bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of tension variability for sleep quality in headache patients: A Holter monitoring study
Authors: Çiçekli Esen , Emre Ender 
Published: August 2022

Background:
Hypertension is one of the common causes of headaches. Disruption in the circadian rhythm of blood pressure (BP) also leads to some chronic diseases. Sleep disturbances have a relationship with neurologic and cardiac diseases. Our aim was to compare the sleep quality of patients with headaches showing dipper and nondipper BP patterns.

Methods:
This retrospective study included 57 patients who applied to a neurology clinic due to headaches and were referred to the cardiology department for Holter monitoring. Chronic diseases, drugs used, smoking and exercise habits, and physical examination findings were recorded. The 24-hour Holter monitoring results were classified as dipper and nondipper. The Pittsburgh Sleep Quality Index scores were determined for each patient. The Pittsburgh Sleep Quality Index scores of patients with dipper and nondipper patterns were compared.

Results:
The sleep quality of patients with dipper Holter patterns was better than that of patients with nondipper patterns (P < .001), and patients without chronic diseases had significantly better sleep quality compared with those with chronic diseases (P = .029). In the presence of chronic disease, the number of patients with a nondipper Holter pattern was higher (P = .024). There were no significant differences in Holter results or sleep quality between smokers and nonsmokers (P > .05).

Conclusion:
Diagnoses of sleep disorders and BP abnormalities in the outpatient clinic are valuable in increasing the quality of life of patients and in preventing chronic diseases, especially cardiac diseases that may develop in the future.
Association between TGF-β gene polymorphism and myopia: A systematic review and meta-analysis
Authors: Zhu Xiaoyu , Xu Bowei , Dai Lingxue , Wang Zuoyuan , Feng Li , Zhao Jiangyue 
Published: August 2022

Introduction:
The present study was conducted to determine the association of transforming growth factor-beta (TGF-β) gene polymorphism and myopia.

Method:
Four hundred twelve articles were identified, of which 11 articles with 5213 participants in 4 countries were included in the final analysis. Review Manager software (RevMan, version 5.4) was used for data analysis.

Result:
Odds ratio (OR) value of TGF-β1 rs1800469 is 1.33 (95% confidence interval [CI] = 1.15–1.54) in the allelic model; in the dominant model is 1.76 (95% CI = 1.16–2.67); in homozygous model is 5.98 (95% CI = 4.31–8.06). OR value of TGF-β1 rs4803455 is 0.62 (95% CI = 0.43–0.88) in recessive model. TGF-β2 is not associated with myopia. Relevant study on TGF-β3 is scarce.

Conclusion:
Our systematic review and meta-analysis found that TGF-β1 rs4803455 and rs1800469 were correlated with myopia.
Effect of Emergency Severity Index Annual Competency Assessment on Mistriage
Authors: Hoffman Stefanie , Voss Jo A. , Hendrickx Lori , Gibson Nicole 
Published: August 2022

Background:
There is limited evidence identifying best practices to promote competency of accurate assignment of the Emergency Severity Index (ESI) acuity level to patients who present to the emergency department (ED) triage.

Local Problem:
Triage-trained nurses do not receive competency training in an ESI triage tool.

Methods:
A retrospective chart review of 150 patients was completed to evaluate mistriage rates before and after triage-trained nurses completed an ESI competency assessment.

Results:
The retrospective chart review showed no statistically significant difference in mistriage from pre- to postintervention (P = .8535).

Conclusions:
Implementation of an ESI annual competency assessment aligns well with an emerging theme in the literature that ED nurses should be provided with ongoing education that reinforces knowledge and implementation of ESI triaging.
Readmission Predictors in Patients With Type II Diabetes
Authors: Timple Veronica Santos , Kawar Lina Najib 
Published: August 2022

Background:
In patients with type II diabetes, hospital readmissions occur frequently and contribute significantly to morbidity. Limited research has predicted the factors that contribute to preventable readmission.

Purpose:
This study identified the predictors of 30-day hospital readmission in patients with type II diabetes.

Methods:
This single-site 400 patients study examined effects of comorbidities, race, endocrinology consultation, diabetes self-management education, and diabetes medications on 30-day hospital readmissions.

Results:
Patients with more comorbidities, who were Hispanics, and those who received an endocrinology consultation were more likely to be readmitted. Patients who received diabetes self-management education or were prescribed both oral and insulin medications were less likely to be readmitted.

Conclusion:
Findings identified the factors related to 30-day readmission in patients with diabetes, emphasizing the need for diabetes self-management education. Understanding why patients are readmitted within 30 days of initial admission will empower nurses to create targeted plans to improve nursing care quality and prevent readmission.
Risk Factors for Failure of Closed Forearm Fracture Reduction in the Pediatric Emergency Department
Authors: Cohen Neta , Gigi Roy , Haberman Shira , Capua Tali , Rimon Ayelet 
Published: August 2022

ObjectivesThis study aimed to explore risk factors for failure of forearm fracture closed reduction in the pediatric emergency department (ED) and to suggest indications for initial surgery.MethodsThis retrospective cohort study included all patients aged 0 to 18 years who presented to our pediatric ED with an extraarticular forearm fracture treated with closed reduction between May 2017 and April 2021. We explored risk factors for procedural failure, defined as a need for surgical intervention within 6 weeks of the closed reduction attempt.ResultsOf 375 patients (median age 8.1 years, 294 [78.2%] boys), 44 (11.7%) patients sustained a reduction failure, of whom 42 (95.5%) had both radius and ulna fractures. Of the 259 patients with fractures of both bones, the following parameters were independent predictors for reduction failure: refracture (adjusted odds ratio [aOR] 17.6,P< 0.001), open fracture (aOR 10.1,P= 0.007), midshaft fracture (aOR 2.6,P= 0.004), radial translation rate 37% and higher in either plane (aOR 5.1,P= 0.004), and age of 10 years and older (aOR 2.9,P= 0.01).ConclusionsMost pediatric forearm fractures can be successfully managed by closed reduction in the ED. Two-bone fractures had the strongest association with reduction failure. Refracture, open fracture, midshaft location, initial radius bone translation of 37% and higher (and not initial angulation), and patient age of 10 years and older are independent risk factors for reduction failure in two-bone fractures. We propose a risk score for reduction failure that can serve as a decision-making tool.
Impact of a Faster Computed Tomography Scanner on Sedation for Pediatric Head Computed Tomography Scans in 2 Large Emergency Departments—A Retrospective Study
Authors: Burger Rebecca Kriss , Figueroa Janet , Parikh Ashishkumar K. , Riedesel Erica L. 
Published: August 2022

Objectives
Children in the emergency department (ED) often require sedation for head computed tomography (CT) to ensure adequate image quality. Image acquisition time for a head CT using a conventional single-source CT scanner is approximately 12 seconds; however, after installation in November 2017 of 2 new dual-source dual-energy CT scanners, that time decreased to 1 to 3 seconds. We hypothesized that fewer patients would require sedation using the faster CT scanners.

Methods
We conducted a retrospective chart review of patients aged 0 to 18 years undergoing head CT at 2 pediatric EDs within 1 hospital system, 2 years before and 2 years after installation of the faster CT scanner. Patients undergoing multiple CTs or other procedures were excluded. Demographic information, diagnosis, disposition, sedatives (chloral hydrate, dexmedetomidine, etomidate, fentanyl, ketamine, midazolam, methohexital, pentobarbital, and propofol) administered before imaging, and ED length of stay were analyzed.

Results
A total of 15,175 patient encounters met inclusion criteria, 7412 before and 7763 after installation of the new CT. The median age was 7 years and 44% were female. Before the new CT scanner was installed 8% required sedation, compared with 7% after (effect size, 0.0341). Midazolam was the most commonly administered sedative. Fewer patients required deep sedation using the faster CT scanner.

Conclusions
After installation of a dual-source dual-energy CT scanner, fewer patients required sedation to complete head CT in the pediatric ED. Faster image acquisition time decreased the need for deep sedation.
Brain-specific genes contribute to chronic but not to acute back pain
Authors: Bortsov Andrey V. , Parisien Marc , Khoury Samar , Martinsen Amy E. , Lie Marie Udnesseter , Heuch Ingrid , Hveem Kristian , Zwart John-Anker , Winsvold Bendik S. , Diatchenko Luda 
Published: August 2022

Abstract

Introduction:
Back pain is the leading cause of disability worldwide. Although most back pain cases are acute, 20% of acute pain patients experience chronic back pain symptoms. It is unclear whether acute pain and chronic pain have similar or distinct underlying genetic mechanisms.

Objectives:
To characterize the molecular and cellular pathways contributing to acute and chronic pain states.

Methods:
Cross-sectional observational genome-wide association study.

Results:
A total of 375,158 individuals from the UK Biobank cohort were included in the discovery of genome-wide association study. Of those, 70,633 (19%) and 32,209 (9%) individuals met the definition of chronic and acute back pain, respectively. A total of 355 single nucleotide polymorphism grouped into 13 loci reached the genome-wide significance threshold (5x10-8) for chronic back pain, but none for acute. Of these, 7 loci were replicated in the Nord-Trøndelag Health Study (HUNT) cohort (19,760 chronic low back pain cases and 28,674 pain-free controls). Single nucleotide polymorphism heritability was 4.6% (P=1.4x10-78) for chronic back pain and 0.81% (P=1.4x10-8) for acute back pain. Similar differences in heritability estimates between acute and chronic back pain were found in the HUNT cohort: 3.4% (P=0.0011) and 0.6% (P=0.851), respectively. Pathway analyses, tissue-specific heritability enrichment analyses, and epigenetic characterization suggest a substantial genetic contribution to chronic but not acute back pain from the loci predominantly expressed in the central nervous system.

Conclusion:
Chronic back pain is substantially more heritable than acute back pain. This heritability is mostly attributed to genes expressed in the brain.
Evaluation of Quantitative Aspects of Craniofacial Deformities in Transfusion Dependent Beta-Thalassemia Major Patients: A Cephalometric Study
Authors: Gupta Deepak Kumar , Singh Satinder Pal , Utreja Ashok , Verma Sanjeev 
Published: August 2022

Purpose:
To evaluate the quantitative (cephalometric) aspects of the craniofacial deformities in transfusion-dependent beta-thalassemia (TDT) patients.

Materials and Methods:
Sixty-five TDT patients receiving a regular blood transfusion in the Department of Pediatrics of age group 5 to 8 years (younger) and 15 years and above (older) were compared with control groups of similar age using cephalograms (lateral and posterior-anterior view).

Results and Observation:
The prevalence of skeletal class II tendency is higher in thalassemic patients that do not improve with age. The thalassemic patients were found to show large angle ANB i.e. Angle between points point a, nasion and point B (ANB), large flexure angle, small angle SNB i.e. Angle between points sella, nasion and point B (SNB), and normal angle SNA i.e. Angle between points sella, nasion and point A (SNA) angles suggestive of retrognathic mandible. The thalassemic patients were observed to have smaller transverse widths and thickened calvarium on the posterior-anterior view.

Conclusion:
The skeletal class II malocclusion appears to be a manifestation of generalized growth retardation/delayed puberty in thalassemic patients leading to diminished mandibular growth, rather than maxillary prognathism due to marrow hyperplasia.
A Novel Technique for Spreader Flap by Folding the Dorsal Hump in Patients Undergoing Primary Rhinoplasty
Authors: AlAwadh Ibrahim H. , Bogari Ahmad , Assiri Hassan , Alabduljabbar Ziyad , AlNassar Raad , Hudise Jibril , AlArfaj Ahmed 
Published: August 2022

Objectives:
We describe our novel modified spreader flap, which involves keeping the large cartilaginous septal T hump attached to the upper lateral cartilages to increase the thickness and length of the flap. Our objectives were to assess hump reduction and recurrence, nasal axis deviation, dorsal width, internal nasal valve grade, and Rhinoplasty Outcome Evaluation (ROE) score preoperatively and one year postoperatively.

Materials and Methods:
In a prospective study that included 21 patients who met the criteria, patients were followed up for 1 year after surgery, with an assessment of the dorsal projection, tip projection, axis deviation, dorsal width, and internal nasal valve grade. In addition, the modified Cottle maneuver and Rhinoplasty Outcome Evaluation score were also performed and obtained, respectively.

Results:
Our novel technique was performed in 20 patients (95.2%). In 1 additional patient, we added a regular auto-spreader flap on the contralateral side. One year postoperatively, the axis was found in the midline in all patients (100%). Assessment of internal valve collapse showed that collapse was reduced to grade 0 in 13 patients (61.9%) and grade 1 in 8 patients (38.1%). There were no hump recurrences or visible irregularities. The results showed a statistically significant difference between the pre- and postoperative values in dorsal projection, dorsal width, and rhinoplasty outcome evaluation score.

Conclusions:
This novel technique shows promising statistically significant results in reducing dorsal hump projection and width, correcting axis deviation, and improving internal nasal valve and rhinoplasty outcome evaluation score, while being less cartilage and time-consuming.
Nasal Sinus Mucoceles Manifesting Ocular Symptoms
Authors: Peng Xiao-lin , Yue Zhen-zhong , Zhang Yong-lan , Sun Pei-yong 
Published: August 2022

Introduction:
To describe the ocular symptoms in a series of patients with nasal sinus mucoceles of different locations.

Methods:
The authors analyzed the diagnosis and treatment of patients with sinus mucoceles and ocular symptoms who presented to the hospital from February 2010 to April 2020. A total of 61 patients were included in the study. The locations of the mucoceles were the frontal sinus (8 patients), ethmoid sinus (25 patients), and sphenoid sinus (28 patients). The authors selected 1 typical mucocele case from each of the sinuses, including the frontal, ethmoid, and sphenoid sinuses, and analyzed the history, diagnosis, and treatment of mucoceles in each location.

Results:
The main clinical manifestations were ophthalmic symptoms, such as exophthalmos or displacement, eye pain, blindness or decreased vision, blepharoptosis, and diplopia; no obvious nasal symptoms were noted. Most patients with these symptoms went to an ophthalmologist first. All lesions in this study were found through imaging examinations. Most symptoms improved after surgical interventions. Only 2 of the 61 patients had no improvement in vision because of the long period of vision loss.

Conclusions:
Although sinus mucoceles are located in the sinuses, ocular symptoms are more prevalent than nasal symptoms. The earlier the imaging examinations are performed; the sooner lesions are detected, and the patients can be treated.
Errors in Surgery
Authors: Marsh Katherine M. , Turrentine Florence E. , Schenk Worthington G. , Hanks John B. , Schirmer Bruce D. , Davis John P. , McMurry Timothy L. , Ratcliffe Sarah J. , Zaydfudim Victor M. , Jones R.S. 
Published: August 2022

Objective:
While errors can harm patients they remain poorly studied. This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality.

Background:
Errors have been reported to cause <10% or >60% of adverse events. Such discordant results underscore the need for further exploration of the relationship between error and adverse events.

Methods:
Patients with operations performed at a single institution and abstracted into the American College of Surgeons National Surgical Quality Improvement Program from January 1, 2018, to December 31, 2018 were examined. This matched case control study comprised cases who experienced a postoperative morbidity or mortality. Controls included patients without morbidity or mortality, matched 2:1 using age (±10 years), sex, and Current Procedural Terminology (CPT) group. Two faculty surgeons independently reviewed records for each case and control patient to identify diagnostic, technical, judgment, medication, system, or omission errors. A conditional multivariable logistic regression model examined the association between error and morbidity.

Results:
Of 1899 patients, 170 were defined as cases who experienced a morbidity or mortality. The majority of cases (n=93; 55%) had at least 1 error; of the 329 matched control patients, 112 had at least 1 error (34%). Technical errors occurred most often among both cases (40%) and controls (23%). Logistic regression demonstrated a strong independent relationship between error and morbidity (odds ratio=2.67, 95% confidence interval: 1.64–4.35, P<0.001).

Conclusion:
Errors in surgical care were associated with postoperative morbidity. Reducing errors requires measurement of errors.
The Relationship Between Trichotillomania and Serum Brain-Derived Neurotrophic Factor Levels in Children and Adolescents: A Case-Control Study
Authors: Akaltun İsmail 
Published: August 2022

Objective
Trichotillomania (TTM) is a clinical psychiatric manifestation involving significant hair loss in association with recurrent hair-pulling behavior, the etiology of which is still unknown. Insufficiency or disorder in the synthesis of brain-derived neurotrophic factor (BDNF) is reported to be potentially associated with neurological, neurodegenerative, and psychiatric diseases in humans and animals. This study examines the relationship between serum BDNF levels and TTM.

Methods
Ninety-four children and adolescents, 47 patients with TTM and a 47-member control group, were included in the study. Participants were administered the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (6–18 Years) Present and Lifetime Version, and the members of the case group completed the Clinical Global Impression scale. Serum BDNF levels were determined from blood specimens collected from the study and control groups, and the results were subjected to statistical analysis.

Results
Serum BDNF levels were 11.06 ± 1.9 ng/mL in the TTM group and 13.78 ± 2.2 ng/mL in the control group. Serum BDNF was significantly lower in the case group than in the control group. Moderate negative correlation was also determined between Clinical Global Impression scores and serum BDNF levels in the case group.

Conclusions
Low serum BDNF was associated with TTM and the severity thereof. Furthermore, more extensive studies are needed to elucidate this association.
Anakinra in hospitalized COVID-19 patients guided by baseline soluble urokinase plasminogen receptor plasma levels: a real world, retrospective cohort study
Authors: Segala Francesco Vladimiro , Rando Emanuele , Salvati Federica , Negri Marcantonio , Catania Francesca , Sanmartin Flavia , Murri Rita , Giamarellos-Bourboulis Evangelos J. , Fantoni Massimo 
Published: August 2022

AbstractBackgroundIn patients with COVID-19 and baseline soluble urokinase plasminogen receptor plasma (suPAR) levels ≥ 6ng/mL, early administration of anakinra, a recombinant interleukin-1 receptor antagonist, may prevent disease progression and death. In case of suPAR testing unavailability, the Severe COvid Prediction Estimate (SCOPE) score may be used as an alternative in guiding treatment decisions.MethodsWe conducted a monocenter, retrospective cohort study, including patients with SARS-CoV2 infection and respiratory failure. Patients treated with anakinra (anakinra group, AG) were compared to two control groups of patients who did not receive anakinra, respectively with ≥ 6 ng/mL (CG1) and < 6 ng/mL (CG2) baseline suPAR levels. Controls were paired by age, sex, date of admission and vaccination status. Primary endpoint of the study was disease progression at day 14 from admission, as defined by patient distribution on a simplified version of the 11-point World Health Organization Clinical Progression Scale (WHO-CPS).ResultsBetween July, 2021 and January, 2022, 153 patients were included, among which 56 were treated with off-label anakinra, 49 retrospectively fulfilled prescriptive criteria for anakinra and were assigned to CG1, and 48 presented with suPAR levels < 6ng/mL and were assigned to CG2. At day 14, when comparing to CG1, patients who received anakinra had significantly reduced odds of progressing towards worse clinical outcome both in ordinal regression analysis (OR 0.25, 95% CI 0.11-0.54, p<0.001) and in multivariable analysis (OR 0.19, 95% CI 0.03-0.82, p=0.037), and these results were confirmed even when controlling for age, sex, BMI and vaccinal status. Sensitivities of baseline suPAR and SCOPE score in predicting progression towards severe disease or death at day 14 were similar (83% vs 100%, p=0.59).ConclusionThis real-word, retrospective cohort study confirmed the safety and the efficacy of suPAR-guided, early use of anakinra in hospitalized COVID-19 patients with respiratory failure.