bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vein and artery diameter influence on arteriovenous fistula maturation and patency in a Mexican population
Authors: Martinez-Mier Gustavo , Cisneros-Tinoco Miguel Angel , Sanchez-Ruiz Francisco Gerardo 
Published: September 2021

Background: There is no consensus of the optimal arterial and venous sizes on arteriovenous fistula (AVF) function and patency. The purpose of our study was to determine the influence of vein and artery sizes on maturation and patency in autologous first time AVF in a vascular access clinic of Mexican Social Security. Methods: Approved IRB single-center retrospective study in patients referred for their first AVF from 01/2018/ to 04/2020. Perianastomotic inner vein diameter and single inner artery diameter was recorded by duplex ultrasound. Outcomes were: failure to mature (FTM) and cumulative primary patency survival. Results: Eighty-six AVF’s were created (mean age 45.5 ± 15.1 years; 62.8% male; mean BMI 25.9 ± 4.3 kg/m2). About 86% were brachiocephalic AVF. Eight (8.1%) AVF had FTM. Mean follow-up was 19.7 ± 8.5 months. Two-year patency survival was 81.4%. FTM vein and artery diameters (2.1 ± 0.3 and 2.8 ± 0.7 mm respectively) were smaller than successful AVF’s (3.1 ± 0.9 and 3.5 ± 0.6 mm) ( p < 0.05). ROC curve calculated a 2.15 mm vein diameter cutoff (AUC: 0.86) and a 2.95 mm artery diameter cutoff (AUC: 079) for FTM AVF’s (83% sensitivity, 72% specificity both) ( p < 0.05). AVF’s created with a vein diameter <2.15 mm and <2.95 mm artery diameter had statistically significant lower patency survival than AVF’s with larger vein and artery diameters ( p < 0.05). Conclusion: Vein diameter <2.15 mm and artery diameter <2.95 mm influences AVF maturation and patency in a Mexican population.
Evaluating the Level of Pesticides in the Blood of Small-Scale Farmers and Its Associated Risk Factors in Western Ethiopia
Authors: Afata Tariku Neme , Mekonen Seblework , Tucho Gudina Terefe 
Published: September 2021

Background: The presence of agricultural pesticide residue can cause adverse health effects.The main objective of this study was to evaluate the level of pesticides in the blood of small-scale farmers (SSFs) and associated risk factors in western Ethiopia. Methods: Across sectional study was conducted in June 2020 using 240 blood samples, 140 from the exposed small-scale farmers (ESSFs) and 100 from non-exposed small-scale farmers (NESSFs). The blood sample analysis was mad for 5 organochlorines (OCs) and 3 synthetic pyrethroids (SPs) pesticides by gas-liquid chromatography with an electron capture detector (GC-ECD) methods. Extraction, and clean up of the samples were made by using standard analytical methods. To define the relationships between the outcomes and explanatory variables, logistic regression models were used. Results: The results shows that p,p’-DDT, heptachlor and deltamethrin were the most frequently detected pesticides with 96.4%, 95%, and 100% in both ESSFs and NESSFs, respectively. The ESSFs blood samples have shown the highest mean concentrations of permethrin and p,p'-DDT(1.26 ± 0.15) and (0.28 ± 0.4) mgL−1, respectively. SSFs under the age of 40 were 21% less likely to be exposed to permethrin than those above the age of 40 (Adjusted Odd Ratio, AOR, 0.21; 95% CI: 0.1-0.44). Male SSFs were 17 times more likely to be exposed to heptachlor than females (AOR, 17.36; 95%CI: 7.34-41.09) and farmers with no formal education were 18 times more likely to be exposed to deltamethrin than those with primary schools and beyond (AOR, 18.1; 95 %CI: 4.53-72.06). Furthermore, SSFs that did not use PPE appropriately were 3.6 and 6.21 times more likely to be exposed to cypermethrin (AOR, 3.6; 95%CI: 1.94-6.54) and p,p'-DDE(AOR, 6.21; 95%CI: 3.38-11.41) blood levels than those who did, respectively. SSFs that perform different activities like eating and drinking (11%), chewing (10%), and diverse activities (8%) were more likely to be exposed to p,p′-DDT than those farmers who didn’t use pesticides. Conclusions: This study identified a high concentration p,p'-DDE, p,p'-DDT, heptachlor, cypermethrin, permethrin, and deltamethrin in the blood of small scale farmers. The older age, less education, and farmers with inappropriate PPE use are more likely exposed to pesticides.
Optimizing Discharge After Shorter Hospitalizations: Lessons Learned Through After-Hours Calls with Thoracic Surgical Patients
Authors: Blumenthaler Alisa N. , Zhou Nicolas , Parikh Kavita , Hofstetter Wayne L. , Mehran Reza J. , Rajaram Ravi , Rice David C. , Sepesi Boris , Swisher Stephen G. , Vaporciyan Ara A. , Walsh Garrett L. , Antonoff Mara B. 
Published: September 2021

Objective Minimally invasive procedures coupled with enhanced recovery pathways enable faster postoperative recovery and shorter hospitalizations. However, patients may experience unexpected concerns after return home, prompting after-hours calls. We aimed to characterize concerns prompting after-hours calls to improve discharge strategies. Methods A single-institution, retrospective review was conducted of thoracic surgical patients from 11/4/2019 to 6/14/2020. Records were reviewed and elements of patient demographics, surgical procedures, postoperative courses, reasons for calls, and outcome of calls were collected. We compared characteristics of patients who made after-hours calls to those who did not, and performed multivariable analysis to identify characteristics associated with making an after-hours call. Results During the study period, 379 patients underwent thoracic surgical procedures, among whom 88 (23.2%) initiated after-hours calls. Of these, 62 (70%) addressed patient symptoms, while 26 (30%) addressed patient questions including drain management, medications, and hospital policy questions. Patients making after-hours calls more frequently had undergone complex operations (26.1% vs 8.2%, P = 0.001), and were less likely to have received a standardized, clinician-initiated post-discharge telephone follow-up (29.5% vs 54.3%, P < 0.001). Complex operations increased likelihood of after-hours calls (OR: 3.33, 95% CI: 1.69-6.57, P < 0.001), while receipt of clinician-initiated telephone follow-up decreased likelihood of after-hours calls (OR: 0.38, 95% CI: 0.22-0.64, P < 0.001). There were no differences in emergency visits between the 2 groups (11% vs 8%, P = 0.370). Conclusions Despite efforts to optimize patient symptoms and knowledge prior to discharge, a substantial number of patients still have concerns after discharge. Many after-hours calls are related to knowledge gaps that may be addressed with improved predischarge education. Moreover, clinician-initiated telephone follow-up shows benefit in reducing after-hours calls.
Effect of modifiable risk factors in Parkinson’s disease: A case-control study looking at common dietary factors, toxicants, and anti-inflammatory medications
Authors: Shermon Suzanna , Goldfinger Matthew , Morris Alexander , Harper Brian , Leder Adena , Santella Anthony J , Krishnamachari Bhuma 
Published: September 2021

ObjectiveTo investigate how common modifiable exposures, including dietary factors, select toxicants, and anti-inflammatory medications, may affect Parkinson’s disease.MethodsUsing surveys, a case-control study was conducted at a medical center, comparing Parkinson’s disease patients ( N  =  149) and healthy controls ( N  =  105). Subjects reported exposure to red meats, vegetables, alcohol, tobacco, anti-inflammatory medications, and pesticides. The relationship between exposures and Parkinson’s disease diagnosis was analyzed by logistic regression to generate odds ratio and 95% confidence interval.ResultsConsuming red meat “sometimes” or “always” was positively associated with Parkinson’s disease as compared to eating red meats “rarely” or “never”; (odds ratio  =   2.15, 95% confidence interval   =   1.06, 4.39; p  =  0.03) and (odds ratio   =   4.47, 95% confidence interval   =   1.67, 11.94; p  =  0.003), respectively. Exposure to pesticides showed a positive association with Parkinson’s disease (odds ratio  =   2.84, 95% confidence interval   =   1.34, 6.00; p  =  0.007). “Always” use of aspirin was inversely associated with Parkinson’s disease (odds ratio  =   0.32, 95% confidence interval   =   0.14, 0.70; p  =  0.004). “Ever” having used anti-histamines was inversely associated with Parkinson’s disease (odds ratio  =   0.37, 95% confidence interval  =  0.17, 0.81; p  =  0.01).DiscussionOur study suggests that there are modifiable external factors that are associated with Parkinson’s disease. The present study can thus assist clinicians, policy makers, and people living with Parkinson’s disease in improving the experience and management of Parkinson’s disease.
Cost-effectiveness of telemedicine care for patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia
Authors: Faleh AlMutairi Manal , Tourkmani Ayla M. , Alrasheedy Alian A. , ALHarbi Turki J. , Bin Rsheed Abdulaziz M. , ALjehani Mohammed , AlRuthia Yazed 
Published: September 2021

Background and aim: Telemedicine could be used to provide diabetes care with positive clinical outcomes. Consequently, this study evaluated the cost-effectiveness of telemedicine for patients with uncontrolled type 2 diabetes mellitus (i.e. HbA1c >9). Patients and methods: This was a retrospective chart review of patients with uncontrolled type 2 diabetes attending an outpatient integrated care clinic. The study consisted of two arms, namely a telemedicine care model and a traditional care model with 100 patients in each. The clinical effectiveness (i.e. reduction in HbA1c) and the total cost in both arms were determined, and the incremental cost-effectiveness ratio was calculated. This study adopted propensity score matching. Results: The patients in the telemedicine care model had a mean reduction in their HbA1c level of 1.82 (95% CI = 1.56–2.09, p < 0.001), while those in the traditional care model had a mean reduction of 1.54 (95% CI = 1.23–1.85, p < 0.001). Consequently, the incremental effect was 0.28 (95% CI = −0.194 to 0.546). The mean total costs were SAR 4819.76 (US$1285.27) and SAR 4150.69 (US$1106.85) for patients in the telemedicine and traditional care models, respectively. Consequently, the incremental cost was SAR 669.07 (US$178.42) [95% CI = SAR 593.7 (US$158.32)–SAR 1013.64 (US$270.30)]. The ICER was estimated to be SAR 2372.52 (US$632.67) per 1% reduction in the level of HbA1c. Moreover, the telemedicine care model resulted in a higher cost and better outcome (i.e. reduction in the HbA1c level) with an 81.80% confidence level. Conclusion: Telemedicine care is cost-effective in managing type 2 patients with poorly controlled diabetes. Consequently, we believe that telemedicine care can be further expanded and incorporated into routine diabetes care.
Prevalence of programmed death ligand-1 in patients diagnosed with non-small cell lung cancer in Lebanon
Authors: Fakhri Ghina , Akel Reem , Khalifeh Ibrahim , Chami Hassan , Hajj Ali Adel , Al Assaad Majd , Atwi Haneen , Kadara Humam , Tfayli Arafat 
Published: September 2021

Introduction: Programmed death ligand-1 expression has been shown to be a good predictor of response to cancer therapy with checkpoint inhibitors. Its expression varies among different tumor types and among non-small cell lung cancer patients with different clinical and demographic characteristics. The prevalence and determinants of programmed death ligand-1 expression have been previously reported from various regions of the world, but data from Lebanon are lacking. This study examines the prevalence and the clinical, demographic and pathological predictors of programmed death ligand-1 expression in patients diagnosed with non-small cell lung cancer in Lebanon. Methods: Medical records of 180 patients diagnosed with primary non-small cell lung cancer at our institution and tested for programmed death ligand-1 expression were reviewed. Clinical, demographic and pathological information were collected and correlated with programmed death ligand-1 expression using the chi-square test and logistic regression. Results: One hundred eleven of the 180 non-small cell lung cancer tumor samples tested positive for programmed death ligand-1 expression (61.7%). 27.2% of those tumor samples expressed programmed death ligand-1 in 1%–49% of tumor cells, while 34.4% of tumor samples expressed programmed death ligand-1 in 50% or more of their cells. Squamous histology and advanced stage were significant predictors of programmed death ligand-1 expression (odds ratio = 2.79, 95% confidence interval [1.13–6.90], p = 0.012 and odds ratio = 2.48, 95% confidence interval [1.23–4.99], p = 0.044, respectively). Conclusion: Similar to reports from other populations, our results suggest that programmed death ligand-1 expression in non-small cell lung cancer is highly prevalent in the Lebanese population, especially in patients with advanced stage at diagnosis or squamous cell carcinoma histology. Because of the small sample size, while more that 60% of the patients are Lebanese, the results of this article cannot be extrapolated to the Middle Eastern and the Levantine population.
Cervical Spinal Cord Compression in Adult Scoliosis
Authors: Nakashima Hiroaki , Kawakami Noriaki , Ohara Tetsuya , Saito Toshiki , Tauchi Ryoji , Imagama Shiro 
Published: September 2021

Study Design Retrospective cohort study. Objectives The aim was to examine cervical spinal cord compression (SCC) in adult scoliosis and clarify the prevalence of and risk factors for cervical SCC. Methods This study included 270 adult scoliosis patients and 1211 healthy volunteers. Cervical SCC was evaluated on cervical magnetic resonance imaging (MRI). The rates of SCC for those with adult scoliosis and the healthy volunteers were compared. Logistic regression analysis was conducted to examine the factors associated with cervical SCC on MRI. Results In cases with adult scoliosis, preoperative major scoliosis curve was 56.0° ± 18.8°, and cervical SCC was detected in 25 patients (9.3%). Among the healthy volunteers, 64 cases with cervical SCC were detected. Only in cases with adult scoliosis, logistic regression analysis revealed higher age (OR 1.09, 95% CI 1.04–1.14, P < .001), narrow canal diameter (OR 2.27, 95% CI 1.35–3.85, P = .002), and inferior sagittal balance (OR 2.45, 95% CI 1.02–5.89, P = .04) as significant risk factors. In the logistic regression analysis in all subjects (including adult scoliosis and healthy volunteers), higher age (OR 1.08, 95% CI 1.06–1.10, P < .001) and narrow canal diameter (OR 1.62, 95% CI 1.37–1.92, P < .001) were also found to be significant risk factors, but the presence of scoliosis was not a significant factor. Conclusions Adult scoliosis itself was not significantly associated with cervical SCC. Inferior sagittal balance in addition to scoliosis constituted a significant risk factor for cervical SCC.
The current implementation of Oslo Sports Trauma Research Center cycling injury prevention exercises among male elite cyclists in the Gulf Cooperation Council
Authors: Al Attar Wesam Saleh A , Husain Mohamed A , Komir Ramy , Alanazi Khulud , Ghulam Hussain 
Published: September 2021

Background/purpose Cyclists are expected to present with sport-related injuries. The Oslo Sports Trauma Research Center provided exercises for preventing the most common injuries in cycling. We aimed to survey the compliance with Oslo Sports Trauma Research Center exercises among cyclists in the Gulf Cooperation Council countries. It is expected that most cyclists in the Gulf Cooperation Council countries are implementing these exercises as part of their warm-up sessions. Methods This cross-sectional online survey collected the participants’ demographic characteristics (country, age, and sex) and assessed their compliance with the programme. Results Four-hundred and twenty-three cyclists responded, of which 52% were aged 20–29 years. The pelvic control exercise was the most implemented (56%), followed by the elephant and isolated pelvic rotation exercises (54%); the single-leg pelvic rotation exercise was the least implemented (46%). The implementation rate did not differ significantly according to age or country. Saudi Arabia and Kuwait reported the highest mean implementation scores, while the United Arab Emirates reported the lowest Conclusions The implementation rate of Oslo Sports Trauma Research Center exercises was low among cyclists in the Gulf Cooperation Council countries. There is a need to increase awareness between players, programme deliverers, and policymakers and educate them about the importance of implementing such programmes in injury reduction.
Frequency and prognostic impact of blood-circulating tumor mast cells in mastocytosis
Authors: Henriques Ana , Muñoz-González Javier I. , Sánchez-Muñoz Laura , Matito Almudena , Torres-Rivera Lidia , Jara-Acevedo María , Caldas Carolina , Mayado Andrea , Pérez-Pons Alba , García-Montero Andrés C. , Álvarez-Twose Iván , Orfao Alberto 
Published: September 2021

AbstractCirculating tumor mast cells (CTMCs) have been identified in the blood of a small number of patients with advanced systemic mastocytosis (SM). However, data are limited about their frequency and prognostic impact in patients with MC activation syndrome (MCAS), cutaneous mastocytosis (CM) and nonadvanced SM. We investigated the presence of CTMCs and MC-committed CD34+ precursors in the blood of 214 patients with MCAS, CM, or SM using highly sensitive next-generation flow cytometry. CTMCs were detected at progressively lower counts in almost all patients with advanced SM (96%) and smoldering SM (SSM; 100%), nearly half of the patients (45%) with indolent SM (ISM), and a few patients (7%) with bone marrow (BM) mastocytosis but were systematically absent in patients with CM and MCAS (P &lt; .0001). In contrast to CTMC counts, the number of MC-committed CD34+ precursors progressively decreased from MCAS, CM, and BM mastocytosis to ISM, SSM, and advanced SM (P &lt; .0001). Clinically, the presence (and number) of CTMCs in blood of patients with SM in general and nonadvanced SM (ISM and BM mastocytosis) in particular was associated with more adverse features of the disease, poorer-risk prognostic subgroups as defined by the International Prognostic Scoring System for advanced SM (P &lt; .0001) and the Global Prognostic Score for mastocytosis (P &lt; .0001), and a significantly shortened progression-free survival (P &lt; .0001) and overall survival (P = .01). On the basis of our results, CTMCs emerge as a novel candidate biomarker of disseminated disease in SM that is strongly associated with advanced SM and poorer prognosis in patients with ISM.
Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis
Authors: Ito Yusuke , Honda Akira , Kurokawa Mineo 
Published: September 2021

Abstract
Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pretransplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. Thirty articles and abstracts were extracted from PubMed, Embase, and Cochrane Library databases and conference proceedings. Fixed and random effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid malignancies (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.06-1.82 and HR, 2.03; 95% CI, 1.23-3.32, respectively) and lymphoid malignancies (HR, 2.07; 95% CI, 1.79-2.40 and HR, 1.91; 95% CI, 1.61-2.25, respectively), as well as outcomes for several lymphoma subtypes individually. Furthermore, a lower pretransplant vitamin D level was associated with poorer OS in autologous and allogeneic HSCT (HR, 1.65; 95% CI, 1.04-2.61 and HR, 1.50; 95% CI, 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).
Increased hemoglobin and heme in MALDI-TOF MS analysis induce ferroptosis and promote degeneration of herniated human nucleus pulposus
Authors: Shan Liang , Xu Ximing , Zhang Jing , Cai Peng , Gao Han , Lu Yingjie , Shi Jiangang , Guo Yinlong , Su Yue 
Published: September 2021

AbstractBackgroundNeovasculogenesis is characteristic of herniated lumbar discs, in which extruded nucleus pulposus is prone to heme iron-induced cytotoxicity (increased oxidative stress causing ferroptosis). However, recent analyses of neovascularization are very complicated, and the mechanism of action is rarely reported.MethodsMatrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS) was performed to analyze human herniated and nonherniated nucleus pulposus. Then, the clinical relevance of the MALDI-TOF MS results and Pfirrmann classification of the degenerative nucleus pulposus were analyzed. To explore the mechanism, the heme-induced ferroptosis effect was evaluated at both the tissue and cell levels using high-resolution MALDI-TOF MS and molecular biology methods.ResultsThe spectra revealed that hemoglobin (Hb) and heme signals were greatly increased, thus serving as predictors of vasculogenesis in herniated nucleus pulposus. The clinical relevance analysis demonstrated that the intensity of Hb and heme peaks was closely related to the Pfirrmann classification of degenerative nucleus pulposus. Mechanistically, increased heme catabolism and downregulation of glutathione peroxidase 4 (GPX4) levels were detected in herniated nucleus pulposus, reflecting iron-dependent cell death or ferroptosis. Iron levels was also increased in herniated nucleus pulposus compared with that in nonherniated nucleus pulposus. Furthermore, accuracy mass measurements confirmed that the levels of ferroptosis-related metabolites, such as glutathione, arachidonic acid (AA), sphinganine, polyunsaturated fatty acid (PUFA), and tricarboxylic acid (TCA) cycle metabolites, were significantly different between herniated and nonherniated tissues, indicating that the interior of the herniated tissues is a pro-oxidant environment. Moreover, heme-induced ferroptosis was verified in human nucleus pulposus cells (HNPCs), and the underlying mechanism might be associated with the Notch pathway.ConclusionsNeovascularization in herniated nucleus pulposus may expose tissues to high levels of heme, which can induce cytotoxicity and ferroptosis within tissues and accelerate the progressive degeneration of herniated nucleus pulposus. This study is beneficial for understanding the pathological mechanism of herniated nucleus pulposus and facilitating the development of nonoperative interventions for treating lumbar disc herniation (LDH).