bluuebunny/crossref_metadata_2025_split huggingface dataset:
Has a change in established care pathways during the first wave of the COVID-19 pandemic led to an excess death rate in the fragility fracture population? A longitudinal cohort study of 1846 patients
Authors: Ikram Adeel , Norrish Alan , Ollivere Luke , Nightingale Jessica , Valdes Ana , Ollivere Benjamin J 
Published: May 2022

ObjectiveDuring the first wave of the COVID-19 pandemic, changes to established care pathways and discharge thresholds for patients with fragility fractures were made. This was to increase hospital bed capacity and minimise the inpatient risk of contracting COVID-19. This study aims to identify the excess death rate in this population during the first wave of the pandemic.DesignA longitudinal cohort study of patients with fragility fractures identified by specific International Classification of Diseases (ICD)-10 codes. The first wave of the pandemic was defined as the 3-month period between 1 March and 1 June 2020. The control group presented between 1 March and 1 June 2019.SettingTwo acute National Health Service hospitals within the East Midlands region of England.Participants1846 patients with fragility fractures over the aforementioned two specified matched time points.Primary and secondary outcome measuresFour-month mortality of all patients with fragility fractures with a subanalysis of patients with fragility hip fractures.Results832 patients with fragility fracture were admitted during the pandemic period (104 diagnosed with COVID-19). 1014 patients presented with fragility fractures in the control group. Mortality in patients with fragility fracture without COVID-19 was significantly higher among pandemic period admissions (14.7%) than the pre-pandemic cohort (10.2%) (HR=1.86; 95% CI 1.41 to 2.45; p<0.001) adjusted for age and sex. Length of stay was shorter during the pandemic period (effect size=−4.2 days; 95% CI −5.8 to –3.1, p<0.001). Subanalysis of patients with fragility hip fracture revealed a mortality of 8.4% in the pre-pandemic cohort, and 15.48% during pandemic admissions with no COVID-19 diagnosis (HR=2.08; 95% CI 1.11 to 3.90; p=0.021).ConclusionsThere is a significant increase in excess death, not explained by confirmed COVID-19 infections. Altered care pathways and aggressive discharge criteria during the pandemic are likely responsible for the increase in excess deaths.
Human T-cell leukaemia virus type 1 and Adult T-cell leukaemia/lymphoma in Queensland, Australia: a retrospective cross-sectional study
Authors: Martin Fabiola , Gilks Charles F , Gibb Robert , Jenkins Alana , Protani Melinda , Francis Fleur , Redmond Andrew M , Neilsen Graham , Mudge David , Wolley Martin , Binotto Enzo , Norton Robert , Nimmo Graeme R , Heney Claire 
Published: May 2022

ObjectivesHuman T-cell leukaemia virus type 1 (HTLV-1), an STI, is reported to be highly prevalent in Indigenous communities in Central Australia. HTLV-1 is an incurable, chronic infection which can cause Adult T-cell leukaemia/lymphoma (ATL). ATL is associated with high morbidity and mortality, with limited treatment options. We studied the prevalence of HTLV-1 and ATL in the state of Queensland, Australia.MethodsSerum samples stored at healthcare services in Brisbane, Townsville and Cairns and at haemodialysis units in Brisbane (2018–2019) were screened for HTLV-1/2 antibodies using the Abbott ARCHITECT chemiluminescent microparticle immunoassay (CMIA) for antibodies against gp46-I, gp46-II and GD21 (Abbott CMIA, ARCHITECT). Reactive samples were confirmed through Western blot. Pooled Australian National Cancer Registry surveillance data reporting on cases coded for ATL (2004–2015) were analysed.ResultsTwo out of 2000 hospital and health services samples were confirmed HTLV-1-positive (0.1%, 95% CI 0.02% to 0.4%), both in older women, one Indigenous and one non-Indigenous. All 540 haemodialysis samples tested negative for HTLV. All samples were HTLV-2-negative. Ten out of 42 (24.8%) reported cases of ATL in Australia were from Queensland (crude incidence rate 0.025/100 000; 95% CI 0.011 to 0.045); most cases were seen in adult men of non-Indigenous origin. Nineteen deaths due to ATL were recorded in Australia.ConclusionWe confirm that HTLV-1 and ATL were detected in Queensland in Indigenous and non-Indigenous people. These results highlight the need for HTLV-1 prevalence studies in populations at risk of STIs to allow the implementation of focused public health sexual and mother-to-child transmission prevention strategies.
Association of high-risk sexual behaviours with sexually transmitted infections among men who have sex with men living with HIV
Authors: Raccagni Angelo Roberto , Poli Andrea , Galli Laura , Spagnuolo Vincenzo , Bruzzesi Elena , Muccini Camilla , Gianotti Nicola , Canetti Diana , Mainardi Ilaria , Castagna Antonella , Nozza Silvia 
Published: May 2022

ObjectivesTo explore different sexual behaviours as risk factors for STI among men who have sex with men (MSM) living with HIV.MethodsThis is a cross-sectional study on MSM living with HIV followed at the Infectious Diseases Unit of San Raffaele Hospital, Milan, with at least one diagnosis of gonorrhoea, syphilis, chlamydia or anal human papilloma virus (HPV), between July 2016 and February 2021. We conducted a survey on high-risk sexual behaviours with regard to (1) mean number of partners per month, (2) estimated percentage of condom use and (3) most frequent type of sexual intercourse during 2016–2021. Data on these variables were grouped as follows: (1a) ≤5 vs >5, (1b) >10 vs ≤10, (2a) 0% vs >0%, (2b) ≤50% vs >50%, (2c) 100% vs <100%, (3a) ≥50% vs <50% receptive, (3b) 100% vs <100% insertive, and (3c) 100% vs <100% receptive. A high-risk group was defined as >5 partners, <100% use of condom and ≥50% receptive intercourse. Univariate logistic regressions were applied to assess the association between sexual behaviours and the risk of each STI.ResultsOut of 1051 MSM with at least one STI diagnosis, 580 (55%) answered the survey. The risk of chlamydia was lower among individuals with ≤5 partners (≤5 partners vs >5 partners: OR=0.43, 95% CI 0.28 to 0.66, p=0.001) and among those using condoms more frequently (≤50% use of condom vs >50% use of condom: OR=1.55, 95% CI 1.06 to 2.27, p=0.025; 100% vs <100%: OR=0.35, 95% CI 0.20 to 0.59, p=0.001). Individuals using condoms more frequently also had lower risk of gonorrhoea (100% use of condom vs <100% use of condom: OR=0.37, 95% CI 0.17 to 0.79, p=0.011). The risks of chlamydia (OR=3.07, 95% CI 1.92 to 4.90, p<0.001) and gonorrhoea (OR=2.05, 95% CI 1.12 to 3.75, p=0.020) were higher among individuals belonging to the high-risk group.ConclusionsChlamydia and gonorrhoea are more likely associated with high-risk sexual behaviours than syphilis and anal HPV among MSM living with HIV.
Atlantic salmon farms are a likely source of Tenacibaculum maritimum infection in migratory Fraser River sockeye salmon
Authors: Bateman Andrew W. , Teffer Amy K. , Bass Arthur , Ming Tobi , Kaukinen Karia , Hunt Brian P.V. , Krkošek Martin , Miller Kristina M. 
Published: May 2022

Juvenile sockeye salmon (Oncorhynchus nerka) in British Columbia migrate past numerous Atlantic salmon (Salmo salar) farms from which they may acquire infectious agents. We analyse patterns of molecular detection in juvenile sockeye for the bacterium Tenacibaculum maritimum, known to cause disease in fish globally and to cause mouthrot disease in farmed Atlantic salmon in British Columbia. Our data show a clear peak in T. maritimum detections in the Discovery Islands region of British Columbia, where sockeye migrate close to salmon farms. Using well-established differential equation models to describe sockeye migration and bacterial infection, fit to detection data, we assessed support for multiple hypotheses describing farm- and background-origin infection. Our best models (with 99.8% empirical support) describe constant background infection pressure, except around Discovery Islands salmon farms, where farm-origin infection pressure peaked at 12.7 (approximate 95% CI: 4.5 to 31) times background levels. Given the severity of associated disease in related species and the imperilled nature of Fraser River sockeye, our results suggest the need for a more precautionary approach to managing farm–wild interactions in sockeye salmon.
The Importance of Radiological Patterns and Small Airway Disease in Long-Term Follow-Up of Postacute COVID-19: A Preliminary Study
Authors: Mogami Roberto , Araújo Filho Ronaldo Carvalho , Cobo Chantong Carolina Gianella , Santos de Almeida Fernando Carlos , Baptista Koifman Ana Célia , Jauregui Gustavo Federico , Mafort Thiago Thomaz , da Silva Bessa da Costa Hanna , Peres dos Santos Glenda Aparecida , Zangerolame de Carvalho Bruna , da Silva Passos Gabriel , de Souza Barbosa Erick , Abalada Ghetti Angelo Thomaz , Monnerat Laura Braga , Soares da Cal Mariana , Souza Santos Batista Desiree Louise , Affonso Helen Aksenow , Bousquet Gabriel Oliveira , Marenco Avila Jose Ignacio , Bento Dutra Anna Luiza , Leidersnaider Caio Leal , Malta da Costa Messeder Alexandre , Monteiro Alexandra , Lopes Agnaldo José 
Published: May 2022

Postacute COVID-19 has become a relevant public health problem, and radiological and pulmonary function tests are tools that help physicians in decision-making. The objectives of this study are to characterize the findings and patterns on a chest radiograph (CXR) and computed tomography (CT) that are most important in the postacute phase and to evaluate how these changes correlate with clinical data, spirometry, and impulse oscillometry (IOS). This was a retrospective study of 29 patients who underwent CXR, CT, spirometry, and IOS. The inclusion criteria were age >18 years and persistent respiratory symptoms after four weeks. The exclusion criteria were radiological exams with low technical quality and non-COVID-19 acute lung diseases. The inferential analysis was carried out with the chi-square (χ2) or Fisher’s exact test to evaluate the interrelationships between the clinical and COVID-19 variables according to spirometry, IOS, CT, and CXR. In our sample, 19 patients were women (65.5%). The predominance of abnormal spirometry was associated with CT’s moderate/severe degree of involvement (

p

= 0.017; 69.2%, CI 95%: 44.1%–94.3%). There was no significant association between IOS and tomographic and radiographic parameters. A significant association was found between the classifications of the moderate/severe and normal/mild patterns on CT and CXRs (

p

= 0.003; 93.3%, CI 95%: 77.8%–100%). Patients with moderate/severe impairment on CXR were associated with a higher frequency of hospitalization (

p

= 0.033; 77.8%, CI 95%: 58.6%–97.0%) and had significantly more moderate/severe classifications in the acute phase than the subgroup with normal/mild impairment on CXR (

p

= 0.017; 88.9%, CI 95%: 74.4%–100%). In conclusion, the results of this study show that CXR is a relevant examination and may be used to detect nonspecific alterations during the follow-up of post-COVID-19 patients. Small airway disease is an important finding in postacute COVID-19 syndrome, and we postulate a connection between this pattern and the persistently low-level inflammatory state of the lung.
A filtração do líquido ascítico melhora o diagnóstico microbiológico da peritonite bacteriana espontânea? Um estudo experimental laboratorial
Authors: Chaves Lucas , Barbosa Junior Francisco , Souza Fernanda Fernandes de , Santana Rodrigo de Carvalho , Martinez Roberto , Bellissimo-Rodrigues Fernando 
Published: May 2022

Contexto: A Peritonite Bacteriana Espontânea (PBE) é uma complicação grave e frequente entre pacientes cirróticos com ascite, diagnosticada por meio da análise citológica do líquido ascítico. A cultura microbiológica do líquido ascítico, por sua vez, é positiva em menos de 40% dos casos de PBE, o que resulta frequentemente na instituição de terapia antimicrobiana inapropriada. A terapia empírica pode ser subótima, aumentando o risco de agravamento do paciente, ou superestimada, impulsionando desnecessariamente a resistência bacteriana. Objetivo: Estudo experimental laboratorial, propôs padronizar e verificar a viabilidade técnica da filtração a vácuo do líquido ascítico, como forma de otimizar o diagnóstico etiológico na PBE, comparativamente ao sistema automatizado de culturas de sangue. Método: O método avaliado e padronizado neste estudo foi a da filtragem a vácuo do líquido ascítico. Esse tem como princípio a concentração da bactéria em uma membrana filtrante. Resultados: Nesse estudo, foram incluídos 36 pacientes cirróticos atendidos em um hospital público universitário, entre 13.11.2017 e 30.06.2019. Entre eles, 47,2% (17/36) apresentaram citologia compatível com PBE. Nesses, a sensibilidade da cultura pelo método semi-automatizado foi de 35,3% (6/17) e da cultura pelo método da filtragem a vácuo foi de 11,8% (2/17). Conclusão: Em conclusão, a filtragem a vácuo não melhora o diagnóstico microbiológico da PBE em relação ao método automatizado.
Is arginine supplementation effective in preventing preeclampsia in pregnant women?
Authors: Citrangulo Gabriel Leite , Fonseca Ana Luísa Scafura da , Diniz Pedro Viana , Rodrigues João Pedro Torres Neiva , Drumond Denise Gasparetti 
Published: May 2022

Objectives: The objective of this study was to review data from randomized controlled trials to assess whether or not the supplementation of L-Arginine (L-Arg) is effective in reducing the incidence of preeclampsia (PE) in pregnancies at risk of developing the disorder.
Methods: We aimed to systematic review randomized controlled trials, including those which compared L-Arg supplementation with placebo in pregnant women at high risk of PE development, analyzing PE incidence as the main outcome. Data were collected from MEDLINE/ Pubmed, EMBASE/ Elsevier, LILACS/ BVS and Cochrane.
Results: A total of 46 papers were identified in the primary search. After analysis of eligibility, inclusion and exclusion criteria, two articles (which respected in detail all the stages of evaluation) were included in the present review. A risk of bias assessment was performed. Data analysis revealed that the incidence of PE was significantly lower in both studies, and no major adverse effects were reported. The limitations of this study were the lack of standardization between the trials analyzed and the relative low number of studies included.
Conclusions: The supplementation with L-Arg appears to reduce the incidence of PE in pregnant women with high risk for its development.
Predicting Outcomes in Trauma Patients With Cirrhosis Using Model for End-Stage Liver Disease Score: A Retrospective Study
Authors: Natkha Vitaliy P. , Southerland Parker , Almekdash Mhd Hasan , Keesair Rohali , Dhanasekara Chathurika S. , Dissanaike Sharmila 
Published: May 2022

Background Liver cirrhosis is associated with increased mortality in trauma victims. We stratified the impact of cirrhosis on trauma mortality by Model for End-stage Liver Disease (MELD) score. Methods Trauma center database was accessed for patients with established diagnosis of cirrhosis presenting 2014 - 2018, matched to control patients without cirrhosis in a 2:1 ratio by age, sex, and TRISS. Primary outcome was mortality, secondary outcomes were length of stay, intensive care unit days, and ventilator dependent days. Results Cirrhosis was present in 182 (1.5%) trauma patients. Mortality difference between 12 (7%) deaths in cirrhosis cohort versus 14 (4%) in control was not statistically significant (p = 0.38). No difference was found in secondary outcomes. Categorization of cirrhosis severity by MELD score range (MELD 6-7, 8-10, 11-14, 15-20, 21-30) showed a 1.9 fold increase in the odds of mortality for every increase in MELD score category (OR = 1.91, p = 0.03, 95% CI = 1.08 – 3.37). Conclusion Mortality effects of cirrhosis in trauma patients can be estimated using MELD score.
Experimental investigation of buckling behavior of E-glass/epoxy laminated composite materials with multi-walled carbon nanotube under uniaxial compression load
Authors: Mutu Halil Burak , Aslan Züleyha 
Published: May 2022

This study experimentally investigated the effects of nanoparticle reinforcement on the buckling behavior of composite materials. Different sizes of carboxylic acid functionalized multi-walled carbon nanotubes were used as nanoparticles. E-glass fiber-reinforced composite materials with polymer matrix in the [0°/90°/0°/90°]s cross-ply array with and without carbon nanotube reinforcement were produced by hand lay-up and vacuum bagging. Three types of carbon nanotubes in different sizes and proportions of 0.1%, 0.2%, 0.3%, 0.4%, and 0.5% by weight were added to the epoxy resin. For the buckling test, the samples with two clamped and two free sides were attached to the universal testing machine to apply a uniaxial compressive load. As a result of the experiments, it was found that the addition of carbon nanotube in certain proportions increases the critical buckling load of composite materials. The highest increase in the critical buckling load (26.10% increase) was achieved with a carbon nanotube reinforcement of 0.2% by weight, having an outer diameter of 10–20 nm, internal diameter of 5–10 nm, and length of 0.5–2 mm. As the carbon nanotube sizes added to the epoxy resin decreased, the buckling strength increased.
Adolescent borderline personality disorder: Does early intervention ‘bend the curve’?
Authors: Allison Stephen , Bastiampillai Tarun , Looi Jeffrey CL , Mulder Roger 
Published: May 2022

Objective The Global Alliance for Prevention and Early Intervention for Borderline Personality Disorder (BPD) proposed a major change for youth mental health services. The Alliance recommended that early detection and specialised treatment for youth BPD becomes a major focus of their clinical activities. Since structured psychotherapies for BPD are complex and lengthy, this proposal has significant implications for youth policy, planning and resource allocation. Our commentary addresses whether BPD is diagnosable and treatable in youth, and whether early intervention results in longer-term benefits. Conclusion People diagnosed with BPD are highly heterogeneous and experience high levels of comorbidity. The low quality of the evidence for the treatment of BPD in adolescence limits our ability to develop evidence-based guidelines. Accordingly, there is no clear case for BPD early intervention as a major component of youth mental health services. The introduction of ICD-11 classification system may facilitate further empirical studies of personality disorders in adolescence and emerging adulthood.
Between Heaven and Hell: Experiences of Preoperative Pain and Pain Management among Older Patients with Hip Fracture
Authors: Unneby Anna , Gustafson Yngve , Olofsson Birgitta , Lindgren Britt-Marie 
Published: May 2022

Introduction Among older adults, hip fracture is a common and serious consequence of a fall. Preoperative pain is common and often severe among patients with hip fracture. Opioids are usually used but have many side effects. One alternative is a femoral nerve block, which has been shown to reduce pain and lower the need for opioids. However, to our knowledge no study has explored qualitatively how patients with hip fracture experience treatment with femoral nerve block. Objective The aim of this study was to explore experiences of preoperative pain and pain management among older patients with hip fracture who had received a femoral nerve block. Method A qualitative design with semi-structured interviews (n = 23) conducted 2–6 days after surgery. Inclusion criteria were Swedish-speaking patients aged 70 years or older with hip fracture admitted to the orthopedic ward, treated with femoral nerve block before nursing actions. Data were analyzed with qualitative content analysis. Results Our result revealed one theme, hovering between heaven and hell, with five subthemes: how the pain was described – no pain, to worst pain and everything in between; they were dealing with pain in their own way; felt dependent on staff´s willingness to relieve pain; pain management could be lifesaving and a near-death experience; and how they experienced memory loss with respect to the pain and pain management. Conclusion The experience of pain and pain management was described as hovering between heaven and hell. We conclude that independent of which pain management given, staff should have an individualized pain mangement approach towards the patient in order to achieve well managed pain.
The ISHLT chronic lung allograft dysfunction consensus criteria are applicable to pulmonary chronic graft-versus-host disease
Authors: Pang Yifan , Charya Ananth V. , Keller Michael B. , Sirajuddin Arlene , Fu Yi-Ping , Holtzman Noa G. , Pavletic Steven Z. , Agbor-Enoh Sean 
Published: May 2022

Abstract
Pulmonary chronic graft-versus-host disease (PcGVHD) is a devastating complication of allogeneic hematopoietic stem cell transplant (HCT). The 2014 National Institutes of Health cGVHD consensus criteria (NIH criteria) only captures bronchiolitis obliterans syndrome (BOS). In this study, we adapted the 2019 International Society for Heart and Lung Transplantation (ISHLT) criteria of chronic lung allograft dysfunction (CLAD) to define novel phenotypes of PcGVHD and compared the performance of this criteria with the NIH criteria to identify patients with high-risk PcGVHD. We reviewed consecutive patients in a cGVHD natural history protocol (#NCT00092235) and adapted the 2019 CLAD criteria (the adapted criteria) to define PcGVHD as post-HCT forced expiratory volume at 1 second &lt; 80% predicted value, with 4 phenotypes: obstructive, restrictive, mixed obstructive/restrictive, and undefined. An independent adjudication committee evaluated subjects for diagnosis and phenotyping. We identified 166 (47.4%) patients who met the adapted criteria, including obstruction (n = 12, 3.4%), restriction (n = 67, 19.1%), mixed obstruction/restriction (n = 47, 13.4%), and undefined (n = 40, 11.4%). In these patients, less than half (n = 78) met the NIH criteria for BOS (NIH+); the rest (n = 88) did not (NIH−). The NIH− subjects showed increased risk of death compared with those without PcGVHD (hazard ratio = 1.88, 95% confidence interval = 1.20-2.95; P = .006) that was similar to NIH+ subjects (P = .678). Our study demonstrated the potential of the adapted criteria in identifying patients with high-risk PcGVHD that have been missed by the NIH criteria. The adapted criteria could become a valuable tool to better phenotype and study lung disease in cGVHD.