bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can we Overcome the Predestined Poor Survival of Diabetic Patients? Perspectives from Pre- and Post-Dialysis
Authors: Kim Yong-Lim 
Published: October 2020

Although the survival of diabetic peritoneal dialysis (PD) patients has improved, it is still much worse than the survival of nondiabetic patients. Diabetes has its own risks for cardiovascular disease (CVD), such as increased levels of advanced glycation end-products, carbonyl and oxidative stress, and low-grade inflammation. An independent, graded association has been observed between a reduced glomerular filtration rate and the risk of CVD events in chronic kidney disease (CKD). Both CKD and diabetes synergistically lead to a high risk of CVD. It seems that the poor survival of diabetic PD patients is predestined at the initiation of dialysis because of multiple pre-existing risk factors and comorbid diseases, particularly CVD. Recently, several trials were successful in improving the survival of patients with diabetic CKD. Tight control of glucose, blood pressure management using angiotensin converting-enzyme inhibitors or angiotensin II receptor blockers, and use of statins, antioxidants, or peroxisome proliferator-activated receptor gamma agonists may improve the survival of diabetic PD patients. However, simple correction of a single CVD risk factor is not likely to be effective. New PD solutions such as those low in glucose degradation products or those with icodextrin may also be effective in reducing the risk of CVD in diabetic PD patients. Therefore, multifactorial interventions—including diet control, early referral, and choice of an optimal PD solution—may improve the survival of diabetic PD patients.
How Peritoneal Dialysis Has Developed in Vietnam
Authors: Pham Van Bui 
Published: October 2020

In Vietnam, continuous ambulatory peritoneal dialysis (CAPD) with a straight line and one bag was first used in 1998. Because the complication rate, mainly as a result of catheter obstruction and peritonitis, was very high (50%), treatment was stopped after the first 10 cases. Use of the modality resumed only in 2001. However, because of skepticism and concern on both the part of physicians and patients about the effectiveness of peritoneal dialysis (PD) and about the infection risk, CAPD developed very slowly. Until late 2004, patient numbers were very limited, and there was only one PD unit in the entire country. Since then, CAPD using Y-set and two-bag system—plus routine omentectomy during catheter insertion and better patient selection and training in bag exchange—has resulted in much better outcomes with fewer complications, and the technique has been developing far faster. This success, together full insurance coverage of both dialysis and erythropoietin since 2005, has led to a steep rise in the number of patients on PD and the number of PD units. As a result, despite the initial difficulty, the number of PD patients increased to nearly 700 in just 3 years (2004 – 2007), while it took more than 20 years before more than 3000 patients were receiving hemodialysis. Automated PD and icodextrin are not yet available in Vietnam.
Predictors of the start of declining eGFR in patients with systemic lupus erythematosus
Authors: Yip Terry Cheuk-Fung , Saria Suchi , Petri Michelle , Magder Laurence S 
Published: October 2020

Objective To characterize the longitudinal trajectory of estimated glomerular filtration rate (eGFR) in patients with systemic lupus erythematosus (SLE) and identify predictors of the change in eGFR trajectory. Methods The longitudinal eGFR levels of patients in the Hopkins Lupus Cohort were modelled by piecewise linear regression to evaluate the slope of different line segments. The slopes were classified into declining (≤−4 mL/min/1.73 m2 per year), stable (−4 to 4 mL/min/1.73 m2 per year), and increasing (≥4 mL/min/1.73 m2 per year) states. The transition rate between states and the impact of clinical parameters were estimated by a Markov model. Results The analysis was based on 494 SLE patients. At a mean follow-up of 8.8 years, 347 (70.2%), 107 (21.7%), 33 (6.7%), and 7 (1.4%) patients had zero, one, two, and three state transitions, respectively. In patients with no transition, 37 (10.7%), 308 (88.8%), and 2 (0.6%) were in declining, stable, and increasing state, respectively. In patients with one transition, 43 (40.2%) changed from declining to stable state while 29 (27.1%) changed from stable to declining state. When patients were in a non-declining GFR state, those who were younger and African Americans were more likely to transition to a declining GFR state. In adjusted analyses, high blood pressure, C4 and low hematocrit were associated with change from non-declining to declining state. High urine protein-to-creatinine ratio also tended to be associated with change from non-declining to declining state. African American patients were less likely to move from declining to non-declining state. Use of prednisone was associated with change from declining to non-declining state. Conclusions Patients with high blood pressure, low complement C4, low haematocrit, and high urine protein-to-creatinine ratio are more likely to have a declining eGFR trajectory, while the use of prednisone stabilizes the declining eGFR trajectory.
Milk fat globule epidermal growth factor 8 (MFG-E8) on monocytes is a novel biomarker of disease activity in systemic lupus erythematosus
Authors: Ushikubo Mari , Saito Shuntaro , Kikuchi Jun , Takeshita Masaru , Yoshimoto Keiko , Yasuoka Hidekata , Yamaoka Kunihiro , Seki Noriyasu , Suzuki Katsuya , Oshima Hisaji , Takeuchi Tsutomu 
Published: October 2020

Background Milk fat globule epidermal growth factor (MFG-E8) is related secreted protein which links phosphatidylserine on apoptotic cells and integrin αvβ3/5 on phagocytes. To clarify the clinical significance of MFG-E8 in SLE, we analyzed the correlation between expression level of MFG-E8 in circulating phagocytic leukocytes and clinical parameters of patients. Methods The study was conducted under a multi-center, prospective cohort design. Patients with one or both BILAG A or B, or SLEDAI- 2 K ≥ 4 with clinical symptoms were defined as the active SLE group. Expression of MFG-E8 on monocytes and concentration in serum were measured by FACS and ELISA, respectively. Results 96 subjects were enrolled. The absolute number and proportion of MFG-E8-positive monocytes to total monocytes were significantly higher in the active SLE group (p < 0.01). Importantly, the proportion was also significantly correlated with SLEDAI-2K, clinical SLEDAI, as well as serum levels of anti-ds-DNA antibody and complement and C1q. In addition, the proportion of MFG-E8-positive monocytes to total monocytes was significantly decreased from baseline in active SLE patients after 6 months’ treatment and increased concordantly with disease activity in 6 refractory cases. Further, in receiver operating characteristic curve analysis for discrimination between active and inactive SLE, the AUC of the proportion of MFG-E8 was 0.854, which was equivalent to classical activity markers such as anti-ds DNA antibody (0.776), complement (0.897) and C1q (0.815) Conclusions The proportion of MFG-E8-positive monocytes to total monocytes in peripheral blood was positively associated with disease activity in SLE and may be a novel biomarker of disease activity.
Time-inconsistent preferences and the minimum legal tobacco consuming age
Authors: Crettez Bertrand , Deloche Régis 
Published: October 2020

In both the United States of America and the European Union, Member States are encouraged to prevent young people from starting to smoke by forbidding selling tobacco products to people under a certain age. By contrast, there are in general no legal minimum age requirements for consuming those products. Our aim is to address such discrepancy from a theoretical viewpoint by focusing on the case where people have time-inconsistent preferences. Specifically, we build a three-period (youth, adulthood, old age) model of smoking decision in which individual intertemporal preferences are present-biased. Then, using this model, we show that when agents are naive, that is when they are unaware that their intertemporal preferences are time-inconsistent, it may be worthwhile, from the individual viewpoint, to legally prevent young people from smoking. This conclusion does not always hold, because what is good for an agent in youth can be disputable in adult age (and conversely). When individuals are sophisticated, that is, not naive, a legal smoking age (either for buying, consuming or selling tobacco products) is pointless. This conclusion is also reached if one follows the continuing person approach advocated by Sugden. JEL Classification Numbers : I12, I18, K32, D15
Comparing the outcome of Muller’s muscle conjunctival resection for mild/moderate versus severe involutional aponeurotic ptosis
Authors: Nacaroglu Senay Asik , Karabulut Gamze Ozturk , Fazil Korhan , Serefoglu Cabuk Kubra , Kandemir Besek Nilay , Taskapili Muhittin 
Published: October 2020

Aims: To compare predictability of the outcomes of Muller’s muscle conjunctiva resection (MMCR) in patients with severe versus mild/moderate involutional aponeurotic ptosis. Methods: This was a retrospective case-control study. All cases were recruited into the groups in terms of preoperative marginal reflex distance of upper eyelid (MRD-1). Group 1 consisted of patients with mild to moderate blepharoptosis was defined as an MRD-1 equal to 1.1 to 3 mm and Group 2 consisted of patients with severe blepharoptosis defined as MRD-1 ⩽ 1 mm. All patients underwent MMCR based on the response to phenylephrine and the amount of ptosis. MRD-1 obtained both manually and with ImageJ analysis program preoperatively and on the postoperative sixth month was compared. Successful surgical outcome criteria were defined as MRD-1 ⩾ 2.5 mm and inter-eyelid symmetry ⩽ 1 mm. Results: A total of 97 eyes of 83 participants met the inclusion criteria for this study (Group 1 n = 50, Group 2 n = 47). In terms of MRD-1 success rates were 88% in Group 1, and 70.2% in Group 2 ( p = 0.03). Preoperative MRD-1 which was measured by ImageJ, and the amount of resected tissue in mm were the predictive data of surgical outcome by the logistic regression analysis (OR 6.45, 95% CI 1.82–22.78, p = 0.004, OR 2.47, 95% CI 1.05–5.80, p = 0.037, respectively). Conclusion: The surgical success of MMCR can be predicted via tissue resection length and preoperative MRD-1. Higher surgical success rates were obtained in cases with mild-moderate ptosis and clinically acceptable success rates were obtained in cases with severe ptosis.
Treat and extend versus fixed regimen in neovascular age related macular degeneration: A systematic review and meta-analysis
Authors: Fallico Matteo , Lotery Andrew J , Longo Antonio , Avitabile Teresio , Bonfiglio Vincenza , Russo Andrea , Castellino Nicolò , Parisi Guglielmo , Pulvirenti Alfredo , Eandi Chiara , Cennamo Gilda , Furino Claudio , Cicinelli Maria Vittoria , Alovisi Camilla , Reibaldi Michele 
Published: October 2020

Purpose: To compare efficacy of treat and extend (T&E) versus fixed regimen treatment protocols in neovascular age-related macular degeneration (nAMD). Methods: Randomized clinical trials (RCTs) comparing T&E versus fixed regimen protocols for nAMD were systematically searched. Primary outcome was to compare the mean best corrected visual acuity (BCVA) change in T&E regimen versus fixed regimen. Secondary outcomes were change in the mean optical coherence tomography (OCT) central retinal thickness (CRT) and mean number of injections. Standardized mean difference (SMD) along with 95% confidence intervals (CIs) were calculated. Random-effect models were used for meta-analyses. Results: Four RCTs were included, with a total of 649 and 621 eyes in the T&E and fixed regimen cohort at 12 months, and 267 and 249 eyes at 24 months. Pooled analysis of mean BCVA change included all four RCTs at 12 months and two RCTs at 24 months, showing no difference between the two groups (12-month: SMD = 0.08, 95% CI: −0.20 to 0.35, p = 0.55; 24-month: SMD = 0.04, 95% CI: −0.13 to 0.21, p = 0.64). Pooled analysis of OCT CRT change at 12 months included three studies, showing no difference between the two groups (SMD = 0.03, 95% CI: −0.46 to 0.51, p = 0.91). Pooled analysis of mean injection number included all four RCTs at 12 months and two RCTs at 24 months, showing significant difference between the two groups (12-month: SMD = −1.11, 95% CI: −1.67 to −0.56, p < 0.001; 24-month: SMD = −1.34, 95% CI: −1.54 to −1.15, p < 0.001). Conclusion: A T&E regimen proved as effective as a fixed dosage regimen throughout a 24-month follow-up and with a lower number of injections.
The patient experience of hemodialysis vascular access decision-making
Authors: Woo Karen , Pieters Huibrie 
Published: October 2020

Background: To describe vascular access (VA)-related decision-making from the patient perspective, in patients who have already chosen hemodialysis as their renal replacement modality, and identify areas where physicians can improve this experience. Methods: In-person, semi-structured interviews with 15 patients with end-stage kidney disease were systematically analyzed by two independent researchers using thematic analysis. Interviews were conducted until systematic analysis revealed no new themes. Results: Patients had mean age 57 (range 22–85), with seven males and diverse racial/ethnic/marital status. All (15/15) patients viewed VA as “intertwined and interrelated” with dialysis, prioritized the dialysis, described the VA merely as the “hookup” to life-preserving dialysis and gave it minimal consideration. Three themes were identified: consolidation of dialysis and VA, reliance on supportive advisors and communication with physicians. Although 14/15 patients described processes common to medical decision-making, including information seeking, learning from the experiences of others, and weighing risks and benefits, they did not apply these processes specifically to VA. While all participants took ownership of the VA decision, they lacked clear understanding about the different types of VA and their consequences. Most patients (14/15) depended on family and friends for reinforcement, motivation and advice. Patients all described physician characteristics they associated with trustworthiness, the most common being listening and explaining, demonstrating empathy and making an effort to meet the patient’s individual needs. Perceived arrogance, unavailability and lack of expertise represented untrustworthiness. The majority (14/15) accepted VA recommendations from physicians they found trustworthy and authoritative. Conclusions: The study participants were minimally engaged in VA decision-making. Educational aids and shared decision-making tools are needed to empower patients to make better-informed, self-efficacious VA decisions.
Drug-Coated Balloon Angioplasty Compared With Uncoated Balloons in the Treatment of Infrapopliteal Artery Lesions (AcoArt II–BTK)
Authors: Jia Xin , Zhuang Baixi , Wang Feng , Gu Yongquan , Zhang Jiwei , Lu Xinwu , Dai Xiangchen , Liu Zhaoyu , Bi Wei , Liu Changwei , Wang Shenming , Liistro Francesco , Guo Wei 
Published: October 2020

Purpose To compare the safety and efficacy of drug-coated balloon (DCB) vs uncoated balloon angioplasty in the treatment of de novo and restenotic infrapopliteal lesions in patients with chronic limb-threatening ischemia (CLTI). Materials and Methods The prospective, multicenter, randomized study AcoArt II–BTK study ( ClinicalTrials.gov identifier NCT02137577) enrolled 120 patients who were randomly assigned to angioplasty with either a DCB (n=61; mean age 70.7±7.4 years; 36 men) or a conventional balloon catheter (n=59; mean age 70.8±9.0 years; 36 men). There were no significant differences observed in baseline clinical or target lesion characteristics between the groups. The target lesion length was 169.95±86.35 mm in the DCB group vs 179.93±80.16 mm in the control group, and approximately three-quarters of the lesions were chronic occlusions. Primary patency was assessed by angiography at 6 months, and mortality and clinically-driven target lesion revascularization (CD-TLR) were evaluated at 12 months. Results Primary patency at 6 months was 75.0% in the DCB group and 28.3% in the control group (p<0.001), while late lumen loss was 0.43±0.62 mm for DCBs vs 0.99±0.55 mm for controls (p<0.001). Freedom from CD-TLR at 12 months was 91.5% in the DCB group vs 76.8% in the controls (p=0.03); there was no significant difference in mortality (1.7% DCB vs 3.6% controls; p=0.53). Conclusion This study demonstrated that the Litos/Tulip DCBs are safe and effective in treating infrapopliteal lesions, with improved angiographic and clinical outcomes vs plain balloon angioplasty. The DCBs demonstrated significantly higher primary patency with fewer CD-TLRs than conventional angioplasty. The safety of the DCBs was noninferior to that of the uncoated balloons after 1 year of follow-up.
Experience of managing superior mesenteric artery aneurysm and its midterm follow-up results with 18 cases
Authors: Wang Lunchang , Shu Chang , Li Quanming , Jiang Xiaohua , Li Xin , He Hao , Li Ming 
Published: October 2020

Objectives To characterize the clinical features, treatment, and prognosis of superior mesenteric artery aneurysms and provide evidence for clinical decision-making. Methods We retrospectively reviewed the diagnosis and treatment of 18 cases of superior mesenteric artery aneurysm admitted to our center from 2003 to 2020, including demographic data, risk factors, clinical manifestations, diagnosis, treatment strategies, and follow-up results. Results The average age of the patients was 49.1 years, and males accounted 83.3%. The development of the disease was associated with infection, hypertension, pancreatitis, and trauma, but no significant associations with atherosclerosis were noted by our results. Nine patients were diagnosed with true aneurysm, seven patients with pseudoaneurysm, and two patients with dissecting aneurysm. Rupture of aneurysm occurred in three patients (16.7%), and one of them died before surgery. The surgery success rate was 94.1%, and open surgery was performed on nine patients, endovascular surgery on three patients, and conservative treatment on three patients. The follow-up rate was 77.8% (14/18), and the average follow-up time was 48.2 months. The mortality and reintervention rate during follow-up was 0. The two-year patency rate of artificial vessels and covered stents was 50%. Conclusion The clinical manifestations and features of superior mesenteric artery aneurysms vary between patients. Careful evaluation of vascular anatomy and personalized treatment strategy are critical in the management of superior mesenteric artery aneurysms. Midterm follow-up results of superior mesenteric artery aneurysms are satisfactory.
The glucose error in arterial sampling: assessing staff awareness and the effect of sampling technique*
Authors: Patel Vikesh , Skorupska Natalia , Hodges Emily J , Blunt Mark C , Young Peter J , Mariyaselvam Maryanne ZA 
Published: October 2020

Background Using a dextrose-containing solution, instead of normal saline, to maintain the patency of an arterial cannula results in the admixture of glucose in line samples. This can misguide the clinician down an inappropriate treatment pathway for hyperglycaemia. Methods Following a near-miss and subsequent educational and training efforts at our institution, we conducted two simulations: (1) to observe whether 20 staff would identify a 5% dextrose/0.9% saline flush solution as the cause for a patient’s refractory hyperglycaemia, and (2) to compare different arterial line sampling techniques for glucose contamination. Results (1) Only 2/20 participants identified the incorrect dextrose-containing flush solution, with the remainder choosing to escalate insulin therapy to levels likely to risk fatality, and (2) glucose contamination occurred regardless of sampling technique. Conclusion Despite national guidance and local educational efforts, this is still an under-recognised error. Operator-focussed preventative strategies have not been effective and an engineered solution is needed.
Telemedicine, Patient Satisfaction, and Chronic Rhinosinusitis Care in the Era of COVID-19
Authors: Morisada Megan V. , Hwang Joshua , Gill Amarbir S. , Wilson Machelle D. , Strong E. Bradley , Steele Toby O. 
Published: October 2020

Background Telemedicine has become increasingly popular in the care of rhinologic patients during the COVID-19 pandemic. This change in practice patterns may place patients at risk of a perceived lower-quality exchange with their healthcare provider, which may in turn impact satisfaction. Objective This study compares patient satisfaction scores between in-person clinic visits and telemedicine video visits in patients with chronic rhinosinusitis (CRS). Methods Sixty-nine patients with CRS presenting to an academic rhinology clinic between March to April 2020 were retrospectively divided into video visits (VV) and clinic visits (CV) groups based on mandated state quarantine orders on March 19. Patient demographics, disease severity measures, and Patient Satisfaction Questionnaire-18 (PSQ-18) scores were collected and analyzed. Chi square test and Fisher’s exact test were performed. Results There were no significant differences in age (p = 0.81), gender (p = 0.55), CRS phenotype (p = 0.16), and disease severity measures (Sinonasal Outcomes Test-22 (SNOT-22) (p = 0.92); Lund-Mackay score (p = 0.96)) between the video and clinic visit groups. There were no significant differences in PSQ-18 total scores (VV PSQ-18 mean score = 78.1, CV PSQ-18 mean score = 78.4; p = 0.67) or the following subdomain scores between the two groups: general satisfaction (p = 0.73), technical quality (p = 0.62), interpersonal manner (p = 0.41), communication (p = 0.31), financial aspects (p = 0.89), time spent with doctor (p = 0.88), and accessibility and convenience (p = 0.47). Conclusion Patient satisfaction with telemedicine in the COVID-19 pandemic parallels that of traditional in-person visits. Video visits can serve as a viable alternative to clinic visits, while still maintaining high satisfaction.
Interstitial lung disease is a major characteristic of anti-KS associated ant-synthetase syndrome
Authors: Ge Yongpeng , Li Sizhao , Li Shanshan , He Linrong , Lu Xin , Wang Guochun 
Published: October 2020

Background: Anti-KS autoantibodies are rare myositis-specific autoantibodies that have been described to target asparaginyl-transfer RNA synthetase. Methods: Here, we review the published literature on critical issues concerning the detection of anti-KS antibodies and the clinical features associated with their presence. Results: Seven articles are reviewed, in all of which immunoprecipitation was employed for the detection of anti-KS antibodies. A total of 47 patients were included; the ratio of females to males was 1.9:1. In total, 46 (98%) of these patients had interstitial lung disease (ILD), which was the sole manifestation in half (50%) of them. Pulmonary pathology revealed 7 (27%) with usual interstitial pneumonia, and 16 (62%) with non-specific pneumonia. Arthritis was present in about one-quarter (26%) of patients, and the incidence of Raynaud’s phenomenon and mechanic’s hands was 19% and 32%, respectively. However, manifestations of myositis were rare (9%). In addition, three (11%) patients had malignant tumors. Most patients responded to glucocorticoid therapy. Conclusions: Identifying anti-KS in patients with ILD may be useful for treatment, but reliable practical detection is needed. Furthermore, clinicians need to be aware of the possible presence of anti-KS antibodies in patients with ILD, either isolated or in combination with myositis.