bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preterm Delivery Is a Lifelong Risk Factor for Hypertension
Authors: Rosenberg Karen 
Published: February 2022

According to this study:

Compared with women who delivered full term, those who had a preterm delivery or an extremely preterm delivery had a more than 1.6-fold risk and 2.2-fold risk of hypertension, respectively, within the next 10 years, even after adjustment for potential confounders.Early evaluation and long-term risk reduction and monitoring for hypertension are recommended for women who have a history of preterm delivery.
Factors Affecting Slip Progression After In Situ Screw Fixation of Stable Slipped Capital Femoral Epiphysis
Authors: Makarewich Christopher A. , Wait Eric S. , Fedorak Graham T. , MacWilliams Bruce A. 
Published: February 2022

Background:
Slip progression after in situ fixation of slipped capital femoral epiphysis (SCFE) has been reported as occurring in up to 20% of patients. We review SCFE treated with in situ single screw fixation performed at 2 hospitals over a 15-year period to determine the factors associated with slip progression.

Methods:
This case-control study reviews SCFE treated with in situ single cannulated screw fixation with minimum follow up of 1 year and full closure of the affected physis. Slip progression (failure) was defined as worsening of the Southwick slip angle of 10 or more degrees or revision surgery for symptomatic slip progression. Univariate and multivariate analyses were performed comparing success and failure groups for patient characteristics, screw type and position, and radiographic measurements.

Results:
Ninety three patients with 108 slips met all criteria, with 15 hips (14%) classified as having slip progression (failure). All failures had 3 threads or fewer across the physis. Five hips had 2 threads across the physis, and 4 of the 5 were classified as failures. Lower modified Oxford bone scores were found in the failure group, though the difference was small (0.9, P=0.013). Failure was also associated with partially threaded screws (P=0.001). Failed hips were associated with lower initial Southwick angles (32.8 degrees) than successful hips (40.4 degrees) (P=0.047). In the stepwise model for multivariate regression, 4 factors were identified as significant, with lower initial number of threads (P<0.0001), mild initial Southwick category (P=0.0050), male sex (P=0.0061), and partially threaded screw type (P=0.0116) predicting failure.

Conclusion:
This study is the largest to date evaluating risk factors for slip progression after SCFE fixation, and the first to consider revision surgery for symptomatic slip progression. For stable SCFE, we demonstrate that 4 threads across the physis with a fully threaded screw of 6.5 mm diameter or greater was sufficient to avoid slip progression. We provide a risk stratification for progression of slip showing that in some cases 3 threads across the physis may be sufficient.

Level of Evidence:
Level III—case-control study.
Does the Skeletal Phenotype of Osteogenesis Imperfecta Differ for Patients With Non-COL1A1/2 Mutations? A Retrospective Study in 113 Patients
Authors: Zerfu Tewodros , Yong Bicheng , Harrington Jennifer , Howard Andrew 
Published: February 2022

Background:
Osteogenesis imperfecta (OI) is a heritable disease characterized by bone fragility and other extra skeletal manifestations. Most patients with OI have mutations in the COL1A1 or COL1A2 genes. However, a significant minority of patients with clinical OI have non-COL1A1/2 mutations, which have become easier to detect with the use of genetic panels. Traditional understanding of OI pathogenesis was expanded because of these new mutations, and their phenotypic-genotypic relationship is largely unknown. We hypothesized that patients with non-COL1A1/2 mutations have different skeletal clinical presentations from those with OI caused by COL1A1/2 mutations.

Methods:
Patients were categorized into 4 groups according to our modified functional classification, namely, quantitative COL1A1/2 haploinsufficiency (group 1), qualitative COL1A1/2 dominant negative mutations (group 2), mutations indirectly affecting type I collagen synthesis, processing and posttranslational modification (group 3) and mutations altering osteoblast differentiation and function (group 4). Both group 3 and 4 were classified as non-COL1A1/2 mutation group.

Results:
Of 113 OI patients included, 51 had COL1A1/2 quantitative haploinsufficiency mutations (group 1), 39 had COL1A1/2 qualitative dominant negative mutations (group 2), and 23 patients had OI caused by mutations in 1 of 9 other noncollagen genes (groups 3/4). Patients with non-COL1A1/2 mutations (groups 3 and 4) have severe skeletal presentations. Specifically, OI patients with non-COL1A1/2 mutations experienced more perinatal fractures, vertebral compression fractures and had more long bone deformities. Although the occurrence of scoliosis was similar, the cobb angle was larger in the non-COL1A1/2 mutation group. Radial head dislocations, ossification of interosseous membrane, extraskeletal ossification, cervical kyphosis, and champagne glass deformity of the pelvis were more frequent in this group.

Conclusions:
The clinical phenotype of OI in patients with non-COL1A1/2 is severe and has unique features. This information is useful for clinical diagnosis and prognosis.

Level of Evidence:
Level III.
Nebivolol and incident cardiovascular events in hypertensive patients compared with nonvasodilatory beta blockers
Authors: Huck Daniel M. , Rosenberg Michael A. , Stauffer Brian L. 
Published: February 2022

Objective:
Nonvasodilatory beta blockers are associated with inferior cardiovascular event reduction compared with other antihypertensive classes, and there is uncertainty about first-line use of beta blockers for hypertension in guidelines. The third generation vasodilatory beta blocker nebivolol has unique beneficial effects on central and peripheral vasculature. Our objective was to compare longitudinal cardiovascular outcomes of hypertensive patients taking nebivolol with those taking the nonvasodilatory beta blockers metoprolol and atenolol.

Methods:
We performed a retrospective cohort analysis of hypertensive adults in the University of Colorado health system, without preceding diagnosis of cardiovascular or cerebrovascular disease. The primary outcome was composite incident heart failure, stroke, myocardial infarction, angina, or coronary revascularization. Mahalanobis 1:2 distance matching and Cox proportional hazards regression was used. Matching and regression variables included baseline demographics, socioeconomic factors, medical insurance type, prescribing provider type, cardiovascular risk factors, Charlson comorbidity index, other medications, and follow-up duration.

Results:
After matching, patients were predominantly women (54%, 3085 of 5705) and non-Hispanic Caucasian (79%, 4534 of 5705), with median age of 58. In matched Cox regression analysis, nebivolol was associated with 17% reduction in incident cardiovascular events compared with all nonvasodilatory beta blockers [hazard ratio 0.83, 95% confidence interval (CI) 0.74–0.94, P
= 0.004], and 24% reduction compared with metoprolol (hazard ratio 0.76, CI 0.66–0.87, P = 0.0001).

Conclusion:
The vasodilatory beta blocker nebivolol was associated with reduced incident cardiovascular events compared with nonvasodilatory beta blockers. Additional study of other beta blockers is necessary to determine if this is a vasodilatory beta blocker class effect or is specific to nebivolol.

Graphical abstract:

http://links.lww.com/HJH/B916
Epidermolysis Bullosa Pruriginosa in Two Siblings: A Case Report
Authors: Suwanthaweemeesuk Jongjin , Phunmanee Chatip , Singthong Sasathorn , Kwangsukstid Oraya , Supsrisunjai Chavalit 
Published: February 2022

Introduction:
Epidermolysis bullosa pruriginosa (EBP) is a rare clinical subtype of inherited dystrophic epidermolysis bullosa (DEB) caused by type VII collagen mutations. The onset of EBP is variable and may present in late adulthood. The clinical features of EBP include prurigo-like papules, plaques, nodules, or linear configuration on the lower extremities.
Here, we reported two sisters with EBP.

Case presentation:
We identified two Thai sisters with mild to moderate form of EBP, which resulted from a shared glycine substitution (Gly2287Val) in COL7A1 identified by genomic sequencing.

Discussion:
The histology and molecular findings of both cases supported a diagnosis of dystrophic EBP, however, the clinical manifestations differ between both cases.

Conclusion:
Molecular testing is the key for the diagnosis of EBP due to nonspecific clinical manifestation and histologic findings, however, there is no clear genotype-phenotype correlation in EBP.
Maternal weight and gestational diabetes impacts on child health
Authors: Dalrymple Kathryn V. , El-Heis Sarah , Godfrey Keith M. 
Published: February 2022

Purpose of review
To review recent evidence linking maternal body mass index and gestational diabetes mellitus (GDM) with offspring health outcomes.

Recent findings
It is now established that the rising prevalences of maternal obesity and GDM are both making substantial contributions to the growing burden of childhood obesity and associated disorders. Strengthening evidence also links maternal obesity with increased offspring risks of cardiovascular disease, nonalcoholic fatty liver disease, lower respiratory tract infections during infancy, wheezing illnesses, asthma and attention deficit hyperactivity disorder during childhood, and with higher risks of psychiatric disorders and colorectal cancer in adulthood. GDM has been associated with increased offspring risks of cardiovascular disease, childhood wheeze/asthma (but not allergic sensitization), and with high refractive error, attention deficit hyperactivity and psychiatric disorders from childhood onwards.

Summary
The long-term consequences of maternal obesity and GDM for the offspring in childhood and later adult life present major challenges for public health across the life course and for future generations. Tackling these challenges requires a systems-based approach to support achieving a healthy weight in young people prior to conception, alongside new insights into population based preventive measures against gestational diabetes.
Is It Time for the Mental Health Field to Consider Unplanned Discharge a Key Metric of Patient Safety?
Authors: Riblet Natalie B. , Gottlieb Daniel J. , Watts Bradley V. , Levis Maxwell , Scott Robert , Shiner Brian 
Published: February 2022

Abstract
Mental health lacks robust measures to assess patient safety. Unplanned discharge is common in mental health populations and associated with poor outcomes. Clarifying whether unplanned discharge varies across settings may highlight the need to develop measures to reduce harms associated with this event. Unplanned discharge rates were compared across the Department of Veterans Affairs' acute inpatient and residential mental health treatment settings from 2009 to 2019. Logistic regression was used to create facility-level, adjusted unplanned discharge rates stratified by setting. Results were described using central tendency. Among 847,661 acute inpatient discharges, the mean unplanned discharge rate was 3.3% (range, 0%–18%). Among 358,117 residential discharges, the mean unplanned discharge rate was 17.9% (range, 1%–48.3%). Unplanned discharge is a marked problem in mental health, with large variation across treatment settings. Unplanned discharge should be measured as part of patient safety efforts.
Application of Rapid Digital Locating Technology in Emergency Treatment of Maxillofacial Space Infection
Authors: Xu Guikun , Ju Rui 
Published: February 2022

Abstract:
Space infection occurs commonly in the oral and maxillofacial region, and is usually caused by odontogenic infection, resulting in acute symptoms through the maxillofacial space. if timely, correct, and effective treatment is not provided, local infection may quickly spread through the maxillofacial space and cause serious consequences such as suffocation, intracranial infection, and chest infection. A 55-year-old man visited our hospital with obvious swelling and pain in the right maxillofacial region. Maxillofacial computed tomography images showed revealed obvious low-density shadows on the inner side of the right mandibular angle and the right neck. Unlike the usual presentation of maxillofacial space infection, no obvious flushing or fluctuation was seen in the patient’s maxillofacial region due to the deep location of the infection. Blind puncture examination and incision exploration may cause unnecessary pain and trauma to the patient. Therefore, to accurately position the infection focus, the operator reconstructed the infection cavity in three-dimensional with digital technology. The puncture point and incision site were quickly determined by three-dimensional measurement and the use of the compass and straightedge construction method, thereby achieving free drainage with an accurate and minimally invasive incision. Following 1 week of routine flushing and dressing changes, the patient recovered and was discharged from hospital. To our knowledge, this is the first precise minimally invasive treatment of a maxillofacial space infection conducted with the aid of digital positioning technology.
Long-Term Results of Fibrous Dysplasia of the Paranasal Sinuses
Authors: Lee Dong Hoon , Lim Sang Chul 
Published: February 2022

Introduction:
Fibrous dysplasia (FD) is a benign, idiopathic skeletal disorder, in which the normal bone and marrow are replaced by fibrous tissue and immature woven bone. The authors aim to analyze the long-term results of patients diagnosed with FD of the paranasal sinuses via imaging or surgical biopsy.

Methods:
The authors retrospectively enrolled 21 patients with FD of the paranasal sinuses from 2006 to 2021.

Results:
The mean age at the time of diagnosis of FD of the paranasal sinuses was very high at 45.9 years. The most common site ofoccurrence was the sphenoid sinus (71.4%). During the mean follow-up period of 52.8 months, there was no significant change in the size of FD of the paranasal sinuses, and there was no worsening of symptoms or complications. Endoscopic sinus surgery was performed in 16 patients (76.2%), of which 13 underwent only biopsy and 3 underwent partial resection.

Conclusions:
The most common site of FD of the paranasal sinuses was the sphenoid sinus, and the age at diagnosis was higher thanthat of patients with FD at other sites. Observation with serial radiologic examinations is recommended for asymptomatic FD of the para-nasal sinuses.
Predictive Value of International Classification of Diseases Codes for Idiopathic Intracranial Hypertension in a University Health System
Authors: Khushzad Fareshta , Kumar Riya , Muminovic Irma , Moss Heather E. 
Published: February 2022

Background:
Misclassification bias is introduced into medical claims–based research because of reliance on diagnostic coding rather than full medical record review. We sought to characterize this bias for idiopathic intracranial hypertension (IIH) and evaluate strategies to reduce it.

Methods:
A retrospective review of medical records was conducted using a clinical data warehouse containing medical records and administrative data from an academic medical center. Patients with 1 or more instances of International Classification of Diseases (ICD)-9 or -10 codes for IIH (348.2 or G93.2) between 1989 and 2017 and original results of neuroimaging (head CT or MRI), lumbar puncture, and optic nerve examination were included in the study. Diagnosis of IIH was classified as definite, probable, possible, or inaccurate based on review of medical records. The positive predictive value (PPV) for IIH ICD codes was calculated for all subjects, subjects with an IIH code after all testing was completed, subjects with high numbers of IIH ICD codes and codes spanning longer periods, subjects with IIH ICD codes associated with expert encounters (ophthalmology, neurology, or neurosurgery), and subjects with acetazolamide treatment.

Results:
Of 1,005 patients with ICD codes for IIH, 103 patients had complete testing results and were included in the study. PPV of ICD-9/-10 codes for IIH was 0.63. PPV in restricted samples was 0.82 (code by an ophthalmologist n = 57), 0.70 (acetazolamide treatment n = 87), and 0.72 (code after all testing, n = 78). High numbers of code instances and longer duration between the first and last code instance also increased the PPV.

Conclusions:
An ICD-9 or -10 code for IIH had a PPV of 63% for probable or definite IIH in patients with necessary diagnostic testing performed at a single institution. Coding accuracy was improved in patients with an IIH ICD code assigned by an ophthalmologist. Use of coding algorithms considering treatment providers, number of codes, and treatment is a potential strategy to reduce misclassification bias in medical claims–based research on IIH. However, these are associated with a reduced sample size.
The impact of working during the Covid-19 pandemic on health care workers and first responders: mental health, function, and professional retention
Authors: Hendrickson Rebecca C. , Slevín Roisin A. , Chang Bernard P. , Sano Ellen , McCall Catherine , Raskind Murray A. 
Published: February 2022

AbstractBackgroundThe COVID-19 pandemic has greatly affected front line health care workers (HCW) and first responders (FR). The infection risk from SARS CoV-2, the high mortality of hospitalized COVID-19 patients and the duration of the pandemic have created sustained and often traumatic stressors affecting HCW and FR.ObjectivesTo assess the relationship of COVID-19 stressor frequency scores to psychiatric rating scale scores amongst HCW and FR. To determine if psychiatric rating scale scores mediate stressor effects on perceived work function and likelihood of remaining in current occupation.DesignObservational, self-report in a convenience sample.Participants118 HCW and FR caring for COVID-19 patients in the United States.Main MeasureCOVID-19 related stressor frequencies were assessed using a 17-item questionnaire. Psychiatric symptoms were assessed with the PTSD Checklist 5 (PCL5), the Patient Health Questionnaire 9 (for depression) (PHQ9), the Insomnia Severity Index (ISI), and the General Anxiety Disorder 7 (GAD7).Key ResultsStressor frequency scores correlated significantly with PCL5 scores (R=.57, p<1e-8), PHQ scores (R=.35, P<.001), ISI scores (R=.38, p<1e-4), and GAD7 scores (R=.39, p<.001), likelihood of staying in current occupation (R=-.39,p<1e-4), and trouble doing usual work (R=.33,p<.001). 51% of HCW and 44% of FR indicated decreased likelihood of staying in their current occupation. PCL5 scores substantially mediated the association between stress frequency scores and work function impairment.ConclusionsThese results direct attention to recognizing potentially treatable psychiatric symptoms, particularly those of PTSD, in HCW and FR experiencing COVID-19 related stressors. They also suggest that mitigating COVID-19 related stressors when possible, such as by providing adequate personal protective equipment, can improve HCW and FR mental health, work function and retention in the health care work force.Strengths and Limitations of this StudyDetailed assessments of participants’ exposure to covid-19 related occupational stressors, current psychiatric symptoms, and self-reported occupational functioning and likelihood of remaining in their current field (functional outcomes).Assessment of the dose-response relationship between exposure to covid-19 related occupational stressors and current psychiatric symptoms and functional outcomes.Mediation analysis quantifying the potential for current psychiatric symptoms to mediate the relationship between exposure to covid-19 related occupational stressors and functional outcomes.Limitations: convenience sample, limited numbers of first responder participants
Pooling for SARS-CoV2 Surveillance: Validation and Strategy for Implementation in K-12 Schools
Authors: Simas Alexandra M. , Crott Jimmy W. , Sedore Chris , Rohrbach Augusta , Monaco Anthony P. , Gabriel Stacey B. , Lennon Niall , Blumenstiel Brendan , Genco Caroline A. 
Published: February 2022

AbstractRepeated testing of a population is critical for limiting the spread of the SARS-CoV-2 virus and for the safe reopening of educational institutions such as K-12 schools and colleges. Many screening efforts utilize the CDC RT-PCR based assay which targets two regions of the novel Coronavirus nucleocapsid gene. The standard approach of testing each person individually, however, poses a financial burden to these institutions and is therefore a barrier to using testing for re-opening. Pooling samples from multiple individuals into a single test is an attractive alternate approach that promises significant cost savings - however the of specificity and sensitivity of such approaches needs to be assessed prior to deployment. To this end, we conducted a pilot study to evaluate the feasibility of analyzing samples in pools of eight by the established RT-PCR assay. Participants (1,576) were recruited from amongst the Tufts University community undergoing regular screening. Each volunteer provided two swabs, one analyzed separately and the other in a pool of eight. Because the positivity rate was very low, we spiked approximately half of the pools with laboratory-generated swabs produced from known positive cases outside the Tufts testing program. The results of pooled tests had 100% correspondence with those of their respective individual tests. We conclude that pooling eight samples does not negatively impact the specificity or sensitivity of the RT-PCR assay and suggest that his approach can be utilized by institutions seeking to reduce surveillance costs.
Prevalence Of Multi Drug Resistant Bacteria On Environmental And Medical Device Surfaces Of Korea Nepal Friendship Hospital
Authors: Paudel Nisha , Awasthi Nagendra Prasad , Lekhak Binod , Acharya Amrit 
Published: February 2022

ABSTRACTThe microbial monitoring of environmental and medical-devices’ surface is used to evaluate efficacy of routine cleaning and disinfection practises and to detect the presence of specific Nosocomial Pathogens. The prevalence of Multidrug Resistance organisms in hospital premises projects serious problems in transmitting to susceptible hosts which is difficult to treat. A cross sectional descriptive research was conducted from December 2016 to June 2017 at the pathology laboratory of Korea Nepal Friendship Hospital (KNFH). A total 140 samples were considered, encompassing the medical devices of the hospital (100), housekeeping surfaces (15) and air (25). Susceptibility test for bacterial isolates was done by disk diffusion assay. Of the total 140 samples taken and analysed, 100% showed growth positivity. In most of the swabs taken, Coagulase Negative Staphylococci was dominant, followed by Staphylococcus aureus, Streptococcus spp. Micrococcus spp., E coli, Pseudomonas spp., Bacillus spp., Acinetobacter spp., Klebsiella spp., Fungi, and least Proteus spp. The dry surfaces were dominantly contaminated by gram positive bacteria whereas moistened surfaces like wash basin were contaminated by gram negative as well as gram positive bacteria. Total 277 strains were exposed to various class of antibiotics, among the gram positive environmental isolates, Coagulase Negative Staphylococci 16 (34.78%) had highest MDR prevalence followed by Staphylococcus aureus 8 (29.62%), Streptococcus spp. 4 (12.90%), Micrococcus spp. 4 (9.30%) and no MDR was shown by any Bacillus spp isolates. Whereas, in case of gram negative, Klebsiella spp. 6 (35.29%) had highest MDR prevalencefollowed by Acinetobacter spp. 6 (31.57%), E. coli 8 (27.58%), Pseudomonas spp. 4 (18.18%), and lastly Proteus spp. with no MDR at all. The thick dirt covering the cotton swabs and heavy microbial load on them has displayed not only disinfecting practice but also cleaning practice is missing. Heavy contamination shows possible NIs breakout, it’s important to have routine microbial assessment with standard protocol and find ways to decrease its load.