bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic Characteristics of Cervical Deformity (CD) Using a Discriminant Analysis
Authors: Lafage Renaud , Virk Sohrab , Elysee Jonathan , Passias Peter , Ames Christopher , Hart Robert , Shaffrey Christopher , Mundis Gregory , Protopsaltis Themistocles , Gupta Munish , Klineberg Eric , Burton Douglas , Schwab Frank , Lafage Virginie ,   ISSG
Published: March 2022

Study Design:
This was a retrospective review of a prospectively collected database.

Objective:
The aim of this study was to delineate radiographic parameters that distinguish severe cervical spine deformity (CSD).

Summary of Background Data:
Our objective was to define parameters that distinguish severe CSD using a consensus approach combined with discriminant analysis as no system currently exists in the literature.

Methods:
Twelve CSD surgeons reviewed preoperative x-rays from a CSD database. A consensus was reached for categorizing patients into a severe cervical deformity (sCD), non–severe cervical deformity (non-sCD), or an indeterminate cohort. Radiographic parameters were found including classic cervical and spinopelvic parameters in neutral/flexion/extension alignment. To perform our discriminant analysis, we selected for parameters that had a significant difference between the sCD and non-sCD groups using the Student t test. A discriminant function analysis was used to determine which variables discriminate between the sCD versus non-sCD. A stepwise analysis was performed to build a model of parameters to delineate sCD.

Results:
A total of 146 patients with cervical deformity were reviewed (60.5±10.5 y; body mass index: 29.8 kg/m2; 61.3% female). There were 83 (56.8%) classified as sCD and 51 (34.9%) as non-sCD. The comparison analysis led to 16 radiographic parameters that were different between cohorts, and 5 parameters discriminated sCD and non-sCD. These parameters were cervical sagittal vertical axis, T1 slope, maximum focal kyphosis in extension, C2 slope in extension, and number of kyphotic levels in extension. The canonical coefficient of correlation was 0.689, demonstrating a strong association between our model and cervical deformity classification. The accuracy of classification was 87.0%, and cross-validation was 85.2% successful.

Conclusions:
More than one third of a series of CSD patients were not considered to have a sCD. Analysis of an initial 17 parameters showed that a subset of 5 parameters can discriminate between sCD versus non-sCD with 85% accuracy. Our study demonstrates that flexion/extension images are critical for defining severe CD.
Iatrogenic retroperitoneal hematoma as an access-site complication of neurointervention
Authors: Tai Wei-An , Wu Chia-Hung , Ling Kan , Chen Shu-Ting , Lin Te-Ming , Hwang Hsuen-En , Luo Chao-Bao , Guo Wan-Yuo , Chang Feng-Chi 
Published: March 2022

Background:
To evaluate the clinical and imaging presentation, management, and outcome of iatrogenic retroperitoneal hematomas (IRPHs) during a series of neurointerventional procedures (NIPs).

Methods:
Six IRPH patients with complications, including five renal subcapsular hematomas (RSH) and one retroperitoneal hemorrhage, were observed among 2290 NIPs performed at our hospital from 2000 through 2020. The medical records, neurointerventional techniques, imaging data, and management of these six IRPH patients were retrospectively reviewed. All six patients received preprocedural dual antiplatelet medication and intraprocedural heparinization.

Results:
All patients underwent right femoral access. The guidewires were not handled under full course fluoroscopy monitoring. The most common symptom of IRPH was periprocedural flank/abdominal pain (6/6, 100%), including five on the left side (83.3%). Hypotension or shock was observed in three patients (50%). Two patients (33%) were diagnosed intraoperatively by sonogram and received on-site treatment, whereas the other four were diagnosed by postprocedural abdominal computed tomography. Active extravasation from a renal artery was diagnosed by angiogram in the five patients with RSH and was successfully treated with embolization. Multiple bleeders in the branches of the renal artery were noted in three RSH patients (60%). The patient with retroperitoneal hematoma was treated conservatively.

Conclusion:
Unexplained periprocedural or postprocedural abdominal/flank pain, especially contralateral to the femoral access side of the NIPs, should raise the possibility of IRPH. To prevent IRPH, the authors suggest using full visual fluoroscopic monitoring for guidewire navigation during femoral catheterization of NIPs.
Complex Suicide: A Case Series
Authors: Singh Sonwani Nagendra , Ateriya Navneet , Kumar Verma Satish , Kumar Aggarwal Narinder 
Published: March 2022

ABSTRACT
Suicide is a common manner of death typically carried out via a specific mechanism. When a suicidal act is committed using more than one method, it is called a complex suicide. A complex suicide can be divided into planned and unplanned. We present three cases of complex suicide in which multiple methods were used and a previous history of self-harm was present. This case series highlights the significance of a detailed medicolegal death investigation, including interviews with relatives and other witnesses, and a thorough forensic autopsy/toxicological analysis to ascertain the cause and manner of death.
Proteome reveals antiviral host response and NETosis during acute COVID-19 in high-risk patients
Authors: Bauer Alina , Pachl Elisabeth , Hellmuth Johannes C. , Kneidinger Nikolaus , Frankenberger Marion , Stubbe Hans C. , Ryffel Bernhard , Petrera Agnese , Hauck Stefanie M. , Behr Jürgen , Kaiser Rainer , Scherer Clemens , Deng Li , Teupser Daniel , Ahmidi Narges , Muenchhoff Maximilian , Schubert Benjamin , Hilgendorff Anne 
Published: March 2022

AbstractSARS-CoV-2 remains an acute threat to human health, endangering hospital capacities worldwide. Many studies have aimed at informing pathophysiologic understanding and identification of disease indicators for risk assessment, monitoring, and therapeutic guidance. While findings start to emerge in the general population, observations in high-risk patients with complex pre-existing conditions are limited.To this end, we biomedically characterized quantitative proteomics in a hospitalized cohort of COVID-19 patients with mild to severe symptoms suffering from different (co)-morbidities in comparison to both healthy individuals and patients with non-COVID related inflammation. Deep clinical phenotyping enabled the identification of individual disease trajectories in COVID-19 patients. By the use of this specific disease phase assignment, proteome analysis revealed a severity dependent general type-2 centered host response side-by-side with a disease specific antiviral immune reaction in early disease. The identification of phenomena such as neutrophil extracellular trap (NET) formation and a pro-coagulatory response together with the regulation of proteins related to SARS-CoV-2-specific symptoms by unbiased proteome screening both confirms results from targeted approaches and provides novel information for biomarker and therapy development.Graphical AbstractSars-CoV-2 remains a challenging threat to our health care system with many pathophysiological mechanisms not fully understood, especially in high-risk patients. Therefore, we characterized a cohort of hospitalized COVID-19 patients with multiple comorbidities by quantitative plasma proteomics and deep clinical phenotyping. The individual patient’s disease progression was determined and the subsequently assigned proteome profiles compared with a healthy and a chronically inflamed control cohort. The identified disease phase and severity specific protein profiles revealed an antiviral immune response together with coagulation activation indicating the formation of NETosis side-by-side with tissue remodeling related to the inflammatory signature.
Human cytomegalovirus strain diversity and dynamics reveal the donor lung as a major contributor after transplantation
Authors: Külekci Büsra , Schwarz Stefan , Brait Nadja , Perkmann-Nagele Nicole , Jaksch Peter , Hoetzenecker Konrad , Puchhammer-Stöckl Elisabeth , Goerzer Irene 
Published: March 2022

AbstractMixed human cytomegalovirus (HCMV) strain infections are frequent in lung transplant recipients (LTRs). To date, the influence of the donor (D) and recipient (R) HCMV-serostatus on intra-host HCMV strain composition and replication dynamics after transplantation is only poorly understood.Here, we investigated ten pre-transplant lungs from HCMV-seropositive donors, and 163 sequential HCMV-DNA positive plasma and bronchoalveolar lavage samples from 50 LTRs with multiviremic episodes post-transplantation. The study cohort included D+R+ (38%), D+R− (36%), and D−R+ (26%) patients. All samples were subjected to quantitative genotyping by short amplicon deep sequencing, and 24 thereof were additionally PacBio long-read sequenced for genotype linkages.We find that D+R+ patients show a significantly elevated intra-host strain diversity compared to D+R− and D−R+ patients (P=0.0089). Both D+ patient groups display significantly higher replication dynamics than D− patients (P=0.0061). Five out of ten pre-transplant donor lungs were HCMV-DNA positive, whereof in three multiple HCMV strains were detected, indicating that multi-strain transmission via lung transplantation is likely. Using long reads, we show that intra-host haplotypes can share distinctly linked genotypes, which limits overall intra-host diversity in mixed infections. Together, our findings demonstrate donor-derived strains as a main source for increased HCMV strain diversity and dynamics post-transplantation, while a relatively limited number of intra-host strains may facilitate rapid adaptation to changing environments in the host. These results foster targeted strategies to mitigate the potential transmission of the donor strain reservoir with the allograft.
SARS-CoV-2 Omicron Variant Infection of Individuals with High Titer Neutralizing Antibodies Post-3rd mRNA Vaccine Dose
Authors: Roeder Alexa J. , Koehler Megan A. , Svarovsky Sergei , Jasbi Paniz , Seit-Nebi Alim , Gonzalez-Moa Maria J. , Vanderhoof John , McKechnie Davis , Edwards Baylee A. , Lake Douglas F. 
Published: March 2022

ABSTRACTBackgroundVaccination with COVID-19 mRNA vaccines prevent hospitalization and severe disease caused by wildtype SARS-CoV-2 and several variants, and likely prevented infection when serum neutralizing antibody (NAb) titers were >1:160. Preventing infection limits viral replication resulting in mutation, which can lead to the emergence of additional variants.MethodsDuring a longitudinal study to evaluate durability of a three-dose mRNA vaccine regimen (2 primary doses and a booster) using a rapid test that semi-quantitatively measures NAbs, the Omicron variant emerged and quickly spread globally. We evaluated NAb levels measured prior to symptomatic breakthrough infection, in groups infected prior to and after the emergence of Omicron.ResultsDuring the SARS-CoV-2 Delta variant wave, 93% of breakthrough infections in our study occurred when serum NAb titers were <1:80. In contrast, after the emergence of Omicron, study participants with high NAb titers that had received booster vaccine doses became symptomatically infected. NAb titers prior to infection were ≥1:640 in 64% of the Omicron-infected population, ≥1:320 (14%), and ≥1:160 (21%).DiscussionThese results indicate that high titers of NAbs elicited by currently available mRNA vaccines do not protect against infection with the Omicron variant, and that mild to moderate symptomatic infections did occur in a vaccinated and boosted population, although did not require hospitalization.
Spike mutations of the SARS-CoV-2 Omicron: more likely to occur in the epitopes
Authors: Li Hu , Chen Zhiwei , Liu Xiaoqing , Hu Peng 
Published: March 2022

AbstractAlmost two years since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in 2019, and it is still pandemic over the world. SARS-COV-2 continuing to mutate and evolve, which further exacerbated the spread of the epidemic. Omicron variant, as an emerging mutation recently in South Africa, spreaded fastly to other countries worldwide. However, the gene charicterstic of Omicron and the effect on epitopes are still unclear. In this study, we retrieved 800 SARS-CoV-2 full-length sequences from GISAID database on 14 December 2021 (Alpha 110, Beta 101, Gamma 108, Delta 110, Omicron 107, Lambda 98, Mu 101, GH/490R 65). Overall, 1320 amino acid (AA) sites were mutated in these 800 SARS-CoV-2 sequences. Covariant network analysis showed that the covariant network of Omicron variant was significantly different from other variants. Further, 218 of the 1320 AA sites were occurred in the S gene, including 78 high-frequency mutations (>90%). Notably, we identified 25 unique AA mutations in Omicron, which may affect the transmission and pathogenicity of SARS-CoV-2. Finally, we analyzed the effect of Omicron on epitope peptide. As expected, 64.1% mutations (25/39) of Omicron variants were in epitopes, which was significantly higher than in other variants. These mutations may cause a poor response to vaccines to Omicron variants. In conclusion, Omicron variants, as an emerging mutation, should be alerted for us due that it may lead to poor vaccine response, and more data is needed to evaluate the virulence and vaccines responses to this variants.
Open label phase I/II clinical trial and predicted efficacy of SARS-CoV-2 RBD protein vaccines SOBERANA 02 and SOBERANA Plus in children
Authors: Puga-Gómez Rinaldo , Ricardo-Delgado Yariset , Rojas-Iriarte Chaumey , Céspedes-Henriquez Leyanis , Piedra-Bello Misleidys , Vega-Mendoza Dania , Pestana Pérez Noelvia , Paredes-Moreno Beatriz , Rodríguez-González Meiby , Valenzuela-Silva Carmen , Sánchez-Ramírez Belinda , Rodríguez-Noda Laura , Pérez-Nicado Rocmira , González-Mugica Raul , Hernández-García Tays , Fundora-Barrios Talía , Echevarría Martha Dubet , Enriquez-Puertas Juliet María , Infante Hernández Yenicet , Palenzuela-Díaz Ariel , Gato-Orozco Evelyn , Chappi-Estévez Yanet , Francisco-Pérez Julio Cesar , Martinez Miladi Suarez , Castillo-Quintana Ismavy C. , Fernandez-Castillo Sonsire , Climent-Ruiz Yanet , Santana-Mederos Darielys , García-Vega Yanelda , Toledo-Romani María Eugenia , Doroud Delaram , Biglari Alireza , Valdés-Balbín Yury , García-Rivera Dagmar , Vérez-Bencomo Vicente ,   SOBERANA Research Group
Published: March 2022

AbstractObjectivesTo evaluate heterologous vaccination scheme in children 3-18 y/o combining two SARS-CoV-2 r-RBD protein vaccines.MethodsA phase I/II open-label, adaptive and multicenter trial evaluated the safety and immunogenicity of two doses of SOBERANA02 and a heterologous third dose of SOBERANA Plus in 350 children 3-18 y/o in Havana Cuba. Primary outcomes were safety (in phase I) and safety/immunogenicity (in phase II) measured by anti-RBD IgG ELISA, molecular and live-virus neutralization titers and specific T-cells response. A comparison with adult‘s immunogenicity and prediction of efficacy were done based on immunological resultsResultsLocal pain was the unique adverse event with frequency >10%, none was serious or severe. Two doses of SOBERANA 02 elicited humoral immune response similar to natural infection; the third dose increased significantly the response in all children, similar to that achieved in vaccinated young adults and higher than in convalescents children. The neutralizing titer was evaluated in a participant‘s subset: GMT was 173.8 (CI 95% 131.7; 229.5) vs. alpha, 142 (CI 95% 101.3; 198.9) vs. delta and 24.8 (CI 95% 16.8; 36.6) vs. beta. An efficacy > 90% was estimated.ConclusionThe heterologous scheme was safe and immunogenic in children 3-18 y/o. Trial registry: https://rpcec.sld.cu/trials/RPCEC00000374
COVID-19 Hospitalisation in Portugal, the first year: Results from hospital discharge data
Authors: Pereira João F. , Caetano Constantino , Antunes Liliana , Patrício Paula , Luísa Morgado Maria , Nunes Baltazar 
Published: March 2022

AbstractUsing Portuguese diagnosis-related groups (DRGs) data we analysed the dynamics of the COVID-19 hospitalisation in Portugal, with the ultimate goal of estimating parameters to be used in COVID-19 mathematical modelling.After processing the data, corresponding to the period between March 2020 and the end of March 2021, an exploratory analysis was conducted, in which the length of stay (LoS) in hospital care, the time until death (TuD), the number of admissions and mortality count were estimated and described with respect to the age and gender of the patients, but also by region of admission and evolution over time.The median and mean of LoS was estimated to be 8 and 12.5 days (IQR:4-15) for non-ICU patients and for ICU patients as 18 and 24.3 days (IQR:11-30). The percentage of patients that, during their hospitalisation, required ICU care was determined to be 10.9%. In-hospital mortality of non-ICU patients (22.6%) and of ICU patients (32.8%) were also calculated. In a visual exploratory analysis we observed that they changed with time, age group, gender and region.Various univariable probability distributions were fitted to the LoS and TuD data, using maximum likelihood estimation (MLE) but also maximum goodness-of-fit estimation (MGE) to obtain the distribution parameters.AMS Subject Classification62-07,62E07,62F10,62P10
Features of an aseasonal 2021 RSV epidemic in the UK and Ireland: analysis of the first 10,000 patients
Authors: Roland D , Williams TC , Lyttle MD , Marlow R , Hardelid PC , Sinha I , Swann OV , Maxwell-Hodkinson A , Cunningham S 
Published: March 2022

AbstractBronchStart is a prospective cohort study of infants with clinical bronchiolitis attending Emergency Departments in the United Kingdom and Ireland. We found the 2021 summer lower respiratory tract infection peak, although temporally disrupted and with an attenuated disease burden, predominantly affected younger age groups as in previous years.
Immunogenicity and reactogenicity against the SARS-CoV-2 variants following heterologous primary series involving CoronaVac and ChAdOx1 and BNT162b2 plus heterologous BNT162b2 booster vaccination: An open-label randomized study in healthy Thai adults
Authors: Niyomnaitham Suvimol , Toh Zheng Quan , Wongprompitak Patimaporn , Jansarikit Laddawan , Srisutthisamphan Kanjana , Sapsutthipas Sompong , Jantraphakorn Yuparat , Mingngamsup Natthakarn , Licciardi Paul V , Chokephaibulkit Kulkanya 
Published: March 2022

AbstractWe evaluated the immunogenicity and reactogenicity of heterologous COVID-19 primary series vaccination schedules. Participants were randomized to one of seven groups that received two-dose homologous BNT162b2 or heterologous combinations of CoronaVac, ChAdOx1 and BNT162b2, with 4 weeks interval. Of 210 participants, median age was 38 (19-60) years, 51% were female. The groups that received BNT162b2 as second dose induced the highest virus-specific IgG response against the ancestral strain [BNT162b2: geometric mean concentration (GMC) 2133-2249, 95%CI 1558 to 3055; ChAdOx1: 851-1201, 95%CI 649 to 1522; CoronaVac: 137-225, 95%CI 103-286 BAU/mL], neutralising antibodies (NAb) against Beta and Delta, and interferon gamma response. All groups induced low to negligible NAb against Omicron. A BNT162b2 booster (3rd dose) following heterologous CoronaVac and ChAdOx1 regimens induced >140-fold increase in NAb titres against Omicron. Our findings indicate that heterologous regimens using BNT162b2 as the second dose may be considered an alternative schedule to maximize immune response.
Evaluation of the role of home rapid antigen testing to determine isolation period after infection with SARS-CoV-2
Authors: Cosimi Lisa A. , Kelly Christina , Esposito Samantha , Seitz Scott , Sher-Jan Cole , Turcinovic Jacquelyn , Friedman Kelley , Nashed Michael , Souweine Jesse , Fitzgerald Nicholas , Gabriel Stacey , Connor John H. , Hung Deborah 
Published: March 2022

AbstractImportanceRecent CDC COVID-19 isolation guidance for non-immunocompromised individuals with asymptomatic or mild infection allows ending isolation after 5 days if asymptomatic or afebrile with improving symptoms. The role of rapid antigen testing in further characterizing the risk of viral transmission to others is unclear.ObjectiveUnderstand rates of rapid antigen test (RAT) positivity after day 5 from a positive COVID-19 test and the relationship of this result to symptoms and viral culture.DesignIn this single center, observational cohort study, ambulatory individuals newly testing SARS-CoV-2 positive completed daily symptom logs, and RAT self-testing starting day 6 until negative. Anterior nasal and oral swabs were collected on a subset for viral culture.Main Outcomes and MeasuresDay 6 SARS-CoV-2 RAT result, symptoms and viral culture.Results40 individuals enrolled between January 5 and February 11, 2022 with a mean age of 32 years (range 22 to 57). 23 (58%) were women and 17 (42%) men. All were vaccinated. 33 (83%) were symptomatic. Ten (25%) tested RAT negative on day 6. 61 of 90 (68%) RATs performed on asymptomatic individuals after day 5 were positive. Day 6 viral cultures were positive in 6 (35%) of 17 individuals. A negative RAT or being asymptomatic on day 6 were 100% and 78% predictive respectively for negative culture, while improving symptoms was 69% predictive. A positive RAT was 50% predictive of positive culture.Conclusion and RelevanceRATs are suboptimal in predicting viral culture results on day 6. Use of routine RATs to guide end of COVID-19 isolation could result in significant numbers of culture negative, potentially non-infectious individuals undergoing prolonged isolation. However, a negative RAT was highly predictive of being culture negative. Complete absence of symptoms was inferior to a negative RAT in predicting a negative culture result, but performed better than improving symptoms. If a positive viral culture is a proxy for infectiousness, these data may help further refine a safer strategy for ending isolation.