bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prehospital norepinephrine administration reduces 30-day mortality among septic shock patients
Authors: Jouffroy Romain , Hajjar Adèle , Gilbert Basile , Tourtier Jean Pierre , Bloch-Laine Emmanuel , Ecollan Patrick , Boularan Josiane , Bounes Vincent , Vivien Benoit , Gueye Papa-Ngalgou 
Published: April 2022

Abstract
Background
Despite differences in time of sepsis recognition, recent studies support that early initiation of norepinephrine in patients with septic shock (SS) improves outcome without an increase in adverse effects. This study aims to investigate the relationship between 30-day mortality in patients with SS and prehospital norepinephrine infusion in order to reach a mean blood pressure (MAP) > 65 mmHg at the end of the prehospital stage.

Methods
From April 06th, 2016 to December 31th, 2020, patients with SS requiring prehospital Mobile Intensive Care Unit intervention (MICU) were retrospectively analysed. To consider cofounders, the propensity score method was used to assess the relationship between prehospital norepinephrine administration in order to reach a MAP > 65 mmHg at the end of the prehospital stage and 30-day mortality.

Results
Four hundred and seventy-eight patients were retrospectively analysed, among which 309 patients (65%) were male. The mean age was 69 ± 15 years. Pulmonary, digestive, and urinary infections were suspected among 44%, 24% and 17% patients, respectively. One third of patients (n = 143) received prehospital norepinephrine administration with a median dose of 1.0 [0.5–2.0] mg h−1, among which 84 (69%) were alive and 38 (31%) were deceased on day 30 after hospital-admission. 30-day overall mortality was 30%. Cox regression analysis after the propensity score showed a significant association between prehospital norepinephrine administration and 30-day mortality, with an adjusted hazard ratio of 0.42 [0.25–0.70], p < 10–3. Multivariate logistic regression of IPTW retrieved a significant decrease of 30-day mortality among the prehospital norepinephrine group: ORa = 0.75 [0.70–0.79], p < 10–3.

Conclusion
In this study, we report that prehospital norepinephrine infusion in order to reach a MAP > 65 mmHg at the end of the prehospital stage is associated with a decrease in 30-day mortality in patients with SS cared for by a MICU in the prehospital setting. Further prospective studies are needed to confirm that very early norepinephrine infusion decreases septic shock mortality.
Associations of sodium and potassium intake with chronic kidney disease in a prospective cohort study: findings from the Hispanic Community Health Study/Study of Latinos, 2008–2017
Authors: Swift Samuel L. , Drexler Yelena , Sotres-Alvarez Daniela , Raij Leopoldo , Llabre Maria M. , Schneiderman Neil , Horn Linda Van , Lash James P. , Mossavar-Rahmani Yasmin , Elfassy Tali 
Published: April 2022

Abstract
Background
According to dietary recommendations, reduction of sodium intake has potential to reduce Chronic Kidney Disease (CKD) risk; however the role of dietary potassium and the sodium -to- potassium ratio in the development of CKD is unclear.

Methods
We studied 9778 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four US urban communities. Participants were aged 18–74 yrs., free from CKD at baseline in 2008–2011 and re-examined between 2014 and − 2017. Dietary intake of sodium, potassium and the ratio of dietary sodium -to- potassium were measured from two baseline 24-h dietary recalls. Incident CKD was defined as: 1) estimated glomerular filtration rate (eGFR) decline of 1 unit per year and eGFR < 60 ml/min/1.73m2 or 2) albumin to creatinine ratio ≥ 30 mg/g at the follow-up visit. We used multivariable survey weighted Poisson regression to estimate adjusted incident rates of incident CKD.

Results
At baseline, mean age was 41 years. Average follow up time was 6.2 years. From fully adjusted Poisson regression analyses, self-reported sodium intake was not associated with incident CKD. However, for each 500 mg decrement in potassium intake, there was an 11% increase risk of incident CKD (IRR = 1.11, 95% CI = 1.00, 1.24). Additionally, every 1 M ratio increment of sodium -to -potassium ratio was associated with a 21% increased risk of incident CKD (IRR = 1.21, 95% CI = 1.02, 1.45), p < 0.05).

Conclusions
We conclude that diets low in potassium and high in sodium are associated with increased risk of developing chronic kidney disease among healthy US Hispanic/Latino adults.
Comparison of early warning scores for predicting clinical deterioration and infection in obstetric patients
Authors: Arnolds David E. , Carey Kyle A. , Braginsky Lena , Holt Roxane , Edelson Dana P. , Scavone Barbara M. , Churpek Matthew 
Published: April 2022

Abstract
Background
Early warning scores are designed to identify hospitalized patients who are at high risk of clinical deterioration. Although many general scores have been developed for the medical-surgical wards, specific scores have also been developed for obstetric patients due to differences in normal vital sign ranges and potential complications in this unique population. The comparative performance of general and obstetric early warning scores for predicting deterioration and infection on the maternal wards is not known.

Methods
This was an observational cohort study at the University of Chicago that included patients hospitalized on obstetric wards from November 2008 to December 2018. Obstetric scores (modified early obstetric warning system (MEOWS), maternal early warning criteria (MEWC), and maternal early warning trigger (MEWT)), paper-based general scores (Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS), and a general score developed using machine learning (electronic Cardiac Arrest Risk Triage (eCART) score) were compared using the area under the receiver operating characteristic score (AUC) for predicting ward to intensive care unit (ICU) transfer and/or death and new infection.

Results
A total of 19,611 patients were included, with 43 (0.2%) experiencing deterioration (ICU transfer and/or death) and 88 (0.4%) experiencing an infection. eCART had the highest discrimination for deterioration (p < 0.05 for all comparisons), with an AUC of 0.86, followed by MEOWS (0.74), NEWS (0.72), MEWC (0.71), MEWS (0.70), and MEWT (0.65). MEWC, MEWT, and MEOWS had higher accuracy than MEWS and NEWS but lower accuracy than eCART at specific cut-off thresholds. For predicting infection, eCART (AUC 0.77) had the highest discrimination.

Conclusions
Within the limitations of our retrospective study, eCART had the highest accuracy for predicting deterioration and infection in our ante- and postpartum patient population. Maternal early warning scores were more accurate than MEWS and NEWS. While institutional choice of an early warning system is complex, our results have important implications for the risk stratification of maternal ward patients, especially since the low prevalence of events means that small improvements in accuracy can lead to large decreases in false alarms.
Research involvement among undergraduate health profession students in a resource-limited setting: awareness, attitude, motivators and barriers
Authors: Kiyimba Blaise , Atulinda Linda , Nalunkuma Racheal , Asasira Ignatius , Kabunga Jonathan , Banturaki Davis , Nabyonga Anastacia Ssebbowa , Nakiganda Rachel , Ndyabawe Rachael , Nkalubo Jonathan , Ssewante Nelson , Bongomin Felix , Bakeera-Kitaka Sabrina 
Published: April 2022

Abstract
Background
Involvement of undergraduate health professions students (HPS) in research will facilitate evidence-based clinical practice among future healthcare practitioners. This study aimed to assess research involvement among undergraduate HPS students and associated factors in Uganda.

Methods
A cross-sectional study was conducted using an online assessment tool sent through WhatsApp groups and E-mail addresses of HPS in 12 medical schools in Uganda between 20th September and 5th October 2021.

Results
We enrolled 398 participants with a mean age of 23.9 ± 3.7 years. Of this, 267 (67.1%) were male. One hundred twenty (30.2%) participants previously participated in a research activity: 90 (58.4%) as research assistants, 39 (25.3%) published as first authors, and 25 (16.2%) as co-authors. Training on the conduct of research was received by 242 (65.8%) participants, and 326 (81.9%) had intentions of conducting research in the future. Factors influencing participation in research activities were, age ≥ 25 years (adjusted odds ratio (aOR): 1.9, 95% confidence interval (95% CI): 1.2–3.2, p = 0.012), being male (aOR: 2.1, 95%CI: 1.2–3.6, p = 0.008), and being in a clinical year i.e., year 3 (aOR: 3.2, 95% CI: 1.1–9.3, p = 0.033), year 4 (aOR: 3.3, 95% CI: 1.1–9.5, p = 0.028) and year 5(aOR: 11.6, 95% CI: 3.2–42.1, p < 0.001). Lack of funds (79.6%), and mentorship (63.3%) were reported as major barriers to research.

Conclusions
Despite a high proportion of HPS showing interest in getting involved in research, less than one-third reported previous involvement. Addressing barriers such as funding could potentially improve research involvement and output among undergraduate HPS in resource-limited settings.
Cancer patients’ perspectives on remote monitoring at home during the COVID-19 pandemic- a qualitative study in Norway
Authors: Leonardsen Ann-Chatrin Linqvist , Helgesen Ann Karin , Stensvold Andreas , Magnussen Jannik , Grøndahl Vigdis A. 
Published: April 2022

Abstract
Background
The COVID-19 pandemic triggered an unprecedented demand for digital health technology solutions, such as remote monitoring. Previous research has focused on patients with chronic diseases, and their experiences with remote monitoring during the pandemic. Several recommendations have been presented to reduce the frequency of cancer patients’ visits to oncology centers and minimizing the risk of exposure to COVID-19, such as remote monitoring. However, few studies have explored how this has influenced the healthcare services to cancer patients.

Aim
To explore cancer patients’ perspectives on remote monitoring at home during the COVID-19 pandemic.

Design
The study had a qualitative design, using in-depth, individual interviews.

Methods
A total of eleven interviews were conducted with patients who received remote monitoring during the COVID-19 outbreak. Three of the interviews were conducted by telephone, and eight on a digital platform, audio recorded, and transcribed verbatime. Data were analyzed using reflexive thematic analysis as recommended by Braun & Clarke.

Results
All participants were conscious about being vulnerable to infections due to having cancer and receiving cancer treatment, and the pandemic to them represented an extra burden. Most of the participants experienced that their healthcare services had changed due to the pandemic, but there was no consensus on how the services had changed. All of the participants presented remote monitoring as something «new». Whether they received remote monitoring by telephone, video consultations or more advanced solutions with the possibility to complete a questionnaire or fill in measurements, did not seem to impact their views. However, all agreed that remote monitoring could never totally replace physical consultations in hospital. Participants’ views seemed to grow more positive over time, but still they emphasized both positive and negative aspects of remote monitoring solutions in cancer care.

Conclusion
Remote monitoring was introduced as a necessity in cancer care during the COVID-19 outbreak. This may seem as an efficient solution, allowing for patients to stay at home and avoid infection. Our results indicate that, in the case of cancer patients, it is important that healthcare personnel balance the remote monitoring solution with person-to-person contact.
Routine evaluation of tonsillectomy specimens: A cross-sectional survey of Canadian Otolaryngology: Head and Neck Surgeons
Authors: Kuhnow Alexi , Al-Sayed Ahmed A. , Taylor Benjamin 
Published: April 2022

Background Tonsillectomy is a commonly performed procedure in Canada. The rate of occult malignancy is rare in adult and pediatric populations. At present, no guidelines exist surrounding the need for routine histopathological evaluation of tonsil specimens when no malignancy is suspected. Methods We sent a confidential online survey to active members of the Canadian Society of Otolaryngology – Head and Neck Surgery (CSO-HNS) about their current tonsillectomy practice and beliefs surrounding the need for routine histopathological evaluation of tonsillectomy specimens when no malignancy is suspected. We used Opinio survey software for data collection and descriptive statistics. Results 95 participants completed our survey (response rate 19.3%). Most participants reported performing both adult and pediatric tonsillectomies. When no malignancy is suspected, participant responses were split between whether they send tonsil specimens in pediatrics only (4.2%), in adults only (31.6%), or not sending specimens (29.5%). Half of the participants reported that routinely sending specimens to rule out occult malignancy is an institutional policy. Approximately 75% of participants were in favour of removing this practice in both the pediatric and adult populations. Conclusion Eliminating the practice of automatically sending tonsil specimens for histopathological evaluation when no malignancy is suspected was supported by the majority of study participants. This is in keeping with Choosing Wisely, a campaign designed to facilitate conversations about unnecessary medical tests and procedures. Institutional change is likely required in order to alter this practice. Graphical Abstract
Bedtime Routines Intervention for Children (BRIC) project: results from a non-randomised feasibility, proof-of concept study
Authors: Kitsaras George , Pretty Iain A. , Allan Julia 
Published: April 2022

Abstract
Background
Bedtime routines are highly recurrent family activities with implications for children’s wellbeing, development and health.

Aims
The objective of this study is to co-develop and test in a feasibility, proof-of-concept study a bedtime routines intervention using text messages aimed at first-time parents with young children.

Methods
Fifty first-time parents with children aged 1–3 years were recruited for this study. Parents received a text message-based intervention for 7-consecutive nights which provided support and information on achieving optimal bedtime routines. Parents completed pre- and post-intervention questionnaires focusing on children’s sleep, bedtime routines and parental mood disturbance. Feedback was provided at the end of the study.

Results
Recruitment target and high retention with 98%, or 49 out of 50 participants completing the study were achieved. Pre- and post-intervention, there were improvements in total children’s sleep with children sleeping longer and having less disrupted sleep overall (MD = − 7.77 (SD = 17.91), t(48) = − 3.03, p = .004, CI (− 12.91, − 2.63) and in overall quality of bedtime routines (MD = − 5.00, SD = 7.01, t(48) = − 4.98, p < .001, CI (− 7.01, − 2.98). Parental mood disturbance decreased pre- to post-intervention (MD = 5.87, SD = 15.43, t(48) = 2.66), p = .010, CI (1.44, 10.30). Parents provided positive feedback about the intervention and valued the support that was provided to them.

Conclusions
Bedtime routines were successfully altered with short-term benefits for children’s sleep and parental mood. Future research will need to utilize a more robust, longitudinal approach for a definite exploration of sustained changes in bedtime routines and their long-term implications for children and parents.
Dietetic intervention in psoriatic arthritis: the DIETA trial
Authors: Leite Beatriz F. , Morimoto Melissa A. , Gomes Carina M. F. , Klemz Barbara N. C. , Genaro Patrícia S. , Shivappa Nittin , Hébert James R. , Damasceno Nágila R. T. , Pinheiro Marcelo M. 
Published: April 2022

AbstractAimTo evaluate whether dietary pattern changes, antioxidant supplementation or 5–10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA).MethodsA total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05.ResultsAfter 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (− 0.6 ± 0.9; p = 0.004 and − 1.39 ± 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (− 1.79 ± 2.4; p = 0.004), as well as waist circumference (− 3.28 ± 3.5, p < 0.001) and body fat (− 1.2 ± 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment.ConclusionA 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement.Trial Registration: The study was recorded on Clinicaltrials.gov (NCT03142503).
Broadband design of acoustic metasurfaces for the stabilization of a Mach 4 boundary layer flow
Authors: Zhao Rui , Liu Xiao , Wen Chihyung , Wang Xiaoyong 
Published: April 2022

AbstractA piecewise acoustic metasurface is designed to suppress the first mode while marginally amplifying the Mack second mode in a Mach 4 flat-plate boundary layer (BL) flow. The results of linear stability theory (LST) and the eN method demonstrate the stabilization effect and transition delay performance, respectively. However, the direct numerical simulation (DNS) results indicate that the designed broadband acoustic metasurface actually weakly excites the first mode with a slightly larger fluctuating pressure amplitude at the surface, which is in contrast to the analysis of LST. The discrepancies are found to lie in the ‘roughness’ effect caused by the recirculation zones inside the microslits and the alternating expansion and compression waves induced at the slit edges, which significantly amplifies the first mode. For further clarification of the competitive mechanism between the acoustic stabilization and ‘roughness’ destabilization effects of metasurfaces on the first mode, a carefully designed metasurface is installed at the maximum growth rate region, which excites the first mode on the metasurface but inhibits its development downstream.
BMP/SMAD1/5 Signaling in the Endometrial Epithelium Is Essential for Receptivity and Early Pregnancy
Authors: Tang Suni , Cope Dominique I , Vasquez Yasmin M , Monsivais Diana 
Published: April 2022

AbstractThe biological processes that control endometrial receptivity and embryo implantation are critical for the successful outcome of pregnancy. The endometrium is the complex inner lining of the uterine wall that is under the cyclical control of estrogen and progesterone and is a site of intimate contact between mother and blastocyst. The bone morphogenetic signaling (BMP) pathway is a highly conserved signaling pathway that controls key cellular processes throughout pregnancy and exerts intracellular effects via the SMAD1/5 transcription factors. To delineate the endometrial compartment–specific roles of BMP signaling, we generated mice with epithelial-specific conditional deletion of SMAD1/5 using Lactoferrin-icre (Smad1flox/flox;Smad5flox/flox;Lactoferrin-cre, “Smad1/5 cKO”). Histological analysis of the reproductive tracts showed that Smad1/5 cKO mice were developmentally normal and displayed no defects in glandular morphology. In fertility analyses, single SMAD1 or SMAD5 deletion had no effect on fertility; however, double-conditional deletion of SMAD1 and SMAD5 resulted in severe subfertility. Timed mating analyses revealed endometrial receptivity defects in the Smad1/5 cKO mice beginning at 3.5 days post coitum (dpc) that perturbed embryo implantation at 4.5 dpc, as demonstrated by the detection of unattached blastocysts in the uterus, decreased COX2 expression, and FOXO1 cytoplasmic mislocalization. We also found that defects that arose during peri-implantation adversely affected embryonic and decidual development at 5.5 and 6.5 dpc. Thus, uterine epithelial BMP/SMAD1/5 signaling is essential during early pregnancy and SMAD1/5 epithelial-specific deletion has detrimental effects on stromal cell decidualization and pregnancy development.
Visualising the cytoskeletal machinery in neuronal growth cones using cryo-electron tomography
Authors: Atherton Joseph , Stouffer Melissa , Francis Fiona , Moores Carolyn A. 
Published: April 2022

ABSTRACT
Neurons extend axons to form the complex circuitry of the mature brain. This depends on the coordinated response and continuous remodelling of the microtubule and F-actin networks in the axonal growth cone. Growth cone architecture remains poorly understood at nanoscales. We therefore investigated mouse hippocampal neuron growth cones using cryo-electron tomography to directly visualise their three-dimensional subcellular architecture with molecular detail. Our data showed that the hexagonal arrays of actin bundles that form filopodia penetrate and terminate deep within the growth cone interior. We directly observed the modulation of these and other growth cone actin bundles by alteration of individual F-actin helical structures. Microtubules with blunt, slightly flared or gently curved ends predominated in the growth cone, frequently contained lumenal particles and exhibited lattice defects. Investigation of the effect of absence of doublecortin, a neurodevelopmental cytoskeleton regulator, on growth cone cytoskeleton showed no major anomalies in overall growth cone organisation or in F-actin subpopulations. However, our data suggested that microtubules sustained more structural defects, highlighting the importance of microtubule integrity during growth cone migration.