bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial
Authors: Igbodike Emeka Philip , Awowole Ibraheem Olayemi , Kuti Olufemi O , Ajenifuja Kayode Olusegun , Eleje George Uchenna , Olateju Simeon Olugbade , Olopade Bolatito Opeyemi , Ijarotimi Omotade Adebimpe , Irek Emmanuel Oladayo , Igbodike Njideka Theresa , Ayegbusi Oluwole Ekundayo , Ikechebelu Joseph Ifeanyichukwu , Okpala Boniface Chukwuneme , Loto Olabisi Morebisi , Fehintola Akintunde Olusegun , Ajiboye Akinyosoye Deji , Fajobi Olusola , Abuchi Chima Stephene , Onwudiegwu Uchenna Uchenna , Fasubaa Olusola Benjamin , Orji Ernest Okechukwu , Makinde Olufemiwa Niyi , Owolabi Alexander Tuesday , Adeyemi Adebanjo Babalola 
Published: November 2021

Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section. Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 ) Results: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001) Conclusions: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes
Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
Authors: Arima Daisuke , Suematsu Yoshihiro , Kurahashi Kanan , Nishi Satoshi , Yoshimoto Akihiro 
Published: November 2021

Purpose Coagulation-fibrinolysis markers are widely used for the diagnosis of Stanford type A acute aortic dissection (SAAAD). However, the role of these markers in estimating prognosis remains unclear. Methods A single-center retrospective study was conducted to identify the relationship between preoperative D-dimer and fibrinogen levels on SAAAD postoperative early prognosis. Results Of 238 SAAAD patients who underwent surgery between January 2012 and December 2018, 201 (84.5%) and 37 (15.5%) patients constituted the survival and non-survival groups, respectively, 30 days after surgery. D-dimer and fibrinogen levels in the survival and non-survival groups were 45.2 ± 74.3 vs. 91.5 ± 103.6 μg/mL ( p = 0.014) and 224.3 ± 95.6 vs. 179.9 ± 96.7 μg/mL ( p = 0.012), respectively. According to logistic predictor analysis of 30-day mortality, significant factors showed patent type (OR 10.89, 95% CI 1.66–20.31) and malperfusion (OR 4.63, 95% CI 1.74–12.32). Increasing D-dimer (per +10 μg/mL) and decreasing fibrinogen (per −10 μg/mL) were significantly associated with patent type and malperfusion. Receiver operating characteristic analysis was performed to distinguish between survival and non-survival. The cutoff value of D-dimer was 60 μg/mL (sensitivity 61.1%; specificity 82.5%; area under curve [AUC] 0.713 ± 0.083); fibrinogen was 150 mg/dL (sensitivity 44.4%; specificity 84.0%; AUC 0.647 ± 0.092). Kaplan-Meier survival curve analysis showed that patients with D-dimer levels > 60 μg/mL and fibrinogen levels < 150 mg/dL had significantly low survival rates at 30 days after surgery (60.0%, p < 0.001). Conclusion Preoperative coagulation-fibrinolysis markers may be useful for predicting early prognosis in SAAAD.
Management and perinatal outcomes of hypertensive disorders of pregnancy in a low-resource setting in Indonesia
Authors: Tjandraprawira Kevin Dominique , Kusumah Aria Yusti , Kamilah Azka Yumna , Putri Dhini Isti , Ananta Mayang Rizky , Sari Selvi Puspa , Djuwantono Tono , Petrie Aviva 
Published: November 2021

Objectives: To provide up-to-date data concerning hypertensive disorders of pregnancy on maternal and neonatal profiles in Indonesia. Methods: Retrospective clinical audit on all pregnancy-associated hypertensive women between 1 January 2020 and 31 March 2020 at Cianjur General District Hospital. Results: Preeclampsia accounts for 66.8% (235/352) of hypertensive disorders of pregnancy, gestational hypertension 29% (102/352) and chronic hypertension 4.3% (15/352). Compared to other pregnant women, those with preeclampsia, on average, had higher systolic and diastolic blood pressures and poorer kidney (ureum and creatinine) and liver function (aspartate transaminase enzyme and alanine transaminase enzyme) profiles (p < 0.001, < 0.001, < 0.001, 0.003, 0.033 and 0.002, respectively), and required more intensive care admission. Neonates from women with severe forms of preeclampsia (eclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)) had, on average, lower birthweight (p = 0.015 and 0.048, respectively) and birth length (p = 0.021, 0.017). Neonates from eclamptic mothers had poorer APGAR (appearance, pulse, grimace, activity and respiration) scores (p = 0.006 and 0.005, respectively). Conclusion: Hypertensive disorders of pregnancy exerts adverse maternal and neonatal outcomes, particularly among eclampsia and HELLP-syndrome neonates. Various challenges remain for optimal management.
Incidence of malignancy in multiple sclerosis: A cohort study in the Danish Multiple Sclerosis Registry
Authors: Nørgaard Mette , Veres Katalin , Sellebjerg Finn T , Svingel Lise S , Foch Caroline , Boutmy Emmanuelle , Sabidó Meritxell , Magyari Melinda 
Published: November 2021

Background The association between multiple sclerosis and malignancy is controversial and a current appraisal is needed. Objective To determine the incidence of malignancy in patients with multiple sclerosis compared with the general population and in relation to disease-modifying therapy. Methods Patients with multiple sclerosis (1995 – 2015) were matched by birth year and sex to individuals without multiple sclerosis in the general population. Patients with multiple sclerosis initiating disease-modifying therapy were evaluated using landmark period analysis. Malignancy risk was assessed by incidence rates, incidence rate ratios, and standardised incidence ratios. Results The standardised incidence ratio of any malignancy (excluding non-melanoma skin cancer) in patients with multiple sclerosis ( n = 10,557) was 0.96 (95% CI 0.88 – 1.06), and there was no increased incidence of specific malignancy types compared with the general population cohort ( n = 103,761). At the 48-month landmark period, the age-adjusted incidence per 100,000 person-years of any malignancy (excluding non-melanoma skin cancer) was 436.7 (95% CI 361.0 – 512.4) in patients newly treated with immunomodulator-only and 675.1 (95% CI 130.4 – 1219.9) in patients newly treated with immunosuppressant-only. Conclusions There was no increased incidence of malignancy overall or by type in patients with multiple sclerosis compared neither with the general population nor in relation to disease-modifying therapy.
Optimal timing for laparoscopic cholecystectomy in the treatment of gallbladder calculi incarceration
Authors: Bao Jian-Heng , Wang Yu-Jie , Shang Hai-Tao , Hao Cheng-Fei , Liu Jun-Jian , Zhang De-Lin , Han Shu-Wang , Li Zhong-Lian 
Published: November 2021

Objective Laparoscopic cholecystectomy (LC) has become a popular method in the treatment of gallbladder calculi incarceration (GCI). This study aimed to investigate the effect of early and delayed LC on patients with GCI to determine the optimal timing for LC. Methods The clinical data of 639 patients with GCI who had received LC were analyzed retrospectively. According to the duration of symptoms before admission and that from admission to LC, the patients were divided into different groups. The relationship between conversion and postoperative complications was compared among the different groups. Results Seventy-two patients (11.27%) underwent conversion to laparotomy, and 65 patients (10.17%) had postoperative complications. Patients in the LC > 15 d group were older ( p < 0.001), had a longer operation time ( p < 0.001), had a longer duration of hospitalization ( p < 0.001), had a higher proportion of conversion ( p < 0.001), and had a higher incidence of postoperative complications ( p < 0.001). Type 2 diabetes mellitus (T2DM) (RR = 1.701; 95% CI: 1.410–2.047; p < 0.001) and duration from admission to LC (RR = 7.072; 95% CI: 3.044–16.431; p < 0.001) were independent risk factors for conversion. Older age, T2DM, CRP, duration of symptoms before admission >3 m, and duration from admission to LC > 15 d were independent predictors of postoperative complications. Conclusion For patients younger than 65 years without contraindications, early operation should be performed within 3 d after admission to reduce the operation time, hospitalization time, conversion, and postoperative complications.
The Perceived Demands of Ice Hockey Goaltending Movements on the Hip and Groin Region: An Elite Coach and Player Perspective
Authors: Wörner Tobias , Frayne Ryan J. , Magnusson Thomas , Eek Frida 
Published: November 2021

Background: Many ice hockey goaltending techniques force hip joints and groin muscles into extreme ranges of motion, which may increase the risk of hip and groin problems. Purpose: To explore how elite goaltenders and goaltending coaches perceive the demands of common goaltending techniques on the hip and groin region. We further explored differences in perception between goaltenders and their coaches as well as between junior (age <20 years) and senior (age ≥20 years) goaltenders. Study Design: Cross-sectional survey. Methods: We developed a model to categorize common ice hockey goaltending techniques into quantifiable units and invited elite goaltenders and coaches in Sweden to complete an online survey. Participants were asked to rate the perceived demands of each technique on the hip and groin using a Likert scale (not at all, slightly, somewhat, very, or extremely demanding). Using the chi-square test, the proportion of participants perceiving each technique as very or extremely demanding were compared between goaltenders and coaches as well as between senior and junior goaltenders. Results: We received responses from 132 goaltenders and 43 coaches. The stances most frequently perceived as very or extremely demanding were the reverse vertical horizontal post-play (40%) and the butterfly save (25%). Among transitions, movements into the post were most frequently rated as very or extremely demanding (11%–40%). Several techniques were perceived as demanding by a larger share of coaches than goaltenders (difference, 13%–46%; P < .001–.028) and a larger share of senior versus junior goaltenders (difference, 12%–20%; P = .13–.18). Conclusion: The post-play and the butterfly were the goaltending techniques most frequently perceived as demanding, and more coaches than goaltenders percieved these techniques demanding. The results of this study may inform injury prevention efforts for ice hockey goaltending.
A Novel Risk Scoring System to Predict Survival in Soft Tissue-Related Extramedullary Multiple Myeloma
Authors: Huang Beihui , Wang Qing , Li Wuping , Zhao Ying , Li Juan 
Published: November 2021

Abstract
Objective:
Extramedullary multiple myeloma (EMM) is an aggressive subtype of multiple myeloma, especially those soft tissue-related extramedullary multiple myeloma (EM-S). Plasma cells often infiltrate in extramedullary tissues, but the proportion of plamas cells in bone marrow is not high, so FISH test often produces false negative results. Therefore, the R-ISS staging system cannot predict the really prognosis of this type of patients. A novel risk score is needed for these patients.
Methos: A cohort of 73 patients with EM-S in four centers in China were included, excluding those only with bone related extramedullary multiple myeloma, primary or secondary plasma leukemia. We performed univariate and multivariate Cox regression analysis, generated risk scores to predict outcomes in EM-S MM and compared with R-ISS staging.
Results: In the Cox multivariate model, high LDH, low count of platelet、central nervous system involved, abdominal viscera involved (including liver, spleen, pancreas, kidney) and Ki67≥70% were found to significantly and independently predict outcomes for EM-S. According to these parameters, the patients were divided into three groups: the low-risk group with a median TTP of 14.13 months, and the medium-risk group with a median TTP of 8.53 months. In the high-risk group, the median TTP was 2.73 months (p&lt;0.05 between any two groups). This novel risk is better to predict prognosis of this group of patients than R-ISS stage, in which the TTP in R-ISS stage I was 20.33 months, R-ISS stage II 9.83 months, and R-ISS stage III 4.83 months (p=0.065). Conclusion: The novel risk stratification for EM-S may be may be superior to R-ISS for EM-S MM patients.
Figure 1 Figure 1.

Disclosures
No relevant conflicts of interest to declare.
Efficacy and Safety of CD19-Targeted CAR-T Cell Therapy for Refractory/Relapsed B-Cell Lymphoma: A Single Center of Real World Data
Authors: Huang Jing , Fei Jia , Ou Ruiming , Liu Zhi , Zheng Liling , Zhu Yangmin , Shen Huijuan , Du Yuanyuan , Zhou Qinjun , Chen Jiali , Zhou Changhua , Yan Rongrong , Wang Jiale , Liu Shuang , Zhang Qing 
Published: November 2021

Abstract
【Abstract】 Objective To investigate the efficacy and safety of CD19-targeted chimeric antigen receptor T cell (CAR-T cell) for refractory/relapsed B-cell lymphoma. Methods The efficacy and safety of CD19-CAR-T cells(4-1BB costimulatory domain) in treatment of 12 patients with relapsed/refractory B-cell lymphoma from March 2018 to December 2019 in the Department of Hematology of Guangdong Second Province Hospital were collected analyzed retrospectively. There were 9 patients (75%) with diffuse large B cell lymphoma, 1 patient with blastic variant of mantle cell lymphoma, 1 patient(8.3%) with Burkitt lymphoma, 1 patient with B cell non-Hodgkin lymphoma that cannot be classified. 3 patients (25%) with large mass (≥7.5cm) and 9 patients (75%) with ECOG score ≥2. The number of chemotherapy courses received before transfusion was 4-9, the median number of chemotherapy courses was 7. All 12 patients were autogenous mouse CAR-T cells. Fludarabine + Cyclophosphamide (FC) regimen was used for pretreatment before transfusion, and the number of CAR-T cells was 1 ~ 3.69×10 6/kg. Results All 12 patients received CD19-targeted CAR-T cell therapy. There were 9 patients had treatment response, and the total effective rate was 75%. Among them, there were 3 patients with complete response (CR), with CR rate of 25%, and 6 patients with partial response (PR), with PR rate of 50%. Among the 3 patients with CR remained CR at the follow-up date. Among the 6 patients with PR, 4 showed disease progression in the second month after transfusion, and 2 showed disease progression in the third month after transfusion. All the 9 patients with effective treatment had different degrees of cytokine release syndrome (CRS), including 3 level-1 CRS, 4 level-2 CRS, and 2 level-3 CRS. Two of them had grade 2 CRES, and all CRS and CRES were controlled after treatment with IL-6 receptor antagonists and glucocorticoids. None of the 3 patients failed to respond to treatment had CRS. Conclusion CD19-targeted CAR-T cell immunotherapy has been shown to be effective in CD19-antigen positive B-cell lymphoma, and adverse CRS reactions during treatment can be controlled after treatment. Patients who obtained CR seemed to be able to maintain long-term CR status, while patients who failed to obtain CR showed disease progression within a short period of 3 months, suggesting that patients who obtained CR at an early stage could achieve better efficacy. Therefore, how to identify patients who receive CR at an early stage may be a research direction for the clinical application of CAR-T cell immunotherapy in B-cell lymphoma.
【Key words】Chimeric antigen receptor T-cell; Relapsed/refractory B cell lymphoma; Efficacy; Safety; Cytokine release syndrome

Disclosures
No relevant conflicts of interest to declare.
Early Platelets Elevation after Complete Remission in Favorable- and Intermediate-Risk Acute Myeloid Leukemia Is an Independent Predictor of Favorable Outcomes:a Retrospective Study
Authors: Wen Xiaoling , Zhang Ruijuan , Li Ruoqi , Zhai Jiahong , Yang Suxia , Wang Yaozi , Zhang Xialin , Tan Yanhong , Yang Linhua 
Published: November 2021

Abstract

Platelet (PLT) recovery after chemotherapy is associated with the prognosis in patients with acute myeloid leukemia (AML); however, its predictive value is yet controversial. A total of 206 de novo non-M3 AMLs treated at the Second Affiliated Hospital of Shanxi Medical University from January 2014 to December 2020 and achieved complete remission (CR) were analyzed in this retrospective study. The overall survival (OS) and relapse-free survival (RFS) were assessed using Kaplan-Meier and Cox regression analyses.According to receiver operating characteristic (ROC) curve analysis, 312×10 9/L was confined as the cutoff of the PLT count, and hence, we divided patients into high PLT group (≥312×10 9/L) and low PLT group (100≤PLT&lt;312×10 9/L). Multivariate analysis revealed that early (we defined the highest PLT count from 28-42 days after induction chemotherapy as early platelet count and called it D28 PLT) high PLT count (≥312×10 9/L) recovery showed favorable RFS (hazard ratio (HR)=0.409, p=0.001) and OS (HR=0.394, p=0.001). The subgroup analysis demonstrated that patients in the favorable- and intermediate-risk (non-adverse-risk ) group with D28 PLT≥312×10 9/L showed better survival outcomes (RFS: HR=0.289, p=0.001; OS: HR=0.266, p&lt;0.001) compared to those with 100≤PLT&lt;312×10 9/L. The current study showed that early high PLT count recovery at CR in non-adverse-riskAMLs is an independent positive predictive factor for survival outcomes.

Disclosures
No relevant conflicts of interest to declare.
Protective Role of Plasminogen Deficiency in Non-Alcoholic Fatty Liver Disease and Glucose Dysmetabolism
Authors: Hur Woosuk Steve Steve , Nyugen Y-Van , Flick Matthew J. 
Published: November 2021

Abstract
Obesity is global health problem with 40% of the world population being classified as overweight (BMI &gt; 25) and 13% as obese (BMI &gt; 30). Obesity drives chronic metabolic inflammation leading to metabolic syndrome, cardiovascular disease, fatty liver disease, Type II diabetes, and certain cancers. A documented clinical manifestation of obesity is perturbed and dysregulated hemostatic system leading to a procoagulant and anti-fibrinolytic state that ultimately results in an increased risk of thrombosis.
Previous work suggested that clotting system components thrombin and fibrin engage in reciprocal mechanisms and contribute to the development of obesity. Specifically, we have shown that fibrin accumulates within obese adipose tissue and liver of obesity patients and mice challenged with a high fat diet (HFD) and colocalizes with macrophages, a key driver of inflammation in obesity. Despite the fact that obesity is known to be linked to an impaired fibrinolytic system, a potential functional contribution of fibrinolytic proteases to the development of obesity and associated downstream diseases has been understudied.
Here, we tested the hypothesis that elimination of the fibrinolytic protease plasminogen would increase HFD-driven fibrin deposition and exacerbate macrophage accumulation and subsequent weight gain and obesity-associated pathologies. Contrary to our hypothesis, plasminogen-deficient (Plg-) mice gained as much weight as the Plg+ mice after 20 weeks on HFD. However, whereas the liver mass of HFD-challenged Plg+ mice was significantly higher than that of low fat diet (LFD)-fed mice, the livers of HFD-fed Plg- mice had a mass comparable to LFD-fed mice. HFD-fed Plg- mice had reduced hepatocellular damage, measured by plasma ALT activity, as well as reduced hepatosteatosis, measured by hepatic triglyceride content and liver histology, compared to HFD-fed Plg+ mice. Circulating cholesterol levels in HFD-fed Plg -/- mice were comparable to LFD-fed Plg- mice, while it was significantly elevated in HFD-fed Plg+ mice. While the epididymal white adipose tissue mass was higher in HFD-fed Plg- mice compared to HFD-fed Plg+ mice, the brown adipose tissue mass was comparable. However, there was an upregulation of uncoupling protein-1 (UCP-1) expression BAT of HFD-fed Plg- mice. Glucose clearance was more efficient in HFD-fed Plg- mice compared to HFD-fed Plg+ mice in a glucose tolerance test. Collectively, our data suggest that plasmin(ogen) contributes to HFD-induced fatty liver disease and glucose dysmetabolism.

Disclosures
No relevant conflicts of interest to declare.