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1,301 results for “retrospective study”
Examining patterns in opioid prescribing for non-cancer-related pain in Wales: preliminary data from a retrospective cross-sectional study using large datasets
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Associations of serum uric acid with cardiovascular disease risk factors: a retrospective cohort study in Southeastern China
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Could dementia be detected from UK primary care patients' records by simple automated methods earlier than by the treating physician? A retrospective case-control study - Extended Data
<p>Extended data for Article published in Wellcome Open Research (Appendices 1,2 & 3). </p> <p>Abstract of Article: </p> <p><strong>Background:</strong> Timely diagnosis of dementia is a policy priority in the United Kingdom (UK). Primary care physicians receive incentives to diagnose dementia; however, 33% of patients are still not receiving a diagnosis. We explored automating early detection of dementia using data from patients’ electronic health records (EHRs). We investigated: a) how early a machine-learning model could accurately identify dementia before the physician; b) if models could be tuned for dementia subtype; and c) what the best clinical features were for achieving detection.</p> <p><strong>Methods:</strong> Using EHRs from Clinical Practice Research Datalink in a case-control design, we selected patients aged >65y with a diagnosis of dementia recorded 2000-2012 (cases) and matched them 1:1 to controls; we also identified subsets of Alzheimer’s and vascular dementia patients. Using 77 coded concepts recorded in the 5 years before diagnosis, we trained random forest classifiers, and evaluated models using Area Under the Receiver Operating Characteristic Curve (AUC). We examined models by year prior to diagnosis, subtype, and the most important features contributing to classification.</p> <p><strong>Results:</strong> 95,202 patients (median age 83y; 64.8% female) were included (50% dementia cases). Classification of dementia cases and controls was poor 2-5 years prior to physician-recorded diagnosis (AUC range 0.55-0.65) but good in the year before (AUC: 0.84). Features indicating increasing cognitive and physical frailty dominated models 2-5 years before diagnosis; in the final year, initiation of the dementia diagnostic pathway (symptoms, screening and referral) explained the sudden increase in accuracy. No substantial differences were seen between all-cause dementia and subtypes.</p> <p><strong>Conclusions:</strong> Automated detection of dementia earlier than the treating physician may be problematic, if using only primary care data. Future work should investigate more complex modelling, benefits of linking multiple sources of healthcare data and monitoring devices, or contextualising the algorithm to those cases that the GP would need to investigate.</p>
Data from: Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: a retrospective study from Burkina Faso and simulated case analysis.
<p>Absolute numbers of COVID-19 cases and deaths reported to date in the sub-Saharan Africa (SSA) region have been relatively low. As a result, there has been limited investigation into deceased cases in the region, as well as the impacts of different case management strategies. We detail demographic, epidemiological, and clinical information derived from publicly available information on deceased cases in SSA and, for cases in Burkina Faso, from aggregate records at the Center Hospitalier Universitaire de Tengandogo. Logistic regression was conducted on a synthetic case population to evaluate the adjusted odds of survival for patients receiving oxygen therapy or convalescent plasma, based on therapeutic effectiveness observed for other respiratory illnesses. Across SSA, deceased cases have been predominantly male and over 50 years of age. After adjustment for sex, age, and underlying conditions, the odds of mortality among cases in the synthetic population not receiving oxygen therapy was significantly higher than those receiving oxygen (OR: 2.07; 95%CI: 1.56-2.75). Cases receiving convalescent plasma had 50% reduced odds of mortality (95%CI: 0.24-0.93).<b> </b>Investment in sustainable oxygen therapy could reduce COVID-19 deaths in SSA. Ongoing investigation into convalescent plasma is warranted, as data on its effectiveness specifically in treating COVID-19 becomes available.</p>
Predictors of abnormal computed tomography findings for paediatric head injury: a retrospective cohort study
<p class="MDPI17abstract"><b>Objectives:</b> Head injuries in children are common causes for visits to the emergency department (ED). Computed tomography<b> (</b>CT) scans are useful for confirming head injury diagnoses. However, radiation exposure from CT scans might cause lethal malignancies. We aimed to examine predictors for the indication of performing CT scans necessary for diagnosis.</p> <p class="MDPI17abstract"><b>Design:</b> Retrospective cohort study.</p> <p class="MDPI17abstract"><b>Setting:</b> Three EDs in Japan</p> <p class="MDPI17abstract"><b>Participants</b>: Patients aged <16 years with head trauma who underwent CT.</p> <p class="MDPI17abstract"><b>Primary and Secondary Outcome Measures</b>: The primary outcome measure was abnormal CT findings that were evaluated using the area under the receiver-operating characteristic curve (AUC). We derived predictors from three existing CDRs: Canadian Assessment of Tomography for Childhood Head Injury (CATCH), Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), and Paediatric Emergency Care Applied Research Network (PECARN).</p> <p class="MDPI17abstract"><b>Results:</b> Of 1,103 eligible patients, 410 were included in this study. There were 283 (68%) boys, and the median age was 2 years. In total, 35 (9%) patients showed an abnormality, 73 (18%) were admitted, and 3 (0.7%) underwent neurosurgery. We developed a CDR consisting of 6 predictors for identifying children with abnormal CT findings: (1) severe or worsening headache; (2) GCS <15; (3) signs of skull fracture; (4) hematoma; (5) loss of consciousness; and (6) altered mental status. Our CDR had a sensitivity of 74.3%, a specificity of 75.2%, a negative predictive value of 96.9%, and a positive predictive value of 21.8%. The AUC for our rule was not inferior to those for CATCH, CHALICE, and PECARN {0.75 (95% confidence interval [CI], 0.67-0.81) versus 0.64 (95% CI, 0.56-0.73; p<0.05), 0.68 (95% CI, 0.60–0.76; p=0.28), and 0.67 (95% CI, 0.60-0.74); p=0.10}.</p> <p class="MDPI17abstract"><b>Conclusions:</b> Our findings suggest that a CDR, which lowers the frequency of CT in children with head injuries, must be developed and validated.</p>
Aetiology and prognostic risk factors of mortality in pneumonia patients receiving glucocorticoids alone or glucocorticoids and other immunosuppressants: a retrospective cohort study
<p><b>Objectives:</b> Long-term use of high-dose glucocorticoids can lead to severe immunosuppression and increased risk of treatment-resistant pneumonia and mortality. We investigated the aetiology and prognostic risk factors of mortality in hospitalised patients who developed pneumonia while receiving glucocorticoid therapy alone or glucocorticoid and other immunosuppressant therapies.</p> <p><b>Design:</b> Retrospective cohort study</p> <p><b>Setting: </b>Six secondary and tertiary academic hospitals in China</p> <p><b>Participants: </b>Patients receiving glucocorticoids who were hospitalised with pneumonia between 1<sup>st</sup> January 2013 and 31<sup>st</sup> December 2019.</p> <p><b>Main Outcomes: </b>We analysed<b> </b>the prevalence of comorbidities, microbiology, antibiotic susceptibility patterns, 30-day and 90-day mortality rates, and prognostic risk factors.</p> <p><b>Results</b>: A total of 716 patients were included, with pneumonia pathogens identified in 69.8% of patients. Significant morbidities occurred, including respiratory failure (50.8%), intensive care unit (ICU) transfer (40.8%), and mechanical ventilation (36%), with a 90-day mortality rate of 26.0%. Diagnosis of pneumonia occurred within 6 months of glucocorticoid initiation for 69.7% of patients with <i>Cytomegalovirus</i> (CMV) pneumonia and 79.0% of patients with <i>Pneumocystis jirovecii</i> pneumonia (PCP). Pathogens, including <i>Pneumocystis</i>, CMV, and multidrug-resistant bacteria, were identified more frequently in patients with persistent lymphocytopenia and high-dose glucocorticoid treatment (≥ 30 mg/day of prednisolone or equivalent within 30 days before admission). The 90-day mortality rate was significantly lower for non-CMV viral pneumonias than for PCP (<i>P</i> < 0.05), with a similar mortality rate as CMV pneumonias (24.2% vs 38.1% vs 27.4%, respectively).Cox regression analysis indicated <a name="_Hlk30339725"></a><a name="_Hlk31278800">several independent negative predictors for mortality in this patient population, including septic shock, respiratory failure, </a>persistent lymphocytopenia, interstitial lung disease, and high-dose glucocorticoid use.</p> <p><b>Conclusions</b>: Patients who developed pneumonia while receiving glucocorticoid therapy experienced high rates of opportunistic infections, with significant morbidity and mortality. These findings should be carefully considered when determining treatment strategies for this patient population.</p>
Association between seven-day serum β-hCG levels after frozen–thawed embryo transfer and pregnancy outcomes: a single-centre retrospective study from China
<p><span><b><span>Objective:</span></b> Early monitoring of plasma human chorionic gonadotropin (β-hCG) level is vital in predicting pregnancy outcome. This study investigated the predictive value of serum β-hCG level on the 7th day after frozen-thawed embryo transfer (FET) for ongoing pregnancy (OP) and adverse pregnancy (AP). </span></p> <p><span><b><span>Design: </span></b>Retrospective study</span></p> <p><span><b><span>Setting:</span></b> The Reproductive and Genetic Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China.</span></p> <p><span><b><span>Participants: </span></b>1,061 pregnant women who underwent FET between January 2014 and January 2017. </span></p> <p><span><b><span>Primary and secondary outcome measures: </span></b>Pregnancy outcome.</span></p> <p><span><b><span>Results: </span></b>Serum β-hCG levels on the 7th day after FET were higher in the single OP group compared to the biochemical pregnancy (BP) group (p <0.001). Besides, the serum β-hCG cutoff level at 4.34 mIU/mL on the 7th day showed high predictive value (area under the curve [AUC] = 0.852). Serum β-hCG levels on the 7th day after FET were higher in the twin OP group compared to the single OP group (p<0.001). Also, the serum β-hCG cutoff level at 17.95 mIU/mL on the 7th day showed high predictive value (AUC = 0.903). Serum β-hCG levels on the 7th day after FET were lower in the ectopic pregnancy (EP) group compared to the single OP group (p <0.001) whereas, serum β-hCG cutoff level at 4.53 mIU/mL on the 7th day exhibited a high predictive value (AUC = 0.860). Further, the serum β-hCG levels on the 7th day after FET were lower in the single early spontaneous abortion (SA) group compared to the single OP group (p<0.001) while the serum β-hCG cutoff level at 5.34 mIU/mL on the 7th day exhibited high predictive value (AUC = 0.738).</span></p> <p><span><b><span>Conclusion:</span></b> Serum β-hCG on the 7th day after FET has good clinical significance for the prediction of OP and AP.</span></p>
Prediction of femoral osteoporosis using machine-learning analysis with radiomics features and abdomen-pelvic CT: A retrospective single center preliminary study
<p>Dataset of prediction of osteoporosis using APCT, radiomics and machine learning analysis.</p>
Data from: Quality of evidence considered by Health Canada in granting full market authorization to new drugs with a conditional approval: a retrospective cohort study
Objectives: This study examines the characteristics of studies that Health Canada uses to grant full marketing authorization for products given a conditional approval between January 1, 1998 and June 30, 2017. Design: Cohort study. Data sources: Journal articles listing drugs that fulfilled their conditions and received full marketing authorization, Notice of Compliance database, Notice of Compliance with conditions web site, Qualifying Notices listing required confirmatory studies, clinicaltrials.gov, PubMed, Embase, companies making products being analyzed, journal articles resulting from confirmatory studies. Interventions: None Primary and secondary outcome measures: Characteristics of studies - study design (randomized controlled trials, observational), primary outcome used (clinical, surrogate), blinding, number of patients in studies, patient median age, number of men and women. Results: Eleven companies confirmed 36 publications for 19 products (21 indications). Twenty-nine out of the 36 studies were randomized controlled trials (RCTs) but only 10 stated if they were blinded. Twenty used surrogate outcomes. The median age of patients was 56 (interquartile range (IQR) 44, 61). The median number of men per study/trial was 184 (IQR 58, 514) versus women - 141 (IQR 46, 263). Conclusions: Postmarket studies required by Health Canada had more rigorous methodology than those required by either the Food and Drug Administration or the European Medicines Agency. There were still deficiencies in these studies. The absence of blinding in the majority of RCTs may introduce bias in their results. The use of surrogate outcomes especially in oncology trials means that improvements in survival are not available. The relatively young age of patients, even for products for cancer, means that predicting how the elderly will respond is often unknown. The almost universal finding that men outnumbered number women may make it hard to differentiate responses by sex. These results raise potential concerns about the quality of evidence that Health Canada accepts.
Effectiveness of steroid therapy on pneumonic chronic obstructive pulmonary disease exacerbation: a multi-centred retrospective cohort study
<p><span>Background</span></p> <p><span>To date, no consensus exists on the effects of steroid use on pneumonic chronic obstructive pulmonary disease (COPD) owing to trial design issues in previous trials involving these conditions. Therefore, we aimed to evaluate steroid effectiveness in pneumonic COPD exacerbation patients.</span></p> <p><span>Methods</span></p> <p><span>This multi-centred, retrospective, observational study was conducted across five acute general hospitals in Japan. We analysed the association between parenteral/oral steroid therapy and time to clinical stability in pneumonic COPD exacerbation. </span></p> <p><span>We used a validated algorithm derived from the 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10) to include pneumonic COPD exacerbation patients. We excluded patients with other hypoxia causes (asthma exacerbation, pneumothorax, heart failure) and complicated pneumonia (obstructive pneumonia, empyema), those who required tracheal intubation/vasopressors, and those who were clinically stable on the admission day. </span></p> <p><span>The primary outcome was time to clinical stability. Multiple imputation was used for missing data. Propensity scores within each imputed dataset were calculated using potential confounding factors. The Fine and Gray model was used within each dataset to account for the competing risk of death and hospital discharge without clinical stability, and we combined the results.</span></p> <p><span>Results</span></p> <p><span>Altogether, 1237 patients were included. The pooled estimated subdistribution hazard ratio of time to clinical stability in steroid versus non-steroid users was 0.89 (95% confidence interval, 0.78<a name="_Hlk33128668"> to</a> 1.03). However, there were potentially unmeasured confounders, and we could not assess longer-term outcomes.</span></p> <p><span>Conclusions</span></p> <p><span>The current study recommends that steroid therapy should not be used routinely for pneumonic COPD exacerbation.</span></p>
Data from: Agreements between industry and academia on publication rights: a retrospective study of protocols and publications of randomized clinical trials
Background: Little is known about publication agreements between industry and academic investigators in trial protocols and the consistency of these agreements with corresponding statements in publications. We aimed to investigate (i) the existence and types of publication agreements in trial protocols, (ii) the completeness and consistency of the reporting of these agreements in subsequent publications, and (iii) the frequency of co-authorship by industry employees. Methods and Findings: We used a retrospective cohort of randomized clinical trials (RCTs) based on archived protocols approved by six research ethics committees between 13 January 2000 and 25 November 2003. Only RCTs with industry involvement were eligible. We investigated the documentation of publication agreements in RCT protocols and statements in corresponding journal publications. Of 647 eligible RCT protocols, 456 (70.5%) mentioned an agreement regarding publication of results. Of these 456, 393 (86.2%) documented an industry partner's right to disapprove or at least review proposed manuscripts; 39 (8.6%) agreements were without constraints of publication. The remaining 24 (5.3%) protocols referred to separate agreement documents not accessible to us. Of those 432 protocols with an accessible publication agreement, 268 (62.0%) trials were published. Most agreements documented in the protocol were not reported in the subsequent publication (197/268 [73.5%]). Of 71 agreements reported in publications, 52 (73.2%) were concordant with those documented in the protocol. In 14 of 37 (37.8%) publications in which statements suggested unrestricted publication rights, at least one co-author was an industry employee. In 25 protocol-publication pairs, author statements in publications suggested no constraints, but 18 corresponding protocols documented restricting agreements. Conclusions: Publication agreements constraining academic authors' independence are common. Journal articles seldom report on publication agreements, and, if they do, statements can be discrepant with the trial protocol.
Data from: Delays and loss to follow up before treatment of drug-resistant TB following implementation of Xpert MTB/RIF in South Africa: a retrospective cohort study
Background: South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for TB diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow up) between the numbers of laboratory confirmed RR-TB patients and those reported to have started second-line treatment. We aimed to assess the impact of Xpert MTB/RIF implementation on the delay to treatment initiation and loss to follow-up before second-line treatment for RR-TB across South Africa. Methods and findings: A nationwide retrospective cohort study was conducted to assess second-line treatment initiation and treatment delay among laboratory diagnosed RR-TB patients. Cohorts, including approximately 300 sequentially diagnosed RR-TB patients per South African province, were drawn from 2011 and 2013, before and after Xpert implementation. Patients with prior laboratory RR-TB diagnoses within 6 months and currently treated patients were excluded. Treatment initiation was determined through data linkage with national and local treatment registers, medical record review, interviews with healthcare staff, and direct contact with patients or household members. Additional laboratory data were used to track cases. National estimates of percentage treatment initiation and time to treatment were weighted to account for the sampling design. There were 2,508 and 2,528 eligible patients in the 2011 and 2013 cohorts respectively; 92% were newly diagnosed with RR-TB (new RR-TB, no prior RR-TB diagnoses). Nationally, among 2,340 and 2,311 new RR-TB patients in the 2011 and 2013 cohorts, 55% (95% CI 53-57) and 63% (95% CI 61-65) respectively started treatment within 6 months of their diagnostic specimen being sent (p<0.001). However, in 2013, there was no difference in the percentage of patients who initiated treatment at six months between the 1,368174 new RR-TB patients diagnosed by Xpert (62%, 95% CI 59-65) and the 943ose diagnosed by other methods (64%, 95% CI 61-67) (p=0.39). The median time to treatment decreased from 44 (IQR 20-69) days in 2011 to 22 (IQR 2-43) days in 2013 (p<0.001). In 2013, across the nine provinces, there were substantial variations in both treatment initiation (range 51-73% by six months) and median time to treatment (range 15-36 days, N=1,450), and only 53% of 1,448 new RR-TB who received treatmented patients were recorded on the national RR-TB register. This retrospective study is limited by the lack of information to assess reasons for non-initiation of treatment, particularly pre-treatment mortality data. Other limitations include the use of names and dates of birth to locate patient-level data, potentially resulting in missed treatment initiation among some patients. Conclusions: In 2013, there was a large treatment gap for RR-TB in South Africa which varied significantly across provinces. Xpert implementation, while reducing treatment delay, had not contributed substantially to reducing the treatment gap in 2013. However, given improved case detection with Xpert, overall a larger proportion of the total RR-TB burden has received treatment, with reduced delays. Nonetheless, strategies to further improve linkage to treatment for all diagnosed RR-TB patients are urgently required.
Clinical Usefulness of Capnographic Monitoring for Feeding Tube Insertion in Critically Ill Patients: Retrospective Cohort Study
<p><strong>Background</strong>: It is not rare for a small-bore feeding tube to be inserted incorrectly into the respiratory system in critically ill patients. Thus, monitoring is necessary to prevent respiratory malplacement of the tube. We investigated the utility of capnographic monitoring for the prevention of respiratory complications due to feeding tube mispositioning in critically ill patients.</p> <p><strong>Methods:</strong> This study is a pre- and post-intervention study, including a total of 445 feeding tube placements events that were retrospectively studied in the medical and surgical intensive care units of the Samsung Medical Center. We compared the outcomes between the time periods before and after the capnographic monitoring and respiratory complications.</p> <p><strong>Results:</strong> Feeding tubes were inserted in 275 cases without capnographic monitoring. Capnographic monitoring was performed in 170 cases. Sixteen patients (4%) had respiratory complications in total tube placements. Tracheal insertion was in 11 (2%) patients and pneumothorax in 5 (1%) patients. Fourteen cases of respiratory complications were detected in control group (14/275, 5%, ten tracheal insertions and four pneumothoraxes). Two cases of respiratory complications were detected in the capnographic monitoring group (2/170, 1%, one tracheal insertions and one pneumothorax). Respiratory complications were less detected in capnographic monitoring group than control group.</p> <p><strong>Conclusions:</strong> Capnographic monitoring is simple, easy to learn, and may be useful to prevent respiratory complication during feeding tube insertion in critically ill patients.</p>
Comparison of Clinical Efficacy and Safety of Amnio-Graft Versus Skin Graft in Injury Patients: Retrospective Cohort Study
<p>Al Mujtahid Hospital, Damascus, Syria</p><p><strong>Title of the Study</strong>: Comparison of Clinical Efficacy and Safety of Amnio-Graft versus Skin Graft in Plastic Surgery</p><p><strong>Principal Investigator</strong>: Dr. Wael Barazi, President of the Plastic Surgery Department</p><p><strong>Study Duration</strong>: From February 19, 2023, to October 23, 2023</p><p>I. <strong>Background and Rationale</strong>:</p><p>Plastic surgery, a rapidly evolving field, continuously explores novel techniques to enhance patient outcomes. This retrospective cohort study aims to compare the clinical efficacy and safety of amnio-graft and skin graft procedures performed in the Plastic Surgery Department of Al Mujtahid Hospital in Damascus, Syria.</p><p>II.<strong> Objectives</strong>:</p><p>To assess the clinical efficacy of amnio-graft and skin graft procedures.</p><p>To evaluate the safety profile of amnio-graft and skin graft procedures.</p><p>To compare the outcomes of patients undergoing plastic surgery with amnio-graft versus skin graft.</p><p>III. <strong>Study Design</strong>:</p><p>This study will adopt a retrospective cohort design, analyzing data collected from patient records in the Plastic Surgery Department during the specified study duration.</p><p>IV. Participants:</p><p>The study will include all patients who underwent either amnio-graft or skin graft procedures within the defined study period.</p><p>V. <strong>Data Collection</strong>:</p><p>Primary Data:</p><p>Patient demographics</p><p>Preoperative clinical characteristics</p><p>Surgical details</p><p>Postoperative outcomes</p><p>Adverse events</p><p>Secondary Data:</p><p>Histopathological findings</p><p>Follow-up information</p><p>Hospitalization duration</p><p>Any additional relevant clinical information</p><p>VI. <strong>Data Analysis</strong>:</p><p>Statistical analysis will be conducted to compare clinical outcomes and safety profiles between the amnio-graft and skin graft groups. Descriptive statistics, such as mean, median, and standard deviation, will be used, and inferential statistics, including chi-square tests and t-tests, will be applied where appropriate.</p><p>VII. <strong>Ethical Considerations:</strong></p><p>Patient Confidentiality:</p><p>All patient information will be kept confidential, with data anonymized during analysis.</p><p><strong>Informed Consent:</strong></p><p>As this is a retrospective study, no new interventions will be performed. Informed consent will not be obtained.</p><p><strong>Patient Welfare:</strong></p><p>Patient welfare and safety are paramount. The study design aims to minimize risks associated with data collection.</p><p><strong>VIII. Potential Risks and Benefits:</strong></p><p><strong>Risks</strong>:</p><p>There are no additional risks associated with this retrospective study as it involves the analysis of existing medical records.</p><p><strong>Benefits</strong>:</p><p>The study results may contribute to improved decision-making in plastic surgery procedures, enhancing patient outcomes.</p><p><strong>IX. Approval</strong>:</p><p>This research protocol has been reviewed and approved by the Institutional Review Board (IRB) of Al Mujtahid Hospital.</p><p>IRB Approval Date: [27/11/2023]</p><p>IRB Approval Code: [<strong>63211</strong>]</p><p><i>Note: Any amendments to this protocol will require additional review and approval by the Institutional Review Board.</i></p><p> </p>
raw data - Association between Bristol Stool Form Scale and the risk of colorectal polyp recurrence: A retrospective cohort study
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A retrospective cohort study on effects of antenatal steroids on respiratory morbidity for term elective Caesarean sections in South Asian women
<p>Respiratory distress (RD) is higher among newborns born by caesarean section (CS) at term. RCOG recommend steroid administration for CS prior to 39 weeks. Evidence for effectiveness of steroids for neonatal RD at term is inconclusive. The racial differences are yet to be studied. </p> <p>A single center retrospective cohort study was conducted in Colombo, Sri Lanka form December 2016 to February 2019. All mothers delivered by CS between 37+0 and 38+6 weeks were included in the study. Mothers with severe maternal hypertension, severe fetal rhesus sensitization, evidence of intrauterine infection, multiple pregnancies and those who received steroids due to other indications at a prior gestation and were excluded. Cohort was subdivided according to administration of IM dexamethasone prior to CS. Primary outcomes measured were RD, admissions to neonatal intensive care unit (NICU) and special care baby unit (SCBU). Neonatal infections and maternal duration of hospital stay was recorded as secondary outcome measures. </p> <p>560 patients were included in the study. 23.2% of patients received antenatal corticosteroids. Incidence of RD, NICU admissions and SCBU admissions in the study cohort was 10%, 0.9%, 2.7% respectively. RR for developing RD in the steroid group compared to non-steroid group was 2.67 (1.64-4.35). NICU and SCBU admissions was needed by 4.6% in steroid group and 3.3% in non-steroid group without a significant difference (p=0.464). A significantly higher number of babies in the steroid group needed IV antibiotics. Average days the mothers were admitted in the hospital was 2.45 days (SD 1.424) for steroid group and 1.4 days (SD 0.856) for the non-steroid group (p < 0.001).</p> <p>There is a significant increase in the respiratory morbidity in the dexamethasone administered south Asian mothers at term prior to CS. However, this effect has no clinical significance since the admission to NICU and SCBU were not significantly different.</p>
The mortality risk factor of severe community-acquired pneumonia (SCAP) patients with Sepsis: a retrospective study
<p><strong><span>Objectives:</span></strong><span> Sepsis is one of the most common comorbidities in severe community-acquired pneumonia (SCAP) patients. We aimed to investigate the characteristics and mortality risk factors of SCAP patients hospitalized with Sepsis.</span></p> <p><strong><span>Design:</span></strong><span> A retrospective, single-centre study.</span></p> <p><strong><span>Setting:</span></strong><span> This study was conducted at a tertiary hospital in Southern China.</span></p> <p><strong><span>Participants:</span></strong><span> A total of 119 patients with SCAP, aged 17 years or older, were treated in the Integrated intensive care unit from 1 January 2018 to 30 December 2020.</span></p> <p><strong><span>Interventions:</span></strong><span> none.</span></p> <p><strong><span>Outcome:</span></strong><span> 180-day mortality was the primary outcome.</span></p> <p><span><strong>Results:</strong></span><span> 119 patients were divided into the survivors (83 patients,69.75%), and the non-survivors (36 patients,30.25%). There are more pronounced inflammatory responses and respiratory problems at the beginning of the disease in non-survivors, requiring stronger respiratory and circulatory support.</span> <span>The CURB-65 score was a better predictor of mortality than the PSI and APACHE2 scores, AUCs of CURB-65: OR 0.744, p<0.005.</span> <span>For the entire treatment cycle, the non-survivors had a longer duration of persistent fever, required continuous and repeated airway intervention, and a longer duration of Vasopressor support (P<0.001). SCAP with bacterial infection as the onset, </span><span>or secondary bacterial infection had a poor prognosis (P=0.018). The non-survivors had more use of different types of antimicrobials (P<0.05), because of Multidrug-resistant (MDR) organisms. And have faced more antifungal treatment failures (P=0.006). The</span> <span>mortality risk factors were comorbid with a duration of Vasopressors support, duration of persistent fever, age, numbers of antimicrobials for MDR organisms, CURB-65 score and duration of Neuromuscular Blocking Agents (NMBAs) (OR=1.234, OR=1.158, OR=1.084, OR=6.484, OR=3.386, OR=1.505, p<0.005, respectively).</span></p> <p><strong><span>Conclusion:</span></strong><span> Dynamic monitoring of the duration of patients' abnormal indicators can help predict the prognosis. Age≥65.5 years, fever duration ≥9.5 days, number of antimicrobials</span> <span>for MDR organisms ≥2 types</span><span>, longer NMBAs and Vasopressors use, and higher CURB-65 score were mortality risk factors in SCAP-Sepsis patients.</span></p>
Data from: Early prediction of in-hospital mortality in patients with congestive heart failure in intensive care unit: a retrospective observational cohort study
<p class="MsoNormal">Objective: Congestive heart failure (CHF) is a clinical syndrome in which heart disease progresses to a severe stage. Risk assessment and early diagnosis of death in patients with CHF are critical to patient prognosis and treatment. The purpose of this study was to establish a nomogram predicting in-hospital death for CHF patients in the ICU.</p> <p>Design: A retrospective observational cohort study.</p> <p>Setting and participants: The data of study from 30,411 CHF patients in the Medical Information Mart for Intensive Care (MIMIC-IV) database and the eICU Collaborative Research Database (eICU-CRD).</p> <p>Primary outcome: In-hospital mortality.</p> <p>Results: The inclusion criteria were met by 15983 subjects, whose in-hospital mortality rate was 12.4%. Multivariate analysis determined that the independent risk factors were age, race, norepinephrine, dopamine, phenylephrine, vasopressin, <a>mechanical</a> <a>ventilation</a>, intubation, HepF, heart rate, respiratory rate, temperature, SBP, AG, BUN, creatinine, chloride, MCV, RDW, and WBC. The C-index of the nomogram (0.767, 95%CI: 0.759–0.779) was <a>superior</a> to that of the traditional SOFA, APSIII and GWTGHF score, indicating its discrimination power. Calibration plots demonstrated that the predicted results are in good agreement with the observed results. The decision curves of the derivation and validation sets both had net benefits.</p> <p>Conclusion: The twenty independent risk factors for in-hospital mortality of CHF patients were age, race, norepinephrine, dopamine, phenylephrine, vasopressin, <a>mechanical</a> <a>ventilation</a>, intubation, HepF, heart rate, respiratory rate, temperature, SBP, AG, BUN, creatinine, chloride, MCV, RDW, and WBC. The nomogram that included these factors accurately predicted the in-hospital mortality of CHF patients. The novel nomogram has the potential to be a clinical practice aided predictive tool for predicting and assessing mortality in CHF patients in the ICU.</p>
Acupuncture and Acupressure with Improved Cancer-Related Depression of Retrospective Studies
<p>Figure S1: Forest chart of SAS, PS1I, QOL; Figure S2: Forest chart of Patient self-rated functional scale; Figure S3: Forest chart of Karnofsky Performance Status Scale.</p>
Coronary atherosclerotic burden assessed by SYNTAX scores and outcomes in surgical, percutaneous, or medical strategies: A retrospective cohort study
<div><span><strong>Introduction</strong></span></div> <div> </div> <div> <span>Coronary atherosclerotic burden and SYNTAX score (SS) are predictors of cardiovascular events.</span> </div> <div> </div> <div><span><strong>Objectives</strong></span></div> <div> </div> <div> <span>To investigate the value of SYNTAX scores (SS, SSII and residual SS [rSS]) for predicting cardiovascular events in patients with coronary artery disease (CAD).</span> </div> <div> </div> <div><strong><span>Design</span></strong></div> <div> </div> <div> <span>Retrospective cohort study.</span> </div> <div> </div> <div><strong><span>Setting</span></strong></div> <div> </div> <div> <span>Single tertiary centre.</span> </div> <div><strong> </strong></div> <div><strong><span>Participants</span></strong></div> <div> </div> <div> <span>Medicine, Angioplasty or Surgery Study (MASS) database patients with stable multivessel CAD and preserved ejection fraction.</span> </div> <div> </div> <div> <span>Interventions</span><span> CAD patients undergoing coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), or medical treatment (MT) alone from January 2002 to December 2015.</span> </div> <div> </div> <div> <span>Primary and secondary outcomes</span><span> Primary: 5-year all-cause mortality. Secondary: composite of all-cause death, myocardial infarction, stroke, and subsequent coronary revascularization at 5 years.</span> </div> <div> </div> <div><strong><span>Results</span></strong></div> <div> </div> <div> <span>A total of 1,719 patients underwent PCI (n = 573), CABG (n = 572), or MT (n = 574) alone. </span><span>The SS was not considered an independent predictor of 5-year mortality in the PCI </span><span>(low, intermediate and high SS 6.5%, 6.8% and 4.3%, respectively, p=0.745)</span><span>, CABG </span><span>(low, intermediate and high SS 5.7%, 8.0% and 12.1%, respectively, p=0.194)</span><span> and MT </span><span>(low, intermediate and high SS 6.8%, 6.9% and 6.5%, respectively, p=0.993)</span><span> cohorts. The SSII (low, intermediate and high SSII, 3.6% vs. 7.9% vs. 10.5%, respectively, p <0.001) was associated with a higher mortality risk in the overall population. Within each treatment strategy, SSII was associated with a significant 5-year mortality rate, especially in CABG patients with higher SSII (</span><span>low, intermediate and high SSII, </span><span>1.8%, 9.7% and 10.0%, respectively, </span><span>p = 0.004) and in MT patients with high SSII (</span><span>low, intermediate and high SSII, 5.0%, 4.7% and 10.8%, respectively,</span><span> p = 0.031). </span><span>SSII demonstrated a better predictive accuracy for mortality compared with SS and rSS </span><span>(c-index = 0.62)</span><span>. </span> </div> <div> </div> <div><span><strong>Conclusions</strong></span></div> <div> </div> <div><span>Coronary atherosclerotic burden alone was not associated with significantly increased risk of all-cause mortality. The SSII better discriminates the risk of death. </span></div>
ScienceDex guides
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These curated guides explain access requirements, typical timelines, costs, and reuse considerations for widely used research datasets.
Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
ABODe is a University of Edinburgh DataShare dataset for behavior classification in group-housed mice using home-cage video, identities, bounding boxes, ground-plate positions, and annotator labels.
DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.