bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application Value and Relevance Analysis of the Risk Evaluation System for Arteriovenous Fistula Puncture in Thrombosis after Puncture
Authors: Li Mei , Sun Chao , Du Xuan 
Published: December 2021

Objective. To analyze the application value and relevance of risk evaluation system for arteriovenous fistula (AVF) puncture in thrombosis after puncture. Methods. The clinical data of 180 patients treated with hemodialysis in the hemodialysis center of our hospital from November 2017 to November 2019 were retrospectively analyzed. After puncture, all patients received the digital subtraction angiography (DSA) examination, and based on whether they had AVF thrombosis, they were divided into the nonthrombosis group (n = 102) and thrombosis group (n = 78), and then, according to the parity of their admission numbers, the patients in the thrombosis group were subdivided into the study group (n = 39) and the reference group (n = 39), so as to analyze the risk factors of thrombosis after AVF puncture and the application value of the risk evaluation system for AVF puncture in preventing and treating thrombosis. Results. Compared with the reference group after intervention, the study group had significantly higher mean internal fistula blood flow volume (

P

< 0.001) and significantly lower total incidence rate of vascular complications in fistulas (

P

< 0.05); according to the multifactor binary logistic regression analysis, it was found that diabetes, systolic blood pressure reduction, hemoglobin, low-density lipoprotein cholesterol (LDL-C), ultrafiltration rate, and elevation of blood phosphorus and platelet levels were the risk factors of thrombosis after AVF puncture in hemodialysis patients. Conclusion. When risk factors of thrombosis are found in patients treated with hemodialysis, timely detection and intervention shall be applied in the early stage. Adopting the AVF puncture risk evaluation system has an extremely high application value in the clinic and is of important meaning in prolonging the service life of fistulas.
Persistence of ctDNA in Patients with Breast Cancer During Neoadjuvant Treatment Is a Significant Predictor of Poor Tumor Response
Authors: Zhou Qing , Gampenrieder Simon P. , Frantal Sophie , Rinnerthaler Gabriel , Singer Christian F. , Egle Daniel , Pfeiler Georg , Bartsch Rupert , Wette Viktor , Pichler Angelika , Petru Edgar , Dubsky Peter C. , Bago-Horvath Zsuzsanna , Fesl Christian , Rudas Margaretha , Ståhlberg Anders , Graf Ricarda , Weber Sabrina , Dandachi Nadia , Filipits Martin , Gnant Michael , Balic Marija , Heitzer Ellen 
Published: December 2021

Abstract

Purpose:
Accurate response assessment during neoadjuvant systemic treatment (NST) poses a clinical challenge. Therefore, a minimally invasive assessment of tumor response based on cell-free circulating tumor DNA (ctDNA) may be beneficial to guide treatment decisions.

Experimental Design:
We profiled 93 genes in tissue from 193 patients with early breast cancer. Patient-specific assays were designed for 145 patients to track ctDNA during NST in plasma. ctDNA presence and levels were correlated with complete pathological response (pCR) and residual cancer burden (RCB) as well as clinicopathologic characteristics of the tumor to identify potential proxies for ctDNA release.

Results:
At baseline, ctDNA could be detected in 63/145 (43.4%) patients and persisted in 25/63 (39.7%) patients at mid-therapy (MT) and 15/63 (23.8%) patients at the end of treatment. ctDNA detection at MT was significantly associated with higher RCB (OR = 0.062; 95% CI, 0.01–0.48; P = 0.0077). Of 31 patients with detectable ctDNA at MT, 30 patients (96.8%) were nonresponders (RCB II, n = 8; RCB III, n = 22) and only one patient responded to the treatment (RCB I). Considering all 145 patients with baseline (BL) plasma, none of the patients with RCB 0 and only 6.7% of patients with RCB I had ctDNA detectable at MT, whereas 30.6% and 29.6% of patients with RCB II/III, respectively, had a positive ctDNA result.

Conclusions:
Overall, our results demonstrate that the detection and persistence of ctDNA at MT may have the potential to negatively predict response to neoadjuvant treatment and identify patients who will not achieve pCR or be classified with RCB II/III.
Association Between Circulating GDF‐15 and Cardio‐Renal Outcomes and Effect of Canagliflozin: Results From the CANVAS Trial
Authors: Sen Taha , Li Jingwei , Neuen Brendon L. , Arnott Clare , Neal Bruce , Perkovic Vlado , Mahaffey Kenneth W. , Shaw Wayne , Canovatchel William , Hansen Michael K. , Heerspink Hiddo J. L. 
Published: December 2021

Background
Studies have suggested that sodium glucose co‐transporter 2 inhibitors exert anti‐inflammatory effects. We examined the association of baseline growth differentiation factor‐15 (GDF‐15), a marker of inflammation and cellular injury, with cardiovascular events, hospitalization for heart failure (HF), and kidney outcomes in patients with type 2 diabetes in the CANVAS (Canagliflozin Cardiovascular Assessment Study) and determined the effect of the sodium glucose co‐transporter 2 inhibitor canagliflozin on circulating GDF‐15.

Methods and Results
The CANVAS trial randomized 4330 people with type 2 diabetes at high cardiovascular risk to canagliflozin or placebo. The association between baseline GDF‐15 and cardiovascular (non‐fatal myocardial infarction, non‐fatal stroke, cardiovascular death), HF, and kidney (40% estimated glomerular filtration rate decline, end‐stage kidney disease, renal death) outcomes was assessed using multivariable adjusted Cox regression models. During median follow‐up of 6.1 years (N=3549 participants with available samples), 555 cardiovascular, 129 HF, and 137 kidney outcomes occurred. Each doubling in baseline GDF‐15 was significantly associated with a higher risk of cardiovascular (hazard ratio [HR], 1.2; 95% CI, 1.0‒1.3), HF (HR, 1.5; 95% CI, 1.2‒2.0) and kidney (HR, 1.5; 95% CI, 1.2‒2.0) outcomes. Baseline GDF‐15 did not modify canagliflozin’s effect on cardiovascular, HF, and kidney outcomes. Canaglifozin treatment modestly lowered GDF‐15 compared with placebo; however, GDF‐15 did not mediate the protective effect of canagliflozin on cardiovascular, HF, or kidney outcomes.

Conclusions
In patients with type 2 diabetes at high cardiovascular risk, higher GDF‐15 levels were associated with a higher risk of cardiovascular, HF, and kidney outcomes. Canagliflozin modestly lowered GDF‐15, but GDF‐15 reduction did not mediate the protective effect of canagliflozin.
The Connection between Carnot and CAPE Formulations of TC Potential Intensity
Authors: Rousseau-Rizzi Raphaël , Merlis Timothy M. , Jeevanjee Nadir 
Published: December 2021

Abstract
Tropical cyclone (TC) potential intensity (PI) theory has a well-known form, consistent with a Carnot cycle interpretation of TC energetics, which relates PI to mean environmental conditions: the difference between surface and TC outflow temperatures and the air–sea enthalpy disequilibrium. PI has also been defined as a difference in convective available potential energy (CAPE) between two parcels, and quantitative assessments of future changes make use of a numerical algorithm based on this definition. Here, an analysis shows the conditions under which these Carnot and CAPE-based PI definitions are equivalent. There are multiple conditions, not previously enumerated, which in particular reveal a role for irreversible entropy production from surface evaporation. This mathematical analysis is verified by numerical calculations of PI’s sensitivity to large changes in surface-air relative humidity. To gain physical insight into the connection between the CAPE and Carnot formulations of PI, we use a recently developed analytic theory for CAPE to derive, starting from the CAPE-based definition, a new approximate formula for PI that nearly recovers the previous Carnot PI formula. The derivation shows that the difference in undilute buoyancies of saturated and environmental parcels that determines CAPE PI can in fact be expressed as a difference in the parcels’ surface moist static energy, providing a physical link between the Carnot and CAPE formulations of PI. This combination of analysis and physical interpretation builds confidence in previous numerical CAPE-based PI calculations that use climate model projections of the future tropical environment.
A computed tomography-based radiomic nomogram for predicting lymph node metastasis in patients with early-stage papillary thyroid carcinoma
Authors: Lai Lisha , Guan Qianwen , Liang Yingying , Chen Junwei , Liao Yuting , Xu Honggang , Wei Xinhua 
Published: December 2021

Background Accurate assessment of lymph node metastasis (LNM) is important for the selection of the optimal therapeutic strategy in patients with papillary thyroid carcinoma (PTC). Purpose To develop and validate a radiomics nomogram based on computed tomography (CT) for predicting LNM in patients with early-stage PTC. Material and Methods A total of 92 patients with pathologically confirmed PTC were divided into a training cohort (n =  64) and validation cohort (n  =  28). Radiomic features of the tumor and peritumoral interstitium were extracted from contrast-enhanced CT images. The radiomic signature was constructed and the radiomic score (Rad-score) was calculated. Combined with the Rad-score and independent clinical factors, a radiomic nomogram was constructed and its performance was assessed by receiver operating characteristic (ROC) curves and calibration plots. The comparison of ROC curves was performed with DeLong's test Results A combined nomogram model of the thyroid tumor and peritumoral interstitium was constructed based on the Rad-score, tumor location, maximum diameter, and T stage, and it had areas under the ROC curve of 0.956 (95% confidence interval [CI] = 0.913–1.000) and 0.876 (95% CI = 0.741–1.000) in the training and validation cohorts, respectively. Decision curve analysis suggested that the combined nomogram model had better clinical usefulness than the other models. Conclusion A CT-based radiomics nomogram incorporating the radiomic signature and the selected clinical predictors can be a reliable approach to preoperatively predict the LNM status in patients with early-stage PTC, which is helpful for treatment decisions and prognosis.
The Association Between Veteran Status and Obesity Differs Across Race/Ethnicity
Authors: Cuevas Adolfo G. , Cofie Leslie E. , Nolte Sarah 
Published: December 2021

Purpose This study aims to evaluate the interaction between veteran status and race/ethnicity on obesity status. Design Cross-sectional survey Setting The 2013–2017 National Health Interview Survey Sample A total of 151,765 adults (8.62% veterans and 91.38 nonveterans) with 69.30% identifying as White, 13.05% identifying as Hispanic, 12.57% identifying as Black, and 5.08% identifying as Asian Measures Obesity status (measured using self-reported body mass index), race/ethnicity, survey year, age, marital status, educational attainment, federal poverty level, health insurance, type of insurance, self-reported health status, and whether participant had a usual care source. Analysis Weighted logistic regression analysis Results In a fully adjusted model, there was no evidence that veterans overall had higher odds of obesity compared to nonveterans (adjusted odd ratio (aOR): 1.05, 95% CI: .99, 1.11). White veterans had lower odds of obesity compared to White nonveterans (OR: .93, 95% CI: .87, .98). Hispanic veterans had higher odds of obesity compared to Hispanic nonveterans (aOR: 1.53, 95% CI: 1.23, 1.90). There was no evidence of an association between veteran status and obesity status for Black and Asian adults. Conclusions Effectual prevention strategies are needed to decrease obesity risks among active and retired Hispanic veterans.
Labial-Nasal Evaluation for Nasal Floor Reconstruction With the New Triangular Flap in Unilateral Cleft Lip Repair
Authors: Liu Yingmeng , Li Chenghao , Yao Meilin , Tsauo Chialing , Wu Min , Shi Bing 
Published: December 2021

In this study, we present a modified technique for primary cleft lip repair with a rotation triangular flap from the cleft lateral side to reconstruct the nasal floor; and evaluate the outcome compared with traditional Millard repair. 40 patients with unilateral cleft lip were included in this research. The patients were divided into 2 groups; 17 patients treated with the Millard technique, and 23 patients treated with the newly modified technique. 14 measurement indexes were employed to evaluate the nose-lip morphology of postoperative patients with UCCL in standardized photographs preoperatively, postoperatively and 1-year follow-up. For lip symmetry, statistical significance was detected in the measurements of the vertical philtral height ratio indicating that the newly modified technique resolve the shortage of lip height on the cleft side 1-year follow-up. ( P < .05). In addition, statistical significance was detected in the 1-year postoperative columellar angle, alar width ratio, nostril width ratio, nostril height ratio, and nostril shape (cleft) ( P < .05), showing more successful repair of the nose compared with the traditional repair. The modified unilateral cleft lip repair with rotation triangle flap from the cleft lateral side was beneficial in the correction of lip and nasal deformity in and had positive effects on labial symmetry.
Mandibular Measurements at the 20-Week Anatomy Ultrasound as a Prenatal Diagnostic Predictor of Pierre Robin Sequence
Authors: Bruce Madeleine K. , Islam Raeesa , Anstadt Erin E. , Kenkre Tanya S. , Pfaff Miles J. , Canavan Timothy , Goldstein Jesse A. 
Published: December 2021

Background Pierre Robin Sequence (PRS) is characterized by micrognathia, glossoptosis, and upper airway obstruction. Early recognition and appropriate perinatal management is crucial for optimizing outcomes. This study aimed to evaluate 20-week fetal ultrasounds to determine if specific mandibular measurements could predict PRS diagnosis and disease severity. Methods A retrospective case-control study of 48 patients with PRS and gender-matched controls was performed. Medical records were reviewed for respiratory and surgical interventions. Three parameters to assess micrognathia were measured on mid-sagittal profile ultrasound images: frontal nasal-mental angle (FNMA), facial-maxillary angle (FMA), and alveolar overjet. Student's t-test and univariate logistic regression was performed. P ≤ 0.05 was considered statistically significant. Results Patients with PRS demonstrated a significantly smaller mean FNMA compared to the control group, 129.3 ± 8.6° and 137.4 ± 3.2°, respectively (p < 0.0001), as well as significantly smaller mean FMA, 63.2 ± 9.2° and 74.8 ± 6.1°, respectively (p < 0.0001). The PRS group also demonstrated significantly larger mean alveolar overjet compared to the control group, 3.9 ± 1.4 mm and 2.1 ± 0.9 mm, respectively (p < 0.0001). The odds of respiratory intervention increased among cases when FMA was <68°. Additionally, there was a significant difference in median overjet between patients with PRS who did and did not require respiratory intervention. Conclusions Mandibular features on the 20-week ultrasound can be measured to predict diagnosis and severity of PRS. This is an important first step to prepare for potential respiratory intervention at delivery to minimize perinatal hypoxia. Alveolar overjet, previously not described in prenatal ultrasound literature, is measurable and has utility in prenatal screening for PRS, as do FMA and FNMA.
Assessment of temporal and spatial distribution patterns of aerosol produced by air-puff non-contact tonometer
Authors: Chen Xuhao , Li Bingzhen , Zhang Chun 
Published: December 2021

Purpose To assess the distribution pattern of aerosol in the aspect of time and direction during the intraocular pressure (IOP) measurement by air-puff non-contact tonometer (NCT) and further offer references for protection from coronavirus disease-19 (COVID-19) in the routine ophthalmic examination. Method A single-center observational study was conducted in the ophthalmology clinics of Peking University Third Hospital. Two air quality detectors were equipped to assess the generated particulate matter (PM) concentration simultaneously within 30 s after IOP measurement in the outpatient hall. Detector A was fixed next to the NCT as a reference, while Detector B was fixed 1 meter away. The participants were divided into two groups depending on the position of Detector B. The generation of aerosol was compared within different groups and time intervals. Results 144 participants were enrolled in the final analysis. At a 1 m distance from the NCT, the PM2.5 concentration significantly increased at the 30 s ( Z = 2.898, Bonferroni-corrected P = 0.038) while the PM10 concentration increased immediately after the IOP measurement ( Z = 2.967, Bonferroni-corrected P = 0.030). The PM2.5 and PM10 concentrations at 1 m were significantly higher immediately ( Z = −2.183, P = 0.029; Z = −2.502, P = 0.012) and 30 s ( Z = −2.021, P = 0.043; Z = −2.071, P = 0.038) after the IOP measurements when the Detector B was vertical to the air jet on the lateral side. Conclusions NCT may produce aerosol after the IOP measurement by air-puff. The generated PM2.5 had a prolonged existence compared with PM10 at a 1 m distance. The lateral side of the air-puff direction may be of higher exposure risk to aerosol.
Ethical problems in the nurses action in the beginning of life
Authors: Paço Sandra , Deodato Sérgio 
Published: December 2021

Introduction The act of caring in nursing requires previous deliberation and decision, however this perception only arises when an ethical problem emerges. Objective: Identify ethical problems of nurses action in the area of beginning of human life Method: Exploratory and descriptive method, with a qualitative approach. Semi-structured interviews were used to collect data, who were submitted to content analysis. The sample was constituted by 26 nurses. Results 18 categories of problem areas and 56 ethical problems in early human life were identified. The results obtained are very diverse, including areas such as termination of pregnancy, informed consent or maintaining privacy. However, other problem areas also emerge and numerous new subcategories/ethical problems, including: dealing with miscarriage, extreme situations, minors’ pregnancy, serious malformations detected at birth, consent regarding care during childbirth, Non- identification of a ethical problem, nurse social recognition and non-involvement of the person in labour. Conclusion Nurses face different ethical problems that impact their lives. We intend to contribute in helping to make decisions in this field, which the outset is of hope and joy, but which hides, behind this evidence, countless situations of suffering for everyone involved. The identification of ethical problems in this field, it is the first step to reflect about theme and helping decision-making for nurses that are taking care in this area of beginning of human life, when confronted whit the same type of ethical problems.
Psychosocial Impact of Congenital Heart Diseases on Patients and Their Families: A Parent's Perspective
Authors: Jaschinski Christoph , Knetsch Vivien , Parzer Peter , Meyr Juliane , Schroeder Brian , Fonseca Elizabeth , Karck Matthias , Kaess Michael , Loukanov Tsvetomir 
Published: December 2021

Background Currently, over 90% of children with congenital heart disease (CHD) survive into adulthood. As a consequence the psychosocial impact on children and their families has become an important outcome measure. Therefore, the goal of this study was to assess the psychosocial impact from a parent's perspective and to identify possible predictors. Methods We included all parents of children who underwent open-heart surgery in the years 2010 and 2011 at the Department of Cardiothoracic Surgery at University Hospital Heidelberg and invited them to complete standardized questionnaires. Psychosocial outcome was measured via parent self- and proxy reporting of family burden (Family Burden Questionnaire, FaBel), health-related quality of life (KidScreen-10), developmental problems (Five-to-Fifteen, FTF), and mental health problems (Strength and Difficulties Questionnaire, SDQ). Results In total, 113 families returned the questionnaires completely (71.5%). The Aristotle Basic Complexity score and the STAT 2020 Score overall did not predict the psychosocial impact, whereas the number of surgical operations did significantly predict psychosocial impact across all domains in this study cohort. Conclusions These data suggest that the number of surgical operations might be a relevant predictor for the long-term psychosocial impact on families suffering from CHD and a potential connecting factor for specialized psychological support. When setting up screening instruments or support programs the entire family must be considered.
Association of Pre-Operative Vitamin D Levels and Severity of Fracture among Orthopedic Trauma Patients in A Single, Tertiary-Level Hospital
Authors: Mendoza Christian Julius P. , Ver Mikhail Lew Perez , Tabberrah Andrew Gabriel Jacinto , Ver Mario Ratio 
Published: December 2021

Background/Purpose The high prevalence of hypovitaminosis D among trauma patients have been related to risk of fractures, falls, non-union and poor operative outcomes. There is limited evidence that ties up Vitamin D levels with fracture severity. The objective of this study is to determine the association of pre-operative Vitamin D levels and fracture severity. Methods This was a retrospective, cross-sectional study of patients with extremity fractures classified according to the AO Trauma classification system with baseline pre-operative vitamin D levels. The association between vitamin D levels and fracture severity of surgically treated trauma patients were analyzed. Sub-group analysis was performed on patients without osteoporosis and those patients who suffered from low-energy trauma. Results Ninety-six (96) patients were included. Those with severe fractures (AO -C fractures, 31B1.3/B2.3 and 31A3) were associated with lower Vitamin D levels (µ  =  17.87 µg/mL) (p < 0.001). There was a strong, positive significant correlation ( rs (4)  =  .426, p  =  < 0.001) between hypovitaminosis D and increasing fracture severity. This significant association of hypovitaminosis D with worse fracture patterns remains in the patient sub-group without osteoporosis ( p  =  0.030), and in those who sustained low-mechanism injuries (­ p­ < 0.001). Conclusion We present initial evidence that low pre-operative Vitamin D level is associated with increasing fracture severity at the time of injury. Early detection, surveillance and management of low vitamin D levels can lead to drastic changes in the holistic approach to fracture prevention and treatment.