bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-hospital outcomes of patients with antiphospholipid syndrome undergoing transcatheter and surgical aortic valve replacement: A population-based analysis of national inpatient sample from 2015–2021
Authors: Li Renxi , Huddleston Stephen J 
Published: February 2025

Background Valvular abnormalities are common in antiphospholipid syndrome (APS). For patients who undergo aortic valve replacement (AVR), previous single institutional studies or case reports reported higher risks of mortality and thromboembolic complications among APS patients. This study aimed to investigate in-hospital outcomes of APS patients undergoing transcatheter (TAVR) and surgical aortic valve replacement (SAVR) using the largest all-payer database in the United States. Methods Patients who underwent TAVR and SAVR were selected from National Inpatient Sample from Q4 2015-2021. Exclusion criteria were age under 18 years and concomitant procedures. Preoperative characteristics were matched between APS and non-APA patients using a 1:5 propensity-score matching in TAVR and SAVR, separately. In-hospital outcomes were examined. Results After propensity-score matching, 504 non-APS patients were matched to 100 APS patients in TAVR, while 581 non-APS patients were matched to 119 APS patients in SAVR. All outcomes between APS and non-APS patients were comparable after TAVR. In contrast, APS patients undergoing SAVR had higher risks of pulmonary embolism (PE; 5.13% vs 0.86%, p < .01) and acute kidney injury (AKI; 35.04% vs 22.55%, p = .01). Conclusion This study represents one of the first large-scale, population-based analyses of AVR outcomes for APS patients using a national registry. APS patients had all comparable outcomes after TAVR, while they had higher risks of PE and AKI after SAVR. This highlights the necessity for close perioperative antithrombotic management and careful monitoring of renal function in APS patients. TAVR may offer a safer alternative to SAVR for appropriately selected patients, including those with APS.
Soluble Urokinase Plasminogen Activator Receptor in Full–Term Neonates with Sepsis: Relation to Disease Severity and Clinical Outcome
Authors: Shinkar Dina Mohamed , Ismail Eman Abdel Rahman , Abdallah Heba Ibrahim , El-Shimi Mohamed Sami 
Published: February 2025

Background Urokinase plasminogen activator receptor (uPAR) is a membrane-linked receptor that has extracellular protease activity and is expressed on various cell types. We evaluated soluble uPAR (suPAR) as an early diagnostic and prognostic marker for neonatal sepsis. Methods Baseline serum suPAR levels were measured in 70 full-term neonates with proven sepsis on admission and repeated 48 hours after antibiotic therapy. suPAR levels were compared with 35 age- and sex-matched healthy controls. Results Baseline suPAR levels were significantly elevated in septic neonates compared with controls ( P < .001). Patients with culture-positive sepsis ( n = 48) and culture-negative sepsis ( n = 22) had higher suPAR compared with controls but no significant difference was found between both septic groups. Baseline suPAR was significantly higher among neonates with septic shock and those who had a worsening disease course or died. suPAR was decreased 48 hours after antibiotic therapy in neonates whose blood cultures turned negative. suPAR cutoff value of 6 ng/mL predicted worsening clinical course with 82.4% sensitivity and 88.9% specificity, while the cutoff value of 7.1 ng/mL predicted mortality with 94.4% sensitivity and 82.4% specificity. Conclusion suPAR may be considered an early marker for neonatal sepsis and is a powerful predictor of sepsis severity and mortality among neonates with sepsis.
Predictors of participation over the 10 years after TBI in black individuals
Authors: Ohayagha Chimdindu , Xia Bridget , Jones Shawn CT , Klyce Daniel W , Arango-Lasprilla Juan Carlos , Perrin Paul B 
Published: February 2025

Objective This study examined: (a) longitudinal trajectories of participation over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and (b) demographic and injury-related predictors of those trajectories. Method This study included 1,989 Black individuals in the national TBI Model Systems (TBIMS) Database, who had at least one of each Participation Assessment with Recombined Tools-Objective (PART-O) subscale scores at one or more follow-up time points (1, 2, 5, and 10 years after TBI). Results Lower PART-O Productivity trajectories were observed among participants who were male (b = −.26, p = .001), were older at the time of injury (b = −.02, p < .001), had a lower education level (b = .06, p < .001), had public insurance coverage (b = .17, p = .009), and had longer posttraumatic amnesia (PTA) duration (b = −.28, p < .001). Lower PART-O Social trajectories emerged among participants who were older at the time of injury (b = −.02, p < .001), did not have a partner at the time of injury (b = .66, p < .001), had public insurance coverage (b = .19, p = .009), and had longer PTA duration (b = −.19, p = .001). Lower PART-O Out and About trajectories emerged among participants who were older at the time of injury (b = −.01, p = .018) and had a lower education level (b = .05, p < .001). Conclusion The findings highlight the importance of understanding the strengths, risk factors, and unmet needs of this group, many of whom experience decreased community and social engagement after TBI.
Optimised two-stage technique for sheath–dilator insertion in peripherally inserted central catheter placement
Authors: Young Ting-Chia , Cheng Kuang-Hua , Yu Kuan-Pen 
Published: February 2025

Background: Peripherally inserted central catheters (PICCs) provide a valuable alternative to traditional central venous access, offering smaller-diameter lines and supporting prolonged infusion therapy. Although recent advancements have addressed many of the initial challenges of PICC insertion, some catheter-related complications remain significant. In cases of mechanical complications, shearing of the peel-away sheath typically occurs while inserting the sheath–dilator, necessitating further dermatotomy and thereby increasing patient morbidity. Materials and methods: The alternative technique involved disassembling the sheath–dilator apparatus into its individual components: the peel-away sheath and introducer dilator. After successfully advancing the guidewire through the needle, the dilator alone was inserted over the guidewire and then removed. Subsequently, the dilator and sheath were reassembled and inserted simultaneously through the skin. The study included four patients (mean age, 55.75 (range: 26–78) years), all of whom underwent PICC placement using the proposed method. Results: Advanced dilator insertion effectively prevented sheath shearing and facilitated successful PICC placement on the first attempt in all patients. No haematomas or catheter-related complications were observed. Conclusions: Using the alternative technique, a high success rate of first-attempt PICC insertions was achieved. This approach may reduce the need for additional dermatotomy, thus minimising patient morbidity and improving procedural outcomes.
Rapid cognitive assessment: Accuracy and discriminant validity of Mini-Cog and process-based Clock Drawing Test
Authors: Yang Qian , Yang Hao , Long Wei , Zuo Sheng , Zhu Defa , Guo Qihao 
Published: February 2025

Background The Mini-Cog is a brief cognitive examination comprising a three-item memory recall and a simplified Clock Drawing Test (CDT). There is limited research on the effects of detailed scoring criteria for the Mini-Cog on cognitive screening. Objective To assess the diagnostic effectiveness of three Mini-Cog versions and a new process-based CDT test in identifying mild cognitive impairment (MCI) and Alzheimer's disease (AD) compared to cognitively normal controls (NC). Methods We prospectively enrolled 950 subjects who underwent standardized neuropsychological assessments and the Mini-Cog test. The CDT was scored using an adapted 10-point scale. The accuracy of three Mini-Cog versions (Mini-Cog1: 3-word delayed recall + 2-point CDT; Mini-Cog2: 3-word immediate recall + 3-word delayed recall + 3-point CDT; Mini-Cog3: 3-word immediate recall + 3-word delayed recall + 10-point CDT) was assessed through the receiver operating characteristic analysis. Sensitivity and specificity were determined for each diagnostic threshold. Results The optimal cut-off point for Mini-Cog3 is 12/16 for MCI and 10/16 for AD. Mini-Cog3 demonstrated the highest diagnostic efficacy, with AUCs of 0.82 (95% CI: 0.78–0.85) for MCI and 0.95 (95% CI: 0.94–0.97) for AD, with sensitivity of 85% for both MCI and AD. The CDT's AUCs were 0.77 (95% CI: 0.73–0.81) for MCI, and 0.87 (95% CI: 0.84–0.90) for AD, with sensitivity of 89% for MCI, and 82% for AD. Conclusions A more elaborate scoring system, such as Mini-Cog3, may serve as an effective screening method for the rapid and accurate detection of cognitive dysfunction in patients with MCI and AD.
Post-Stent Vein Lumen Shape and Clinical Response in Patients Treated for Iliofemoral Venous Occlusive Disease
Authors: Gagne Paul , Kuku Kayode O. , Mendes Robert , Griggs Amy , Segbefia Edem , Hofmann Lawrence V. , Comerota Anthony , Garcia-Garcia Hector M. 
Published: February 2025

Objective Interventionalists have noted significant venous luminal gain with nitinol venous stents although post-placement lumen shape differed from the circular shape observed with elgiloy stents. The goal of this study was to determine the characteristics of a stented vein lumen that correspond with clinical outcomes, and to identify metrics that might be relevant for stent design by assessing aspect ratio (AR), lumen diameter (LD), lumen area (LA), and stent shape (symmetry and eccentricity) post-implant. Methods This post-hoc analysis evaluated patients from the VIVO US Study (NCT01970007) with pre- and post-stent intravascular ultrasound (IVUS) imaging. Patient characteristics, Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS) were collected in the study. LD, LA, and stent geometry were measured by the core laboratory. Data were analyzed for linear association between core-laboratory assessed pre and post stent LD, LA, AR, stent eccentricity and symmetry index, and VCSS and VDS change. Results IVUS imaging was available for 29 patients (2 sites) enrolled in the VIVO US Study (55.2% women; mean age: 59.8 ± 17 years). The cohort had post-thrombotic (48.3%), nonthrombotic iliac vein lesion (44.8%) or acute deep vein thrombotic (6.9%) disease. Mean lesion length was 111.8 ± 60.9 mm. Eleven stents extended below the inguinal ligament. Median minimum LD and LA significantly increased after stent placement ( P < 0.001); median lumen AR changed from 2.0 pre-stent to 1.4 post-stent ( P < 0.001). Mean VCSS improved from baseline to 12 months (7.6 ± 4.3 to 3.7 ± 2.6). No statistically significant linear relationships were identified between VCSS / VDS change and a specific characteristic of LA, LD, or AR. Conclusions Measures of lumen change pre and post iliofemoral vein nitinol stent placement reflect disease and stent characteristics. After stent placement, minimum LD and LA increased and AR decreased. Stented lumen shape or size with Zilver Vena did not impact 1-year clinical improvement by VCSS.
Implementing an Online Instrument to Measure Nurse Practitioner Workload: A Feasibility Study
Authors: Kilpatrick Kelley , Landry Véronique , Nguemeleu Tchouaket Eric , Daigle André , Jabbour Mira 
Published: February 2025

Introduction/Objectives: Nurse practitioners (NPs) improve access to care in community-based primary care. Determining an appropriate workload for NPs is complex. The number of patients seen by NPs represents an important consideration. We sought to determine the feasibility, acceptability and appropriateness of implementing the online NP workload measurement index (NP-WI). Methods: Feasibility study supported by the Theoretical Framework of Acceptability, conducted across 3 health regions in Québec, Canada. Data were collected from January to July 2024 using the online NP-WI ( n = 66), 8-item acceptability questionnaire ( n = 47), weekly implementation team meetings with NPs and decision-makers ( n = 11), field notes and interviews ( n = 13). Data analysis completed using descriptive statistics and content analysis, with data integration using joint displays. Results: NPs indicated that the NP-WI was easy to use. Acceptability scores were positively rated. Daily data entry took 5 to 7 min to complete. NPs deemed a 4-week collection period sufficient to capture a representative workload sample. The NP-WI captured patient, provider and organizational characteristics and the number of patients seen by NPs. Conclusions: NP-WI implementation was feasible. The instrument can support healthcare workforce planning with more adequate estimations of NP workload in community-based primary care, and provide greater equity in resource allocation and distribution of NP workload.
Global Practices and Preferences in the Use of Osteobiologics for Anterior Cervical Discectomy and Fusion: A Cross-Sectional Study
Authors: Ambrosio Luca , Viswanadha Arun Kumar , Vergroesen Pieter-Paul A. , Buser Zorica , Meisel Hans Joerg , Santesso Nancy , Cheung Jason P. Y. , Le Hai V. , Vadalà Gianluca , Jain Amit , Demetriades Andreas K. , Cho Sam K. , Hsieh Patrick C. , Diwan Ashish D. , Martin Christopher , Yoon Tim , Muthu Sathish ,   AO Spine Knowledge Forum Degenerative
Published: February 2025

Study Design Cross-sectional study. Objectives To assess global practices and preferences in the use of osteobiologics for anterior cervical discectomy and fusion (ACDF) and identify factors influencing the choice of specific osteobiologics. Methods An online survey developed by AO Spine was distributed to spine surgeons worldwide. The survey captured demographic characteristics, osteobiologic use and related information (i.e., previous training, practice patterns, etc.), and factors influencing osteobiologic choice in ACDF. Descriptive statistics, Chi-square tests, and multiple logistic regression were used to analyze responses, focusing on the associations between osteobiologic use and variables such as training, cost awareness, and regional practices. Results Responses from 458 surgeons revealed regional variability in osteobiologic preferences. Autologous iliac crest bone graft (AICBG) was predominant in Asia Pacific and Middle East, while allograft and demineralized bone matrix were favored in North America and Latin America ( P < 0.0001). Over half of the respondents (79.7%) lacked formal training in osteobiologics, and 53.1% were unaware of related costs. Surgeons residing in the Asia Pacific region (OR: 0.47, 95% CI: 0.26-0.84, P = 0.0114), without formal training (OR: 0.53, 95% CI: 0.29-0.97, P = 0.0429), or using cages less often (OR: 0.15, 95% CI: 0.06-0.34, P < 0.0001) were less likely to utilize osteobiologics. Osteobiologic use was also more common when related costs were not an issue for the practitioner (OR: 2.32, 95% CI:1.47-3.70, P = 0.0004). Conclusions Significant variation exists in osteobiologic use in ACDF across global regions, influenced by surgeon training, cost awareness, and institutional resources. Enhanced training and guidelines could improve consistency in osteobiologic application.
Sustainment and adaptation of systems navigation and psychosocial counseling across HIV testing clinics in Vietnam: A qualitative assessment
Authors: Bartels Sophia M. , Nguyen Minh X. , Nguyen Trang T. , Sibley Adams L. , Dang Hong Linh T. , Nong Ha T. T. , Nguyen Ngan T. K. , Tran Ha V. , Sripaipan Teerada , Powell Byron J. , Barrington Clare , Reyes Luz M. , Latkin Carl A. , Giang Le Minh , Phan Huong T. T. , Miller William C. , Go Vivian F. 
Published: February 2025

Background Few evidence-based interventions have been successfully scaled up and sustained long-term. Within an implementation trial testing strategies for scale-up of the Systems Navigation and Psychosocial Counseling (SNaP) intervention for people who inject drugs (PWID) with HIV across HIV testing clinics in Vietnam, we sought to assess if the implementation of SNaP was sustained after study support ended and to identify factors, including adaptations, that affected SNaP sustainment. Method Across all 42 SNaP clinics, we surveyed clinic staff at 6–10 months post-study completion to assess SNaP sustainment. We purposively selected six high and six low-sustaining clinics and conducted 31 in-depth interviews with clinic staff ( n = 23) and clinic directors ( n = 8). Interviews were coded and analyzed using thematic analysis informed by the Integrated Sustainability Framework. Matrices were used to compare themes across high and low-sustaining clinics. Results 1/12 clinics sustained all of SNaP's core components, 2/12 would continue to sustain SNaP if they had new PWID patients, and the remainder did not fully sustain SNaP but continued conducting a modified version, including shorter or fewer SNaP sessions, tailoring SNaP to participants’ specific needs, and conducting SNaP-style counseling for all clients. Facilitators of sustainment included leadership directives to clinic staff around SNaP sustainment, clinicians’ belief in SNaP's effectiveness, and SNaP's perceived fit with clinic activities and mission. Major barriers to SNaP sustainment included lack of funding for PWID outreach activities, time, staff, training continuity, and systemic challenges with getting PWID into care, such as poverty and lack of transportation. Conclusions We identified the challenge of sustaining the SNaP intervention long-term, the ubiquity of intervention adaptations, and multi-level barriers and facilitators to intervention sustainment. These findings demonstrate the need for sustainment strategies and could inform trials of strategies to improve the longevity of effective HIV interventions for populations that are disproportionately affected by this epidemic.
High-salt diet decreases FOLFOX efficacy via gut bacterial tryptophan metabolism in colorectal cancer
Authors: Deng Yufei , Hou Xiaoying , Fang Qian , Wang Haiping , Li Xiaoxuan , Hu Zhiyong , Liu Zhaolu , Fan Limei , Liu Yunyi , Fu Zhengqi , Shu Xiji , Sun Binlian , Huang Lijun , Liu Yuchen 
Published: February 2025

Abstract

Background
FOLFOX is the recommended chemotherapy regimen for colorectal cancer (CRC), but its response rate remains low. Our previous studies have established a close relationship between gut microbiota and the anti-CRC effect of FOLFOX, though the underlying mechanisms remain unclear. Diet has been confirmed as a key factor influencing gut microbiota, and high-salt diets, representative of western dietary habits, has been shown to affect gut microbiota, immune function, and the risk of developing CRC. However, the impact of high-salt diets on the anti-CRC efficacy of FOLFOX remains unstudied. Therefore, we aimed to investigate the effect and mechanism of high-salt diets on the anti-CRC effect of FOLFOX.

Methods
We performed 16 S rRNA sequencing and T500 targeted metabolomics analysis on fecal samples from CRC patients and healthy adults. A CRC orthotopic xenograft mouse model was used to study the effect of a high-salt diet on FOLFOX’s anti-CRC efficacy. 16 S rRNA sequencing and non-targeted metabolomics were conducted on mouse fecal samples. Flow cytometry was used to assess immune cell infiltration in tumor and paracancerous tissues. A mouse macrophage conditioned medium system, with tryptophan metabolites, was employed to annotate the functional metabolites, followed by in vivo verification using the orthotopic xenograft mouse model.

Results
The structure and metabolic profiles of gut microbiota are significantly different between 9 healthy adults and 6 CRC patients. A high-salt diet significantly reduced the efficacy of FOLFOX in mice, with notable changes in gut microbiota and related metabolites. Correlation analysis revealed a significant relationship between gut microbiota, tryptophan metabolites and FOLFOX efficacy. Flow cytometry indicated that a high-salt diet altered macrophage infiltration (CD45+F4/80+) in both the tumor and paracancerous tissues. In vitro experiments confirmed that the tryptophan metabolite SK reduced FOLFOX efficacy, while IPA enhanced it through macrophage-conditioned medium. In vivo, we verified that under a high-salt diet, SK inhibited the efficacy of FOLFOX, while IPA promoted it.

Conclusion
A high-salt diet reduces the anti-CRC efficacy of FOLFOX through gut bacterial tryptophan metabolism mediated macrophage immunomodulation.
Association between diabetes of different durations and hip fracture in middle-aged and older people: a stratified cohort study from CHARLS 2011–2020
Authors: Chang Yu , Huang Yunda , Li Ruonan , Gui Li 
Published: February 2025

Abstract

Background
The effect of the duration of diabetes on hip fracture is inconsistent. The aim of this study was to analyze the association between different durations of diabetes and hip fracture.

Methods
This cohort study included participants from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2020. Diabetes was defined as glycated hemoglobin A1c ≥ 6.5%, fasting blood glucose ≥ 126 mg/dL, random blood glucose ≥ 200 mg/dL, or previous diagnosis of diabetes. Participants were stratified according to diabetes duration, and information was collected on their first hip fracture. The association between diabetes of different durations and hip fracture was assessed using Cox proportional risk models and Kaplan-Meier curves.

Results
A total of 9,927 participants with a mean age of 58.4 ± 8.7 and 54.3% female were included, and 574 participants suffered a hip fracture. Compared with no diabetes, the associations between overall diabetes, newly diagnosed diabetes, diabetes with a duration of < 6 years, and hip fracture were all not significant, all P > 0.05. Known diabetes and diabetes of duration ≥ 6 years significantly increased the risk of hip fracture, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.69 (1.19 ~ 2.4), P = 0.003, and 2.2 (1.34 ~ 3.61), P = 0.002.

Conclusions
Neither newly diagnosed diabetes nor diabetes with a disease duration of < 6 years was associated with hip fracture compared with no diabetes people. When the duration of diabetes is ≥ 6 years, the risk of hip fracture is significantly increased, and appropriate preventive measures are recommended.