bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Rule of 4” ultrasound diagnostic criteria at 6 weeks postoperatively was more appropriate for clinical determination of arteriovenous fistula maturation
Authors: Liu Jiali , Guo Xuemei , You Qiwen , Wang Jingzhu , Lin Ling , Zhang Hongbo , Zhang Heping , Deng Fei , Jing Xueming 
Published: December 2024

Objective The aim of this study was to investigate the timing of assessing the maturation of arteriovenous fistula (AVF) and the diagnostic efficacy of two ultrasound assessment criteria in determining the maturation of AVF. Methods We collected clinical data on 227 patients with end-stage renal disease who were first diagnosed at our institution between February 1, 2023 and February 1, 2024, and were followed up regularly for 12 weeks post-AVF creation, with the diameter of the draining vein and the brachial artery volume flow (VF) recorded at 1 day, 2, 4, 6, 8, 10, and 12 weeks post-operation. We focused on the time of AVF maturation, and ultrasonographic diagnostic criteria 1 (the vein diameter was ≥4 mm, and the brachial artery VF was >500 mL/min, referred to as the “Rule of 4”) and ultrasonographic diagnostic criteria 2 (the vein diameter was ≥5 mm, and the brachial artery VF was> 500 mL/min, referred to as the “Rule of 5”) were used to evaluate the maturation of AVF. And compared with clinically maturation criteria to understand the correlation, consistency, and diagnostic efficacy. Results 1. The venous diameter and brachial artery VF of AVF showed an upward trend, and increased significantly in 1 day to 6 weeks postoperatively ( p < .05),especially between 1 day and 2 weeks, while no significant difference in the increases at 6-12 weeks; 2. Logistic regression analysis showed that venous diameter (OR = 19.589 , 95% CI 1.560-245.979, p = .021) and brachial artery VF (OR = 1.024 , 95% CI 1.005-1.042, p = .011) at 6 weeks were the independent correlates affecting AVF maturation; and the optimal thresholds were 4.08 mm (sensitivity 88.10%, specificity 70.00%) and 472.50 mL/min (sensitivity 93.20%, specificity 84.00%), respectively; 3. Compared with clinical maturation, the two ultrasonographic diagnostic criteria at 6 weeks postoperatively were correlated with clinical maturation, and the specificity of both was 100%, with “Rule of 4” having a sensitivity of 79.66%, an accuracy of 84.14%, and a concordance kappa = 0.633, while “Rule of 5″ had a sensitivity of 31.63%, an accuracy of 46.69%, and a concordance kappa = 0.169; and the area under the ROC curve (AUC) for “Rule of 4″ was higher than that for “Rule of 5” (0.898 vs. 0.658, p < .001). Conclusion Six weeks postoperatively may be the best timing for an ultrasound assessment of AVF maturation, and the “Rule of 4” ultrasound assessment criteria was more suitable for clinical judgment of AVF maturation.
Non-traditional pulmonary function tests in risk stratification of anatomic lung resection: a retrospective review
Authors: Towe Christopher W. , Badrinathan Avanti , Khil Alina , Alvarado Christine E. , Ho Vanessa P. , Bassiri Aria , Linden Philip A. 
Published: December 2024

Background: Guidelines advocate pulmonary function testing (PFT) in preoperative evaluation before lung resection. Although forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lungs for carbon monoxide (DLCO) are recommended, they are often poor predictors of complications. Objectives: Determine if PFT testing results other than FEV1 and DLCO are associated with post-operative complications. We hypothesized that other PFT test results may improve the prediction of post-operative complications. Design: Retrospective cohort study of a single institution. Methods: We analyzed patients who underwent anatomic lung resections from 1/2007 to 1/2017. Percent predicted post-operative (ppo) PFT values were calculated for each test result. Outcome of interest was any post-operative complication. Wilcoxon rank-sum and multivariable regression were used to determine the relationship of PFT results to post-operative complications. Results: We analyzed 922 patients who underwent anatomic lung resections. Complications occurred in 240 (26.0%) patients, and mortality occurred in 12 (1.3%) patients. In univariate analysis, predicted and percent predicted post-operative (ppo) forced vital capacity (FVC), FEV1, FEF2575, DLCO, DLCO/VA, and VC values were predictors of post-operative complications. Multivariable logistic regression found no independent relationship of test results to post-operative complications, likely reflecting the collinearity of PFT results. Conclusion: Our findings suggest that non-traditional PFTs, such as FVC, may enhance risk stratification for post-operative complications following anatomic lung resection. Notably, traditional parameters like FEV1 and DLCO were not independently predictive, highlighting the need to reconsider their role in isolation. These findings highlight the need to reconsider how PFT are used in surgical risk stratification given high levels of collinearity.
Metaverse surgical planning for robotic surgery: preliminary experience and users’ perception
Authors: Volpi Gabriele , Gatti Cecilia , Quarà Alberto , Piramide Federico , Amparore Daniele , Alessio Paolo , De Cillis Sabrina , Colombo Marco , Busacca Giovanni , Sica Michele , Verri Paolo , Piana Alberto , Alba Stefano , Di Dio Michele , Fiori Cristian , Porpiglia Francesco , Checcucci Enrico 
Published: December 2024

Background: The 3D models’ use for surgical planning has recently gained an ever-wider popularity, in particular in the urological field. Different ways of fruition of this technology have been evaluated over the years. Today, new technological developments allow us to enjoy 3D models in the metaverse. Objectives: The aim of this study is to report the preliminary experience and surgeon’s perception of preoperative planning performed in the metaverse. Design: During the eleventh edition of the Techno-Urology Meeting, all the attendees enjoyed the metaverse experience (META_EXP) for pre-surgical planning of both robot-assisted radical prostatectomy and partial nephrectomy. Users’ perception was then evaluated with the Health Information Technology Usability Evaluation Scale (Health-ITUES) and the Face & Content validity questionnaire. Methods: The 3D virtual models, obtained from standard bi-dimensional imaging, were uploaded on a metaverse platform. Surgeons, thanks to dedicated visors, could plan their surgical strategy immersed in this virtual environment and discuss it with other attendees. Answers to the questionnaires were then evaluated and a stratification was subsequently performed based on surgical expertise, dividing participants in residents (Re), young urologists (YU) and senior urologists (SU). Results: Sixty-six participants filled out the questionnaires. As emerged from the Health-ITUES questionnaire, META_EXP covers an important role in the presurgical/surgical planning and decision-making process and appears to be useful for preoperative planning, with a median response of 4 and 5, respectively. Such results were also confirmed at the Face & Content validity questionnaire, with a median rate of 9/10 regarding its usefulness for surgical planning. Also, anatomical accuracy was positively rated regarding both organ’s and disease’s details, with a median response of 9. Conclusion: In conclusion, the metaverse experience for preoperative surgical planning appears to be useful, user-friendly and accurate. This technology has been widely appreciated by surgeons, irrespective of their experience.
Combining serum inflammatory markers and clinical factors to predict survival in metastatic urothelial carcinoma patients treated with immune checkpoint inhibitors
Authors: Cheng Liang-Yun , Su Po-Jung , Kuo Ming-Chun , Lin Chang-Ting , Luo Hao-Lun , Chou Chih-Chi , Huang Shih-Yu , Wu Chia-Che , Chen Chien-Hsu , Huang Chun-Chieh , Tsai Kai-Lung , Yu-Li Su Harvey 
Published: December 2024

Background: Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored. Objectives: The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy. Design: This is a retrospective, multicenter study. Methods: Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers. Results: A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 ( p < 0.001), visceral metastasis ( p < 0.001), leukocytosis ( p < 0.001), Hb levels ⩾10 mg/dL ( p = 0.008), and NLR ⩾5 ( p = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC. Conclusion: Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs.
Sex differences in patients with Non-Small Cell Lung Cancer harboring driver fusions treated with tyrosine kinase inhibitors: a systematic review
Authors: Leporati Rita , Auclin Édouard , Morchón Daniel , Ferriol-Galmés Miquel , Laguna Juan Carlos , Gorria Teresa , Teixidó Cristina , Aranzazu Amores Maria , Ambrosini Paolo , Isla Dolores , Russo Giuseppe Lo , Mezquita Laura 
Published: December 2024

Background: While targeted therapies have transformed the treatment landscape of oncogene-addicted non-small cell lung cancer (NSCLC), the influence of sex on treatment outcomes remains insufficiently understood. Objectives: This systematic review aimed to investigate the impact of sex on clinical outcomes in patients with NSCLC harboring driver fusions treated with targeted therapies enrolled in clinical trials. Data sources and methods: A comprehensive literature search was conducted using PubMed, Embase, and relevant conference abstracts to identify phase III randomized and early clinical trials that reported sex-specific data, including progression-free survival (PFS), overall survival (OS), overall response rate, and adverse events (AEs), in patients with fusion-positive NSCLC treated with tyrosine kinase inhibitors (TKIs). Results: This review involved 10 studies reporting PFS data and 3 studies with OS data, focusing on first-line treatments for ALK fusion (9 studies) and RET fusion-positive (1 study) NSCLC. Pooled analysis of hazard ratios (HRs) for PFS and OS in ALK inhibitors trials revealed no significant differences in survival outcomes based on sex. Additionally, none of the studies provided data on sex-based differences in response rates or toxicities, highlighting a significant knowledge gap regarding the impact of sex on secondary outcomes in targeted therapy. Conclusion: This review found no significant sex-related differences in survival outcomes among patients treated with ALK inhibitors. However, the lack of data on sex-specific response and toxicity emphasizes the need for future research to better understand the role of sex in modulating treatment outcomes and treatment decisions with TKIs.
Evolocumab in metastatic castration-resistant prostate cancer: study protocol for a single-arm, phase II trial, and initial experience with use of a validated lipid biomarker to direct therapy
Authors: Mellor Rhiannon , Ardolino Luke , Scheinberg Tahlia , Fitzpatrick Michael , Lin Hui-Ming , Bonnitcha Paul , Sullivan David , Meikle Peter J. , Stockler Martin R. , Moujaber Tania , Joshua Anthony , Horvath Lisa 
Published: December 2024

Background: Despite advances in the treatment of metastatic castration-resistant prostate cancer (mCRPC), primary and secondary resistance to current therapies remains. Elevated circulating sphingolipids are associated with poor outcomes in patients with mCRPC, including therapeutic resistance and shorter overall survival. PCPro is a clinically accessible, regulatory compliant plasma lipid biomarker of poor prognosis in mCRPC, which incorporates prognostic sphingolipids. We hypothesize that reversal of the PCPro signature in men with mCRPC by sphingolipid-lowering agents will improve their clinical outcomes. However, the first step is to determine whether this poor prognostic lipid signature can be modulated. A potential sphingolipid-lowering agent is the PCSK9-inhibitor evolocumab, which is used in the management of hypercholesterolemia. Objectives: Our primary objective is to assess whether treatment with evolocumab during standard anticancer therapy can safely modify the PCPro signature in men with mCRPC. Design: This is a multicenter, open label phase II trial. Methods: Men with mCRPC commencing docetaxel, cabazitaxel, abiraterone, enzalutamide, olaparib, or lutetium-177 PSMA for disease progression will be screened for the presence of PCPro. Those who are PCPro positive will receive a 12-week course of evolocumab concurrent with their standard therapy. Dosage is as per cardiovascular guidelines (420 mg subcutaneously every 4 weeks). PCPro will be repeated after 12 weeks. The primary endpoint is reversal of PCPro. The secondary endpoint is the safety of combination therapy with exploratory endpoints characterizing changes in comprehensive lipid profiles pre- and post-treatment. Discussion: This study will evaluate whether evolocumab can safely modify the PCPro signature in men with mCRPC, providing essential data to the development of precision metabolic therapy in the management of prostate cancer. Trial registration: This study is approved by the Human Research Ethics Committee (X22-0072 and 2022/ETH00427). It is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001003763).
The analysis of the pulmonary domain involvement in Sjögren’s disease
Authors: Madej Marta , Proc Krzysztof , Wawryka Piotr , Morgiel Ewa , Sebastian Maciej , Wiland Piotr , Sebastian Agata 
Published: December 2024

Background: The EULAR Sjögren’s syndrome (SS) disease activity index (ESSDAI) pulmonary domain is used to assess the activity of respiratory system involvement in Sjögren’s disease (SjD). The most unfavorable form of respiratory involvement in SjD, after lymphomas, is interstitial lung disease (ILD). Objectives: The aim of the study was to assess the involvement of the respiratory system in SjD patients and the occurrence of ILD in high-resolution computed tomography (HRCT), depending on immunological markers, the influence of cigarette smoking, and the age of the patients. Design: Single-center, registry, cohort study. Methods: Among all SjD patients, a group with involvement in the pulmonary domain was distinguished. This group was later subjected to a detailed analysis of immunological and serological markers and chest imaging tests. Results: In all, 64 patients out of 299 with SjD had involvement in the pulmonary domain defined according to the ESSDAI definition. The most frequently reported clinical symptoms of respiratory system involvement included dryness and chronic cough (over 80% of patients), followed by shortness of breath. Nine percent of patients with changes in lungs were asymptomatic. Patients with pulmonary involvement were older (54 vs 48 years, p < 0.05). In the subpopulation of patients with SjD and pulmonary involvement, the presence of rheumatoid factor (73% vs 60%, p < 0.05), and hematological domain involvement according to ESSDAI (54% vs 37%, p < 0.05) were more common. In the group of 64 patients with a positive pulmonary domain, 34 (53%) had ILD on HRCT. A higher incidence of comorbidities was found in the population of patients with ILD. No correlation was found between the type of lung involvement and the immunological profile, inflammatory markers, age, and smoking habit. Conclusion: Involvement of the pulmonary domain is common in patients with SjD. However, the clinical picture is very heterogeneous, which determines the subsequent personalization of treatment.
Efficacy and safety of small molecule oral medications for psoriatic arthritis: a network meta-analysis of randomized controlled trials
Authors: Tsai Ya-Chu , Hung Chen-Yiu , Tsai Tsen-Fang 
Published: December 2024

Background: Although there have been network meta-analyses (NMAs) regarding the efficacy and safety of targeted immunotherapy for psoriatic arthritis, most of them primarily focus on biologics. However, small molecules and biologics have many differences in properties and onset time. This NMA put emphasis on small molecule drugs and incorporates medications including upadacitinib and deucravacitinib, which have been less compared previously. Objective: To compare the efficacy and safety of small molecule drugs (apremilast, deucravacitinib, tofacitinib, and upadacitinib) in active psoriatic arthritis (PsA) using NMA. Design: This study was conducted and reported following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension Statement for Network Meta-Analyses (PRISMA-NMA), with relevant articles identified through searches across electronic databases. Data sources and methods: Databases including PubMed, Cochrane Library, and ClinicalTrial.gov were searched. Randomized controlled trials (RCTs) of targeted synthetic small molecules for PsA controlled by either placebo or active comparators within weeks 12–16 were eligible. A frequentist framework and a random-effect model were employed for the analysis. The revised Cochrane risk-of-bias tool for RCTs was used to assess the quality of the enrolled studies. Results: A total of 9 RCTs involving 3699 patients were analyzed. Apremilast 30 mg bid, deucravacitinib 6 mg and 12 mg qd, tofacitinib 5 mg bid, and upadacitinib 15 mg qd all demonstrated superior efficacy over placebo in achieving American College of Rheumatology (ACR) 20/50/70, Psoriasis Area and Severity Index (PASI) 75, and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores at weeks 12–16. When compared to adalimumab, upadacitinib achieved borderline superiority in PASI 75 at week 12 (risk ratio (RR) = 1.20, 95% confidence interval (CI): 1.02–1.40). Among the four medications studied, only deucravacitinib showed significantly better HAQ-DI scores compared to apremilast (RR = −0.16, 95% CI: −0.29 to −0.02), with no statistically significant differences observed in other parameters. Conclusion: All four small molecule oral medications exhibited superior efficacy to placebo and comparable safety profiles. Across different assessment criteria, including ACR 50, ACR 70, PASI 75, or HAQ-DI, deucravacitinib 12 mg and upadacitinib consistently ranked in the top two positions.
The association between dolutegravir-based antiretrovirals and high blood pressure among adults with HIV in southern Ethiopia: a cross-sectional study
Authors: Hirigo Agete Tadewos , Yilma Daniel , Astatkie Ayalew , Debebe Zelalem 
Published: December 2024

Background: Dolutegravir (DTG), a novel antiretroviral therapy (ART) for HIV, is increasingly adopted across sub-Saharan Africa. However, its impact on blood pressure in Ethiopia remains unclear, highlighting a need for further studies. Objective: This study aimed to investigate the association between DTG-based first-line regimens and other covariates of high blood pressure (HBP) among adults living with HIV receiving care at health facilities in Hawassa City, southern Ethiopia. Design: A cross-sectional study. Methods: Data were collected between January 2023 and May 2024 among 444 systematically selected adults, complemented with a review of their medical records. HBP was defined according to the seventh report of the Joint National Committee (JNC7) guidelines, with a threshold of systolic or diastolic blood pressure of ⩾120/80 mmHg. Multivariable logistic regression analysis was performed to identify predictors of HBP. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed to determine statistically significant associations. Results: Of the study participants, 58.3% were women and 41.7% were men, resulting in a response rate of 95.5%. The mean (standard deviation (SD]) age of the participants was 38.4(±8.9) years. The prevalence of HBP was 57.9% (95% CI: 52.5–62.4), with 40.5% classified as prehypertension and 17.3% as hypertension. Among participants with hypertension, 84.4% were newly diagnosed. Initiating ART with DTG-based regimens was associated with higher odds of HBP (AOR 5.9; 95% CI: 1.5–22.7) and switching to DTG-based regimens also increased the odds of HBP (AOR 3.8; 95% CI: 1.1–13.9). Other significant covariates associated with HBP included being male (AOR 2.6; 95% CI: 1.4–4.9), age >45 years (AOR 2.0; 95% CI: 1.2–3.4), high waist-to-height ratio (AOR 2.4; 95% CI: 1.1–4.9), inadequate vegetable intake (AOR 1.7; 95% CI: 1.0–2.7), low physical activity (AOR 2.4; 95% CI: 1.1–5.4), and LDL-cholesterol (AOR 1.1; 95% CI: 1.0–1.2). Conclusion: Proactive blood pressure screening and management are important for individuals on DTG-based regimens. In addition, early identification and intervention of modifiable risk factors through comprehensive strategies and regular screenings are pivotal for improving cardiovascular health among individuals on ART.
Use of a double pigtail ureteral stent for surgical management of obstructive pancreatolithiasis in a feline patient
Authors: Chang Lydia , Taylor Jim A 
Published: December 2024

Case summary A 7-year-old castrated male domestic shorthair cat was presented for surgical intervention for obstructive pancreatolithiasis. The patient had a history of chronic weight loss, vomiting and lethargy. Elevation of feline pancreas-specific lipase and a marked decrease in cobalamin were documented on blood biochemistry. Abdominal ultrasound revealed an enlarged right pancreatic limb with a dilated central duct and multiple pancreatoliths visualized within, consistent with partial pancreatic duct obstruction. The patient was successfully treated with a minor duodenal papilla construction using a 2.5 Fr double pigtail ureteral stent. Relevance and novel information Pancreatolithiasis is an exceptionally rare condition in veterinary medicine, particularly in cats, with only a few reported cases. Given its low incidence, there is no established consensus regarding the best therapeutic options in clinical practice. This case report outlines the successful application of a locking loop catheter to re-establish the patency of a pancreatic duct. Notably, this is the first documented use of this technique for the surgical management of obstructive pancreatolithiasis.