bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Accuracy of Presepsis and Intrasepsis Characteristics for Prediction of Cardiovascular Events After a Sepsis Hospitalization
Authors: Walkey Allan J. , Knox Daniel B. , Myers Laura C. , Thai Khanh K. , Jacobs Jason R. , Kipnis Patricia , Desai Manisha , Go Alan S. , Lu Yun , Brown Samuel M. , Martinez Adriana , Clancy Heather , Devis Ycar , Liu Vincent X. 
Published: April 2022

OBJECTIVES:
Sepsis survivors face increased risk for cardiovascular complications; however, the contribution of intrasepsis events to cardiovascular risk profiles is unclear.

SETTING:
Kaiser Permanente Northern California (KPNC) and Intermountain Healthcare (IH) integrated healthcare delivery systems.

SUBJECTS:
Sepsis survivors (2011–2017 [KPNC] and 2018–2020 [IH]) greater than or equal to 40 years old without prior cardiovascular disease.

DESIGN:
Data across KPNC and IH were harmonized and grouped into presepsis (demographics, atherosclerotic cardiovascular disease scores, comorbidities) or intrasepsis factors (e.g., laboratory values, vital signs, organ support, infection source) with random split for training/internal validation datasets (75%/25%) within KPNC and IH. Models were bidirectionally, externally validated between healthcare systems.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Changes to predictive accuracy (C-statistic) of cause-specific proportional hazards models predicting 1-year cardiovascular outcomes (atherosclerotic cardiovascular disease, heart failure, and atrial fibrillation events) were compared between models that did and did not contain intrasepsis factors. Among 39,590 KPNC and 16,388 IH sepsis survivors, 3,503 (8.8%) at Kaiser Permanente (KP) and 600 (3.7%) at IH experienced a cardiovascular event within 1-year after hospital discharge, including 996 (2.5%) at KP and 192 (1.2%) IH with an atherosclerotic event first, 564 (1.4%) at KP and 117 (0.7%) IH with a heart failure event, 2,310 (5.8%) at KP and 371 (2.3%) with an atrial fibrillation event. Death within 1 year after sepsis occurred for 7,948 (20%) KP and 2,085 (12.7%) IH patients. Combined models with presepsis and intrasepsis factors had better discrimination for cardiovascular events (KPNC C-statistic 0.783 [95% CI, 0.766–0.799]; IH 0.763 [0.726–0.801]) as compared with presepsis cardiovascular risk alone (KPNC: 0.666 [0.648–0.683], IH 0.660 [0.619–0.702]) during internal validation. External validation of models across healthcare systems showed similar performance (KPNC model within IH data C-statistic: 0.734 [0.725–0.744]; IH model within KPNC data: 0.787 [0.768–0.805]).

CONCLUSIONS:
Across two large healthcare systems, intrasepsis factors improved postsepsis cardiovascular risk prediction as compared with presepsis cardiovascular risk profiles. Further exploration of sepsis factors that contribute to postsepsis cardiovascular events is warranted for improved mechanistic and predictive models.
The Prevalence of Spiritual and Social Support Needs and Their Association With Postintensive Care Syndrome Symptoms Among Critical Illness Survivors Seen in a Post-ICU Follow-Up Clinic
Authors: Eaton Tammy L. , Scheunemann Leslie P. , Butcher Brad W. , Donovan Heidi S. , Alexander Sheila , Iwashyna Theodore J. 
Published: April 2022

OBJECTIVES:
Spiritual and social support may be key facilitators for critical illness recovery and are identified as high priority for research. Understanding the prevalence of spiritual and social support needs in critical illness survivors may guide development of targeted interventions for support, which, in turn, may improve critical illness survivor quality of life. To characterize unmet spiritual and social support needs in critical illness survivors approximately 1 month after hospital discharge and examine the association of these needs with postintensive care syndrome (PICS)–related symptom burden.

DESIGN:
Retrospective, cross-sectional study.

SETTING:
University-affiliated hospital in Pittsburgh, PA.

PATIENTS:
One hundred ninety-six consecutive adult critical illness survivors seen during an initial post-ICU clinic visit from June 2018 to March 2020.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Patient-reported clinical outcome measures assessing spiritual and social support needs and PICS-related symptoms were extracted from the electronic health record. Patients had a median age of 61 (interquartile range [IQR], 51–68.5), and majority were male (55.1%) with a moderate comorbidity burden (Charlson comorbidity index median score, 3; IQR, 2–5). Social support and spiritual needs were prevalent. Of the 196 patients, over 50% reported unpreparedness/fearful for the future, half of patients reported not feeling in control of their care, and over one-third reported needing more support than their family, friends, or insurance can provide. Nearly 13% of respondents reported feeling abandoned or punished by God/not supported by their church/faith. Many patients reported overlapping PICS-related symptom domains (physical, psychologic, and cognitive). Univariate and multivariate analyses revealed associations between reported PICS-related symptoms and the presence of spiritual and social needs.

CONCLUSIONS:
Patients surviving critical illness experience significant social support and spiritual needs independent of commonly identified manifestations of PICS. These findings support the need for formal assessment and tailored interventions for social support and spiritual needs in critical illness survivors.
Reporting Incidents in the Psychiatric Intensive Care Unit
Authors: Mele Federica , Buongiorno Luigi , Montalbò Domenico , Ferorelli Davide , Solarino Biagio , Zotti Fiorenza , Carabellese Felice Francesco , Catanesi Roberto , Bertolino Alessandro , Dell'Erba Alessandro , Mandarelli Gabriele 
Published: April 2022

Abstract
To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.9). The most frequent psychiatric diagnosis was a neurodevelopmental disorder (33%). Physical aggression (84%) was more frequent than the other types of aggression. Nurses and unlicensed assistive personnel were the most frequent victims (65%). Aggressions were more frequent on Friday (18%) and between 4 p.m. and 8 p.m. (35%). A total of 64.9% of the incidents happened in the first 5 days of hospitalization. A significant association between physical aggression and diagnosis of neurodevelopmental disorder emerged. IRS could be helpful to identify high-risk patient groups and develop clinical strategies to reduce adverse events in clinical practice.
Risk of Suicide in Patients With Bipolar Disorder Having Comorbid Chronic Pain Disorders
Authors: Trivedi Chintan , Vadukapuram Ramu , Chaudhari Gaurav , Ashraf Sahar , Tazin Faria , Mansuri Zeeshan , Jain Shailesh 
Published: April 2022

Abstract
Bipolar disorders (BDs) are associated with significant risk of suicide. BD patients (age ≥18 years) admitted to the hospital were identified from the National Inpatient Sample dataset. Based on the secondary diagnosis of chronic pain disorder (CPD), patients were stratified into two groups (1) BD with CPD (BD + CPD) and (2) BD without CPD (BD - CPD). Groups were matched (1:1) for the type of BD and compared for baseline characteristics and suicidal ideation/attempt (SI/SA). Compared with BD - CPD, most patients in the BD + CPD group were older (mean age, 47.6 vs. 40.4 years), female (58.4% vs. 55.2%), and white (77.2% vs. 66.7%). After adjusting for covariates, compared with the BD - CPD group, the BD + CPD group had 21% more risk of SI/SA (odds ratio, 1.21, p < 0.001). CPD is independently associated with the increased risk of suicide among patients with BD. Thus, comorbid CPD among patients admitted for BD can be an essential risk factor for suicide.
The Impact of COVID-19 Restrictions on Online Sales of HIV Self-Test Kits and Implications for HIV Prevention: Analysis of Transaction Data from a Leading E-commerce Platform in China
Authors: Luo Ganfeng , Su Lingyun , Hu Yuqing , Zhou Yiguo , Sun Yinghui , Feng Anping , Lin Yi-Fan , Wu Xinsheng , Zou Huachun 
Published: April 2022

Background:
The effect of the COVID-19 epidemic on HIV self-testing (HIVST) remains unclear. We aimed to quantify the impact of COVID restrictions on HIVST kit purchasing behaviors in mainland China.

Methods:
Deidentified transaction data were retrieved from a large online shopping platform. An interrupted time series model was constructed to examine the impact of COVID restrictions on the weekly number of anonymous customers purchasing HIVST kits, online orders, and purchased kits.

Results:
A total of 2.32 million individuals submitted 4.46 million orders for 4.84 million HIVST kits between January 7, 2016, and April 22, 2020. Compared with expected levels, assuming COVID-19 epidemic and related restrictions had not happened, the number of purchasers, orders, and kits decreased by an estimated 10,500 (51.7%), 18,000 (55.3%), and 18,500 (54.9%) in the first week (January 23, 2020, to January 29, 2020) after COVID restrictions were implemented, respectively. As restrictions eased, the number of purchasers, orders, and kits increased by an average of 7.4%, 4.8%, and 4.9% per week, respectively. In the first week after COVID restrictions were lifted (April 9, 2020, to April 15, 2020), the number of purchasers returned to expected levels, whereas the number of orders and kits were still lower than expected levels. The impact of COVID restrictions on outcomes at the beginning of COVID restrictions and the increasing trends of outcomes were larger among those living in regions with higher COVID-19 incidence (eg, Wuhan city and Hubei province).

Conclusions:
Online sales of HIVST kits were significantly impacted by COVID restrictions, and HIVST kit purchasing patterns returned to expected levels after restrictions were lifted.
Diagnosis of Chronic Thromboembolic Pulmonary Hypertension Using Quantitative Lung Perfusion Parameters Extracted From Dual-energy Computed Tomography Images
Authors: Koike Hirofumi , Sueyoshi Eijun , Uetani Masataka 
Published: April 2022

Purpose:
To evaluate quantified iodine mapping parameters in dual-energy computed tomography in normal patients versus those with chronic thromboembolic pulmonary hypertension (CTEPH) with and without pulmonary thromboembolism.

Materials and Methods:
Using automatically quantified iodine mapping in dual-energy computed tomography, we evaluated lung relative average enhancement, standard deviation (SD), and the SD/lung relative average enhancement ratio. We compared the values for these parameters in normal patients versus those with CTEPH. We also performed a receiver operating characteristic curve analysis to determine the diagnostic cutoffs for the parameters.

Results:
Patients constituted 41 patients (10 male [24.4%] and 31 female [75.6%]; mean age [SD]: 70.0 y [13.3]) with CTEPH and 237 (92 male [38.8%] and 145 female [61.2%]; mean age [SD]: 65.9 y [15.9]) normal patients. We found significant differences in lung relative average enhancement (34.9±6.3 vs. 26.9±6.3;P<0.0001), SD (11.6±1.9 vs. 14.7±3.3;P<0.001), and the SD/lung relative average enhancement ratio (33.7±5.0 vs. 55.7±10.4;P<0.001) between the normal and CTEPH groups, respectively. The ROC analyses demonstrated high discriminatory power (area under the curve=0.99) for using the SD/lung relative average enhancement ratio to differentiate between patients in the normal group and CTEPH group. At a threshold for the area under the curve of 44.2, diagnostic sensitivity, specificity, positive predictive value, and negative predictive value for the ratio were 92.7%, 97.5%, 86.5%, and 98.7%, respectively.

Conclusions:
Patients with CTEPH were well-discriminated from normal patients using the SD/lung relative average enhancement ratio.
Clinical Significance of Shear Wave Ultrasound Elastography in Patients With Idiopathic Adhesive Capsulitis: Can It Be Used Instead of Magnetic Resonance Imaging as an Early Indicator?
Authors: Ozbalci Aysu Basak , Piskin Ahmet 
Published: April 2022

Abstract
The aim of this study was to evaluate the elasticity of the supraspinatus (SSp) and infraspinatus (ISp) tendons and coracohumeral ligament (CHL), as well as the thickness of CHL in patients diagnosed with adhesive capsulitis (AC) using ultrasound (US) and 2D shear wave elastography (2D-SWE), determining their contributions to diagnosis and stage differentiation.
This prospective case-control study was conducted between January 2020 and May 2021. In all cases, the ultrasound examinations were performed using the virtual touch quantification and expressed as shear wave velocity (SWV) in meters per second. After US examinations, magnetic resonance imaging (MRI) was planned for all cases.
The measurements made in US and MRI revealed that CHL thicknesses and SWV values of CHL and SSp and ISp tendons were statistically substantially higher in the patient group. The diagnostic performance of 2D-SWE in predicting AC was evaluated using receiver operating characteristics curve analysis. When the cutoff value of the mean SWE for CHL was taken as 4.67 m/s, the sensitivity of SWE was found to be 90.2% and the specificity 85.7%.
Our study results suggest that CHL thickness on B-mode US, as well as SWV values of CHL and SSp and ISp tendons in 2D-SWE examination, can be used as a useful tool for AC diagnosis without the need for MRI, a costly and time-consuming examination.
Assessment of left ventricle myocardial deformation in a hemorrhagic shock swine model by two-dimensional speckle tracking echocardiography
Authors: Doria de Vasconcellos Henrique , Saad Karen Ruggeri , Saad Paulo Fernandes , Otsuki Denise Aya , Ciuffo Luisa A. , Lester Laeben , Koike Marcia Kiyomi , Armstrong Anderson da Costa , Lima Joao A. C. , Montero Edna Frasson de Souza 
Published: April 2022

BACKGROUND
Trauma-induced secondary cardiac injury has been associated with significant adverse cardiovascular events. Speckle tracking echocardiography is a novel technology that allows an accurate and reproducible cardiac structure and function assessment. We evaluated the left ventricle (LV) myocardial deformation by speckle tracking echocardiography in a hemorrhagic shock (HS) swine model.

METHODS
Seven healthy male Landrace pigs were included in this study. Severe HS was reached through three sequentially blood withdraws of 20% of estimated blood volume, and it was maintained for 60 minutes. Volume resuscitation was performed using all precollected blood volume. A 1.8- to 4.2-MHz phased-array transducer was used to acquire the two-dimensional echocardiography images. Strain measurements were obtained semiautomatically by wall motion tracking software. Results are presented as medians and interquartile ranges and compared using Wilcoxon rank-sum test. A p value of <0.05 was considered statistically significant.

RESULTS
The median weight was 32 (26.1–33) kg, and the median total blood volume withdrawn was 1,100 (1,080–1,190) mL. During the severe HS period, the median arterial systemic pressure was 39 (36–46) mm Hg, and the cardiac index was 1.7 (1.6–2.0) L/min/m2. There was statistically significant absolute decrease in the global longitudinal strain 2 hours postresuscitation comparing with the basal measurements (−9.6% [−10.7 to −8.0%] vs. −7.9% [−8.1 to −7.4%], p = 0.03). There were no statistically significant differences between the basal and 2 hours postresuscitation assessments in the invasive/noninvasive hemodynamic, other two-dimensional echocardiogram (LV ejection fraction, 49.2% [44–54.3%] vs. 53.2% [51.5–55%]; p = 0.09), and circumferential strain (−10.6% [−14.4 to −9.0%] vs. −8.5% [−8.6 to −5.2%], p = 0.06) parameters.

CONCLUSION
In this experimental swine model of controlled HS, LV global longitudinal strain analysis accurately characterizes the timing and magnitude of subclinical cardiac dysfunction associated with trauma-induced secondary cardiac injury.
Public Understandings of the Definition and Determination of Death: A Scoping Review
Authors: Zheng Katina , Sutherland Stephanie , Hornby Laura , Shemie Sam D. , Wilson Lindsay , Sarti Aimee J. 
Published: April 2022

Background.
Advances in medicine and technology that have made it possible to support, repair, or replace failing organs challenge commonly held notions of life and death. The objective of this review is to develop a comprehensive description of the current understandings of the public regarding the meaning/definition and determination of death.

Methods.
This scoping review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Online databases were used to identify articles published from 2003 to 2021. Two reviewers (S.S. and K.Z.) screened the articles using predefined inclusion and exclusion criteria, extracted data for specific content variables, and performed descriptive examination. Complementary searches of reference lists complemented the final study selection. A search strategy using vocabulary of the respective databases was created, and criteria for the inclusion and exclusion of the articles were established.

Results.
Seven thousand four hundred twenty-eight references were identified. Sixty were retained for analysis, with 4 additional references added from complementary searches. A data extraction instrument was developed to iteratively chart the results. A qualitative approach was conducted to thematically analyze the data. Themes included public understanding/attitudes toward death and determination of death (neurological determination and cardiocirculatory determination of death), death and organ donation, public trust and legal variability, and media impacts.

Conclusions.
This review provides a current and comprehensive overview of the literature related to the general public’s understanding and attitudes toward death and death determination and serves to highlight the gaps in this topic.
Epileptic Seizure Induced by Head-Up Tilt: A Case Series Study
Authors: Toprani Sheela , Jaradeh Safwan , Falco-Walter Jessica J. 
Published: April 2022

Purpose:Epilepsy and syncope can be difficult to distinguish, with misdiagnosis resulting in unnecessary or incorrect treatment and disability. Combined tilt-table and video EEG (vEEG) testing (tilt-vEEG) is infrequently used to parse these entities even at large centers. Because of the discovery of a rare case of epileptic seizure induced by head-up tilt (HUT) (no prior cases have been published), the authors sought to verify the rarity of this phenomenon.Methods:An observational, retrospective case series study of all combined tilt-vEEG studies performed at Stanford Health Care over a 2-year period was performed. Studies were grouped into categories: (1) abnormal tilt and normal vEEG; (2) abnormal vEEG and normal tilt; (3) abnormal vEEG and abnormal tilt; (4) normal tilt and normal vEEG, with neurologic symptoms; and (5) normal tilt and normal vEEG without neurologic symptoms.Results:Sixty-eight percent of patients had an abnormal study (categories A–C), with only 3% having both an abnormal tilt and an abnormal EEG (category C). Of these, one patient had a focal epileptic seizure induced by HUT. With HUT positioning, the patient stopped answering questions and vEEG showed a left temporal seizure; systolic blood pressure abruptly dropped to 89 mm Hg (64 mm Hg below baseline); heart rate did not change, but pacemaker showed increased firing (threshold: <60 bpm).Conclusions:Combined tilt-table and vEEG evaluation was able to identify a previously unreported scenario—head-up tilt provocation of an epileptic seizure—and improve treatment. Combined tilt and vEEG testing should be considered for episodes that persist despite treatment to confirm proper diagnosis.
Multiplexed biosensor for point-of-care COVID-19 monitoring: CRISPR-powered unamplified RNA diagnostics and protein-based therapeutic drug management
Authors: Johnston Midori , Ates H. Ceren , Glatz Regina , Mohsenin Hasti , Schmachtenberg Rosanne , Göppert Nathalie , Huzly Daniela , Urban Gerald A. , Weber Wilfried , Dincer Can 
Published: April 2022

AbstractIn late 2019 SARS-CoV-2 rapidly spread to become a global pandemic, therefore, measures to attenuate chains of infection, such as high-throughput screenings and isolation of carriers were taken. Prerequisite for a reasonable and democratic implementation of such measures, however, is the availability of sufficient testing opportunities (beyond reverse transcription PCR, the current gold standard). We, therefore, propose an electrochemical, microfluidic multiplexed biosensor in combination with CRISPR/Cas-powered assays for point-of-care nucleic acid testing. In this study, we simultaneously screen for and identify SARS-CoV-2 infections (Omicron-variant) in clinical specimens (Sample-to-result time: ∼30 min), employing LbuCas13a, whilst bypassing reverse transcription as well as target amplification of the viral RNA, both of which are necessary for detection via PCR and multiple other methods. In addition, we demonstrate the feasibility of combining assays based on different classes of biomolecules, in this case protein-based antibiotic detection, on the same device. The programmability of the effector and multiplexing capacity (up to six analytes) of our platform, in combination with a miniaturized measurement setup, including a credit card sized near field communication (NFC) potentiostat and a microperistaltic pump, provide a promising on-site tool for identifying individuals infected with variants of concern and monitoring their disease progression alongside other potential biomarkers or medication clearance.
Delta/ Omicron and BA.1/BA.2 co-infections occurring in Immunocompromised hosts
Authors: Leuking Richard , Narasimhan Madhusudhanan , Mahimainathan Lenin , Muthukumar Alagar R , Liu Yan , Xing Chao , Larsen Christian P. , Clark Andrew , SoRelle Jeffrey A. 
Published: April 2022

AbstractConcomitant infection of multiple SARS-CoV-2 variants has become an increasing concern, as this scenario increases the likelihood of recombinant variants. Detecting co-infection of SARS-CoV-2 variants is difficult to detect by whole genome sequencing approaches, but genotyping methods facilitate detection. We describe 2 cases of Delta/Omicron and 2 cases of Omicron sublineage BA.1/ BA.2 co-infection as detected by a multiplex genotyping fragment analysis method. Findings were confirmed by whole genome sequencing. Review of the patient characteristics revealed co-morbidities and conditions which weaken the immune system and may make them more susceptible to harboring SARS-CoV-2 variant co-infections.