bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of Vasopressin Addition to Norepinephrine and Efficacy Outcomes in Patients With Septic Shock
Authors: Brask Allison L. , Shemanski Shelby M. , Barnes Tyler E. , Holmes Ashley K. 
Published: August 2022

Background: Current guidelines recommend norepinephrine as the first-line vasopressor in septic shock followed by addition of vasopressin to achieve a goal mean arterial pressure. Limited evidence exists evaluating how the timing of vasopressin addition affects clinical outcomes in septic shock. Objective: The objective of this study was to determine whether the timing of the addition of vasopressin to norepinephrine affects shock resolution. Methods: This was a multi-site, single system, retrospective cohort, institutional review board (IRB)-approved study examining adult patients with septic shock who received norepinephrine and vasopressin. Patients were divided and statistically analyzed in two subgroups: early vasopressin addition (<3 hours) and late vasopressin addition (≥3 hours). The primary outcome was time to shock resolution, defined as vasopressor free for at least 24 hours. Secondary outcomes included norepinephrine dose at 3 hours after initiation of vasopressin, in-hospital mortality, and intensive care unit length of stay. Results: A total of 243 patients were included in this study. A statistically significant decrease in time to shock resolution was observed in the early vasopressin addition group compared to the late vasopressin addition group (37.6 hours vs 60.7 hours; adjusted hazard ratio [HR]: 2.07 [1.48-2.89; P = <0.001]). The early addition of vasopressin did not affect norepinephrine dose or in-hospital mortality but did lead to a decreased intensive care unit (ICU) length of stay (4.3 days vs 5.3 days, P = 0.02). Conclusion and Relevance: Addition of vasopressin to norepinephrine within 3 hours was associated with a faster time to shock resolution. These findings suggest a potential for improved clinical outcomes with earlier vasopressin addition.
Clinical Significance and Dynamic Change of Coagulation Parameters in Ischemic Stroke Patients Treated with Intravenous Thrombolysis
Authors: Li Guangshuo , Wang Chuanying , Wang Shang , Hao Yahui , Xiong Yunyun , Zhao Xingquan 
Published: August 2022

Objective Investigations on coagulation parameters including fibrinogen (Fbg), fibrinogen degradation products (FDP), and D-dimer in ischemic stroke patients treated with intravenous thrombolysis are insufficient. We aimed to investigate the association between in-hospital clinical outcomes and the coagulation parameters at different time points in ischemic stroke patients treated with intravenous tissues plasminogen activator (IV tPA). Methods We retrospectively enrolled patients who received IV tPA therapy within 4.5 h from symptoms onset. Demographics, clinical characteristics, imaging measures, and the discharge mRS score were collected. Multivariable logistic regression analyses were performed to test whether coagulation parameters were independent predictors for the in-hospital clinical outcomes. We also employed machine learning models to investigate whether coagulation parameters were able to improve the prediction of favorable functional outcomes. Results One hundred and fifty-two patients treated with IV tPA were included. Among the coagulation parameters, low D-dimers at 48 h proved to be an independent predictor of favorable functional outcome (adjusted odd ratio 0.24, 95% confidential intervals 0.06-0.92, P  =  0.04). The AUC of D-dimer at 48 h to predict favorable functional outcome was 0.73 (0.60-0.87) and the optimal cut-off value was 0.92 (sensitivity 0.69, specificity 0.78). Machine learning models with D-dimer at 48 h had superior performance in predicting favorable functional outcomes and among the input variables in the machine learning models, D-dimer at 48 h showed the highest weight in predicting mRS 0-1 at discharge (38.44%). Conclusion Increased levels of D-dimer at 48 h was associated with lower proportion of favorable functional outcomes in acute ischemic stroke patients with intravenous thrombolysis.
Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy
Authors: Eliasen Astrid , Kornholt J , Mathiasen R , Brok J , Rechnitzer C , Schmiegelow K , Dalhoff K 
Published: August 2022

Introduction Despite treatment with antiemetic medications, nausea remains uncontrolled for many children receiving chemotherapy. One reason is that risk factors for nausea in children remain poorly explored. The purpose of this study was to identify risk factors for chemotherapy-induced nausea (CIN) in children. Methods Prospective, observational study including 101 children (median age 6.4 years, range 0.8–17.9) with cancer receiving moderately or highly emetogenic chemotherapy. Primary endpoints were complete control of acute and delayed CIN, defined as no nausea in the acute phase 0–24 h after chemotherapy and in the delayed phase starting after the acute phase and ending 5 days later. Multivariable analyses included age, sex, cancer type, susceptibility to motion sickness, chemotherapy duration, numbers of antiemetics, co-administration with opioids or tricyclic antidepressants, and previously uncontrolled nausea or vomiting. Results Acute CIN was associated with susceptibility to motion sickness (odds ratio [OR] 5.73, 95% confidence interval [CI] 1.36–33.7) and older age (OR 4.19, 95% CI 1.30–14.7), comparing age group 8–18 years with 0–3 years. Delayed CIN was associated with uncontrolled acute nausea or vomiting (OR 10.3, 95% CI 2.65–50.9), highly emetogenic chemotherapy (OR 8.26, 95% CI 1.17–76.8), and having a hematologic cancer type (OR 7.81, 95% CI 1.05–79.2). Conclusions Susceptibility to motion sickness and age can influence the risk of acute CIN. More research is needed on how best to integrate risk information in preventive antiemetic strategies. Sufficient acute nausea and vomiting control are crucial to prevent delayed CIN.
Prevalence of Hypertension in Ghana: Analysis of an Awareness and Screening Campaign in 2019
Authors: Tannor Elliot Koranteng , Nyarko Obed Ofori , Adu-Boakye Yaw , Owusu Konadu Saabea , Opoku Gilda , Ankobea-Kokroe Frank , Opare-Addo Mercy , Appiah Lambert Tetteh , Amuzu Evans Xorse , Ansah Gilgal Justice , Appiah-Boateng Kate , Ofori Emmanuel , Ansong Daniel 
Published: August 2022

Introduction: Hypertension is an important public health menace globally and in sub-Saharan Africa. The prevalence of hypertension is on the rise in low- and lower-middle-income countries (LMIC) such as Ghana. This rise led to the adoption of the May Measurement Month (MMM) initiative, a global blood pressure screening campaign. We aimed to create awareness and present the findings of the 2019 MMM screening campaign in the Ashanti region of Ghana. Methods: Ghana was 1 of 92 countries that participated in this global community-based cross-sectional study in May 2019. Participants (⩾18 years) were recruited by opportunistic sampling. The blood pressures of participants were measured 3 times and the mean of the last 2 was used for the analysis. Summary statistics were used to describe the data. Simple and multiple logistic regression models were used to determine the predictors of hypertension. Results: We screened 3080 participants with a mean age of 39.8 ± 16.8 years. The prevalence of hypertension was 27.3% among participants. Two-thirds of the hypertensives were unaware of their condition and only 49.5% of participants with a history of hypertension on medication were controlled. Predictors of hypertension in a multiple logistic regression were increasing age (OR = 1.05 (CI 1.04-1.06), P < .001) and high body mass index (OR = 1.06 (1.02-1.10), P = .005). Conclusion: The MMM initiative is highly commendable and of huge public health importance in LMICs like Ghana. Population-based health programs such as the MMM initiative is encouraged to shape appropriate public health policies to reduce the prevalence of hypertension.
The sequential natalizumab – alemtuzumab therapy in patients with relapsing forms of multiple sclerosis (SUPPRESS) trial – Part I: Rationale and objectives
Authors: Hussain Rehana Z , Sguigna Peter V , Okai Annette , Wright Crystal , Madinawala Mariam , Bass Ann D , Cutter Gary R , Manouchehri Navid , Stuve Olaf 
Published: August 2022

Background Natalizumab is a recombinant humanized monoclonal antibody (mAb) against α4-integrin that is approved for relapsing forms of multiple sclerosis (MS). Natalizumab is associated with an increased risk of developing progressive multifocal leukoencephalopathy (PML), and with disease reactivation after cessation of treatment that is likely mediated by an accumulation of pro-inflammatory lymphocytes in the blood during therapy. Alemtuzumab is a mAb against CD52 that reduces the number of peripheral lymphocytes. Rationale To determine if treatment with alemtuzumab after natalizumab reduces disease activity in patients with relapsing forms of MS. This review article will outline the rationale and objectives of the sequential natalizumab – alemtuzumab therapy in patients with relapsing forms of multiple sclerosis (SUPPRESS; ClinicalTrials.gov ID: NCT03135249) trial in greater detail than would be feasible in a manuscript that summarizes the study results. Methods The SUPPRESS trial is single arm, open-label, multicenter, efficacy pilot study that aims to establish a disease-free state over a 24-months period in patients who received the natalizumab- alemtuzumab sequential therapy. Participants will be recruited from four different sites. The primary endpoint is the annualized relapse rate (ARR) from the time of cessation of natalizumab treatment. Key secondary endpoint is freedom of relapse at 12-months, the number of new/enlarging T2 lesions on magnetic resonance imaging (MRI), and the number of gadolinium (Gd)-enhancing lesions on MRI. An exploratory endpoint is the Expanded Disability Status Scale (EDSS), retinal nerve fiber layer (RNFL) thickness assessment by optic coherence tomography (OCT) and assessment of quality of life (QoL) measures by a pre-defined, self-administered testing battery. To evaluate immunological effects, blood leukocytes will be collected and immunophenotyped by multi-parameter flow cytometry. Conclusion The SUPPRESS trial will provide clinical, imaging, and biological data to determine whether sequential natalizumab to alemtuzumab combination therapy establish a disease-free state in patients with relapsing forms of MS.
The processing of the ambiguous object pronoun in German monolingual and highly proficient L2 speakers with L1 Georgian
Authors: Abashidze Dato , Gagarina Natalia , Bittner Dagmar 
Published: August 2022

Aims and objectives: The current study examines the role of grammatical and positional parallelism on ambiguous German pronoun resolution in monolingual speakers and highly proficient L2 speakers with L1 Georgian. In particular, the study asks whether an object pronoun ihn in a sentence initial position could refer to the non-subject antecedent in a preceding subject–verb–object sentence. Furthermore, it investigates whether L1 and L2 speakers show similar preferences when resolving ambiguous object pronouns. Methodology: Two visual world eye-tracking and two offline experiments were conducted with L1 and L2 speakers of German. During the eye-tracking session, the task was simply to look and listen, while in the offline test, participants were required to decide on the assumed referent of the ambiguous pronoun. Data and analysis: Linear-mixed effect models were applied to the eye-movement data. Two-sample t tests were used in the analysis of the offline data. Findings and conclusions: Eye-movement results revealed a bias toward the subject antecedent in L1 speakers, while the L2 speakers showed a non-subject preference when resolving the referent of the object pronoun. The offline experiments supported the eye-tracking findings of both groups, particularly as regards the role of grammatical parallelism in the resolution of ambiguous pronouns by the L2 speakers. These findings are interpreted in the context of language-specific processing strategies in anaphora resolution. It appears that L1 and L2 speakers may be using different information-structural cues to resolve ambiguous pronouns. Concretely, a less strongly internalized knowledge of the target language or the influence of the first language may produce alternative processing mechanisms in L2 speakers. Originality: This study fills the research gap on ambiguous object pronoun resolution of L1 and L2 speakers of German. Implications: The findings of this study add additional information to the growing body of research into pronoun resolution. It focuses on the resolution of the German object pronoun within an information-structural framework of language processing in L1 and L2.
Outcomes of transcarotid artery revascularization: A systematic review
Authors: Wu Haoliang , Wang Zhiwei , Li Mingxing , Sun Peng , Wei Shunbo , Xie Boao , Zhang Cong , Zhang Liwei , Bai Hualong 
Published: August 2022

Background Ischemic stroke and disability caused by carotid artery stenosis have always been worldwide problems. At present, carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS) have been commonly used to treat carotid artery stenosis. Recently, transcarotid artery revascularization (TCAR) seems to be another option. Methods We searched PubMed and Embase to find literatures comparing TCAR with TFCAS and CEA. The primary outcomes were stroke, myocardial infarction (MI), transient ischemic attack (TIA), death, cranial nerve injure (CNI), and operative time. Secondary outcomes were stroke, death, MI in the elderly; cost; radiation; and entry site complication. Results Initial search of the literature included 165 articles, of which 12 studies were chosen in the end. These studies demonstrated high technical success rate of TCAR. Patients who received TCAR had lower risks of death, stroke/death and less radiation exposure compared to TFCAS. In meta analysis, the risk of stroke was significantly lower in TCAR group than TFCAS (OR 0.63; 95%CI 0.47–0.85). And there was no significant difference in TIA and MI. TCAR was associated with shorter operative time, lower risk of CNI and less blood loss compared to CEA. In older patients, the effect of TCAR was significantly better than that of TFCAS. Conclusion TCAR is associated with a lower risk of perioperative stroke compared to TFCAS. TCAR is also associated with shorter operative time, lower risk of CNI and less blood loss compared to CEA. TCAR may be a promising treatment option besides TFCAS and CEA.
Hydrogel-Embedded Poly(Lactic-co-Glycolic Acid) Microspheres for the Delivery of hMSC-Derived Exosomes to Promote Bioactive Annulus Fibrosus Repair
Authors: DiStefano Tyler J. , Vaso Keti , Panebianco Christopher J. , Danias George , Chionuma Henry N. , Kunnath Kuriakose , Karoulias Stylianos Z. , Wang Minghui , Xu Peng , Davé Rajesh N. , Sahoo Susmita , Weiser Jennifer R. , Iatridis James C. 
Published: August 2022

Objective Intervertebral disk degeneration is a prevalent postoperative complication after discectomy, underscoring the need to develop preventative and bioactive treatment strategies that decelerate degeneration and seal annulus fibrosus (AF) defects. Human mesenchymal stem cell–derived exosomes (MSC-Exos) hold promise for cell-free bioactive repair; however, their ability to promote AF repair is poorly understood. The objective of this study was to evaluate the ability of MSC-Exos to promote endogenous AF repair processes and integrate MSC-Exos within a biomaterial delivery system. Design We characterize biophysical and biochemical properties of normoxic (Nx) and hypoxic (Hx) preconditioned MSC-Exos from young, healthy donors and examine their effects on AF cell proliferation, migration, and gene expression. We then integrate a poly(lactic- co-glycolic acid) microsphere (PLGA µSphere) delivery platform within an interpenetrating network hydrogel to facilitate sustained MSC-Exo delivery. Results Hx MSC-Exos led to a more robust response in AF cell proliferation and migration than Nx MSC-Exos and was selected for a downstream protection experiment. Hx MSC-Exos maintained a healthy AF cell phenotype under a TNFα challenge in vitro and attenuated catabolic responses. In all functional assays, AF cell responses were more sensitive to Hx MSC-Exos than Nx MSC-Exos. PLGA µSpheres released MSC-Exos over a clinically relevant timescale without affecting hydrogel modulus or pH upon initial embedment and µSphere degradation. Conclusions This MSC-Exo treatment strategy may offer benefits of stem cell therapy without the need for exogenous stem cell transplantation by stimulating cell proliferation, promoting cell migration, and protecting cells from the degenerative proinflammatory microenvironment.
Factors Associated With the Use of Hypothermic Machine Perfusion in Kidney Transplant Recipients: A Multicenter Retrospective Cohort Study
Authors: Goulamhoussen Nadir , Slapcoff Lawrence , Baran Dana , Boucher Anne , Houde Isabelle , Masse Mélanie , Albert Martin , Marsolais Pierre , Cardinal Heloïse , Bouchard Josée 
Published: August 2022

Background: Delayed graft function (DGF) is associated with an increased risk of graft loss. The use of cold hypothermic machine perfusion (HMP) has been shown to reduce the incidence of DGF in kidney transplant recipients (KTRs), especially when extended-criteria donors (ECDs) are used. HMP can also improve graft survival. However, there is a paucity of data on the determinants of HMP use in clinical practice. Objective: We aimed to determine the factors associated with the use of HMP in a cohort of donors and KTRs. Design: Multicenter retrospective cohort study. Setting: 5 transplant centers in Quebec. Patients: 159 neurologically deceased donors (NDD) and 281 KTR. Measurements: Use of HMP. Methods: We collected data on consecutive NDD admitted to a dedicated donor unit in a single university-affiliated center and their KTRs between June 2013 and December 2018 in 5 adult transplant centers across the province of Quebec, Canada. All organs were recovered in a single hospital center where a HMP device was available for every organ recovered and the decision to use HMP was left at the discretion of the procurement surgeon. Generalized estimating equations were used to predict the use of HMP. Results: The cohort included 159 NDDs and their 281 KTRs. Thirty-three percent of donors were ECDs, and 59% of KTRs received organs placed on HMP. The median cold ischemia time (CIT) was 12.5 (IQR 7.9-16.3) hours. In univariate analysis, none of the donors’ characteristics were associated with the use of HMP. ECD represented 33% of KTR on HMP vs 35% of those not placed on HMP ( P = .77). In univariate analysis, the use of HMP was associated with KTR race (non-Caucasian), longer CIT, use of basiliximab/alemtuzumab, year of transplant, and transplant center. The use of HMP varied largely across transplant centers, ranging from 15% to 82%. In multivariate analysis, use of HMP was associated with longer CIT (odds ratio [OR] 1.15, 95% confidence interval [CI] = 1.07-1.25), transplant center as well as transplantations performed after 2013. Limitations: One dedicated donor unit including NDD only, absence of specific data on surgeons’ experience and personal or logistic reasons for using or not HMP. Conclusions: We found that use of HMP remains low and varies largely across transplant centers. The use of HMP was strongly associated with the transplant center where the surgeons practiced, suggesting that surgeon preference/training plays an important role in determining the use of HMP. Availability of HMP at the time of organ procurement might also be limited by logistic issues such as difficulty in returning the device. Further studies aimed at determining the reasons underlying the barriers precluding the use of HMP could help increasing its use and improve transplant outcomes.
The experiences of 33 national COVID-19 dashboard teams during the first year of the pandemic in the World Health Organization European Region: A qualitative study
Authors: Barbazza Erica , Ivanković Damir , Davtyan Karapet , Poldrugovac Mircha , Yelgezekova Zhamin , Willmington Claire , Meza-Torres Bernardo , Bos Véronique L.L.C. , Fernandes Óscar Brito , Rotar Alexandru , Nuti Sabina , Vainieri Milena , Carinci Fabrizio , Azzopardi-Muscat Natasha , Groene Oliver , Novillo-Ortiz David , Klazinga Niek , Kringos Dionne 
Published: August 2022

Background Governments across the World Health Organization (WHO) European Region have prioritised dashboards for reporting COVID-19 data. The ubiquitous use of dashboards for public reporting is a novel phenomenon. Objective This study explores the development of COVID-19 dashboards during the first year of the pandemic and identifies common barriers, enablers and lessons from the experiences of teams responsible for their development. Methods We applied multiple methods to identify and recruit COVID-19 dashboard teams, using a purposive, quota sampling approach. Semi-structured group interviews were conducted from April to June 2021. Using elaborative coding and thematic analysis, we derived descriptive and explanatory themes from the interview data. A validation workshop was held with study participants in June 2021. Results Eighty informants participated, representing 33 national COVID-19 dashboard teams across the WHO European Region. Most dashboards were launched swiftly during the first months of the pandemic, February to May 2020. The urgency, intense workload, limited human resources, data and privacy constraints and public scrutiny were common challenges in the initial development stage. Themes related to barriers or enablers were identified, pertaining to the pre-pandemic context, pandemic itself, people and processes and software, data and users. Lessons emerged around the themes of simplicity, trust, partnership, software and data and change. Conclusions COVID-19 dashboards were developed in a learning-by-doing approach. The experiences of teams reveal that initial underpreparedness was offset by high-level political endorsement, the professionalism of teams, accelerated data improvements and immediate support with commercial software solutions. To leverage the full potential of dashboards for health data reporting, investments are needed at the team, national and pan-European levels.