bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intensive Care Unit Dialysis Practice, Clinical Outcomes, and Associate Factors Among Critically Ill Patients at St.Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia: A Prospective Cohort Study Design
Authors: Getahun Zelalem , Demissie Dereje Bayissa , Sulan Menbeu , Tufa Muluneh Kidane , Laytin Adam , Mehari Maraki 
Published: December 2024

Abstract

Introduction: Acute kidney injury (AKI) is a common complication in critically ill patients, associated with increased morbidity and mortality. Despite its widespread use, there is limited research examining intensive care unit dialysis practice and clinical outcomes among critically ill patients. Objective: The aim of this study was to investigate intensive care unit dialysis practice, clinical outcomes, and associate factors among critically ill patients at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia 2024 Methods and Materials: Hospital based prospective quantitative cohort study was conducted in St. Paul Hospital Millennium Medical College over a period of seven month from December 1, 2023 - June 30, 2024. The study used a data abstraction checklist to collect data from patients' charts, which was processed using Kobo collect software and exported for further analyzed using SPSS version 25. Descriptive analysis was performed to describe study variables, and binary and multivariable logistic regression was used to identify significant factors at PV < 0.05, with a 95% CI for the final model. The clinical trial number is not applicable. Result A study involving 301 AKI patients admitted to the ICU, with 90% response rate, with a mean age of 34.3 ± 15.4 Years old. Females were the most frequently admitted patient 49 (54.4%). The study found that most patients with acute kidney injury (AKI) achieved good renal recovery, with 67.8% successfully weaned from ICU care and transferred to a general ward. Sepsis 46 (51.1%) and advanced age > 60 years old (10.0%) were the leading risk factors. This study identified factors significantly associated with patient outcomes were: patient who had Urea Reduction Ratio below 55–60% range were 6 times more likely to have increased mortality than a patient who has Urea Reduction Ratio of greater than 60% (OR = 6.04, 95% CI 1.09-33.318) and Patients with a higher APACHE II score were 2.7 times more likely to experience worsened ICU outcomes compared to those with lower score [AOR] = 2.7, 95% CI 1.086–17.879). Conclusion: The study revealed that 67.8% of acute kidney injury (AKI) patients successfully recovered from ICU care. This study found that sepsis was the most common cause of acute kidney injury (AKI) leading to dialysis in the study setting Intensive care unit. The severity of illness, as measured by the APACHE II score, was a strong predictor of mortality. Inadequate dialysis, characterized by a low urea reduction ratio, was also associated with increased mortality.
Effectiveness of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Symptoms of Adjustment Disorder: A Longitudinal Observational Study in a Routine Online Care Setting
Authors: Sapkota R. P. , Peynenburg V. , Dear B. F. , Titov N. , Hadjistavropoulos H. D. 
Published: December 2024

Abstract

Background: Trials of disorder-specific Internet-delivered cognitive-behavioral therapy (ICBT) for Adjustment Disorder (AD) show moderate effect sizes but may have limited scalability in routine care settings, where clients present with a range of concerns. Transdiagnostic ICBT, which addresses common emotional and behavioral concerns irrespective of diagnosis, could address the need for effective and scalable treatments for symptoms of AD.
Objective: This study aimed to evaluate the effectiveness of a transdiagnostic ICBT course for patients with high AD symptoms, and to investigate predictors of treatment outcomes, and treatment satisfaction.
Methods: 793 participants received a therapist-guided, transdiagnostic ICBT course. The study measured changes in AD symptoms from pre-treatment to post-treatment to 3-month follow-up using the Adjustment Disorder – New Module 8 (ADNM-8).
Results: The prevalence of high AD symptoms (defined as a score >23 on the ADNM-8) was 54.8% at pre-treatment. The study found large reductions in AD symptoms from pre-treatment to post-treatment (d = 1.29, 95% CI [1.13, 1. 45]) and from pre-treatment to the 3-month follow-up (d = 1.67, 95% CI [1.49, 1.85]). These effect sizes were comparable to those found in previous ICBT trials of AD-specific treatments. Approximately 70% of participants scored below clinical cut-off for high AD symptoms at post-treatment, and 79 % met this criterion at follow-up. Engagement in treatment and post-treatment satisfaction were similar between individuals with high AD symptoms and those without, with the majority (76.9%) completing four or more lessons and 81.7% reporting overall satisfaction.
Conclusions: The findings suggest that transdiagnostic ICBT is an effective and acceptable treatment for AD symptoms, with results comparable to those of AD-specific interventions. The high prevalence of AD symptoms and stressful life events among participants in a routine care setting underscores the importance of early identification of individuals with high AD symptoms.
A Retrospective Cohort Study of Chimeric Antigen Receptor T-Cell Therapy in Follicular Lymphoma Patients with or without Histological Transformation
Authors: Wang Jingjing , Zeng Liangyu , Ma Xiao , Wu Depei , Li Caixia , Xu Ting 
Published: December 2024

Abstract

Background: Follicular lymphoma (FL), one of the most common indolent lymphomas, is still classified as an incurable disease. Adverse outcomes in FL frequently occur in patients who experience early relapse or histological transformation to aggressive lymphoma. Chimeric antigen receptor T-cell therapy (CAR-T) has received approval for the treatment of relapsed/refractory B-cell lymphoma.
Methods: This retrospective study presents the clinical characteristics and treatment follow-up of 26 patients with transformed or relapsed/refractory FL who received CAR-T therapy. It evaluates the efficacy of CAR-T and assesses treatment lines, LDH levels, remission status before treatment, and the histological transformation of their prognostic impact.
Results: Among the 14 transformed FL patients, there was one treatment-related death, the overall response rate (ORR) was 92.0%, with a 2-year progression-free survival (PFS) rate of 66.7% and an overall survival (OS) rate of 73.3%. For the 12 relapsed/refractory FL patients, the ORR was 100.0%, with a 2-year PFS rate of 75.0% and an OS rate of 100.0%, which is lower than that for transformed FL. A favorable remission state before CAR-T treatment correlated with improved PFS (P =0.009). Compared to transformed patients, those with relapsed/refractory FL exhibited better OS following CAR-T treatment (P =0.04).
Conclusion: CAR-T therapy demonstrates significant efficacy and good safety for treating relapsed/refractory follicular lymphoma and transformed lymphoma. Further research should focus on identifying prognostic factors, extending remission duration, and preventing recurrence.
Design and Optimization of Miniaturized Co-planar Vivaldi Antennas for Enhanced Microwave Imaging in Brain Hemorrhage Detection
Authors: Zhang Weijia , Xie Jin , Somjit Nutapong , Cheng Xue , Jiang Yanrong , Sun Dongqin , Cai Shaomin 
Published: December 2024

Abstract

This paper presents an innovative design and optimization of a miniaturized coplanar Vivaldi antenna tailored for advanced microwave imaging applications in cerebral hemorrhage detection. Measuring just 80 × 80 × 1 mm³, the antenna integrates novel features such as curved radiating arms, optimized solder pads, and strategically placed metallized vias to address challenges in deep tissue imaging. These enhancements deliver outstanding broadband performance (1.6–8 GHz), exceptional impedance matching with a voltage standing wave ratio (VSWR) consistently below 1.5 in the critical 2–4 GHz range, and a reflection coefficient as low as -45 dB at 4 GHz. Notably, the gain peaks at 9.5 dB at 6.5 GHz, ensuring superior signal penetration and resolution. The innovation extends beyond design, employing ANSYS HFSS simulations and multi-layer cranial models to replicate real biological conditions. Comparative analysis of single, double, and 36-antenna arrays demonstrates the antenna's ability to achieve high-resolution imaging, even in complex tissue environments. Additionally, a novel application of real-time differential imaging and beamforming algorithms, including Delay-And-Sum (DAS) and Delay-Multiply-And-Sum (DMAS), enhances imaging clarity and detection sensitivity. The results show significant improvements in identifying hemorrhagic regions, offering crucial technical advancements for portable, non-invasive diagnostic systems. By combining miniaturization, performance optimization, and application-specific enhancements, this work establishes a transformative foundation for early stroke detection technologies.
Proving the Efficacy of Autologous Fat Grafting in the Treatment of Rectocele: A Retrospective Study
Authors: Dandin Ozgur , Ozturk Kamil , Vural Veli , Calis Hasan , Sabuncuoglu Mehmet Zafer , Zihni Ismail 
Published: December 2024

Abstract

Background
Rectocele, a prevalent condition linked with pelvic organ prolapse, affects many women postpartum, leading to symptoms like constipation, straining during bowel movements, and vaginal pressure, significantly impairing quality of life. Traditional surgical procedures for rectocele repair often lead to complications and symptom recurrence. Recently, autologous fat grafting (AFG) has emerged as a minimally invasive alternative. This retrospective study evaluates the efficacy and safety of AFG, using a stem cell-enriched approach for rectocele treatment.
Material and Methods
Conducted at Akdeniz University Faculty of Medicine, this study included female patients who underwent AFG for rectocele from January 2023 to January 2024. Inclusion criteria were patients diagnosed with rectocele, aged 18 or older, with a follow-up period of at least 6 months post-procedure. Data were collected on patient demographics, clinical characteristics, pre- and post-procedural symptoms, procedural details, and follow-up outcomes. Statistical analysis compared pre- and post-procedural variables using appropriate tests.
Results
The study included 65 patients, with a mean (± SD) age of 51,2 (± 12,41) years. Pre-procedural symptoms included rectal pain, constipation, and dyspareunia. Post-procedural outcomes demonstrated significant improvements in these symptoms, with a mean (± SD) follow-up period of 12,13 (± 4,29) months. The majority of patients reported symptom relief, particularly from rectal pain and constipation. Complications were minimal, with 25% of patients experiencing mild skin ecchymosis that resolved with treatment. Obstructive defecation, Quality of life, and constipation assessments showed significant improvements, with patients reporting higher satisfaction and improved functional outcomes.
Conclusion
AFG shows promise as an effective minimally invasive treatment for rectocele. It offers significant symptom relief and improved quality of life with minimal complications. The results suggest that AFG could be a valuable alternative to traditional surgical methods.
Tailored vertebral artery mobilisation in complex craniovertebral junction surgery- a blessing in disguise
Authors: Maurya Ved Prakash , Kumar Ashutosh , J Ananth Chaitanya , Dikshit Priyadarshi , Ranjan Ravi , Bhaisora Kamlesh Singh ,   7.	Kuntal Kanti Das, Rai Shreyash , Verma Pawan Kumar , Kanjilal Soumen , Mehrotra Anant , Jaiswal Awadhesh Kumar , Srivast Arun Kumar 
Published: December 2024

Abstract

Background: The surgical exposure of the complex craniovertebral junction (CVJ) requires manipulation of the neurovascular structures and the atlantoaxial joint (C1-C2 joint) to access the pathological region. To achieve adequate C1-C2 joint manipulation, the mobilization of the vertebral artery (VA) is mandatory. The present retrospective observational study aims to describe the surgical nuances and share the experience of tailored vertebral artery mobilization for efficient management of CVJ pathologies.
Methodology: All the operated cases of CVJ anomalies from January 2019 to December 2023 were included. The clinico-radiological scan, including their three-dimensional computerized tomography (3-D CT), was recorded with a VA angiogram course. The intraoperative details of these patients were collected from the neurosurgery operative records. The patients' details were obtained either by the outpatient department or by telephone.
Results: A total of 18 patients were analyzed with a mean age of 49.21±18.30 years. The median pre-operative Nurick's grade amongst the study population was 4 (IQR: 3,4 and Range: 3-5). Twelve patients underwent bilateral vertebral artery mobilization, whereas the remaining six underwent unilateral vertebral artery mobilization. After surgery, at three months of follow-up visit, the median post-operative Nurick's grade was 3 (IQR: 2,3 and Range: 2-5), which was statistically significant (P=0.002). The mean follow-up duration was 23.2 months without any procedure-related mortality.
Conclusions: Tailored vertebral artery mobilisation (VAM) is an excellent surgical strategy for negotiating through the atlantoaxial joint in a specific group of patients. It offers safe access to managing CVJ anomalies, keeping in mind the principles of micro neurosurgery.
Association of neutrophil percentage-to-albumin ratio with all-cause and respiratory disease-related mortality in US adults with asthma: results from NHANES 1999-2018
Authors: Wang Dan , Su Rui , Li Ruina , Li Xiaofeng , Zhao Hui 
Published: December 2024

Abstract

Background: Systemic inflammation and immune dysregulation may be associated with asthma onset and progression. Neutrophil percentage-to-albumin ratio (NPAR) is a novel marker of systemic inflammation. We aimed to investigate the association of NPAR with all-cause and respiratory disease-related mortality in adults with asthma through NHANES 1999-2018.
Methods:NPAR was calculated by neutrophil percentage (% of total white blood cell count) × 100/serum albumin (g/dl). Asthma was diagnosed by standardized questionnaire. Mortality was obtained by prospective matching with the National Death Index. Multivariate Cox proportional hazards regression analysis was used to explore these associations.
Results:A total of 5042 adults with asthma were included. After a median follow-up duration of 104 months, 697 participants died, of which 101 were respiratory disease-related deaths. In fully adjusted models, NPAR was significantly and positively associated with both all-cause and respiratory disease-related mortality (hazard ratios [HR] of 1.126 and 1.194, respectively, both p < 0.05). Compared to Q1, NPAR at Q4 was associated with significantly increased all-cause and respiratory disease-related mortality (all-cause: HR 2.112, p < 0.0001; respiratory disease-related: HR 2.595, p = 0.013). NPAR was nonlinearly associated with all-cause mortality, with an inflection point of 13.76. This association was significant only after the inflection point. The effect of NPAR on all-cause mortality was more pronounced in those <60 years of age.
Conclusions:Higher NPAR was associated with increased all-cause and respiratory disease mortality in US adults with asthma. Further exploration of the prognostic potential and underlying mechanisms of NPAR is needed.
Clinical trial number Not applicable.
Impact of Antiemetic Steroid Use on Survival in Small Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors and Chemotherapy
Authors: Park Soh Mee , Jeong Jonghyun , Kim Yu Jung , Lee Ju-Yeun 
Published: December 2024

Abstract

Immune checkpoint inhibitors (ICIs) combined with conventional cytotoxic agents have become the new standard of care for extensive-stage small cell lung cancer (SCLC). The platinum-based agents in these regimens are highly emetogenic, necessitating prophylactic antiemetic steroids. This study evaluated the impact of prophylactic antiemetic steroid use on survival outcomes and efficacy in patients with SCLC undergoing combination therapy. Using data from the National Health Insurance Service of Korea database, patients treated with atezolizumab, etoposide, and carboplatin between 2020 and 2022 were categorized by antiemetic steroid dosage. Primary outcomes included overall survival (OS) and time to next treatment (TTNT), assessed using multivariate Cox proportional hazards models. After propensity score matching, 2,116 patients were categorized into low-dose (0–12 mg), moderate-dose (13–24 mg), and high-dose (25–36 mg) groups. Median OS was 10.2 months (interquartile range [IQR], 5.2–18.5), and median TTNT was 8.6 months (IQR, 4.8–15.5), with no significant differences among groups. Subgroup analysis revealed increased mortality associated with higher antiemetic steroid doses in patients concurrently receiving non-antiemetic steroids. Although antiemetic steroids did not significantly impact survival outcomes overall, reducing their dosage in patients already on steroid therapy for other indications is recommended.
Patient perspectives on telehealth access among people experiencing homelessness: A rapid review
Authors: Doherty Claire , Pepper Hayley , Jessup Rebecca , Hutton Jennie 
Published: December 2024

Abstract

Background

Telehealth services are rapidly expanding across the globe yet under-served populations, particularly people experiencing homelessness (PEH), are at risk of being further marginalised in society if focussed interventions to address telehealth access are not implemented.
The aim of this rapid review was to report on the patient experience of PEH when accessing telehealth services. Secondary objectives of the review were to summarise both the patient and health service outcomes that were reported.

Methods

This rapid review identified peer reviewed literature that explored patient experiences of telehealth for people experiencing homelessness. Databases searched were MEDLINE, Embase, APA PsychINFO and CINAHL. Study characteristics were extracted and during the second-phase, two authors independently extracted data from each paper using a framework for evaluating telehealth outcomes (access to care, cost, experience, effectiveness) with a third author reviewing the extracted data and finalising the results table.

Results

Twelve eligible studies were identified with publication dates between 2020 and 2024. Two were qualitative, nine were quantitative and one was a mixed-methods study design. A large variation was found across the literature in relation to participant experience of telehealth for PEH. Telehealth was shown to be an acceptable form of healthcare for PEH. It was more acceptable in settings where participants were accessing it with clinician support, in an environment that was familiar to the participant, where the participant was living in at least temporary accommodation. Furthermore, telehealth was accessible where the processes to access telehealth were not prohibitive and where the internet connection was reliable. However, significant adaptions to improve a participant’s experience of telehealth was identified as a need.

Conclusion

There is limited evidence available that explores the experiences of PEH when accessing telehealth. We have identified a number of simple factors that can be implemented to make telehealth services more accessible for PEH. Acknowledging that telehealth services are an accepted form of healthcare delivery across the globe, future research involving people experiencing primary homelessness and undertaking research utilising a digital inclusion framework would be of value.

Registration

The review was registered on the International prospective register of systematic reviews, (PROSPERO in October 2023 CRD42023466817).
Does Inflammatory Bowel Disease Elevate Infection Risk in Total Hip Arthroplasty? Insights from a nationwide study highlighting steroid use as the key determinant
Authors: Hong Seok Ha , Yu Yeon Ju , Han Seung Beom 
Published: December 2024

Abstract

Introduction
This study investigated the association between medication status and total hip arthroplasty (THA) complications in patients who have inflammatory bowel disease (IBD), considering varying illness severities.
Materials and Methods
This retrospective analysis of the National Health Insurance Review and Assessment Service database in South Korea, included patients undergoing unilateral THA between 2012–2022, specifically those diagnosed with IBD. Propensity score matching was used to adjust for baseline characteristics between IBD and non-IBD cohorts, with a matching ratio of 1:10.
Results
There was a significant difference between the IBD (n = 962) and non-IBD matched groups (n = 9,620) in terms of chronic periprosthetic joint infection (PJI) (2.1 vs 1.3%, P= 0.03) but not with acute PJI or other surgical complications (periprosthetic fracture, dislocation, and aseptic loosening). Medication use itself was not associated with PJI, except for corticosteroid use, significantly associated with PJI among IBD medications (OR: 2.79 [1.03–10.68], P = 0.04). Multivariable analysis indicated a significant increase in PJI risk with corticosteroid use within one year before THA (OR: 3.30 [1.21–10.86], P = 0.01). Patients not using steroids did not exhibit an inherent risk of IBD related complications.
Conclusions
This nationwide study confirmed that IBD increases the risk of chronic PJI. Preoperative corticosteroid use within the year before arthroplasty significantly increased the risk of PJI, particularly in patients with poorly controlled IBD and acute flares-up. Conversely, well-controlled IBD did not correlate with increased surgical complications. Attention should be directed towards recognizing the risk of steroid use, such as acute flares in cases of uncontrolled IBD, to optimize preoperative treatment for IBD undergoing arthroplasty.
Level of Evidence
Level III, Prognostic