bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental Worrying, Family Functioning, and Quality of Life During the COVID-19 Pandemic
Authors: Taha Asma A. , Azar Najood Ghazi , Eisen Aaron M. , Abdul-Rahman Hana Q. , Hanes Douglas A. 
Published: December 2021

Background
The 2019 novel coronavirus pandemic has affected many aspects of American life, with reported increases in parental anxiety and adverse health outcomes among children. However, it is unknown how family functioning and parental anxiety may be associated with child health outcomes during this pandemic.

Objectives
The aim of this study was to explore associations among parental worrying, family functioning, and the health-related quality of life (HRQoL) of middle and high school-aged children in the United States during the 2019 novel coronavirus pandemic.

Methods
Ninety-three parent–child dyads were recruited via snowball sampling through the WhatsApp messenger from December 2020 to February 2021 in this exploratory cross-sectional study. Each family completed a series of self-report measures, including the General Functioning Scale–Family Assessment Device and the Worry Domains Questionnaire for parent respondents and the KIDSCREEN-10 for child respondents. A hierarchical regression analysis was performed to examine effects of parental worrying and family functioning on the HRQoL of middle and high school-aged children.

Results
Lower levels of parental worrying and better family functioning predicted better child HRQoL, whereas parental worrying was associated with worse family functioning. The relationship between family functioning and child HRQoL did not differ by levels of parental worrying. Increased child age and parental education were associated with worse child HRQoL.

Discussion
The high socioeconomic status sample reported healthy family functioning during the 2019 novel coronavirus pandemic. Family functioning appears to improve child HRQoL consistently, even as parental worrying increases or decreases, although increased worrying would likely decrease family functioning and child HRQoL. The inverse relationships of parental educational attainment with family functioning and child HRQoL are surprising; they may be due to pandemic circumstances and the nature of the sample being high-socioeconomic status families with middle and high school-aged children.
Needs of chemotherapy regimen checks procedure: from the survey on chemotherapy regimen checks performed by pharmacists in hospitals other than designated cancer hospitals in Japan
Authors: Ohta Takahiro , Suzuki Shinya , Shinohara Akira , Ohashi Yasukata , Ueki Daisuke , Konuma Daisuke , Ryushima Yasuaki , Udagawa Ryoko , Kawasaki Toshikatsu , Yamaguchi Masakazu 
Published: December 2021

Abstract

Introduction:
Pharmacists perform regimen checks of physicians’ prescription orders in hospitals for providing appropriate chemotherapy. Details of these steps and procedures are confined to reports within individual facilities.

Methods:
In July 2016, a questionnaire was sent to the 33 pharmacists of the total 33 National Hospital Organization hospitals that were not cancer hospitals in Japan to survey the items checked in regimen checks and to assess whether the regimen checks are performed for oral anticancer drugs (OACDs) and injected anticancer drugs (IACDs) according to prescription category. The questionnaires included items on characteristics of respondents and their facilities and the 7 items related to regimen checks.

Results:
All facilities responded to the questionnaires, and 15 and 22 of the facilities performed chemotherapy regimen checks for OACDs and IACDs, respectively. Regimen checks for OACDs were performed for 80% (12/15) of internal and 27% (4/15) of external prescriptions for outpatient care and 93% (14/15) of prescriptions for inpatient care. Regimen checks for IACDs were performed for 91% (20/22) of prescriptions for outpatient care and 100% (22/22) of inpatient care.

Conclusions:
The surveyed facilities differed in terms of items checked, suggesting that procedures of regimen checks followed protocols unique to each facility. It is vital to establish an adequate procedure to perform safe chemotherapy.
Influence of Immune Cell Subtypes on Mitochondrial Measurements in Peripheral Blood Mononuclear Cells From Children with Sepsis
Authors: Weiss Scott L. , Henrickson Sarah E. , Lindell Robert B. , Sartori Laura F. , Zhang Donglan , Bush Jenny , Farooqi Sumera , Starr Jonathan , Deutschman Clifford S. , McGowan Francis X. , Becker Lance , Tuluc Florin , Wherry E. John , Picard Martin , Wallace Douglas C. 
Published: December 2021

ABSTRACT

Introduction:
Peripheral blood mononuclear cells (PBMCs) are commonly used to compare mitochondrial function in patients with versus without sepsis, but how these measurements in this mixed cell population vary by composition of immune cell subtypes is not known, especially in children. We determined the effect of changing immune cell composition on PBMC mitochondrial respiration and content in children with and without sepsis.

Methods:
PBMC mitochondrial respiration and citrate synthase (CS) activity, a marker of mitochondrial content, were measured in 167 children with sepsis at three timepoints (day 1–2, 3–5, and 8–14) and once in 19 nonseptic controls. The proportion of lymphocytes and monocytes and T, B, and NK cells was measured using flow cytometry. More specific CD4+ and CD8+ T cell subsets were measured from 13 sepsis patients and 6 controls. Spearman's correlation and simple and mixed effects linear regression were used to determine the association of PBMC mitochondrial measures with proportion of immune cell subtypes.

Results:
PBMC mitochondrial respiration and CS activity were correlated with proportion of monocytes, lymphocytes, T B, and NK cells in controls, but not in sepsis patients. PBMC mitochondrial respiration was correlated with CD4+ and CD8+ T cell subsets in both groups. After controlling for differences in immune cell composition between groups using linear regression models, PBMC respiration and CS activity remained lower in sepsis patients than controls.

Conclusions:
Mitochondrial measurements from PBMCs varied with changes in immune cell composition in children with and without sepsis. However, differences in PBMC mitochondrial measurements between sepsis patients and controls were at least partially attributable to the effects of sepsis rather than solely an epiphenomena of variable immune cell composition.
Quality Improvement Initiative Using Blended In Situ Simulation Training on Procedural Sedation and Analgesia in a Pediatric Emergency Department
Authors: Nucci Alessia , Sforzi Idanna , Morley-Fletcher Alessio , Saffirio Claudia , Bussolin Leonardo , Masi Stefano , Weinstock Peter , De Luca Marco 
Published: December 2021

Introduction
There is evidence in the literature for high-fidelity in situ simulation training programs being an effective modality for physicians training. This quality initiative focused on implementation of the procedural sedation and analgesia (PSA) in our pediatric emergency department (PED). The primary outcomes of this study were to evaluate the impact of blended in situ simulation training (BST) program on PSA for closed forearm fracture reduction in the PED and to assess its cost-effectiveness. The secondary outcomes were to estimate this change on PSA's clinical efficacy and safety.

Methods
Between 2014 and 2018, a single-center, quasi-experimental, uncontrolled before and after study on forearm fracture reduction management was conducted. To assess the impact of our BST-PSA course, both historical control and prospective analyses were performed. Statistical significance was based on Fisher exact test or Pearson χ2 test.

Results
Eight hundred eighty-five children met inclusion criteria. A significant difference in the number of PSAs performed in the PED, before and after BST, was found (37% vs. 85.3%, P < 0.001). Furthermore, a reduction in the number of hospitalizations for closed fracture reduction was measured (68.2% vs. 31.8%, P < 0.001). The overall cost savings from the BST-enabled increase in PSAs carried out in the PED was €370,714 ($440,838) with a return on investment of 64:1. No significant increase of PSA-related adverse events was found, and no serious adverse events occurred.

Conclusions
Findings provide evidence of the benefits of implementing BST to enable PSA use in the PED, with an improved patient flow and significant cost savings from avoiding unnecessary hospitalizations.
Diabetes Remission After Bariatric Surgery in Patients on Glucocorticoids: A Pilot Study
Authors: Vahibe Ahmet , Livia Christopher , Portela Ray , Shah Meera , McKenzie Travis , Kellogg Todd , Ghanem Omar M. 
Published: December 2021

Background:
Diabetes mellitus type 2 (DM2) remission after bariatric surgery has long been reported in the medical literature. Glucocorticoid use is associated with weight gain and could theoretically affect diabetes remission post bariatric surgery.

Objectives:
The aim is to identify remission rates of DM2 among patients using glucocorticoids after bariatric surgery and assess long-term postsurgical follow-up.

Methods:
A retrospective analysis was performed on patients who used glucocorticoids and underwent bariatric surgery at the Mayo Clinic between 2008 and 2020. Data were analyzed for 3-month, 6-month, 1-year, 2-year, and 5-year intervals for factors indicative of diabetes remission.

Results:
Within our retrospective search, we identified 92 patients who were on any immunosuppressant medication before surgery. Of those, 22 patients had a diagnosis of DM2 while 18 of them were concurrently on glucocorticoids. Diabetes remission occurred in 11 of the 18 DM2 patients (61.11%). There was a statistically significant negative correlation between diabetes remission and combination therapy with glucocorticoids and tacrolimus (P=0.016); patients with a longer duration of DM2 diagnosis (P=0.024), and patients who used insulin three months after the procedure (P=0.001). However, percent total weight loss and the number of preoperative oral DM2 medications were not associated with worse outcomes.

Conclusions:
Patients who use systemic glucocorticoids are able to achieve diabetes remission after bariatric surgery. Concurrent therapy with tacrolimus is associated with worse remission outcomes.
Ictal Theta Power as an Electroconvulsive Therapy Safety Biomarker
Authors: Miller Jeremy , Jones Tom , Upston Joel , Deng Zhi-De , McClintock Shawn M. , Ryman Sephira , Quinn Davin , Abbott Christopher C. 
Published: December 2021

Objective
Electroconvulsive therapy (ECT) remains the benchmark for treatment resistant depression, yet its cognitive adverse effects have a negative impact on treatment. A predictive safety biomarker early in ECT treatment is needed to identify patients at cognitive risk to maximize therapeutic outcomes and minimize adverse effects. We used ictal electroencephalography frequency analysis from suprathreshold treatments to assess the relationships between ECT dose, ictal power across different frequency domains, and cognitive outcomes.

Methods
Seventeen subjects with treatment resistant depression received right unilateral ECT. Structural magnetic resonance imaging was obtained pre-ECT for electric field modeling to assess ECT dose. Serial assessments with 24-lead electroencephalography captured ictal activity. Clinical and cognitive assessments were performed before and after ECT. The primary cognitive outcome was the change in Delis Kaplan Executive Function Verbal Fluency Letter Fluency.

Results
Ictal theta (4–8 Hz) power in the Fp1/Fp2 channels was associated with both whole-brain electric field strength (t
(2,12) = 19.5, P = 0.007)/(t
(2,10) = 21.85, P = 0.02) and Delis Kaplan Executive Function Verbal Fluency Letter Fluency scores (t
(2,12) = −2.05, P = 0.05)/(t
(2,10) = −2.20, P = 0.01). Other frequency bands (beta, alpha, delta, and gamma) did not demonstrate this relationship.

Conclusions
This pilot data identify ictal theta power as a potential safety biomarker in ECT and is related to the strength of the ECT dose. Ictal theta power could prove to be a convenient and powerful tool for clinicians to identify those patients most susceptible to cognitive impairment early in the treatment series. Additional studies are needed to assess the role of longitudinal changes in ictal theta power throughout the ECT series.
A Clinical Case Series of Acute and Maintenance Home Administered Transcranial Direct Current Stimulation in Treatment-Resistant Depression
Authors: Le Brandon , Alonzo Angelo , Bull Michael , Kabourakis Michael , Martin Donel , Loo Colleen 
Published: December 2021

Objectives
Transcranial direct current stimulation (tDCS) is a noninvasive neurostimulation technique being translated clinically for the treatment of depression. There is limited research documenting the longer-term effectiveness and safety of tDCS treatment. This case series is the first report of remotely supervised, home-administered tDCS (HA-tDCS) for depression in a clinical setting.

Methods
We report clinical, cognitive, and safety outcomes from 16 depressed patients who received acute and/or maintenance HA-tDCS. We retrospectively examined clinical data from up to 2.5 years of treatment. Descriptive statistics are reported to document patient outcomes.

Results
Twelve patients received acute treatment for a current depressive episode and 4 commenced tDCS maintenance therapy after responding to ECT or repetitive transcranial magnetic stimulation (rTMS). The cohort was highly treatment-resistant wherein 15 of 16 patients failed 3 trials or more of antidepressant medication in the current episode, and 6 patients failed to gain significant benefit from prior ECT or rTMS. Five of 12 patients responded to acute tDCS within 6 weeks, and 9 patients who received tDCS for more than 12 weeks maintained improvements over several months. Cognitive tests showed no evidence of impairments in cognitive outcomes after up to 2 years of treatment. Two patients were withdrawn from treatment because of blurred vision or exacerbation of tinnitus. Transcranial direct current stimulation was otherwise safe and well tolerated.

Conclusions
Transcranial direct current stimulation given for at least 6 weeks may be of clinical benefit even in treatment-resistant depression. Results provide support for long-term effectiveness, safety, and feasibility of remotely supervised HA-tDCS and suggest a role for maintenance tDCS after acute treatment with tDCS, rTMS, or ECT.
The Effect of Electroconvulsive Therapy on Positive Affect and Hedonism in Patients With Depression
Authors: Crauwels Bo , Vansteelandt Kristof , Obbels Jasmien , Lambrichts Simon , Pilato Eva , Demyttenaere Koen , Sienaert Pascal 
Published: December 2021

Objectives
The outcome of antidepressant treatments is generally assessed with standardized symptom scales such as the Quick Inventory of Depressive Symptomatology–Clinician Rating (QIDS-C). These scales, however, might not reflect patients' expectations for treatment, including a recovery of positive affect (PA) and hedonism. The Leuven Affect and Pleasure Scale (LAPS) was developed to better reflect patients' expectations for treatment. We used the LAPS to investigate changes in PA and hedonism alongside depressive symptoms during electroconvulsive therapy (ECT) and over 12 weeks after treatment.

Methods
Fifty-three patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, depressive episode, referred for ECT, were included in this prospective study. The LAPS and QIDS-C were administered before and 1 and 12 weeks after the ECT course. LAPS normative levels were obtained in 149 healthy controls.

Results
Pearson correlations revealed only moderate overlap of the QIDS-C with PA and hedonism. Piecewise linear mixed models indicated significant improvements in depressive symptoms (QIDS-C and LAPS negative affect), PA, and hedonism during ECT. In the 12 weeks after ECT treatment, negative affect and QIDS-C further improved, but PA and hedonism plateaued. Exploratory analyses indicated that only fully remitted patients (QIDS-C) attained normative levels on PA and hedonism at 12 weeks after ECT.

Conclusions
Standardized symptom scales (QIDS-C) may incompletely reflect clinical change in ECT treatment for depression. Although ECT improved depressive symptoms, PA, and hedonism in patients with depression, only fully remitted patients attained normative levels of PA and hedonism, due to plateaus in improvement. These plateaus were not observed for depressive symptoms, which further improved after ECT discontinuation.
First Acute-Course Electroconvulsive Therapy for Moderate-to-Severe Depression Benefits Patients With or Without Accompanying Baseline Cognitive Impairment
Authors: Copersino Marc L. , Long Marina P. , Bolton Paula , Ressler Kerry J. , Seiner Stephen J. , Yip Agustin G. 
Published: December 2021

Background
Researchers are increasingly investigating therapeutic response associated with new patient subgroups as a way to improve electroconvulsive therapy (ECT) treatment outcomes and reduce adverse events. This study is the first to examine baseline cognitive impairment status as a predictor of clinical outcome in first acute-course ECT patients.

Methods
Baseline cognitive function at various thresholds and serial depressive symptom severity data from first-time ECT patients were examined using generalized linear mixed-effects models.

Results
Of 1345 patients who met the inclusion criteria, 617 had available data at their third assessment visit (~15th treatment visit). There was a robust improvement in depression symptoms over time (P < 0.0001), and cognitive function was not associated with baseline levels of depressive symptoms or serially measured change in self-reported symptom severity during acute-phase ECT.

Conclusions
These results indicate that an acute course of ECT for the treatment of moderate-to-severe depression benefits patients with or without accompanying baseline cognitive impairment. These findings may be useful in informing shared decision-making discussions about ECT risks and expected benefits.
A preliminary study of commercially available general-purpose chest radiography artificial intelligence-based software for detecting airspace opacity lesions in COVID-19 patients
Authors: Suzuki Munemura , Niimura Aruta , Nakamura Yusuke , Otsuka Yujiro 
Published: December 2021

AbstractPurposeTo validate commercially available general-purpose artificial intelligence (AI)-based software for detecting airspace opacity in chest radiographs (CXRs) of COVID-19 patients.Materials and MethodsWe used the ieee8023-covid-chestxray-dataset to validate commercial AI software capable of detecting “Nodule/Mass” and “Airspace opacity” as regions of interest with probability scores. From this dataset, we excluded computed tomography images and CXR images taken using an anteroposterior spine view and analyzed CXR images tagged with “Pneumonia/Viral/COVID-19” and “no findings.” A radiologist then reviewed the images and rated them on a 3-point opacity score for the presence of airspace opacity. The maximum probability score of airspace opacity for each image was calculated using this software. The difference in each maximum probability for each opacity score was evaluated using Wilcoxon’s rank sum test. The threshold of the probability score was determined by receiver operator characteristic curve analysis for the presence or absence of COVID-19, and the true positive rate (TPR) and false positive rate (FPR) were determined for the individual and overall opacity scores.ResultsImages from 342 patients with COVID-19 and 15 normal images were included. Opacity scores of 1, 2, and 3 were observed in 44, 70, and 243 images, respectively, of which 33 (75%), 66 (94.2%), and 243 (100%), respectively, were from COVID-19 patients. The overall TPR and FPR were 0.82 and 0.13, respectively, at an area under the curve of 0.88 and a threshold of 0.06, while the FPR for opacity score 1 was 0.18 and the TPR for score 3 was 0.97.ConclusionUsing a public database containing CXR images of COVID-19 patients, commercial AI software was shown to be able to detect airspace opacity in severe pneumonia.SummaryCommercially available AI software was capable of detecting airspace opacity in CXR images of COVID-19 patients in a public database.
Multi-Analyte Liquid Biopsies for Molecular Pathway Guided Personalized Treatment Selection in Advanced Refractory Cancers: A Clinical Utility Pilot Study
Authors: Patil Darshana , Akolkar Dadasaheb , Nagarkar Rajnish , Srivastava Navin , Datta Vineet , Patil Sanket , Apurwa Sachin , Srinivasan Ajay , Datar Rajan 
Published: December 2021

AbstractPurposeThe selection of safe and efficacious anticancer regimens for treatment of broadly refractory patients with metastatic cancers remains a clinical challenge. Such patients are often fatigued by toxicities of prior failed treatments and may have no further viable standard of care treatment options. Liquid Biopsy-based multi-analyte profiling in peripheral blood can identify a majority of drug targets that can guide the selection of efficacious combination regimens.Patients and MethodsLIQUID IMPACT was a pilot clinical study where patients with advanced refractory cancers received combination anticancer treatment regimens based on multi-analyte liquid biopsy (MLB) profiling of circulating tumor biomarkers; this study design was based on the findings of prior feasibility analysis to determine the abundance of targetable variants in blood specimens from 1299 real-world cases of advanced refractory cancers.ResultsAmong the 29 patients in the intent to treat (ITT) cohort of the trial, 26 were finally evaluable as per study criteria out of whom 12 patients showed Partial Response (PR) indicating an Objective Response Rate (ORR) of 46.2% and 11 patients showed Stable Disease (SD) indicating the Disease Control Rate (DCR) to be 88.5%. The median Progression-Free Survival (mPFS) and median Overall Survival (mOS) were 4.3 months (95% CI: 3.0 – 5.6 months) and 8.8 months (95% CI: 7.0 – 10.7 months), respectively. Toxicities were manageable and there were no treatment-related deaths.ConclusionThe study findings suggest that MLB could be used to assist treatment selection in heavily pretreated patients with advanced refractory cancers.