bluuebunny/crossref_metadata_2025_split huggingface dataset:
Von Hippel-Lindau gene single nucleotide polymorphism (rs1642742) may be related to the occurrence and metastasis of HBV-related hepatocellular carcinoma
Authors: Chen Xuebing , Zhang Hao , Ou Shimei , Chen Huijuan 
Published: September 2021

Abstract
It is well-known that microRNAs are able to regulate the expression of target mRNAs through complementary base-pairing to their 3′-untranslated regions (3′UTR) sequences. This study aimed to investigate whether single nucleotide polymorphisms resided in the 3′UTR sequences in patients with chronic hepatitis B viruses (HBV) infection are associated with the development and metastasis of hepatocellular carcinoma (HCC). Seventeen single nucleotide polymorphisms in the 3′UTR sequence of 10 genes regulated or affected by hepatitis B virus X protein were found by bioinformatics methods. Two hundred fifteen patients with HBV-related HCC and 216 patients with chronic HBV infection were recruited. Through case-control study, only found that the von Hippel-Lindau gene rs1642742 (G>A) may be associated with the occurrence and metastasis of HCC. The ORs of the frequencies of rs1642742 A allele versus G allele were 1.424 (P = .038, 95% confidence interval [CI] = 1.019–1.989) between HBV-related HCC and chronic HBV infection group and were 2.004 (P = .037, 95%CI = 1.031–3.895) between tumor metastasis and non-metastasis group, respectively. Through multivariate regression analysis, we also found that rs1642742 AA genotype was an independent risk factor for tumor metastasis (odds ratio = 2.227, 95% CI = 1.043–4.752, P = .038) in HBV-related HCC group. Our study suggested that Von Hippel-Lindau rs1642742 contributed to susceptibility to developing HCC and correlated with tumor metastasis.
Immune-related cholangitis induced by immune checkpoint inhibitors: a systematic review of clinical features and management
Authors: Pi Borui , Wang Jin , Tong Yifan , Yang Qiao , Lv Fangfang , Yu Yunsong 
Published: September 2021

Background & Aims
Immune checkpoint inhibitors (ICIs) improve the survival of patients with advanced tumors. However, immune-related adverse events limit the use of ICIs. Although liver toxicity has been concerned gradually, little is known about bile duct injury associated with ICIs. Hence, this review aims to describe clinicopathological features, imaging, and management of immune-mediated cholangitis (IMC) induced by ICIs.

Methods
We retrieved the literature from the PubMed database for case reports and series of IMC induced by ICIs. IMC was then classified as small-ducts type, large-ducts type and mixed type. Biochemical parameters, pathological characteristics, imaging features, treatment and response were evaluated and compared among three patterns.

Results
Fifty-three cases of IMC were enrolled. The median values of alkaline phosphatase and alanine transaminase of IMC were 1328 and 156 IU/L. The ALP level of the large-ducts type was higher than that of the small-ducts type (P = 0.021). The main pathological characteristics of small-ducts cholangitis were portal inflammation, bile duct injury and ductular reaction. The imaging features of large-duct cholangitis were bile duct dilatation, stenosis and bile duct wall thickening and irregularity. Forty-eight (90%) cases received immunosuppression therapy. Biliary enzymes reduced in 79% of cases receiving immunosuppression therapy, but only 8.5% of cases returned to normal. It took a long time for biliary enzymes to recover.

Conclusions
The clinicians should be aware of the possibility of IMC if the biliary enzymes increase significantly after the use of ICIs. The liver function can be improved partially by immunosuppressive therapy in the majority of IMC.
Factors associated with delayed revascularization in patients with ischemic stroke: a prospective study in one French region
Authors: Laurent Emeline , Bonnaud Isabelle , Gaudron Marie , Lahondère Alexia , Godillon Lucile , Vannier Sophie , Bouilleau Guillem , De Toffol Bertrand , Cottier Jean-Philippe , Laribi Saïd , Grammatico-Guillon Leslie 
Published: September 2021

Background and importance
Optimizing the care pathway of stroke is crucial for the revascularization of ischemic stroke.

Objectives
to identify factors associated with (1) a time interval over 4 h between the symptom onset and cerebral imaging in suspected stroke patients and (2) the absence of revascularization in patients with ischemic stroke.

Design, settings and participants
Patients over 18 years old with a suspected stroke admitted in 22 emergency rooms or stroke units in one French region between 1 March 2019 and 30 April 2019 were prospectively included by filling a dedicated form.

Outcome measures and analysis
Factors associated with the previously mentioned outcome measures were identified using logistic regression models.

Main results
In total 991 patients were included; 537 patients (64% of 845 with available time intervals) were admitted more than 4 h after symptom onset. Three predictors were identified: not calling emergency medical services (EMS) [odds-ratio (OR) 5.2; 95% confidence interval (3.4–8.1)], a preexisting autonomy loss [2.0 (1.3–2.9)] and atypical clinical presentation [2.0 (1.3–3.1)]. A total of 385 patients had an ischemic stroke of whom 93 underwent a revascularization procedure (24%). The same three predictors were associated with the absence of revascularization procedure, added to an initial admission in a hospital without stroke unit [3.1 (1.1–8.6)].

Conclusion
This study shows that efforts to organize the care chain for stroke need to be intensified in the region to reduce treatment time intervals, which could include information campaigns focused on the impact of EMS call and the clinical presentation recognition.
The clinical application of frailty in nephrology and transplantation
Authors: Alsaad Ranim , Chen Xiaomeng , McAdams-DeMarco Mara 
Published: September 2021

Purpose of review
Clinicians treating end-stage kidney disease (ESKD) and kidney transplant patients face unique challenges in their care because of the high burden of frailty in these patients. Frailty has gained significant attention by medical and surgical specialties for risk stratification in the past decades. This review highlights the importance of measuring frailty in kidney transplant candidates and recipients.

Recent findings
Emerging data support that frailty is present even at younger ages among patients undergoing dialysis, transplant evaluation, or transplantation. It is estimated that 18.8% of younger (18–64 years) candidates, 25.2% of older (≥65 years) candidates, 14.3% of younger recipients, and 20.8% of older recipients are frail. Additionally, frailty is dynamic and subject to change pretransplantation and posttransplantation. Although many patients and clinicians are aware of the importance of measuring frailty, further studies addressing the need for interventions to reduce frailty burden are needed.

Summary
Frailty is independently associated with many adverse outcomes in ESKD and kidney transplant populations. Given the growing number of ESKD and kidney transplant patients, it is pivotal to expand the utility of frailty measurement in clinical practice, recognize the burden of frailty, and identify appropriate interventions to mitigate the adverse effects of frailty.
Recent advances in dialysis membranes
Authors: Canaud Bernard 
Published: September 2021

Purpose of review
Improvement in hemodialysis treatment and membrane technology are focused on two aims: the first one is to achieve a better control of circulating uremic solutes by enhancing removal capacity and by broadening molecular weight spectrum of solutes cleared; the second one is to prevent inflammation by improving hemocompatibility of the global dialysis system.

Recent findings
Despite impressive progresses in polymers chemistry few hazards are still remaining associated with leaching or sensitization to polymer additives. Research has focused on developing more stable polymers by means of additives or processes aiming to minimize such risks. Membrane engineering manufacturing with support of nanocontrolled spinning technology has opened up membrane to middle and large molecular weight substances, while preserving albumin losses. Combination of diffusive and enhanced convective fluxes in the same hemodialyzer module, namely hemodiafiltration, provides today the highest solute removal capacity over a broad spectrum of solutes.

Summary
Dialysis membrane is a crucial component of the hemodialysis system to optimize solute removal efficacy and to minimize blood membrane biological reactions. Hemodialyzer is much more than a membrane. Dialysis membrane and hemodialyzer choice are parts of a treatment chain that should be operated in optimized conditions and adjusted to patient needs and tolerance, to improve patient outcomes.
Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations
Authors: Goldberg Elijah K. , Lal Ashutosh , Fung Ellen B. 
Published: September 2021

Background:
Reports of nutritional deficiencies in patients with thalassemia (Thal) are common. Despite its importance, however, nutritionally focused research in Thal has been limited by inadequate sample size, inconsistent methodology, a lack of control comparisons, and few interventional trials. Due to these limitations, clinicians lack evidence-based nutrition recommendations to support clinical decision-making. This systematic review summarizes observed relationships between nutrition and morbidity in Thal published in the last 3 decades.

Methods:
PubMed, Web of Science, and Embase were screened for articles pertaining to nutrition in Thal using comprehensive search terms. Studies performed in humans, written in English, and published between 1990 and 2020 were included. Over 2100 manuscripts were identified, from which 97 were included.

Results:
Patients with Thal were most often deficient in vitamins A, C, D, selenium, and zinc. Prevalence of nutritional deficiency was positively correlated with age and iron overload. Evidence to support the role of vitamin D and zinc for bone health was observed; zinc was also found to improve glucose metabolism.

Conclusions:
Due to the risk for multinutrient deficiency, nutritional status should be assessed annually in patients with Thal with prompt nutrient replacement when deficiency is detected. Routine supplementation with vitamin D and zinc is recommended.
Bortezomib-based Anthracycline-free Induction for Pediatric Relapsed ALL as a Bridge to Immunotherapy
Authors: Dadi Gal , Jacoby Elad , Toren Amos , Bielorai Bella 
Published: September 2021

Background:
Immunotherapy may lead to durable remissions in patients with relapsed and refractory acute lymphoblastic leukemia (R/R ALL). Patients receiving immunotherapy with a lower disease burden tend to have improved long-term outcomes and less toxicity. Thus, an induction protocol to achieve lower disease burden is required. Bortezomib added to a 4-drug induction was shown to lead to high rates of remission in R/R ALL patients. Inclusion of anthracyclines in this protocol may preclude most patients, having maximized the cumulative dose of anthracyclines. Thus, our goal was to evaluate anthracycline-free bortezomib-based induction for patients with R/R ALL.

Procedure:
We conducted a retrospective analysis of patients treated with bortezomib-based protocols for R/R ALL between 2011 and 2019 at our center. Data regarding toxicity and response rate was collected and analyzed.

Results:
Eighteen children with R/R ALL were treated with bortezomib-based induction, 13 of them without anthracyclines. Eleven patients did not complete the induction course: 6 due to toxicity, and 5 due to physician decision to proceed to immunotherapy early. Two events of treatment-related mortality occurred. There was no significant difference in toxicity between patients who treated with anthracycline and those who were not. Ten patients achieved complete remission, with 4 patients having polymerase-chain-reaction minimal residual disease below 10−4. Fifteen patients proceeded directly to immunotherapy: 11 patients received CD19 chimeric-antigen receptor-T-cells, 2 blinatumomab and 2 hematopoietic stem cell transplant.

Conclusion:
Anthracyclines can be safely omitted from bortezomib-based therapies in patients with R/R ALL, when planning to proceed to immunotherapy.
Examining the Experiences and Support Needs of Bereaved Parents After the Death of a Child During Early Adulthood From Cancer
Authors: Law Kate , Kirk Susan 
Published: September 2021

Background
Parents experience unique grief, which may be experienced differently by mothers and fathers. A lack of knowledge about the particular bereavement experiences of the parents of young adults exists.

Objective
The aim of this study was to investigate experiences and support needs of parents after the death of a child (aged 16-29 years) from cancer, exploring changes over time.

Methods
The study used a Charmazian constructivist grounded theory approach. Semistructured interviews were conducted with 11 parents (7 mothers and 4 fathers) purposefully sampled and bereaved between 15 months and 7 years. Data were analyzed inductively using the constant comparative approach for category development.

Results
“Living with continual loss” emerged as the core category central to parents’ experiences of bereavement. Feelings of continual loss were compounded by parents’ lack of information (“grieving in the dark”) and a perceived lack of understanding from families and friends (“grieving alone”). Parents discovered strategies to manage the feeling of loss: “changing routines,” “preserving the meaning of home,” “maintaining memories and presence,” and “sharing experiences.”

Conclusions
This is the first study focusing solely on the experiences and support needs of bereaved parents of young adults who have died of cancer. Parents live with a continual sense of loss irrespective of the length of bereavement, and a lack of bereavement information and empathetic emotional support can exist.

Implications for Practice
The need for improved information giving and development of peer support for bereaved parents has been identified. Cancer centers have a continuing role in developing and providing this support.
Coping Strategies for Stress and Self-Efficacy in Patients With Cancer and Their Spouses
Authors: Amirshamsi Mohammad , Shahrbabaki Parvin Mangolian , Dehghan Mahlagha 
Published: September 2021

Background
Cancer is one of the most important diseases of the present century worldwide. Patients and their spouses can find more difficulty accepting the diagnosis of cancer than its phases of treatment. Both the physical health and mental health of the patient and spouse are important in the process of recovery from cancer and its treatment.

Objective
The aim of this study was to determine the relationship between coping strategies for stress and self-efficacy in patients with cancer and that of their spouses.

Methods
In this descriptive-analytical cross-sectional study, 91 patients and their 91 spouses completed the Endler and Parker Coping Inventory, the Sherer General Self-Efficacy Scale, and a demographic information questionnaire.

Results
The problem-oriented coping style was used more than the other strategies by patients with cancer and their spouses. The least used coping style by patients and their spouses was the avoidance style. The self-efficacy of patients and their spouses was above average. Self-efficacy was directly and moderately correlated with problem-oriented coping style (P < .001) and inversely and moderately correlated with emotion-oriented coping style (P < .001).

Conclusions
Adoption of strategies like training and consulting may enhance the problem-focused coping style and reduce emotion-focused coping style and therefore lead to increased self-efficacy in patients and their spouses.

Implications for Practice
Healthcare providers’, especially nurses’, knowledge and sensitivity about the coping strategies of patients with cancer and their spouses may help providers select more effective interventions for improving patients’ and their spouses’ effective coping styles and self-efficacy.
Bladder Stimulation for Clean Catch Urine Collection
Authors: Ravichandran Yagnaram , Parker Sarah , Farooqi Ahmad , DeLaroche Amy 
Published: September 2021

Objectives
Previous studies have demonstrated the efficacy of fluid intake with suprapubic and lumbar paravertebral massage for clean catch urine (CCU) collection in infants. We investigated the acceptability and feasibility of integrating this bladder stimulation technique (BST) into routine care in the pediatric emergency department (PED).

Methods
This was a prospective cohort study. Infants less than 6 months of age requiring a urinalysis and urine culture as part of their PED visit were recruited. All PED nurses and technicians received a standardized training outlining the BST using a video module and print materials. Success rates, bacterial contamination, parental perception of patient distress, and parent and provider satisfaction with the BST for CCU collection were compared with urethral catheterization.

Results
A total of 124 patients were recruited. The BST was successful in 38% (47/124) with a median time to void of 73 seconds (interquartile range: 19, 151). The BST was more likely to be successful in infants less than 90 days (53%; 95% confidence interval, 0.075–0.046; P = 0.005). A urinary tract infection was diagnosed in 4% of patients, with no significant differences between BST (1/47; 2%) and catheterization (4/59; 7%; P = 0.65). Patients experienced less discomfort during the BST compared with catheterization (mean numeric rating scale score, 2/10 vs 6/10; P < 0.001), and the BST was viewed positively by both parents and providers. Compared with catheterization, parents were significantly more satisfied with the BST (BST, 98%; catheterization, 58%; P < 0.001) and were more likely to consent to the BST in the future (BST, 98%; catheterization, 69%; P < 0.001). Most providers reported that the BST was well tolerated by participants (46/47; 98%), and providers felt that the BST improved parental satisfaction with the clinical encounter (46/47; 98%).

Conclusion
The BST for CCU collection is a well-tolerated and well-received approach that can easily be implemented into clinical practice with minimal training.
Who Recovers Independent Bowel Management During the First Year After a Traumatic Spinal Cord Injury?
Authors: Dionne Antoine , Mac-Thiong Jean-Marc , Lim Victor , Richard-Denis Andréane 
Published: September 2021

Objectives
The aims of the study were (1) to document the characteristics of patients with impaired bowel functioning during the subacute and chronic phases and (2) to identify factors associated with recovery of independent bowel functioning during the first year after traumatic spinal cord injury in patients who present impaired bowel functioning during the subacute phase, when bowel rehabilitation is completed.

Design
This is a case-control study on 123 adult traumatic spinal cord injury patients. Bowel function assessments using item 7 of the Spinal Cord Independence Measure III were obtained 3 mos after traumatic spinal cord injury and during the early chronic phase. Univariate and multivariate analyses were conducted to identify predictors associated with recovery of independent bowel functioning between the initial assessment and follow-up.

Results
Of the 110 patients available for analysis, 54 (49%) displayed impaired bowel functioning 3 mos after traumatic spinal cord injury. Of these, 19 (35%) recovered independent bowel functioning over the following 9 mos. The total motor score was the only significant predictor of this outcome. A total motor score lower than 42 was 100% predictive of absence of recovery.

Conclusions
Recovering independent bowel management 1 yr after traumatic spinal cord injury was possible in 35% of patients despite impaired bowel functioning during the subacute phase. The total motor score measured 3 mos after injury could be useful for prognosticating potential for bowel functioning recovery because patients with total motor score lower than 42 are unlikely to recover.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Demonstrate a comprehensive understanding of the course of recovery of independent bowel function after traumatic spinal cord injury; (2) Describe the vulnerable subset of patients who present impaired bowel function at 3 mos after injury despite having received specialized bowel rehabilitation; and (3) Predict with improved accuracy the level of bowel function reached in the chronic phase for patients who present with impaired bowel function at 3 mos after injury.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Impact of Vaccination in the Rate of COVID-19 Staff Infection in an Acute Inpatient Rehabilitation Facility
Authors: Esquenazi Alberto , Watanabe Thomas , Barcikowski Jaclyn , Cao Ning , Sachinwalla Eric , Kwasniewski Michael 
Published: September 2021

Abstract
This brief report summarizes the comparative experience of an inpatient rehabilitation facility dealing with two episodes of COVID-19 infection, one before and one after the availability of vaccination, which was deployed to staff. The experience exemplifies the high rate of infection and potential for asymptomatic presentation of COVID-19 as well as the protective advantage of the vaccine for healthcare workers in this report. With a significant reduction in the rate of infection, from nearly 30% before vaccination to only 2.5% after vaccination. The data presented should serve as an encouragement for vaccination across all populations.
Metabolic Cost and Performance of Athletes With Lower Limb Amputation and Nonamputee Matched Controls During Running
Authors: Fischer Gabriela , Antunes Diego , Volpato Ana , Delevatti Rodrigo Sudatti 
Published: September 2021

Abstract
The elastic function of running-specific prostheses likely contributes to a lower metabolic cost of running. However, it remains unclear whether running-specific prostheses provide advantages concerning the metabolic cost of running in relationship with nonamputee runners. This study aimed to systematically review the scientific literature to examine the peak performance (peak oxygen consumption—VO2peak and peak speed) and the metabolic cost between paired amputees and nonamputees during running and between amputee runners with traditional prostheses and running-specific prostheses. A literature search on three databases (MEDLINE/PubMed, Scopus, and Web of Science) was conducted using the following key words: (amputation OR amputee) AND (run OR running OR runner) AND (prosthesis OR prosthetics), resulting in 2060 records and 4 studies within the inclusion criteria. A methodological quality assessment was carried out using a modified version of the Downs and Black checklist. VO2peak of the amputees athletes (54 ± 2 mL kg−1 min−1) is similar (mean difference = −0.80 mL kg−1 min−1, confidence interval = −4.63 to 3.03) to nonamputees athletes (55 ± 2 mL kg−1 min−1). The average metabolic cost of the paired amputee athletes (4.94 ± 1.19 J kg−1 m−1) also does not differ (mean difference = 0.73 J kg−1 m−1, confidence interval = −0.74 to 2.20) from nonamputee runners (4.21 ± 0.16 J kg−1 m−1). The research on running in amputee and nonamputee athletes is limited. The few existing studies have limited methodological quality. The metabolic cost data from amputee athletes running with running-specific prostheses are within the range of nonamputee data.