 34] mmHg; P < 0.001). The area under the receiver operating characteristic curve (95% CI) for ETco
2 was 0.95 (0.91 to 0.99). The sensitivity and specificity (95% CI) for the optimal cutoff value were 0.92 (0.82 to 0.98) and 0.94 (0.92 to 0.99), respectively. In multivariable analysis, minimum ETco
2 was associated with anaphylaxis after adjusting for confounders and competing predictors, including arterial pressure, heart rate, and peak airway pressure (odds ratio [95% CI] for ETco
2: 0.51 [0.38 to 0.68]; P < 0.001).

Conclusions
In case of severe hypotension after anesthesia induction, a low ETco
2 contributes to the diagnosis of anaphylaxis, in addition to the classical signs of perioperative immediate hypersensitivity.

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What We Already Know about This Topic

What This Article Tells Us That Is New
The 3-Dimensional-Computed Tomography Texture Is Useful to Predict Pancreatic Neuroendocrine Tumor Grading
Authors: Ricci Claudio , Mosconi Cristina , Ingaldi Carlo , Vara Giulio , Verna Martina , Pettinari Irene , Alberici Laura , Campana Davide , Ambrosini Valentina , Minni Francesco , Golfieri Rita , Casadei Riccardo 
Published: January 2022

Objectives
The aim of this study is to evaluate the computed tomography texture parameters in predicting grading.

Methods
This study analyzed 68 nonfunctioning pancreatic neuroendocrine neoplasms (Pan-NENs). Clinical and radiological parameters were studied. Four model models were built, including clinical and standard radiologic parameters (model 1), first- and second-order computed tomography features (models 2 and 3), all parameters (model 4). The diagnostic accuracy was reported as area under the curve. A score was computed using the best model and validated to predict progression-free survival.

Results
The size of tumors and heterogeneous enhancement were related to the risk of “non-G1” Pan-NENs (coefficients 0.471, P = 0.012, and 1.508, P = 0.027). Four second-order parameters were significantly related to the presence of “non-G1” Pan-NENs: the gray level co-occurrence matrix correlation (6.771; P = 0.011), gray level co-occurrence matrix contrast variance (0.349; P = 0.009), the neighborhood gray-level different matrix contrast (−63.129; P = 0.001), and the gray-level zone length matrix with the low gray-level zone emphasis (−0.151; P = 0.049). Model 4 was the best, with a higher area under the curve (0.912; P = 0.005). The score obtained predicted the progression-free survival.

Conclusions
Computed tomography radiomics signature can be useful in preoperative workup.
Outcomes of Endoscopic Management of Sterile Walled-Off Pancreatic Necrosis
Authors: Valverde-López Francisco , Han Samuel , Coughlin Sarah , Thiruvengadam Nikhil , Moreau Christopher , Akshintala Venkata S. , Lee Peter J. ,   on behalf of the Collaborative Alliance for Pancreatic Education and Research
Published: January 2022

Objectives
The aim of this study is to systematically review outcomes related to treatment success, mortality, and adverse events of endoscopic management in patients with sterile walled-off pancreatic necrosis.

Methods
We reviewed studies published from 2008 to 2018 from Medline and Embase that evaluated the endoscopic treatment of necrotizing pancreatitis. The primary outcome was success of treatment in resolving the collection. Secondary outcomes included length of hospitalization, mortality rate, and adverse events.

Results
Five studies were included, which entailed a total of 280 patients with a mean age of 51.8 years. The primary indication for endoscopic treatment was symptomatic walled-off pancreatic necrosis. Four studies used endoscopic transmural drainage, one of them combining percutaneous drainage and 1 study performed transpapillary drainage. The pooled treatment success was 94.3% with a mean time to resolution of 77.8 days. The mean length of stay was 16.3 days, and mortality rate was 1.3%. The overall adverse event rate was 24.6%, with bleeding the most common adverse event (11%), followed by pancreatic fistula formation (3.4%) and perforation (2.7%).

Conclusions
Although endoscopic management of sterile pancreatic necrosis has a high rate of treatment success, there is a relatively high rate of adverse events, bleeding being the most common.
Pancreatogenic Diabetes, 2 Onset Forms and Lack of Metabolic Syndrome Components Differentiate It From Type 2 Diabetes
Authors: Valdez-Hernández Pedro , Pérez-Díaz Ivan , Soriano-Rios Andrea , Gómez-Islas Valeria , García-Fong Kevin , Hernández-Calleros Jorge , Uscanga-Dominguez Luis , Pelaez-Luna Mario 
Published: January 2022

Objectives
We compared pancreatogenic (DM3c) and type 2 diabetes mellitus.

Methods
We compared age-, sex-, and diabetes mellitus duration–matched DM3c cases (n = 142) and type 2 diabetes mellitus (n = 142). Pancreatogenic diabetes was considered when it appeared after the diagnosis of pancreatitis or after pancreatic surgery.

Results
Pancreatogenic diabetes presented lower body mass index (BMI) [odds ratio (OR), 1.2; 95% confidence interval (CI), 1.13–1.28; P < 0.001], worse glycemic control (OR, 1.196; 95% CI, 1.058–1.35; P = 0.004), required insulin more frequently (OR, 4.21; 95% CI, 2.57–6.93; P = 0.0001), had more hypoglycemic episodes (OR, 3.65; 95% CI, 1.64–8.16; P = 0.001) but lower frequency of dyslipidemia (OR, 0.42; 95% CI, 0.26–0.68; P = 0.001) and arterial hypertension (OR, 0.52; 95% CI, 0.32–0.86; P = 0.01). Pancreatogenic diabetes cases on pancreatic enzyme replacement therapy had lower glycosylated hemoglobin (8.52% vs 9.44%; P = 0.026), serum carotenes (79.1 vs 116.1; P = 0.03), and BMI (23.4 vs 26.1; P = 0.0005) than those not on pancreatic enzyme replacement therapy. Pancreatogenic diabetes onset occurred earlier in necrotizing pancreatitis and after pancreatic surgery.

Conclusions
Pancreatogenic diabetes presents with low BMI and lacks metabolic syndrome components. The type of pancreatic disease or surgery defines its onset time.
A Classification Algorithm for Types of Diabetes in Chronic Pancreatitis Using Epidemiological Characteristics
Authors: Kempeneers Marinus A. , Issa Yama , Ahmed Ali Usama , Bruno Marco J. , van Geenen Erwin J. M. , van Hooft Jeanin E. , Römkens Tessa E. H. , Siersema Peter D. , Spanier B. W. Marcel , Yahya Ibtisam , DeVries J. Hans , Besselink Marc G. , van Santvoort Hjalmar C. , Boermeester Marja A. ,   for the Dutch Pancreatitis Study Group
Published: January 2022

Objectives
We developed an epidemiological algorithm to classify types of diabetes mellitus (DM) in chronic pancreatitis (CP), and applied it to a nationwide prospective longitudinal cohort of CP patients.

Methods
Patients with definite CP (M-ANNHEIM criteria) were classified as having DM types 1, 2, or 3c, or no DM using an algorithm based on epidemiological characteristics: DM onset in relation to age, CP onset, exocrine insufficiency. Variables associated with development of DM were identified.

Results
Of 1130 included patients with CP between 2011 and 2018, 368 patients (33%) had DM at inclusion. Among patients with DM, 11 were classified as having type 1 (3%), 159 as type 2 (43%), and 191 as type 3c (52%). Patients with DM type 3c had longer duration of CP, more severe pain and lower physical quality of life. During longitudinal follow-up of median 47 months, 120 (20%) patients developed DM, of which 99 patients were classified as type 3c. This was independently associated with pancreatic endoscopy and surgery.

Conclusions
The described algorithm based on epidemiological characteristics can help to classify types of DM in patients with CP. Diabetes mellitus type 3c is associated with longer duration of CP and more severe CP sequelae.
Time to Stop Routinely Prescribing Opiates after Carpal Tunnel Release
Authors: Lalonde Donald H. , Lalonde Janice F. , MacDermid Joy C. , Chung Kevin C. , Gan Bing Siang , Mierisch Cassandra , Van Demark Robert E. , Luc Mario 
Published: January 2022

Background:
North American surgeons continue to routinely order narcotic medication for postoperative pain relief after carpal tunnel surgery. For some patients, this instigates persistent use. This double-blind, multicenter trial investigated whether over-the-counter medications were inferior to opioid pain control after carpal tunnel release.

Methods:
Patients undergoing carpal tunnel release in five centers in Canada and the United States (n = 347) were randomly assigned to postoperative pain control with (opioid) hydrocodone/acetaminophen 5/325 mg versus over-the-counter ibuprofen/acetaminophen 600/325 mg. The two primary outcome measures were the Numeric Pain Rating Scale (0 to 10) and the six-item Patient-Reported Outcome Measurement Information System Pain Interference T-score. Secondary outcome measures were total medication used and overall satisfaction with pain medication management.

Results:
The authors found no significant differences between opioid and over-the-counter patients in the Numeric Pain Rating Scale scores, Pain Interference T-scores, number of doses of medication, or patient satisfaction. The highest Numeric Pain Rating Scale group difference was the night of surgery, when opiate patients had 0.9/10 more pain than over-the-counter patients. The highest group difference in Pain Interference T-scores (2.1) was on the day of surgery, when the opiate patients had more pain interference than the over-the-counter group. Patient nationality or sex did not generate significant pain score differences.

Conclusions:
Pain management is not inferior for patients managed with over-the-counter acetaminophen/ibuprofen versus opioids. This study provides high-quality evidence that U.S. and Canadian surgeons should stop the routine prescription of narcotics after carpal tunnel surgery for patients who are not taking pain medicines daily before surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Analysis of Adverse Effects of Multimodal Gabapentin in Abdominal Wall Reconstruction
Authors: Sarac Benjamin A. , Schoenbrunner Anna R. , Brower Kristin I. , Joshi Girish P. , Janis Jeffrey E. 
Published: January 2022

Background:
Multimodal analgesia, a key component of enhanced recovery after surgery protocols, emphasizes the use of nonopioid analgesics. Preoperative and postoperative gabapentin is often included within multimodal analgesia because it has been shown to reduce postoperative opioid use. However, the role of gabapentin has been questioned because of concerns of adverse effects, particularly in the elderly. In an effort to better understand the specific role of gabapentin within the context of an established enhanced recovery after surgery protocol, the authors studied the prevalence of its adverse effects in patients undergoing abdominal wall reconstruction.

Methods:
Following institutional review board approval, a retrospective review of a prospectively collected database of 267 consecutive patients who underwent abdominal wall reconstruction performed by a single surgeon was conducted. Demographic variables; operative details; postoperative analgesic use; the presence of dizziness, lightheadedness, or altered mental status; hypotension; negative Richmond Agitation Sedation Scale scores; and postoperative falls were recorded and analyzed according to postoperative gabapentin administration.

Results:
Two hundred thirteen patients (80 percent) met inclusion criteria, of which 138 (65 percent) received postoperative gabapentin. Postoperative gabapentin use was not associated with dizziness, lightheadedness, or altered mental status; hypotension; negative Richmond Agitation Sedation Scale scores; or falls. Furthermore, even among those aged 65 years or older, postoperative gabapentin use was not significantly associated with these adverse events.

Conclusions:
In patients undergoing abdominal wall reconstruction, postoperative gabapentin administration was not associated with an increase in adverse effects. Further prospective analysis may better allow the characterization of the adverse effects of perioperative gabapentin.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Physician Residents Shadowing a Certified WOC Nurse to Develop Interprofessional Competencies
Authors: Monahan Laura , Zhao Meng , Monahan Michael , Acker Katelijne , Sandrik Mary 
Published: January 2022

PURPOSE:
The aim of this quality improvement (QI) project was to assess a shadowing experience with a certified WOC nurse (CWOCN) on 4 interprofessional collaborative practice domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice.

PARTICIPANTS AND SETTING:
Forty-nine physician residents in Family and Internal Medicine participated in this project set at a health system in Chicago, Illinois.

APPROACH:
Residents spent 16 hours shadowing a CWOCN and completed the Interprofessional Education Collaborative Competency Self-Assessment Tool (IPESAT) pre- and postshadowing that measured 4 interprofessional education (IPE) domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. Paired t tests were performed to determine differences in IPESAT scores before and after the shadowing experience.

OUTCOMES:
Residents demonstrated significant improvement in their overall knowledge of IPE (P = .000) as well as knowledge within each of the 4 domains (P = .000). After the shadowing experience, the overall ranking improved by 7.5%; the greatest gain (10.8%) occurred in the teamwork domain.

IMPLICATIONS FOR PRACTICE:
We found that even a comparatively brief shadowing experience with a CWOCN improved knowledge in IPE competencies. The shadowing experience is now permanently part of the Internal Medicine Residency program, and based on these IPE outcomes, other residency programs in our setting, such as the Rehabilitation and Family Medicine program, have increased their requests to shadow with the CWOCN.
The Impact of State Paid Sick Leave Policies on Longitudinal Weekday Workplace Mobility During the COVID-19 Pandemic
Authors: Pollack Catherine C. , Deverakonda Akshay , Hassan Fahim , Haque Syed , Desai Angel N. , Majumder Maimuna S. 
Published: January 2022

AbstractObjectivesTo evaluate whether the Families First Coronavirus Response Act (FFCRA) modified the association between pre-existing state paid sick leave (PSL) and weekday workplace mobility between February 15 and July 7, 2020.MethodsThe 50 US states and Washington, D.C. were divided into exposure groups based on the presence or absence of pre-existing state PSL policies. Derived from Google COVID-19 Community Mobility Reports, the outcome was measured as the daily percent change in weekday workplace mobility. Mixed-effects, interrupted time series regression was performed to evaluate weekday workplace mobility after the implementation of the FFCRA on April 1st, 2020.ResultsStates with pre-existing PSL policies exhibited a greater drop in mobility following the passage of the FFCRA (β=-8.86,95%CI:-11.6,-6.10,P< 001). This remained significant after adjusting for state-level health, economic, and sociodemographic indicators (β=-3.13,95%CI:-5.92,-0.34,P=.039).ConclusionsPre-existing PSL policies contributed to a significant decline in weekday workplace mobility after the FFCRA, which may have influenced local health outcomes.Policy implicationsThe presence of pre-existing state policies may differentially influence the impact of federal legislation enacted during emergencies.
Cell viability assessment associated with a contact of gas bubbles produced by femtosecond laser breakdown in cell culture media
Authors: Yasukuni Ryohei , Koyanagi Akari , Tanaka Yukihiro , Okano Kazunori , Hosokawa Yoichiroh 
Published: January 2022

AbstractHigh intensity near infrared femtosecond laser is a promising tool for three-dimensional processing of biological materials. During the processing of cells and tissues, long lasting gas bubbles randomly appeared around the laser focal point, however physicochemical and mechanical effects of the gas bubbles has not been emphasized. This paper presents characteristic behaviors of the gas gabbles and their contact effects on cell viability. High-speed imaging of the gas bubble formation with various additives in physiological medium confirms that the gas bubble consists of dissolved air, and amphipathic proteins stabilize the bubble surface. This surface protective layer reduces interactions of gas bubbles and cell membranes. Consequently, the gas bubble contact does not cause critical effects on cell viability. On the other hands, burst of gas bubbles stimulated by an impact of femtosecond laser induced cavitation can lead to liquid jet flow that might cause serious mechanical damages on cells. These results provide insights for the parameter of biological tissue processing with intense fs laser pulses.
3D black blood MRI atlases of congenital aortic arch anomalies and the normal fetal heart: application to automated multi-label segmentation
Authors: Uus Alena U. , van Poppel Milou P.M. , Steinweg Johannes K. , Grigorescu Irina , Collado Alexia Egloff , Gilliland Paula Ramirez , Roberts Thomas A. , Rutherford Mary A. , Hajnal Joseph V. , Lloyd David F.A. , Pushparajah Kuberan , Deprez Maria 
Published: January 2022

AbstractBackground3D image-domain reconstruction of black blood contrast T2w SSTSE fetal MRI datasets using slice-to-volume registration methods showed to provide high-resolution 3D images of the heart with superior visualisation of fetal aortic arch anomalies [1]. However, there is a lack of formalisation of the MRI appearance of fetal cardiovascular anatomy and standardisation of vessel segmentation protocols.MethodsIn this work, we present the first set of 3D fetal MRI atlases defining normal and abnormal fetal aortic arch anatomy created from 3D reconstructed images from 87 subjects scanned between 29-34 weeks of gestation with postnatally confirmed outcomes. We also implement and evaluate atlas-guided registration and deep learning (UNETR) methods for automated 3D multi-label fetal heart vessel segmentation.ResultsWe created four atlases representing the average anatomy of the normal fetal heart, coarctation of the aorta, right aortic arch and suspected double aortic arch. Inspection of atlases confirmed the expected pronounced differences in the anatomy of the aortic arch. The results of the multi-label heart vessel UNETR segmentation showed 100% per-vessel detection rate for both normal and abnormal aortic arch anatomy.ConclusionsThis work introduces the first set of 3D black blood T2w MRI atlases of the normal and abnormal fetal cardiovascular anatomy along with detailed segmentation of the major cardiovascular structures. We also demonstrated the feasibility of using deep learning for multi-label vessel segmentation.
Supporting per-locus substitution rates improves the accuracy of species networks and avoids spurious reticulations
Authors: Cao Zhen , Ogilvie Huw A. , Nakhleh Luay 
Published: January 2022

AbstractThe development of statistical methods to infer species phylogenies with reticulation (species networks) has led to many discoveries of gene flow between distinct species. However, because the dimensionality of species networks is not fixed, these methods may compensate for kinds of model misspecification, such as assuming a single substitution rate for all genomic loci, by increasing the number of dimensions beyond the true value. The popular full Bayesian species network method MCMC_SEQ has previously made this assumption, so we have added support for the proven Dirichlet model for per-locus rates to enhance its accuracy and avoid spurious results. We studied the effects of this model using simulation and an empirical dataset from Heliconius butterflies.We found that assuming a single substitution rate applies to all loci leads to the inference of spurious reticulation in simulated and empirical datasets when a full Bayesian method is used, however, the summary method InferNetwork_ML is robust to per-locus variation in substitution rates when set to ignore gene tree branch lengths. Our implementation of the model resolves this misspecification and successfully converges to the true species networks. It also infers far more accurate gene trees than assuming a single rate, or independent inference of gene trees.Our implementation of the Dirichlet per-locus rates model is now available in PhyloNet, a software package for phylogenetic inference, open source on GitHub https://github.com/NakhlehLab/PhyloNet.