bluuebunny/crossref_metadata_2025_split huggingface dataset:
811 DELIRIUM IN COVID-19: COMMON AND CLINICALLY SIGNIFICANT: EXPERIENCES FROM THE NIGHTINGALE HOSPITAL EXETER
Authors: Reed W , Fearnley C , Tregarthen A , Hubbard J , Griffiths J , Whitehead T , Hacon J , Anning L 
Published: March 2022

Abstract

Background
Delirium is an independent predictor of mortality in patients admitted with community-acquired pneumonia (Pieralli, 2014), but significance and incidence in Covid-19 infection has not been established. The Nightingale Hospital Exeter (NHE) as a multidisciplinary team model, managed 242 patients with Covid-19 from November 2020 to February 2021. This study identifies the delirium incidence, outcome, premorbid function and demographics of this cohort.

Methods
Electronic records were retrospectively reviewed for keywords ‘Delirium’, ‘Hyperactive’, ‘Hypoactive’, ‘Confused’ and ‘Muddled’. Patients were categorised as Hyperactive, Hypoactive or Confused/non-specified. Prior functional support (independent, package of care, residential or nursing care) and presence of pre-established neurological conditions (including dementia) were noted.

Results
242 patients were included, average age 84 years (range 59–102). Of these patients, 130 (54%) developed delirium (29 (22%) hyperactive, 37 (28%) hypoactive, 2 (1%) mixed and 62 (48%) ‘confused’/non-specified). Of those with delirium, 56 (43%) were previously living independently and 51 (39%) were living at home with a package of care. 60 (46%) of those diagnosed had no pre-existing neurological condition, 32% had underlying dementia. There were 37 deaths at NHE (mortality 15%), 73% of these patients had delirium during their admission compared to 50% of those who survived.

Conclusions
Over half this cohort developed delirium, a high proportion of whom had been living independently prior to admission with no pre-existing neurological condition, emphasising how common delirium is in patients with Covid-19. In a comparable cohort with pneumonia (mean age 82 years, range 65–99) 25% developed delirium, and it was an independent predictor of in-hospital mortality (Pieralli, 2014). The fact that 73% of all patients who died developed delirium suggests it may have important prognostic implications, and both this and the high incidence indicate further work is required to fully understand how to prevent and manage delirium in Covid-19.
GraphGONet: a self-explaining neural network encapsulating the Gene Ontology graph for phenotype prediction on gene expression
Authors: Bourgeais Victoria , Zehraoui Farida , Hanczar Blaise 
Published: March 2022

AbstractMotivationMedical care is becoming more and more specific to patients’ needs due to the increased availability of omics data. The application to these data of sophisticated machine learning models, in particular deep learning (DL), can improve the field of precision medicine. However, their use in clinics is limited as their predictions are not accompanied by an explanation. The production of accurate and intelligible predictions can benefit from the inclusion of domain knowledge. Therefore, knowledge-based DL models appear to be a promising solution.ResultsIn this article, we propose GraphGONet, where the Gene Ontology is encapsulated in the hidden layers of a new self-explaining neural network. Each neuron in the layers represents a biological concept, combining the gene expression profile of a patient and the information from its neighboring neurons. The experiments described in the article confirm that our model not only performs as accurately as the state-of-the-art (non-explainable ones) but also automatically produces stable and intelligible explanations composed of the biological concepts with the highest contribution. This feature allows experts to use our tool in a medical setting.Availability and implementationGraphGONet is freely available at https://forge.ibisc.univ-evry.fr/vbourgeais/GraphGONet.git. The microarray dataset is accessible from the ArrayExpress database under the identifier E-MTAB-3732. The TCGA datasets can be downloaded from the Genomic Data Commons (GDC) data portal.Supplementary informationSupplementary data are available at Bioinformatics online.
Antibiotics versus placebo in adults with CT-confirmed uncomplicated acute appendicitis (APPAC III): randomized double-blind superiority trial
Authors: Salminen Paulina , Sippola Suvi , Haijanen Jussi , Nordström Pia , Rantanen Tuomo , Rautio Tero , Sallinen Ville , Löyttyniemi Eliisa , Hurme Saija , Tammilehto Ville , Laukkarinen Johanna , Savolainen Heini , Meriläinen Sanna , Leppäniemi Ari , Grönroos Juha 
Published: March 2022

Abstract

Background
Non-operative management of uncomplicated acute appendicitis is an option, but omission of antibiotics from the regimen has not been tested.

Methods
A double-blind, placebo-controlled, superiority RCT in adults with CT-confirmed uncomplicated acute appendicitis was designed to compare placebo with antibiotics (intravenous ertapenem followed by oral levofloxacin and metronidazole). The primary endpoint was treatment success (resolution resulting in discharge without appendicectomy within 10 days); secondary outcomes included pain scores, complications, hospital stay, and return to work.

Results
From May 2017 to September 2020, 72 patients with a mean(s.d.) age of 37.5 (11.1) years were recruited at five hospitals. Six were excluded after randomization (5 early consent withdrawals, 1 randomization protocol violation), 35 were assigned to receive antibiotics, and 31 to receive placebo. Enrolment challenges (including hospital pharmacy resources in an acute-care surgery setting) meant that only the lowest sample size of three predefined scenarios was achieved. The 10-day treatment success rate was 87 (95 per cent c.i. 75 to 99) per cent for placebo and 97 (92 to 100) per cent for antibiotics. This clinical difference of 10 (90 per cent c.i. −0.9 to 21) per cent was not statistically different for the primary outcome (1-sided P = 0.142), and secondary outcomes were similar.

Conclusion
The lack of antibiotic superiority statistically suggests that a non-inferiority trial against placebo is warranted in adults with CT-confirmed mild appendicitis. Registration number: EudraCT 2015-003634-26 (https://eudract.ema.europa.eu/eudract-web/index.faces), NCT03234296 (http://www.clinicaltrials.gov).
SARS-CoV-2 in Exhaled Aerosol Particles from COVID-19 Cases and Its Association to Household Transmission
Authors: Alsved Malin , Nygren David , Thuresson Sara , Medstrand Patrik , Fraenkel Carl Johan , Löndahl Jakob 
Published: March 2022

Abstract

Background
Coronavirus disease 2019 (COVID-19) transmission via exhaled aerosol particles has been considered an important route for the spread of infection, especially during super-spreading events involving loud talking or singing. However, no study has previously linked measurements of viral aerosol emissions to transmission rates.

Methods
During February–March 2021, COVID-19 cases that were close to symptom onset were visited with a mobile laboratory for collection of exhaled aerosol particles during breathing, talking, and singing, respectively, and of nasopharyngeal and saliva samples. Aerosol samples were collected using a BioSpot-VIVAS and a NIOSH bc-251 2-stage cyclone, and all samples were analyzed by RT-qPCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection. We compared transmission rates between households with aerosol-positive and aerosol-negative index cases.

Results
SARS-CoV-2 RNA was detected in at least 1 aerosol sample from 19 of 38 (50%) included cases. The odds ratio (OR) of finding positive aerosol samples decreased with each day from symptom onset (OR 0.55, 95 confidence interval [CI] .30–1.0, P = .049). The highest number of positive aerosol samples were from singing, 16 (42%), followed by talking, 11 (30%), and the least from breathing, 3 (8%). Index cases were identified for 13 households with 31 exposed contacts. Higher transmission rates were observed in households with aerosol-positive index cases, 10/16 infected (63%), compared to households with aerosol-negative index cases, 4/15 infected (27%) (χ2 test, P = .045).

Conclusions
COVID-19 cases were more likely to exhale SARS-CoV-2-containing aerosol particles close to symptom onset and during singing or talking as compared to breathing. This study supports that individuals with SARS-CoV-2 in exhaled aerosols are more likely to transmit COVID-19.
Balsalazide Exposure During the Development of Fertilizing Sperm May Be Associated With Offspring Birth Defects
Authors: Wensink Maarten J , Streett Sarah E , Damkier Per , Lindahl-Jacobsen Rune , Kjeldsen Jens , Eisenberg Michael L 
Published: March 2022

Lay Summary
We report an association between balsalazide exposure during the development of fertilizing sperm and birth defects in offspring. Exposed offspring were approximately 8 times more likely to have a birth defect. There were no pre-existing reasons to suspect such a relationship, which should be confirmed in other data.
Football feminism: Global governance perspectives
Authors: Krech Michele , Weiler Joseph H H 
Published: March 2022

Abstract
This Symposium explores a unique and relatively understudied intersection of global law and governance, on the one hand, and gender and feminist theory, on the other—which we label “football feminism.” Football (soccer), we hazard to claim, occupies a place in the global space unlike any other cultural/economic phenomenon. Given the mass global consumption and veneration of football, it plays a particularly powerful role in shaping, validating, and entrenching gender relations far beyond the sport, all around the world. Football matters in this way, whether we like it or not, so its governance should attract scholarly feminist critique. Significantly, the primary regulator of football is a private organization headquartered in Zurich, controlling billions of dollars and a worldwide network of national football associations. The “constitution” of this organization—the FIFA Statutes—includes a prohibition on gender discrimination and, as of quite recently, commitments to promote women in football and to respect all internationally recognized human rights. However, many questions remain as to the specific meaning of these good-governance and human-rights norms in the context of football, as well as to the seriousness of the commitment to their actual implementation and the availability of mechanisms for enforcing them vis-à-vis the powerful private organizations that govern the sport. Together, these organizations embody a distinctive form of global governance that raises particular questions of legality, legitimacy, democracy, transparency, and accountability. The contributions to this Symposium consider some of these questions as they relate to gender inequality in football, both on and off the pitch.
Lockdown surgery: the impact of coronavirus disease 2019 measures on cardiac cases
Authors: Nägele Felix , Engler Clemens , Graber Michael , Remmel Nina , Hirsch Jakob , Pölzl Leo , Huber Rosalie , Schweiger Victor , Kilo Juliane , Bonaros Nikolaos , Tancevski Ivan , Grimm Michael , Gollmann-Tepeköylü Can , Holfeld Johannes 
Published: March 2022

Abstract

OBJECTIVES
The need to ration medical equipment and interventions during the coronavirus disease 2019 pandemic translated to an ever-lengthening wait list for surgical care. Retrospective analysis of lockdowns is of high importance to learn from the current situation for future pandemics. This monocentric study assessed the impact of lockdown periods on cardiac surgery cases and outcomes.

METHODS
The single-centre cross-sectional descriptive observational study was conducted to investigate the first lockdown period and the following post-lockdown period in comparison to the same periods during the previous 3 years at the Department of Cardiac Surgery at the Medical University of Innsbruck. Data were prospectively collected and retrospectively analysed from the department-specific quality management system. The primary objective was to compare the number of open-heart procedures between the prelockdown and the lockdown period. The secondary objectives were to analyse the characteristics and the outcomes of open-heart procedures.

RESULTS
There were no differences in patient demographics. A significant decrease of 29% in weekly surgical procedures was observed during the lockdown period. The surgical case-mix was unaffected: The numbers of aortic valve replacements, coronary artery bypass grafts, mitral valve repair or replacement procedures and others remained stable. The urgency of cases increased significantly, and the general health conditions of patients appeared to be worse. However, outcomes were unchanged.

CONCLUSIONS
By implementing a rational patient selection process, the quality of open-heart procedures was maintained even though patients who underwent surgery during lockdown were sicker and more symptomatic.
Free of choice on anterior and posterior chest tube position after lung cancer resection
Authors: Pu Qiang , Zhou Jian , Zheng Quan , Hao Jianqi , Wu Dongsheng , Zhang Ruoxi , Wang Hang , Wang Tengyong , Liu Lunxu 
Published: March 2022

Abstract

OBJECTIVES
The optimal location to insert a chest tube for postoperative drainage has not been identified. We performed a retrospective equivalence study to identify whether the efficiency is similar regarding anterior or posterior position of chest tube in thoracic cavity after video-assisted thoracoscopic surgery for non-small-cell lung cancer.

METHODS
A retrospective review of 4263 patients undergoing non-small-cell lung cancer resection from October 2009 to August 2019 in the Western China Lung Cancer Database was conducted. Propensity score matching was performed to balance baseline characteristics between anterior and posterior groups. Chest tube duration, drainage volume, postoperative complications and hospitalization cost were compared. Equivalence margin was defined as (−1, 1) in 95% confidence interval of the mean difference of chest tube duration.

RESULTS
After propensity score matching, we investigated 2912 patients with anterior or posterior (1456 vs 1456) chest tube location following lung cancer resection. The mean time to chest tube removal was 3.39 days in the anterior group and 3.38 days in the posterior group (P = 0.52), while the mean difference and 95% confidence interval were 0.02 (-0.17, 0.20). The mean postoperative hospital stays in 2 groups were 5.47 vs 5.24 days (anterior vs posterior, P = 0.02). No significant differences were identified regarding the drainage volume during the first 3 postoperative days, postoperative complications and hospitalization cost.

CONCLUSIONS
The comparison of clinical outcomes between anterior and posterior location of chest tube met the criteria for equivalence. For lung cancer patients undergoing video-assisted thoracoscopic surgery resection, it was free choice on anterior or posterior single-tube insertion.
Usability challenges with electronic health records (EHRs) during prerounding on pediatric inpatients
Authors: Alami Jawad , Hammonds Clare , Hensien Erin , Khraibani Jenan , Borowitz Stephen , Hellems Martha , Riggs Sara Lu 
Published: March 2022

AbstractObjectivePrerounding is critical for a healthcare team to develop a shared understanding of the patient’s condition and to develop a care plan. However, the design of electronic health records (EHRs) often makes prerounding inefficient, ineffective, and time consuming. The goal of this study was to observe how residents use the EHR while prerounding to identify usability challenges associated with the design of EHRs.Materials and MethodsThirty residents were tasked to preround 2 pediatric patients using the think-aloud protocol. The data from the surveys, video recordings, and think-aloud comments were analyzed to identify usability issues related to EHR. The time it took for participants to complete the 6 required prerounding tasks were calculated and the pages most commonly accessed were noted.ResultsParticipants spent on average 6.5 min prerounding each patient with the most time spent on checking lab results and reviewing notes. Twenty-eight distinct pages were visited by at least 2 participants, mostly due to a lack of interconnectivity between related data across pages. Usability issues with the most commonly used pages include: data overload, missing/hidden information, difficulty identifying trends, and having to conduct manual calculations.ConclusionsWe list usability issues and provide a set of recommendations to remedy these issues that include: reducing information access cost, creating a checklist, automate calculations, and standardizing notes and EHR training. Ideally, the outcome of this work will help improve EHR design to maximize the time clinicians spend interacting with and providing care to their patients.
56 Characterization of Pasture Management by Horse Operation Purposes in Florida
Authors: Vasco Carol M , Silva Liliane , Mullenix Kim , Dillard Leanne L , Wickens Carissa , Warren Lori K 
Published: March 2022

Abstract
Adequate pasture management can decrease costs related to supplemental feed in horse operations. However, the purpose of the horse operation may influence the level of pasture management applied. An online survey was conducted from 2018 to 2020 to evaluate if pasture management strategies used on Florida horse farms are associated with the purpose of the operation. This survey also provided inputs as needs assessment for educational programs in Florida and the Southeast United States. Survey data (n = 79 respondents) were submitted to descriptive analysis and Fisher’s exact test. Significantly associated variables were also evaluated using multiple correspondence analysis. The primary function of the operation most reported was recreational (62%), followed by training (15%), boarding (8%), breeding (6%), and other (5%). Horses were turned out onto pasture full time (24 h/d) in 57% of operations. The purpose of the operation tended to be associated with turnout practices (P = 0.08). Multiple correspondence analysis revealed that boarding- and recreational-purpose operations tended to turn horses out full time or most of the day (12 h/d), while training facilities tended to turn horses out during the night or for a short duration (~4 h/d) during the day. As for level of pasture management, pasture establishment but no maintenance was implemented by 3% of the respondents, 9% implemented pasture establishment and maintenance, 82% performed maintenance only, and 6% did not implement any pasture management. Concerning types of pasture management, pastures were overseeded by 34% of the operations, fertilized by 57%, and continuously stocked by 52%. The purpose of the operation was not associated (P &gt; 0.05) with the level or type of pasture management strategy. Results demonstrate that pasture management practices were implemented similarly among Florida horse operations regardless of their purpose. These results illustrate an educational need to provide information and resources for horse owners aiming to improve the adoption of best pasture management strategies and decrease feeding costs.
136 Application of Ear-attached Sensor Technology (CowManager) to Detect Estrus in a Commercial Beef Cow AI Program
Authors: Weber W E , Looney C R , Rook W L 
Published: March 2022

Abstract
The CowManager (Agis, Harmelen, the Netherlands) ear sensor technology was developed for dairy cows in confinement and has recently been adopted for pastured beef cows. The sensors fit around the ‘840’ RFID button and houses a 3-dimensional accelerometer that registers movement of the cow’s ear. Each sensor stores up to 7 d of internal data at a time and is transmitted by solar powered routers in the pasture. The objective was to determine the effectiveness of the CowManager system’s estrus detection (ED) feature in beef cows during estrous synchronization (ES), AI, and during exposure to bulls for 60 d. Fifty 6-8 yr multiparous commercial Angus-crossbred cows with calves, were fitted with CowManager ear sensors for 14 d to allow for acclimation. Cows then underwent ES using a 6-d CO-Synch + controlled internal drug release (CIDR) protocol with AI at 72 h post CIDR + prostaglandin F2α with sexed female semen. Estrus detection was determined using breeding patches (Estrotect™, Rockway Inc., Spring Valley, WI), with estrus classified as greater than 50% of color rubbed off, and CowManager sensors with a notification to a smartphone and/or computer. The CowManager sensors were effective in determining estrus in 92% (46/50) of the synchronized cows, and the first service conception rate was 74% (37/50). CowManager sensors detected 100% (37/37), and ESTROTECT patches detected 91% (34/37) of the cows in estrus that conceived by AI. During bull exposure, CowManager detected 100% (13/13) of estrus and the natural breeding dates were confirmed by ultrasound fetal aging. ESTROTECT patches were not used during exposure to bulls. However, CowManager detected 5 of the AI pregnant cows as in estrus during the exposure to bulls. CowManager’s ED feature was highly effective in determining estrus for beef cattle and was similar to breeding patches for ED.
6 Effect of Exogenous Melatonin on the Cellular and Humoral Response of Holstein Heifer Calves During Vaccination
Authors: Martin Allie , Machado Vinicius , Crossland Whitney L 
Published: March 2022

Abstract
Despite rigorous vaccination protocols, calf morbidity is the primary contributor to economic loss in beef and dairy industries. Melatonin has been used as a vaccine adjuvant in many species, yet there are few studies in cattle. It was hypothesized implantation of slow-release (90-day) exogenous melatonin during vaccination could bolster cellular and humoral immune function. The objective was to evaluate the effect of exogenous melatonin on polymorphonuclear leukocyte (PMN) function and adaptive immune response in dairy calves vaccinated against a model antigen (ovalbumin). Total serum protein (TSP) was measured in Holstein heifer calves (n=60; &lt; 3 d old) which were randomly assigned to one of four treatments: either no treatment (CON), a two-series vaccination of 0.5 mg ovalbumin on d 0 and 21 (VAC), an implantation of 24 mg melatonin on d 0 (MEL), or both melatonin and vaccine treatments (MVAC). Jugular blood was collected on days 0, 21, 42, 63, and 84 to measure PMN function and anti-ovalbumin immunoglobulin-G (IgG). Experimental design was a RCBD with repeated measures (day), a two-by-two factorial arrangement of treatments, and block was enrollment cohort. TSP was not correlated with any measurements on day 0 (r2 ≤ 0.16,P ≤ 0.23). There was a treatment by day interaction for median florescent intensity of phagocytosis where MVAC was greater than other treatments on day 42 (P =0.01). Across treatments, neutrophil oxidative burst intensity decreased after day 0 (P &lt; 0.01) and phagocytosis intensity increased toward day 42 and decreased toward day 84 (P &lt; 0.01). As expected, there was a treatment by day interaction (P &lt; 0.01) were vaccinated calves developed greater anti-ovalbumin IgG over time than non-vaccinated calves, and MVAC tended (P = 0.08) to be greater than VAC on d 63. Exogenous melatonin may influence PMN function and potentially IgG response during vaccination.