bluuebunny/crossref_metadata_2025_split huggingface dataset:
Both subthalamic and pallidal deep brain stimulation are effective for GNAO1-associated dystonia: three case reports and a literature review
Authors: Liu Ye , Zhang Qingping , Wang Jun , Liu Jiyuan , Yang Wuyang , Yan Xuejing , Ouyang Yi , Yang Haibo 
Published: April 2022

Background: Mutations in the G-protein subunit alpha o1 ( GNAO1) gene have recently been shown to be involved in the pathogenesis of early infantile epileptic encephalopathy and movement disorders. The clinical manifestations of GNAO1-associated movement disorders are highly heterogeneous. However, the genotype–phenotype correlations in this disease remain unclear, and the treatments for GNAO1-associated movement disorders are still limited. Objective: The objective of this study was to explore diagnostic and therapeutic strategies for GNAO1-associated movement disorders. Methods: This study describes the cases of three Chinese patients who had shown severe and progressive dystonia in the absence of epilepsy since early childhood. We performed genetic analyses in these patients. Patients 1 and 2 underwent globus pallidus internus (GPi) deep brain stimulation (DBS) implantation, and Patient 3 underwent subthalamic nucleus (STN) DBS implantation. In addition, on the basis of a literature review, we summarized and discussed the clinical characteristics and outcomes after DBS surgery for all reported patients with GNAO1-associated movement disorders. Results: Whole-exome sequencing (WES) analysis revealed de novo variants in the GNAO1 gene for all three patients, including a splice-site variant (c.724–8G > A) in Patients 1 and 3 and a novel heterozygous missense variant (c.124G > A; p. Gly42Arg) in Patient 2. Both GPi and STN DBS were effective in improving the dystonia symptoms of all three patients. Conclusion: DBS is effective in ameliorating motor symptoms in patients with GNAO1-associated movement disorders, and both STN DBS and GPi DBS should be considered promptly for patients with sustained refractory GNAO1-associated dystonia.
Effectiveness and safety of secukinumab in axial spondyloarthritis: a 24-month prospective, multicenter real-life study
Authors: Ramonda Roberta , Lorenzin Mariagrazia , Sole Chimenti Maria , D’Angelo Salvatore , Marchesoni Antonio , Salvarani Carlo , Lubrano Ennio , Costa Luisa , Dal Bosco Ylenia , Fracassi Elena , Ortolan Augusta , Ferraioli Mario , Carriero Antonio , Visalli Elisa , Bixio Riccardo , Desiati Francesca , Bergamini Alberto , Pedrollo Elisa , Doria Andrea , Foti Rosario , Carletto Antonio 
Published: April 2022

Objectives: To evaluate, in a multicentric Italian cohort of axial spondyloarthritis (axSpA) patients on Secukinumab (SEC) followed for 24 months: (1) the long-term effectiveness and safety of SEC; (2) the drug retention rate and low disease activity (LDA) measured as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 4/Ankylosing Spondylitis Disease Activity Score (ASDAS) < 2.1 and very low disease activity (VLDA) measured as BASDAI < 2/ASDAS < 1.3; (3) any differences in outcomes according to line of biological treatment (naïve/non-naïve), gender (male/female), subtype of axSpA [radiographic axSpA (r-axSpA)/non-radiographic axSpA (nr-axSpA)]. Methods: Consecutive axSpA patients treated with SEC were evaluated prospectively. Disease characteristics, previous/ongoing treatments, comorbidities, and follow-up duration were collected. Disease activity/functional/clinimetric scores and biochemical-values were recorded at baseline (T0), 6 (T6), 12 (T12), and 24 (T24) months. Effectiveness was evaluated over-time with descriptive statistics; multivariate Cox and logistic regression models were used to evaluate predictors of drug discontinuation and LDA at T6. Infections and adverse events were recorded. Results: A total 249 patients (47.8% male; median age 51) were enrolled; 40.9% had HLA-B27; 53.8% had r-axSpA, and 46.2% nr-axSpA. SEC was prescribed in 28.9% naïve and in 71.1% non-naïve patients. SEC effectiveness was shown as an improvement in several outcomes, such as ASDAS [T0 = 3.5 (2.9–4.4) versus T24 = 1.9 (1.2–2.4); p = 0.02] and BASDAI [T0 = 6.5 (5.0–7.5) versus T24 = 2.8 (1.8–4.0); p = 0.03]. At T24, naïve patients showed better physical functioning and lower disease activity than non-naïve. After 24 months of treatment, 90.7% of naïve and 75.3% of non-naïve patients achieved LDA (BASDAI < 4). Treatment was discontinued in 24.5% patients, mainly due to primary/secondary loss of effectiveness, and in 6.8% due to adverse events. Retention rate at T24 was 75% in the whole population, with some difference depending on gender ( p = 0.002). Conclusion: In a real-life clinical setting, SEC proved to be safe and effective in axSpA, mainly in naïve-patients, with a notable drug retention rate. No differences were observed between r-axSpA and nr-axSpA.
Mortality, healthcare resource utilization, and cost among Medicare beneficiaries with Clostridioides difficile infection with and without sepsis
Authors: Amin Alpesh , Nelson Winnie W. , Dreyfus Jill , Wong Anny C. , Mohammadi Iman , Teigland Christie , Dahdal David N. , Feuerstadt Paul 
Published: April 2022

Objective: To describe mortality, healthcare resource utilization (HRU), and costs among Medicare beneficiaries with primary Clostridioides difficile infection (pCDI) or recurrent CDI (rCDI), with and without sepsis. Methods: We conducted a retrospective observational study of 100% Medicare Fee-for-Service claims from adults aged ⩾ 65 years with ⩾1 CDI episode between 1 January 2009 and 31 December 2017. Patients were continuously enrolled in Medicare Parts A/B/D 12 months before and up to 12 months after pCDI. ICD-9/10 codes defined CDI using ⩾1 inpatient claim, or ⩾1 outpatient claim plus ⩾1 claim for CDI treatment. The pCDI episode ended after 14 days without a CDI claim. rCDI episodes started within 8 weeks from the end of a previous CDI episode. ICD-9/10 codes identified all-cause sepsis over 12 month follow-up. Results: Of 497,489 CDI patients, 41.0% ( N = 203,888) had sepsis; 57.7% with sepsis died versus 32.4% without sepsis. Among patients with pCDI only ( N = 345,893) or ⩾1 rCDI ( N = 151,596), 39.2% and 45.1% suffered sepsis, respectively. All-cause hospitalizations were frequent for all cohorts (range: 81–99%). Among patients who died, those with sepsis versus without had more-frequent intensive care unit (ICU) use (pCDI: 29% versus 15%; rCDI: 65% versus 34%), longer hospital stays (pCDI: 12 versus 10 days; rCDI: 12 versus 9 days), and higher per-patient-per-month costs (pCDI: $34,841 versus $22,753; rCDI: $42,269 versus $25,047). In both cohorts, sepsis patients who survived had higher total costs and all-cause HRU than those without sepsis. All p < 0.001 above. Conclusions: Sepsis was common among Medicare beneficiaries with CDI. CDI patients with sepsis, especially after an rCDI, experienced higher mortality, HRU, and costs compared with those without sepsis.
Mentorship in Undergraduate Biomedical Education: Identifying Student Opinions and Expectations
Authors: Wright Bradley C. , Schadler Aric D. , Swanson Hollie I. 
Published: April 2022

Objective To evaluate undergraduate biomedical education student opinions and expectations on mentorship. Methods A survey was administered to students enrolled in the undergraduate biology, neuroscience and nursing programs at a large public research-intensive university. The survey queried demographics, previous mentorship experiences, ideal qualities of mentors, benefits/value of mentorship and future plans for seeking mentorship. Survey responses were evaluated using either t-test comparisons or one-way ANOVA. Results The majority of the respondents were female and were interested in pursuing professional schools (nursing and medicine). Survey results indicate high student interest in receiving mentoring, but few were active participants in a mentoring relationship. Respondents indicated either lack of knowledge or discomfort in identifying a mentor. While faculty mentors versus peer mentors were preferred, respondents indicated that mentoring by either faculty or peers would be of value. Survey results indicate that desired benefits of mentoring included guidance in future education and career decisions, networking and career advice. Conclusion The major conclusions are that despite high student interest in being mentored, their participation in mentoring is very low. These finding are supportive of the development of structured mentoring programs to facilitate and enhance mentoring of undergraduate STEM students and aid in their academic career progression.
One-year healthcare costs of patients with spontaneous intracerebral hemorrhage treated in the intensive care unit
Authors: Smeds Marika , Skrifvars Markus B , Reinikainen Matti , Bendel Stepani , Hoppu Sanna , Laitio Ruut , Ala-Kokko Tero , Curtze Sami , Sibolt Gerli , Martinez-Majander Nicolas , Raj Rahul 
Published: April 2022

Background: Spontaneous intracerebral hemorrhage (ICH) entails significant mortality and morbidity. Severely ill ICH patients are treated in intensive care units (ICUs), but data on 1-year healthcare costs and patient care cost-effectiveness are lacking. Methods: Retrospective multi-center study of 959 adult patients treated for spontaneous ICH from 2003 to 2013. The primary outcomes were 12-month mortality or permanent disability, defined as being granted a permanent disability allowance or pension by the Social Insurance Institution by 2016. Total healthcare costs were hospital, rehabilitation, and social security costs within 12 months. A multivariable linear regression of log transformed cost data, adjusting for case mix, was used to assess independent factors associated with costs. Results: Twelve-month mortality was 45% and 51% of the survivors were disabled at the end of follow-up. The mean 12-month total cost was €49,754, of which rehabilitation, tertiary hospital and social security costs accounted for 45%, 39%, and 16%, respectively. The highest effective cost per independent survivor (ECPIS) was noted among patients aged >70 years with brainstem ICHs, low Glasgow Coma Scale (GCS) scores, larger hematoma volumes, intraventricular hemorrhages, and ICH scores of 3. In multivariable analysis, age, GCS score, and severity of illness were associated independently with 1-year healthcare costs. Conclusions: Costs associated with ICHs vary between patient groups, and the ECPIS appears highest among patients older than 70 years and those with brainstem ICHs and higher ICH scores. One-third of financial resources were used for patients with favorable outcomes. Further detailed cost-analysis studies for patients with an ICH are required.
An Unusual Case of Ruptured Sinus of Valsalva Misdiagnosed as Acute Coronary Syndrome
Authors: Shetty Rajesh Mohan , Kumar Rajendra Santhosh , Hossain Motahar 
Published: April 2022

Background: Ruptured sinus of Valsalva aneurysm (RSOVA) is rare and can mimic many other diseases. It may be misdiagnosed on initial evaluation. Uncorrected almost invariably, it has a rapid downhill course. We present a case which was initially misdiagnosed as acute coronary syndrome (ACS). Case Summary: A 49-year-old lady presented to a local hospital with history of chest pain. She was diagnosed with ACS based on history and electrocardiogram findings and treated conservatively. She deteriorated and developed multiorgan failure. She was transferred to our center for further management. On re-evaluation, transthoracic echocardiography showed RSOVA. She was treated with transcatheter device closure. She recovered well and was discharged in stable condition. Discussion: This case highlights the diagnostic difficulty when patients present with features of other common diseases. Right heart failure evaluation in the setting of appropriate clinical features should prompt consideration of RSOVA as a differential diagnosis. RSOVA if managed appropriately can lead to complete recovery.
Intervening on the storage time of RBC units and its effects on adverse recipient outcomes using real-world data
Authors: Bruun-Rasmussen Peter , Kragh Andersen Per , Banasik Karina , Brunak Søren , Johansson Pär Ingemar 
Published: April 2022

Abstract
Randomized controlled trials (RCTs) have found no evidence that the storage time of transfused red blood cell (RBC) units affects recipient survival. However, inherent difficulties in conducting RBC transfusion RCTs have prompted critique of their design, analyses, and interpretation. Here, we address these issues by emulating hypothetical randomized trials using large real-world data to further clarify the adverse effects of storage time. We estimated the comparative effect of transfusing exclusively older vs fresher RBC units on the primary outcome of death, and the secondary composite end point of thromboembolic events, or death, using inverse probability weighting. Thresholds were defined as 1, 2, 3, and 4 weeks of storage. A large Danish blood transfusion database from the period 2008 to 2018 comprising &gt;900 000 transfusion events defined the observational data. A total of 89 799 patients receiving &gt;340 000 RBC transfusions during 28 days of follow-up met the eligibility criteria. Treatment with RBC units exclusively fresher than 1, 2, 3, and 4 weeks of storage was found to decrease the 28-day recipient mortality with 2.44 percentage points (pp) (0.86 pp, 4.02 pp), 1.93 pp (0.85 pp, 3.02 pp), 1.06 pp (–0.20 pp, 2.33 pp), and −0.26 pp (–1.78 pp, 1.25 pp) compared with transfusing exclusively older RBC units, respectively. The 28-day risk differences for the composite end point were similar. This study suggests that transfusing exclusively older RBC units stored for &gt;1 or 2 weeks increases the 28-day recipient mortality and risk of thromboembolism or death compared with transfusing fresher RBC units.
Early initiation of tolvaptan is associated with early discharge in patients with heart failure regardless of age
Authors: Kiuchi Shunsuke , Hisatake Shinji , Kabuki Takayuki , Oka Takashi , Dobashi Shintaro , Murakami Yoshiki , Sano Takahide , Ikeda Takanori 
Published: April 2022

Abstract
Background
Elderly patients with heart failure (HF) have been observed to decrease activities of daily living (ADL) during hospitalization. Prevention of ADL decline from shortening of hospital stays is especially important in the elderly, because decreasing ADL is associated with poor prognosis. We investigated the relationship between the early initiation of tolvaptan (TLV) after hospitalization and the length of hospital stay in patients with HF aged younger than 80 years and aged 80 years and older.

Methods
We analyzed 146 patients younger than 80 years (< 80) and 101 patients aged 80 years and older (≥ 80) who were hospitalized with HF from February 2011 to June 2016 and had initiated TLV. The relationship between the time until commencement of TLV and the length of hospital stay was assessed. Additionally, a comparison made between the TLV early start group (within the median) and the delayed start group (over the median) for both groups. Multivariate analysis was also performed on factors that required hospital stays below the median.

Results
A significant correlation was observed between time to TLV initiation and the length of hospital stay (< 80: r = 0.382, P < 0.001; ≥ 80: r = 0.395, P < 0.001). The length of hospital stay in the early group was significantly longer than that in the delayed group for both groups (< 80: early 21.0 ± 13.0 days and 33.0 ± 22.7 days, respectively, P < 0.001; ≥ 80: early 21.3 ± 12.5 days and 32.9 ± 17.9 days, respectively, P < 0.001). Conversely, no statistically significant difference found in the length of hospital stay after initiation of TLV. Moreover, no increase in adverse events in the elderly observed. A multivariate analysis revealed that a predictive factor for short-term hospitalization was early administration of TLV regardless of age.

Conclusions
The early initiation of TLV after hospitalization was associated with a shorter length of hospital stay in patients with HF regardless of age.
Effects of aerobic exercise on quality of life of people with HIV-associated neurocognitive disorder on antiretroviral therapy: a randomised controlled trial
Authors: Nweke Martins , Mshunqane Nombeko , Govender Nalini , Akinpelu Aderonke O. , Ogunniyi Adesola 
Published: April 2022

Abstract
Background
HIV-associated neurocognitive disorder (HAND) negatively impacts quality of life (QoL) of people living with HIV who are on antiretroviral therapy (ART). Behavioural intervention adjunct to ART may improve QoL of people with HAND. We determine the effect of a 12-week aerobic exercise programme on QoL in people with HAND who were receiving ART.

Trial design
This was a parallel-group, randomised controlled trial with concealed allocation and intention-to-treat analysis.

Methods
We identified 73 participants diagnosed with HAND. Participants were sampled from an earlier study that examined the prevalence of HAND according to the Frascati criteria. Participants were randomised and allocated to an intervention of 12-weeks of aerobic exercise, comprising three 20–60 min sessions per week of moderate-intensity aerobic exercise using a cycle ergometer. The primary outcome was QoL, which was evaluated using the World Health Quality of Life Questionnaire (WHOQoL)-BREF.

Results
Participants in the exercise (n = 39) and control (n = 35) groups had similar sociodemographic characteristics (p > 0.05). Following the 12-week aerobic exercise programme, participants in the exercise group had improved physical (p < 0.001), psychological (p = 0.008) and environmental (p = 0.001) domains of the QoL (p = 0.001) and overall QoL (p = 0.001) relative to the control group. Similarly, participants in the exercise group had lower depression scores than participants in the control group. Depression scores in the exercise group were still lower 3 months post-intervention (p = 0.007). Only the improvements in physical (p = 0.02) and psychological (p = 0.007) domains of QoL were sustained at 3 months post-intervention.

Conclusions
Aerobic exercise improves the QoL of people with HAND. To ensure sustained benefits, people with HAND may need to engage in long-term physical exercise.
Trial registration The trial is registered with the PAN African Trial Registry (PACTR). Date: 01/09/2020, ID: PACTR202009483415745
Tracking of health-related physical fitness in adolescent girls: a 3-year follow-up study
Authors: Kasović Mario , Oreški Ana , Vespalec Tomaš , Jenčíková Kateřina , Štefan Lovro 
Published: April 2022

Abstract
Background
Evidence has shown that higher levels of physical fitness (PF) in youth have beneficial effects on adult health-related outcomes. However, the tracking of separate PF components during adolescence has been less studied. Since PF often starts to rapidly decline during adolescence, it is necessary to provide information regarding critical time-point for interventions. This study aimed to analyze the extent of tracking the components of PF through PF tests.

Methods
In this longitudinal study, we recruited 240 adolescent girls with recoded data at 2 time-points (15 y and 17 y). PF included body composition (fat mass), explosive power of lower extremities (standing broad jump), muscle endurance of the trunk (sit-ups in 60 s), flexibility (sit-and-reach test), muscle endurance of lower extremities (squats in 60 s), aerobic endurance (the 800 m run test) and speed endurance (the 400 m run test). Tracking coefficients were calculated using generalized estimating equations. Tertiles (high, moderate and low) were calculated for each fitness component.

Results
The highest tracking coefficients between the two time-points were found for explosive power of lower extremities (β = 0.98), followed by flexibility (β = 0.89), body composition (β = 0.88), speed endurance (β = 0.86), aerobic endurance (β = 0.75), muscle endurance of lower extremities (β = 0.65), and muscle endurance of the trunk (β = 0.51). Tertile ratings remained stable across the two time-points.

Conclusions
Moderate to high tracking of PF in adolescent girls suggests that interventions aiming to increase the level of PF should probably begin in early adolescence.
Development of a social distancing monitoring system in Republic of Korea: results of a modified Delphi process
Authors: Seo Suin , Han Jin-Ok , Shin Sool , Lee Heeyoung 
Published: April 2022

Abstract
Background
Social distancing policies work in different ways and at different levels. In addition, various forms of monitoring systems have been implemented in different countries. However, there is an almost complete lack of specific monitoring system in Republic of Korea to effectively monitor social distancing measures compliance and outcome. This study aims to develop a monitoring system for social distancing measures compliance and outcome in Korea to evaluate and improve the implemented policy.

Methods
A draft monitoring system was developed after reviewing Korea’s social distancing measures (central and local government briefings) and checking available data about social distancing behavior. The modified Delphi process was used to evaluate the draft of the social distancing monitoring system. In total, 27 experts participated in the evaluation. The round 1 evaluation includes (1) commenting on the composition of the monitoring fields (open response), (2) monitoring indicators for each monitoring field (10-point Likert scale), and (3) commenting on the source of data used to develop the monitoring system (open response). In the round 2 evaluation, 55 indicators, excepting open responses, were re-evaluated.

Results
The response rate for the Delphi survey was 100% in both the first and second rounds. Of the 55 indicators, 1 indicator, which did not satisfy the quantitative criteria, was excluded. According to the experts’ open response comments, 15 indicators were excluded, as these indicators overlapped with other indicators or had little relevance to social distancing. Instead, 23 new indicators were added. Finally, 62 indicators were included with 12 available data sources. The monitoring system domain was divided into ‘social distancing measures state, social distancing measures compliance, social distancing outcome’.

Conclusions
This study is significant in that it is the first in Korea to develop a comprehensive monitoring system for checking if social distancing measures are being followed well, and is applicable to estimates utilizing data that are immediately available for each indicator. Furthermore, the developed monitoring system could be a reference for other countries that require the development of such systems to monitor social distancing.