bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of after-hours house-call medical service in the treatment of COVID-19 patients awaiting hospital admission
Authors: Inokuchi Ryota , Jin Xueying , Iwagami Masao , Ishikawa Masatoshi , Tamiya Nanako 
Published: February 2022

Abstract
Due to the increasing number of coronavirus disease 2019 (COVID-19) cases in Japan, hospitals are unable to provide admission and immediate inpatient care. The after-hours house call (AHHC) service offers telephone consultations and in-home care to patients awaiting admission. Currently, there is no report on the management of COVID-19 patients when inpatient beds are insufficient.
We aimed to describe the clinical characteristics and outcomes of COVID-19 patients treated by an AHHC medical service in Osaka and Tokyo, between April and May 2021 (during the fourth wave in Japan). Patients were classified into 2 groups: Moderate I and Moderate II, according to the severity of infection under Japanese guidelines. A retrospective study of the hospital records and follow-up telephone consultations was performed.
The AHHC treated a total of 55 COVID-19 patients (17 with Moderate I, 38 with Moderate II disease). The median ages (interquartile range) were 63 (49–80.5) and 64 (50.8–81), respectively. In each group, approximately 30% of AHHC patients received out-of-hospital oxygen therapy for the duration of their treatment until it was no longer required. Major symptoms, including shortness of breath or difficulty breathing (47.1% and 78.9%, respectively) and fever or chills (41.2% and 76.3%, respectively) were lower in the Moderate I group than in the Moderate II group. Overall, 16.4% of patients died, with 17.6% in the Moderate I group and 15.8% in the Moderate II group.
We found the proportion of mortality in patients treated by the AHHC was slightly higher to that of patients treated in Japanese hospitals. This study will provide an alternative management of patients requiring oxygen in situations where hospital beds are in short supply.
Influenza vaccination in patients with heart failure
Authors: Fukuta Hidekatsu , Hagiwara Hiromi , Kamiya Takeshi 
Published: February 2022

Abstract

Background:
Heart failure is a major public health problem. Although there have been significant advances in the management of heart failure, the mortality and morbidity in heart failure patients remain high. Heart failure patients are susceptible to influenza-related complications including acute heart failure exacerbations and secondary infections such as pneumonia, both of which lead to significant morbidity and mortality. An earlier meta-analysis of observational cohort studies reported that influenza vaccination was associated with reduced risk of mortality in heart failure patients. Although there are no published randomized controlled trials (RCTs) on the effect of influenza vaccination on clinical outcomes in heart failure patients, there are several on-going RCTs examining the effect in these patients. We aim to conduct a meta-analysis of RCTs to assess the efficacy and safety of influenza vaccination in heart failure patients.

Methods:
This meta-analysis will include RCTs examining the effect of influenza vaccination in heart failure patients. Information of studies will be collected from electronic databases. The primary outcome of interest will be cardiovascular death. The secondary outcomes of interest will be all-cause death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, and hospitalization for any cause.

Discussion:
This meta-analysis will evaluate the efficacy and safety of influenza vaccination in heart failure patients, providing evidence to the use of influenza vaccine in these patients.

Systematic review registration:
INPLASY202210115.
Pregnancy After 40: Recommendations for Counseling, Evaluation, and Management From Preconception to Delivery
Authors: Moutos Christopher P. , Ly Phuong , Moutos Dean M. , Clark Shannon M. 
Published: February 2022

Importance
Pregnant patients over age 40 often have unique risk factors and potential complications before and during pregnancy that play a role in their counseling and management.

Objective
To provide practitioners an overview on how to approach preconception evaluation and counseling, prenatal care, and management of associated comorbidities, as well as potential complications, in pregnant patients over age 40.

Evidence Acquisition
Literature review was performed using OVID and PubMed, with further relevant information queried from guidelines of professional organizations.

Results
Pregnant patients over age 40 should receive preconception evaluations by their obstetrician–gynecologist and other appropriate specialty care providers as they pertain to preexisting medical comorbidities. In the preconception period, attention should be given to managing and optimizing preexisting medical conditions and associated pharmacotherapeutics. Referral to specialists in assisted reproductive technologies or maternal-fetal medicine should be considered if indicated for appropriate evaluation and counseling. During pregnancy, accurate dating and counseling on aneuploidy screening, with consideration for early diabetes screening, should be performed in the first trimester. A detailed anatomy scan and fetal echocardiogram should be completed by 22 weeks' gestation, along with routine and high-risk (if indicated) prenatal care. Close attention should be given to the development of pregnancy-related complications associated with advancing age. Third-trimester fetal surveillance can be considered. Given that no contraindications exist, these patients should be encouraged to pursue a vaginal delivery with consideration for induction at 39 to 40 weeks' gestation.

Conclusion
Pregnancy rates are increasing in persons over age 40. As a result, preconception evaluation and counseling tailored to that demographic are essential. In addition to standard prenatal care, they should have early screening and diligent monitoring for pregnancy-related comorbidities associated with advancing age.

Relevance
With the increased pregnancy-associated comorbidities in patients over age 40, providers should be familiar with how to evaluate, counsel, and manage them during the preconception and pregnancy periods.

Target Audience
All obstetrical care providers

Learning Objectives
After participating in this activity, the provider should be better able to explain the benefits of preconception counseling and workup for patients over age 40 desiring pregnancy; identify the impact of chronic medical conditions on pregnancy; and describe antenatal management by trimester for this patient population.
A Review of Current Management of Placental Site Trophoblastic Tumor and Epithelioid Trophoblastic Tumor
Authors: Burkett Wesley C. , Soper John T. 
Published: February 2022

Importance
Placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT) are rare forms of gestational trophoblastic neoplasia (GTN). These tumors differ from choriocarcinoma as they are monophasic, have slower growth rates, have lower β-hCG concentrations, and are more chemoresistant. Placental site trophoblastic tumor and ETT can be misdiagnosed, leading to inappropriate management.

Objective
The aim of this study was to review the pathogenesis, presentation, pathologic findings, and treatment for PSTT and ETT.

Evidence Acquisition
A comprehensive literature review was performed identifying relevant research and review articles. Relevant textbook chapters and guidelines were also reviewed.

Results
Placental site trophoblastic tumor and ETT can present months to years after any antecedent pregnancy event with abnormal uterine bleeding and an elevated β-hCG. Tumors are typically confined to the uterus and secrete lower levels of β-hCG compared with other GTNs. The International Federation of Gynecology and Obstetrics prognostic scoring system does not correlate well with prognosis. These lesions can be misdiagnosed as smooth muscle tumors, metastatic melanoma, and cervical squamous cell carcinoma. However, they can be distinguished by their unique histologic and immunophenotypic features.

Conclusions
Surgery is the mainstay of treatment for early-stage PSTT and ETT. For patients with advanced disease or for those with poor prognostic indicators, such as an antecedent pregnancy interval of greater than 48 months, a multimodal treatment paradigm of surgery and chemotherapy using a high-risk GTN platinum-etoposide containing regimen is recommended.

Relevance
Placental site trophoblastic tumor and ETT should be considered in the differential diagnosis in a reproductive age patient presenting with abnormal uterine bleeding and an elevated β-hCG after any antecedent pregnancy event.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After participating in this activity, the reader should be better able to identify the presentation and diagnosis of PSTT and ETT; explain how PSTT and ETT differ from the more common forms of GTN; and describe how surgical resection is the primary treatment modality for PSTT and ETT.
Single-Cell Transcriptomic Atlas of the Human Endometrium During the Menstrual Cycle
Authors: Wang Wanxin , Vilella Felipe , Alama Pilar , Moreno Inmaculada , Mignardi Marco , Isakova Alina , Pan Wenying , Simon Carlos , Quake Stephen R. 
Published: February 2022

(Abstracted from Nat Med 2020;26:1644–1653)
The monthly remodeling, shedding, and regeneration of the endometrium defining the human menstrual cycle is driven by gene expression changes in the underlying tissue hierarchy. Significant heterogeneity exists among cell types in the endometrium, such that multiple cell types vary dramatically in state through a monthly cycle and undergo various forms of differentiation at rapid rates.
Refining the Clinical Definition of Active Phase Arrest of Dilation in Nulliparous Women to Consider Degree of Cervical Dilation as Well as Duration of Arrest
Authors: Kawakita Tetsuya , Gold Stacey L. , Huang Jim C. , Iqbal Sara N. 
Published: February 2022

(Abstracted from Am J Obstet Gynecol 2021;225:294.e1–294.e14)
In the United States, the progression of labor has been substantially slower than reported previously, according to a retrospective observational study by the Consortium on Safe Labor. Yet, the optimal threshold for arrest of dilation that balances the likelihood of vaginal delivery with the risk of adverse maternal and neonatal outcomes is unknown.
Fat Quantification in Dual-Layer Detector Spectral Computed Tomography
Authors: Molwitz Isabel , Campbell Graeme Michael , Yamamura Jin , Knopp Tobias , Toedter Klaus , Fischer Roland , Wang Zhiyue Jerry , Busch Alina , Ozga Ann-Kathrin , Zhang Shuo , Lindner Thomas , Sevecke Florian , Grosser Mirco , Adam Gerhard , Szwargulski Patryk 
Published: February 2022

Objectives
Fat quantification by dual-energy computed tomography (DECT) provides contrast-independent objective results, for example, on hepatic steatosis or muscle quality as parameters of prognostic relevance. To date, fat quantification has only been developed and used for source-based DECT techniques as fast kVp-switching CT or dual-source CT, which require a prospective selection of the dual-energy imaging mode.
It was the purpose of this study to develop a material decomposition algorithm for fat quantification in phantoms and validate it in vivo for patient liver and skeletal muscle using a dual-layer detector-based spectral CT (dlsCT), which automatically generates spectral information with every scan.

Materials and Methods
For this feasibility study, phantoms were created with 0%, 5%, 10%, 25%, and 40% fat and 0, 4.9, and 7.0 mg/mL iodine, respectively. Phantom scans were performed with the IQon spectral CT (Philips, the Netherlands) at 120 kV and 140 kV and 3 T magnetic resonance (MR) (Philips, the Netherlands) chemical-shift relaxometry (MRR) and MR spectroscopy (MRS). Based on maps of the photoelectric effect and Compton scattering, 3-material decomposition was done for fat, iodine, and phantom material in the image space.
After written consent, 10 patients (mean age, 55 ± 18 years; 6 men) in need of a CT staging were prospectively included. All patients received contrast-enhanced abdominal dlsCT scans at 120 kV and MR imaging scans for MRR. As reference tissue for the liver and the skeletal muscle, retrospectively available non–contrast-enhanced spectral CT data sets were used. Agreement between dlsCT and MR was evaluated for the phantoms, 3 hepatic and 2 muscular regions of interest per patient by intraclass correlation coefficients (ICCs) and Bland-Altman analyses.

Results
The ICC was excellent in the phantoms for both 120 kV and 140 kV (dlsCT vs MRR 0.98 [95% confidence interval (CI), 0.94–0.99]; dlsCT vs MRS 0.96 [95% CI, 0.87–0.99]) and in the skeletal muscle (0.96 [95% CI, 0.89–0.98]). For log-transformed liver fat values, the ICC was moderate (0.75 [95% CI, 0.48–0.88]). Bland-Altman analysis yielded a mean difference of −0.7% (95% CI, −4.5 to 3.1) for the liver and of 0.5% (95% CI, −4.3 to 5.3) for the skeletal muscle. Interobserver and intraobserver agreement were excellent (>0.9).

Conclusions
Fat quantification was developed for dlsCT and agreement with MR techniques demonstrated for patient liver and muscle. Hepatic steatosis and myosteatosis can be detected in dlsCT scans from clinical routine, which retrospectively provide spectral information independent of the imaging mode.
Association of Covert Cerebrovascular Disease Identified Using Natural Language Processing and Future Dementia
Authors: Kent David M , Leung Lester Y , Zhou Yichen , Luetmer Patrick H , Kallmes David F , Nelson Jason , Fu Sunyang , Zheng Chengyi , Liu Hongfang , Chen Wansu 
Published: February 2022

ABSTRACTObjectiveTo estimate the risk of dementia associated with incidentally-discovered covert cerebrovascular disease (CCD), including both covert brain infarction (CBI) and white matter disease (WMD).Patients and MethodsWe included individuals aged ≥ 50 years enrolled in the Kaiser Permanente Southern California health system receiving a head CT or MRI for a non-stroke indication from January 1, 2009 and December 31, 2019, without prior ischemic stroke, transient ischemic attack, hemipelegia, hemiparesis, dementia/Alzheimer’s disease or a visit reason / scan indication suggestive of cognitive decline. Using natural language processing (NLP), we identified the presence of CBI and WMD on the neuroimage report; WMD was characterized as mild, moderate, severe, or undetermined.ResultsAmong 241,050 qualified individuals, NLP identified 69,931 (29.0%) with WMD and 11,328 (4.7%) with CBI. The dementia incidence rates (per 1,000 person-years) were 23.5 (95% CI 22.90 to 24.0) for patients with WMD; 29.4 (95% CI 27.9 to 31.0) with CBI and 6.0 (5.8 to 6.2) without CCD. The effect of WMD on dementia risk was stronger in younger versus older patients and for CT-versus MRI-discovered lesions. For patients with versus without WMD on CT scan, the adjusted HR (aHR) was 2.87 (2.58 to 3.19) for those < age 70 and 1.87 (1.79 to 1.95) for those ≥ age 70. For patients with versus without WMD on MRI, the aHR for dementia risk was 2.28 (1.99 to 2.62) for patients < age 70 and 1.48 (1.32 to 1.66) for those ≥ age 70. The aHR associated with CBI was 2.02 (1.70 to 2.41) for patients age <70 and 1.22 (1.15 to 1.30) for patients age ≥70 for either modality. Dementia risk with WMD was strongly correlated with WMD severity.ConclusionIncidentally-discovered CCD is common and identifies patients at high risk of dementia, representing an opportunity for prevention.
Healthy dynamics of CD4 T cells may drive HIV resurgence in perinatally-infected infants on antiretroviral therapy
Authors: Morris Sinead E. , Strehlau Renate , Shiau Stephanie , Abrams Elaine J. , Tiemessen Caroline T. , Kuhn Louise , Yates Andrew J. 
Published: February 2022

AbstractIn 2019 there were 490,000 children under five living with HIV. Understanding the dynamics of HIV suppression and rebound in this age group is crucial to optimizing treatment strategies and increasing the likelihood of infants achieving and sustaining viral suppression. Here we studied data from a cohort of 122 perinatally-infected infants who initiated antiretroviral treatment (ART) early after birth and were followed for up to four years. These data included longitudinal measurements of viral load (VL) and CD4 T cell numbers, together with information regarding treatment adherence. We previously showed that the dynamics of HIV decline in 53 of these infants who suppressed VL within one year were similar to those in adults. However, in extending our analysis to all 122 infants, we find that a deterministic model of HIV infection in adults cannot explain the full diversity in infant trajectories. We therefore adapt this model to include imperfect ART adherence and natural CD4 T cell decline and reconstitution processes in infants. We find that individual variation in both processes must be included to obtain the best fits. We also find that, perhaps paradoxically, infants with faster rates of CD4 reconstitution on ART were more likely to experience resurgences in VL. Overall, our findings highlight the importance of combining mathematical modeling with clinical data to disentangle the role of natural immune processes and viral dynamics during HIV infection.Author SummaryFor infants infected with HIV at or near birth, early and continued treatment with antiretroviral therapy (ART) can lead to sustained suppression of virus and a healthy immune system. However many treated infants experience viral rebound and associated depletion of CD4 T cells. Mathematical models can successfully capture the dynamics of HIV infection in treated adults, but many of the assumptions encoded in these models do not apply early in life. Here we study data from a cohort of HIV-positive infants exhibiting diverse trajectories in response to ART. We show that wide-ranging outcomes can be explained by a modified, but still remarkably simple, model that includes both the natural dynamics of their developing immune systems and variation in treatment adherence. Strikingly, we show that infants with strong rates of recovery of CD4 T cells while on ART may be most at risk of virus resurgence.
Examining the Association between Mitochondrial Genome Variation and Coronary Artery Disease
Authors: Vilne Baiba , Sawant Aniket , Rudaka Irina 
Published: February 2022

AbstractBackgroundLarge-scale genome-wide association studies have identified hundreds of single-nucleotide variants (SNVs) significantly associated with coronary artery disease (CAD). However, collectively, these explain <20% of the heritability.HypothesisHere, we hypothesize that mitochondrial (MT) SNVs might present one potential source of this “missing heritability”.MethodsWe analyzed 265 MT-SNVs in ∼500,000 UK Biobank individuals, exploring two different CAD definitions: a more stringent (myocardial infarction and/or revascularization; HARD=20,405), and a more inclusive (also angina and chronic ischemic heart disease; SOFT=34,782).ResultsIn HARD cases, the most significant (P<0.05) associations were for m.295C>T (control region) and m.12612A>G (ND5), found more frequently in cases (OR=1.05), potentially related to reduced cardiorespiratory fitness in response to exercise, as well as for m.12372G>A (ND5) and m.11467A>G (ND4), present more frequently in controls (OR=0.97), previously associated with lower ROS production rate. In SOFT cases, four MT-SNVs survived multiple testing correction (at FDR<5%), all potentially conferring increased CAD risk. Of those, m.11251A>G (ND4) and m.15452C>A (CYB) have previously shown significant associations with body height. In line with this, we observed that CAD cases were slightly less physically active and their average body height was ∼2.00 cm lower compared to controls, both traits known to be related to an increased CAD risk. Gene-based tests identified CO2 associated with HARD/SOFT CAD, whereas ND3 and CYB associated with SOFT cases (P<0.05), dysfunction of which has been related to MT oxidative stress, obesity/T2D (CO2), BMI (ND3) and angina/exercise intolerance (CYB). Finally, we observed that macro-haplogroup I was significantly (P<0.05) more frequent in HARD cases vs. controls (3.35% vs. 3.08%), potentially associated with response to exercise.ConclusionsWe found only spurious associations between MT genome variation and HARD/SOFT CAD and conclude that more MT-SNV data in even larger study cohorts may be needed to conclusively determine the role of MT-DNA in CAD.
Controlling cluster size in 2D phase-separating binary mixtures with specific interactions
Authors: Palaia Ivan , Šarić Anđela 
Published: February 2022

ABSTRACTBy varying the concentration of molecules in the cytoplasm or on the membrane, cells can induce the formation of condensates and liquid droplets through phase separation. Their thermodynamics, much studied, depends on the mutual interactions between microscopic constituents. Here, we focus on the kinetics and size control of 2D clusters, forming on membranes. Using molecular dynamics of patchy colloids, we model a system of two species of proteins, giving origin to specific heterotypic bonds. We find that concentrations, together with valence and bond strength, control both the size and the growth time rate of the clusters. In particular, if one species is in large excess, it gradually saturates the binding sites of the other species: the system becomes then kinetically arrested and cluster coarsening slows down or stops, thus yielding effective size selection. This phenomenology is observed both in solid and fluid clusters, which feature additional generic homotypic interactions and are reminiscent of the ones observed on biological membranes.
Subcortical and cortical tracking of communication sound envelopes in challenging listening conditions
Authors: Souffi S. , Varnet L. , Zaidi M. , Bathellier B. , Huetz C. , Edeline J.-M. 
Published: February 2022

AbstractHumans and animals constantly face challenging acoustic environments such as various background noises restricting the detection, discrimination and identification of behaviorally salient sounds. Here, we disentangled the role of temporal envelope tracking on the decrease in neuronal and behavioral discrimination between communication sounds in situations of acoustic degradations. We simulated responses of auditory nerve fibers and recorded neuronal activity in cochlear nucleus, inferior colliculus, thalamus and auditory cortex in anesthetized guinea-pigs. Furthermore, a Go/No-Go sound discrimination task involving two of the guinea-pig whistles was performed on mice in silence and noise. For all conditions, we found that auditory neurons better track the slow amplitude modulations (<20 Hz) of the stimulus envelopes than the faster ones. In addition, the decrease in neuronal and behavioral discrimination performance in noise can be explained by an increased similarity of the vocalization envelopes in the low frequency range (<20 Hz). Together, these results suggest that slow envelope tracking is a general property of auditory neurons, and any difference between the slow envelopes of natural stimuli allows coping with degraded conditions.