bluuebunny/crossref_metadata_2025_split huggingface dataset:
Veno-Arterial Partial Pressure of Carbon Dioxide Difference as a Metric of Systemic Oxygen Delivery: Insights from a Correlative Meta-Analysis
Authors: Loomba Rohit S. , Farias Juan S. , Savorgnan Fabio , Acosta Sebastian , Flores Saul , Villarreal Enrique G. 
Published: March 2022

AbstractThe assessment of cardiac output and adequacy of systemic oxygen delivery in children after cardiac surgery require the use of an aggregate of hemodynamic monitors and blood tests. There are previously published data regarding the utility of the veno-arterial partial pressure of carbon dioxide difference (AVDco2) to help with this. This study pooled data on the correlation of AVDco2 with other metrics of cardiac output and systemic oxygen delivery such as arteriovenous oxygen saturation difference, venous saturation, and serum lactate. A systematic review of the literature was done to identify studies analyzing the correlation of AVDco2 with other hemodynamic and laboratory values. Data were extracted, and correlation coefficients were pooled for each specific comparison to create a point estimate for the overall correlation. A total of four studies with 350 patients and 809 paired blood gases were pooled. Adequate data were available to assess the correlation of AVDco2 with arteriovenous oxygen saturation difference, venous saturation, and serum lactate. There was a significant, moderate correlation with arteriovenous oxygen saturation difference and venous saturation. A significant, weak correlation with serum lactate was found. The AVDco2 has significant, moderate correlations with other metrics of the adequacy of systemic oxygen delivery such as arteriovenous oxygen saturation difference and venous saturation. There was a significant but only weak correlation with serum lactate. AVDco2 may be complementary to assess the adequacy of cardiac output and systemic oxygen delivery.
Opportunities for Antibiotic Stewardship Interventions in a Pediatric Hospital
Authors: Grewer-Katona Gabor , Hüebner Johannes , Pecar Alenka , Wolf Gerhard K. 
Published: March 2022

Abstract
Objective This study's objective was to assess an antibiotic stewardship intervention, compare pediatric antibiotic usage in a non-university hospital (Children's Hospital Traunstein [TS]) with a university hospital (Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich [MUC]), and assess adherence to national guidelines.
Methods Antibiotic usage pre- and post-antibiotic stewardship (ABS) intervention was compared, and antibiotic prescriptions over 4 months were prospectively recorded. ABS intervention consisted of weekly teaching sessions, antibiotic pocket cards, and rounds with pediatric infectious disease staff. Medical records were reviewed to describe antibiotic consumption, antibiotic dosages and length of use, and adherence to national guidelines. Pediatric antibiotic usage was compared between hospitals and patient groups.
Results After the ABS intervention, the use of second-generation cephalosporins decreased, while penicillin with β-lactamase inhibitors (BLI) increased. Survey of antibiotic prescriptions over the 4 months study period in the non-university hospital showed a high administration rate of second-generation cephalosporins and extended-spectrum penicillins in the non-intensive care units (ICU) wards (48.53 and 38.93 days of therapy [DoT]/1,000 patient days [PD], respectively) and a high rate of third-generation cephalosporins in the ICU ward (110.33 DoT/1,000PD). A high prescriptions rate was seen in the neonatal intensive care unit (NICU) wards (DoT/ length of therapy [LoT] ratio of 2.185). Reserve group antibiotics were only given in the ICU. Adherence to national guidelines was highest in the NICU and pediatric ICU wards. Striking was the relatively high rate of incorrect usage of second-generation cephalosporins. Comparing the pediatric wards of the non-university hospital (TS) and the university hospital (MUC), the prescription ratio was 11.1% (TS) versus 30.6% (MUC), and DoT/1,000PD 198.9 (TS) versus 483.6 (MUC), p = 0.02. ABS intervention changed the choice of described antibiotics, but not the overall frequency.
Conclusion Adherence to national guidelines was highest in fields with standardized therapy recommendations, like in the NICU. In MUC, antibiotics, in particular restricted ones, were prescribed more frequently, probably due to higher severity of illness.These data indicate that the usage of antibiotics and adherence to national guidelines show a wide variety, but ABS interventions were effective in changing prescription behavior.
Influence of shape effect on dynamic surface charge transport mechanism of cellular electret after corona discharge
Authors: ZHANG Jiawei , ZHANG Zelei , MATSUMOTO T , GAO Qingqing , LIU Yuanye , NISHIJIMA K , LIU Yifan 
Published: March 2022

Abstract
Surface charge accumulation and transport on cellular polypropylene play an important role in nanogenerators, which could have a potential impact on energy harvesting and wearable devices for zero carbon energy systems and the internet of things. Different shapes have different charge accumulation and decay characteristics of the polymer. Therefore, we studied the influence of the sample’s shape on the surface charge decay by experiment and modeling. The surface potential of square and circular cellular polypropylene was measured by a two-dimensional surface potential measurement system with electrostatic capacitive probe. The experimental result shows that the surface potential distribution of the square sample dissipates non-uniformly from the bell shape to a one-sided collapsed shape, while that of the circular sample dissipates uniformly from the bell shape to the crater-like shape. Moreover, the simulated results of the initial surface potential distributions of the square and circular cellular polypropylene are consistent with the experimental results. The investigation demonstrates that the charge transport process is correlated with the shape of the sample, which provides significant reference for designing electret material used for highly efficient nanogenerators.
MultiBaC: an R package to remove batch effects in multi-omic experiments
Authors: Ugidos Manuel , Nueda María José , Prats-Montalbán José M , Ferrer Alberto , Conesa Ana , Tarazona Sonia 
Published: March 2022

AbstractMotivationBatch effects in omics datasets are usually a source of technical noise that masks the biological signal and hampers data analysis. Batch effect removal has been widely addressed for individual omics technologies. However, multi-omic datasets may combine data obtained in different batches where omics type and batch are often confounded. Moreover, systematic biases may be introduced without notice during data acquisition, which creates a hidden batch effect. Current methods fail to address batch effect correction in these cases.ResultsIn this article, we introduce the MultiBaC R package, a tool for batch effect removal in multi-omics and hidden batch effect scenarios. The package includes a diversity of graphical outputs for model validation and assessment of the batch effect correction.Availability and implementationMultiBaC package is available on Bioconductor (https://www.bioconductor.org/packages/release/bioc/html/MultiBaC.html) and GitHub (https://github.com/ConesaLab/MultiBaC.git). The data underlying this article are available in Gene Expression Omnibus repository (accession numbers GSE11521, GSE1002, GSE56622 and GSE43747).Supplementary informationSupplementary data are available at Bioinformatics online.
fastISM: performantin silicosaturation mutagenesis for convolutional neural networks
Authors: Nair Surag , Shrikumar Avanti , Schreiber Jacob , Kundaje Anshul 
Published: March 2022

AbstractMotivationDeep-learning models, such as convolutional neural networks, are able to accurately map biological sequences to associated functional readouts and properties by learning predictive de novo representations. In silico saturation mutagenesis (ISM) is a popular feature attribution technique for inferring contributions of all characters in an input sequence to the model’s predicted output. The main drawback of ISM is its runtime, as it involves multiple forward propagations of all possible mutations of each character in the input sequence through the trained model to predict the effects on the output.ResultsWe present fastISM, an algorithm that speeds up ISM by a factor of over 10× for commonly used convolutional neural network architectures. fastISM is based on the observations that the majority of computation in ISM is spent in convolutional layers, and a single mutation only disrupts a limited region of intermediate layers, rendering most computation redundant. fastISM reduces the gap between backpropagation-based feature attribution methods and ISM. It far surpasses the runtime of backpropagation-based methods on multi-output architectures, making it feasible to run ISM on a large number of sequences.Availability and implementationAn easy-to-use Keras/TensorFlow 2 implementation of fastISM is available at https://github.com/kundajelab/fastISM. fastISM can be installed using pip install fastism. A hands-on tutorial can be found at https://colab.research.google.com/github/kundajelab/fastISM/blob/master/notebooks/colab/DeepSEA.ipynb.Supplementary informationSupplementary data are available at Bioinformatics online.
Efficacy of surgeon performed ultrasound scan in localization of parathyroid adenomas in patients with primary hyperparathyroidism
Authors: Habib Ayaaz , Snowden Chris , England James 
Published: March 2022

Abstract

Introduction
The success of minimally invasive parathyroid surgery is largely based on accurate preoperative localization of parathyroid adenomas. In the U.K, NICE guidance recommends either ultrasound scanning alone or combined with sestamibi scintigraphy to help guide surgery. In the recent past, surgeon performed ultrasound (SUS) has been adopted in North America and Australia for preoperative localization with a sensitivity of 63–91%. This was equivalent or superior to radiology performed ultrasound (RUS). In comparison, data from the U.K for surgeon performed imaging is sparse. In this study, we investigate the efficacy of surgeon performed ultrasound in localization of parathyroid disease and discuss its cost benefits.

Methods
This is a prospective study with data collected from November 2019 to June 2021. All patients had primary hyperparathyroidism and underwent either MIBI, radiology performed ultrasound or both. A single experienced surgeon performed ultrasound on all patients under general anaesthesia. The intraoperative findings were used to determine the accuracy of all imaging techniques.

Results
A total of 46 patients underwent surgery and were found to have single gland disease. The categories were: Double imaging (n=17), MIBI (n=34), RUS (n=22), SUS(n=46), no imaging (n=9). MIBI, radiology performed ultrasound and surgeon performed ultrasound had sensitivities of 58%, 55% and 81% respectively. 8 patients had ectopic glands and were not included in the sensitivity analysis of ultrasound scans.

Conclusion
Surgeon performed ultrasound by an experienced provider is effective in localizing parathyroid adenomas and guides minimally invasive surgery. It could significantly reduce costs associated with outpatient radiology performed ultrasound scanning
Intraoperative use of tranexamic acid eliminates bleeding complications in thyroid and parathyroid surgery
Authors: Karakozis Lampros , Karageorgou Maria , Alexandrou Nikolaos , Karakozis Stavros 
Published: March 2022

Abstract

Introduction
Postoperative neck bleeding is a rare but life-threatening complication in thyroid and parathyroid surgery. It requires an emergency treatment algorithm to prevent asphyxia and severe brain injury. Tranexamic acid is an antifibrinolytic medication which treats or prevents excessive blood loss in a variety of clinical situations such as, major trauma, postpartum bleeding, and heavy menstruation. We studied the use of tranexamic acid to eliminate the incidence of postoperative neck hematoma.

Methods
All thyroid and parathyroid patients operated from the same surgical team were evaluated. The patients were divided in two groups: Group A before and Group B after the use of tranexamic acid. The medication was used intravenously to all Group B patients during the hemostasis control and prior the neck wound closure.

Results
A total of 1457 consecutive patients were studied from 01-01-2001 to 06-06-2021. Group A included 669 patients (620 thyroid and 49 parathyroid patients) from 01-01-2001 until 27-06-2018. Group B included 788 patients (705 thyroid and 83 parathyroid patients) from 27-06-2018 until 06-06-2021. Group A had 15 (2,24% incidence) postoperative neck hematomas and 6 of them (0,89%) required emergency surgical drainage. Group B had no postoperative bleeding episodes with the intraoperative use of tranexamic acid.

Conclusion
The use of tranexamic acid eliminates postoperative bleeding episodes in thyroid and parathyroid surgery.
Molecular testing in the diagnosis and management of thyroid malignancy: a feasibility study
Authors: Anneback Matilda , Damji Samir , Flora Rashpal , Tolley Neil , Palazzo Fausto , DiMarco Aimee 
Published: March 2022

Abstract

Background
NHS England’s reorganization of genomic testing has provided an opportunity to explore molecular testing as part of thyroid nodule diagnostics and the routine postoperative histology.

Aim
Routine molecular testing in an NHS service has not previously been explored. This study aims to evaluate whether (1) there is sufficient material to perform this on an FNAC in cytologically indeterminate nodules (2) what the yield is from indeterminate nodules (3) whether post-operative testing is feasible and (4) whether management is altered.

Methods
This in an ongoing feasibility study in a UK tertiary institution commenced in January 2021. Data until May in presented. Two groups are enrolled: those with indeterminate pre-operative cytology and those who have undergone thyroidectomy for malignancy. FNAC samples were sent for a routine panel including BRAFv600e, H-K-NRAS and histology for TP53, RET and NTRK in addition.

Results
Out of 30 patients with indeterminate cytology, molecular testing was requested in eight. The material was insufficient for added molecular testing in six and the panel of mutations tested was negative in two.
Thirty-one patients underwent thyroidectomy for malignancy and 11 surgical specimens underwent molecular testing. Mutations were detected in 54.5%(n=6). BRAFv600e mutation was found in four specimens with PTC, whereas NRAS mutation was detected in one Hobnail variant of PTC and one minimal invasive follicular carcinoma.

Conclusion
Addition of molecular testing to preoperative cytology was shown to require a further FNAC in a majority of cases. In postoperative specimens, molecular testing is feasible but further follow-up is required to determine whether clinical management is altered.
Parathyroid Cancer: A single centre experience of the Endocrine Surgical Care Group.
Authors: Galata' Gabriele , Hubbard Johnathan , Talat Nadia , Anscomb Natalie , Klang Patrick , Al-Lawati Ammar , Aldrees Abdulaziz , Schulte Klaus-Martin 
Published: March 2022

Abstract

Aim
Parathyroid Cancer is a rare condition (&lt;3% of Primary Hyperparathyroidism). Under staging/treatment can have disastrous consequences. Risk of local recurrence, distal metastases and death is as double of those treated appropriately.
This study shows the experience of a single centre with the objective of demonstrating the importance of preoperative diagnosis, staging and initial treatment showing the difference and improved outcomes for patients appropriately treated applying the Schulte’s 3 + 3 rule.

Methods
Retrospective single centre review. The data consists of patients whom underwent oncological Parathyroidectomy between 2005 and 2020 at King’s College Hospital. SPSS software was used for analysis.

Results
38 patients were included in the study: 10 patients underwent local excision; 28 underwent oncological resection (unilateral en-bloc resection of thyroid lobe, both parathyroids and level VI lymphadenectomy). Three patients who underwent local excision elsewhere had local recurrence and were referred to our centre for further treatment. One patient with pre-operative lung metastases, underwent oncological resection had also local recurrence and died after 12 years follow up. One patient with single lung met who underwent oncological resection and excision of lung met is free of disease after 10 years. Thirty-three patients are free of disease. Average pre-operative Calcium was 3.01nmol/L, PTH 287ng/L and size 36mm.

Conclusion
Under staging/treatment showed 12-fold increase in recurrence rates. The only observed recurrence in patients that underwent initial en-bloc resection was related to advance staging/distant metastasis. This highlights the importance of recognising pre-operative indicative factors for appropriate surgical planning, reducing risk of recurrence/death.
Outcomes of surgery and treatment with selective RET TK inhibitor Selpercatinib in children with MEN2 and advanced MTC
Authors: Kurzawinski Tom , Hubbard Jonathan , Aziz Tarek Abdel , Butler Colin , Gaze Mark , Brain Caroline , Marshall Lynley , Shankar  
Published: March 2022

Abstract

Background
Patients with MEN2 without family history often present late with advanced MTC. Surgery is not always curative but RET tyrosine kinase pathway is a potential target for molecular treatment for progressive MTC.

Methods
Retrospective review of clinical, genetic, biochemical and imaging data of children with MEN2 who developed recurrent and progressive MTC after surgery and were treated with Selpercatinib, a selective RET TK inhibitor. The main parameters were safety, efficacy and objective treatment response.

Results
Six children (3M,3–12years,4x2B,2x2A,RET918,804) presented with palpable lymphadenopathy(5) and elevated calcitonin (median 6560ng/L,140-46850). Five had metastatic disease on imaging. All had total thyroidectomy with unilateral(2) and bilateral(2) levels 2,3,4,5,6 lymphadenectomy and resections of JV(1), RLN(2), Vagus(1). Post-operative complications included transient(3) and permanent(1) hypoparathyroidism and Horner’s syndrome(2). Two children had second surgery and one EBRT complicated by delayed oesophageal perforation and stridor requiring tracheostomy. None of the children were cured and all had disease progression evidenced by clinical deterioration, rising calcitonin and CEA(3) and worsening radiology(5). All children received Selpercatinib (92mg/m2/dose) orally twice daily. The objective clinical, radiological and biochemical response was 100% with complete resolution of all clinical symptoms (third month) and significant decrease of calcitonin and CEA within 4 weeks. Four had partial radiological response(1–3months). No child had to discontinue Selpercatinib because of a drug toxicity. Median follow up was 13 months(10–20months).

Conclusions
Children with MEN2 and advanced MTC can’t be cured by surgery and EBRT alone, but Selpercatinib has shown remarkable therapeutic efficacy with clinical, biochemical and radiological improvement and minimal toxicity.
4DCT as first line imaging during Covid pandeminc
Authors: Karamali Katerina , Salau Eniola , Das Tilak , Scoffings Daniel , Casey Ruth , Masterson Liam , Fish Brian 
Published: March 2022

Abstract

Aim
The Covid-19 pandemic encouraged prompt modification to clinical practice to minimise hospital attendances in an aim to minimize exposure and protection of the NHS whilst maintaining the standards of patient care. Current literature advocates that Four-Dimensional Computerised Tomography (4DCT) has equal diagnostic value as ultrasound alone or a combination of ultrasound and Sestamibi scan in the identification of abnormal parathyroid glands in the work up for surgical management of hyperparathyroidism. In response to the evolving pandemic at Addenbrookes we modified our practice and escalated 4DCT as our first line imaging. In light of this we had a unique opportunity to evaluate the diagnostic value of the currently used imaging modalities.

Methods
This is a retrospective study of 270 parathyroidectomies who underwent pre-operative 4DCT (n=270), ultrasound (n= 254) and sestamibi scan (n=253). Subsequently, we assessed the accuracy of these three modalities with the of intra-operative findings, histology, post-operative calcium and PTH.

Results
The sensitivity of the 4DCT was 77% in comparison to 43% sensitivity of the ultrasound alone. (p&gt;0.05). The combined sensitivity of ultrasound and Sestamibi scan was found to be 69%.

Conclusion
The implementation of 4DCT as a single modality diagnostic imaging can be considered equally effective and accurate in the diagnosis of parathyroid abnormality. Implementing this would reduce the number of diagnostic tests improving the likelihood of successful operative planning and reduce financial cost.
Risk of malignancy of BTA/RCPath Thyroid cytopathology diagnostic categories in a specialist cytopathology centre
Authors: HOMER Jarrod , Bowen Alex , Enarche Alina , Rana Durgesh , Holbrook Miles , Shelton David 
Published: March 2022

Abstract

Aim
Fine Needle Aspiration Cytology (FNAC) remains the primary determinant of management options for a patient with a U3-5 thyroid nodule. There is significant variation in risk of malignancy (ROM) between different centres, possibly reflecting the degree of specialist reporting and interpretation of RCPath guidance. The aims of this study is to report on ROM of FNAC categories in a specialist cytopathology centre.

Methods
Consecutive thyroid FNAC results were analysed over 2 years (2017/18), all reported by dedicated cytopathologists and suspicious samples were peer reviewed. Cases suspicious for NIFTP/FVPTC were classified as Thy4. U-grade was recorded if classified during ultrasonography. Results were analysed with regard to histology available on thyroid surgery and/or clinical follow up.

Results
There were 695 samples from 567 patients. The ROM in each category was: Thy1(6%); Thy2(1%), Thy3a(13%); Thy3f(11%); Thy4(27%); Thy 5(100%). In addition, 34/86 Thy3a nodules were subject to repeat FNAC, with 19 reported as Thy2, 7 as Thy3a again, 1 as Thy3f and 2 as Thy4 on second FNAC. We found that stratification of Thy3a-3f-4 by U grade did not help with risk stratification.

Conclusions
Compared to the recent meta-analysis (Poller et al), we found a greatly reduced ROM in the Thy4 group (27% vs 79%), with smaller reductions in both Thy 3 groups in our specialised cytopathology centre. The reasons for this will be discussed. The descriptor of Thy 4 as “suspicious for malignancy” is inaccurate in our experience. Each centre should use their own figures when advising patients. Repeat FNAC for Thy3a lesions leads to &gt;20% potentially avoiding surgery.