bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acquired ineffective erythropoiesis in pediatric ECMO patients: Higher than anticipated serum EPO levels and lower than anticipated reticulocytes counts were associated with mortality
Authors: Weber Zachary , Yost Christian C , Cody Mark , King Jonathan M , Henderson Cody , Christensen Robert D , Carr Nicholas R 
Published: November 2024

Background ECMO plays a crucial role in treating severe respiratory and cardiac failure in pediatric patients. However, its impact on the regulation of erythropoietin (EPO) and erythropoiesis remains poorly understood. Factors such as improved oxygenation, inflammation, and hemodilution associated with ECMO treatment may influence EPO production and erythropoiesis. This study aimed to examine the effects of ECMO on EPO regulation and erythropoiesis in pediatric patients. Methods This retrospective study serially quantified EPO serum levels, measured markers of erythropoiesis, and tabulated clinical outcomes of pediatric ECMO patients. Descriptive statistics and Pearson correlation coefficients were used to identify associations between biomarkers and clinical care parameters. Results Preliminary findings suggest a disconnection between elevated EPO levels and reduced markers of erythropoiesis or iron metabolism, indicating ineffective erythropoiesis. Patients receiving more than 10 mL/kg/day of RBC transfusions had higher reticulocyte counts. Non-survivors had sustained elevations of EPO serum levels but reduced erythropoietic activity. Conclusion In ECMO-treated pediatric patients, ineffective erythropoiesis is a significant concern and may be associated with higher mortality rates. Understanding the mechanisms behind this pathology could better inform clinical approaches and optimize management strategies. Further research is imperative to uncover the factors resulting in ineffective erythropoiesis in these patients and to develop targeted interventions.
Time trends of cancer incidence in young adults (20-49 years) in Italy. A population - based study, 2008-2017
Authors:   AIRTUM Working Group, Stracci Fabrizio , Serraino Diego , Fusco Mario , Mazzucco Walter , Fabiano Sabrina , Tittarelli Andrea , Perotti Viviana , Dal Maso Luigino , Zorzi Manuel , Migliore Enrica , Ferrante Margherita , Gasparotti Cinzia , Ghisleni Silvia , Cavallo Rossella , Teresa Pesce Maria , Casella Claudia , Ballotari Paola , Galasso Rocco , Manzoni Federica , Spata Eugenia , Gentilini Maria Adalgisa , Bella Francesca , Fanetti Anna Clara 
Published: November 2024

Objective: To evaluate short-term (2008–2017) cancer incidence trends in Italy for individuals aged 20-49 years by sex and cancer type. Methods: Observational study from population-based data collected by 20 Italian Cancer Registries, covering 33% of the Italian population. The age-standardized incidence rates (ASRs), overall and stratified by area, sex, cancer site or type, and major age groups (i.e., 20-39, 40-49), were computed. Results: In 2008-2017, cancer incidence rates were almost two times higher in Italian women aged 20-49 than in age-corresponding men (202.2 vs 112.4 per 100,000) on account of elevated rates of breast and thyroid cancers. Contrasting trends emerged according to cancer sites/types. ASRs for female breast cancer increased steadily from 2008 (82.4) to 2014 (86.2) and remained unchanged thereafter (i.e., 86.5 in 2017). During the study period, there was an increase for testicular cancer, skin melanoma in both sexes, and thyroid cancer until 2013 (followed by a slight decrease from 2014 to 2017). Conversely, ASRs consistently declined for colorectal cancer and were substantially stable or slightly decreasing for cervix uteri (from 8.1 to 7.7), ovary (from 7.5 to 6.9) and non-Hodgkin lymphoma (from 8.3 to 7.6 in men and from 5.9 to 5.5 in women). Conclusions: Study findings do not support a unique temporal pattern for the incidence of early-onset cancer in Italy until 2017, as reported in other countries. Increases in incidence documented in both sexes for some tumor sites was counterbalanced by a decrease in other sites. The importance of supporting prevention strategies from the youngest of ages must be emphasized, and the role of anticipated screening should be carefully addressed.
Reversibility of pulmonary hypertension in systemic lupus erythematosus after induction immunosuppressive therapy: An inflammatory manifestation?
Authors: Luppino-Assad Ana Paula , Alves Junior Jose Leonidas , Figueiredo Neves Yuki Emily , Seguro Luciana Parente Costa , Pasoto Sandra Gofinet , Fernandes Caio Julio Cesar dos Santos , Sobral-Alves Juliana , Jardim Carlos Viana Poyares , Bonfá Eloisa , Souza Rogerio , Borba Eduardo F. 
Published: November 2024

Objective To evaluate the possible reversibility of PAH to a normopressoric state in SLE after induction immunosuppressive (IS) and predictors of response. Methods We retrospectively evaluated all SLE-PAH patients who underwent IS therapy at our center. PAH reversion was defined as the normalization of pulmonary arterial pressure (PAP), either by the presence of systolic PAP <40 mmHg on echocardiogram or mean PAP <20 mmHg on right heart catheterization (RHC). SLE patients were divided in Reversion and No-Reversion of SLE-PAH groups for comparative analysis at baseline and after IS. Results Among 2,074 SLE patients, 28 SLE-PAH received IS therapy (1.3%). Ten patients (35.7%) achieved SLE-PAH reversion. Demographic data, disease duration, SLEDAI-2K, and SDI Damage scores were similar between Reversion and No-Reversion of SLE-PAH groups ( p > 0.05). At baseline, Reversion of SLE-PAH had lower sPAP ( p = 0.032), lower right ventricle dilatation ( p = 0.003) and hypokinesia ( p = 0.017) frequencies on echocardiogram, and also lower BNP levels ( p = 0.041) and risk stratification score ( p = 0.014). Hemodynamic parameters were similar among groups ( p > 0.05). After IS, a significant decrease in CRP levels was identified only in Reversion of SLE-PAH ( p = 0.013), although both groups had a significant reduction in SLEDAI-2K ( p < 0.05). Both groups had significant improvement in risk stratification score ( p = 0.009 and p < 0.001) with a better survival rate in Reversion of SLE-PAH ( p = 0.047). Conclusion This is the first study that identified that more than one third of SLE-PAH had a complete reversion of PAH after IS therapy with a significant impact on their survival. These findings strongly support the notion of an underlying inflammatory etiology of this condition, which reinforces the use of immunosuppressive treatment for all SLE patients at PAH onset.
Time taken to reach treatment for eating disorders in New Zealand
Authors: Lawson Rachel , Watterson Roma , Kennedy Martin A , Bulik Cynthia M , Jordan Jennifer 
Published: November 2024

Objective The significant cost burden of eating disorders (EDs) could be lessened with quicker access to treatment. Little is known about the time it takes to reach treatment. We aimed to examine the time to access treatment in New Zealand. Method 468 respondents of the Costs of Eating Disorders online survey provided data including demographics; diagnoses; treatment journey, length of time to seek help; time to diagnosis after seeking help; GP referral to a specialist after diagnosis; and waiting time to see an EDs specialist. Results Half the sample took more than a year to seek help. Those with bulimia nervosa (BN) and binge-eating disorder (BED) took significantly longer to seek help than those with anorexia nervosa and Other EDs. Once participants sought help, half the sample was diagnosed within 1 week. GPs referred most participants to an EDs specialist. Of those placed on a waiting list to see an EDs specialist, just under half were seen within 6 weeks, with no significant differences by diagnosis in waiting time. Conclusions Improving the acceptability of seeking help, particularly in those with BN and BED, early recognition of symptoms, and improving treatment pathways are key to minimising longer term impacts.
Subchondral Bone Degeneration and Pathology 3-15 Years Following Ankle Sprain Injury in Adolescent Sport
Authors: Bott Kirsten N. , Kuczynski Michael T. , Owoeye Oluwatoyosi B. A. , Jaremko Jacob L. , Roach Koren E. , Galarneau Jean-Michel , Emery Carolyn A. , Manske Sarah L. 
Published: November 2024

Background: Sport-related ankle sprains (SASs) are prevalent in adolescents (ages 10-19), increasing the risk of developing posttraumatic osteoarthritis (PTOA). Although early ankle osteoarthritis (OA) is not well defined, OA eventually includes alterations in bone mineral density (BMD), structural changes, and soft tissue pathology. This study examined the impact of SAS sustained in adolescent sport on bone and soft tissue structural outcomes 3-15 years postinjury. Methods: Participants (n = 10) with prior unilateral SAS in adolescent sport (HxAI) were compared to age- and sex-matched controls. To assess injury-related pathologies and BMD, 1.5-tesla (T) extremity magnetic resonance imaging (MRI) and computed tomography scans were used. Semiquantitative scores for injury patterns and OA features from MRI scans were summed and compared between groups. The talus, calcaneus, navicular, and 5% distal tibia were segmented, and BMD was measured for each bone. Results: All HxAI participants exhibited MRI injury pathology (median 2; IQR 1-6), whereas only 1 of 10 controls showed pathology (median 0; IQR 0-0), χ2(1, n = 20) = 16.36, P < .001. Both the injured and uninjured ankles in HxAI displayed injury pattern pathology. Additionally, 3 of 10 injured ankles and 2 of 10 uninjured ankles in the HxAI group (median 0; IQR 0-3), but none of the controls (median 0; IQR 0-0), exhibited OA features. In the HxAI group, talus BMD was lower in the injured ankle (502.4 ± 67.9 g/cm3) compared with the uninjured ankle (515.6 ± 70.1 g/cm3) ( F = 13.33, P = .002), with no significant BMD differences at the calcaneus, navicular, or 5% distal tibia. No differences were observed between the ankles of the control group. Conclusion: The presence of injury pattern pathology, structural changes, and reduced talus BMD suggest that degenerative changes may occur in individuals as early as 3-15 years following ankle injury.
Patient-Perceived Benefits and Limitations of Standard of Care Remote Symptom Monitoring During Cancer Treatment
Authors: Smith Catherine S. , Henderson Nicole L. , Hendrix Emma K. , Padalkar Tanvi , Huang Chao-Hui Sylvia , Dent D’Ambra N. , Ingram Stacey A. , McGowan Chelsea , Odom J. Nicholas , Kaufmann Tara , Weiner Bryan , Howell Doris , Stover Angela M. , Basch Ethan , Pierce Jennifer Young , Rocque Gabrielle B. 
Published: November 2024

Introduction Remote symptom monitoring (RSM) allows patients to electronically self-report symptoms to their healthcare team for individual management. Clinical trials have demonstrated overarching benefits; however, little is known regarding patient-perceived benefits and limitations of RSM programs used during patient care. Methods This prospective qualitative study from December 2021 to May 2023 included patients with cancer participating in standard-of-care RSM at the University of Alabama at Birmingham (UAB) in Birmingham, AL, and the Univeristy of South Alabama (USA) Health Mitchell Cancer Institute (MCI) in Mobile, AL. Semi-structured interviews focused on patient experiences with and perceptions surrounding RSM participation. Interviews occurred over the phone, via digital videoconference, or in person, at the convenience of the patient. Grounded theory was used to conduct content coding and identify recurring themes and exemplary quotes using NVivo. Results Forty patients (20 UAB, 20 MCI) were interviewed. Participants were predominately female (87.5%), aged 41-65 (50%), and married (57.5%). Data is consistent with local demographics, comprising mainly White (72.5%) and 27.5% Black individuals. Three main themes emerged regarding perceived benefits of RSM: (1) Facilitation of Proactive Management, identifying the patient’s needs and intervening earlier to alleviate symptom burden; (2) Promotion of Symptom Self-Management, providing patients autonomy in their cancer care; and (3) Improvement in Patient-Healthcare Provider Relationships, fostering genuine connections based on healthcare team’s responses. However, participants also noted Perceived Limitations of RSM; particularly when support of symptom management was unnecessary, ineffective, or felt impersonal. Conclusion This study focused on patient experiences when utilizing a RSM program while undergoing treatment for cancer and found benefits to its implementation that extended beyond symptom management. At the same time, patients noted drawbacks experienced during RSM, which can help with future tailoring of RSM programs. Patient perceptions should be regularly assessed and highlighted for successful and sustained implementation.
Detecting the Tumor Prognostic Factors From the YTH Domain Family Through Integrative Pan-Cancer Analysis
Authors: Zhu Chong-ying , Yang Qi-wei , Mu Xin-yue , Zhai Yan-yu , Zhao Wen-yan , Yin Zuo-jing 
Published: November 2024

Objectives: Emerging evidence suggests that N6-methyladenosine (m6A) methylation plays a critical role in cancers through various mechanisms. This work aims to reveal the essential role of m6A methylation “readers” in regulation of cancer prognosis at the pan-cancer level. Methods: Herein, we focused on one special protein family of the “readers” of m6A methylation, YT521-B homology (YTH) domain family genes, which were observed to be frequently dysregulated in tumor tissues and closely associated with cancer prognosis. Then, a comprehensive analysis of modulation in cancer prognosis was conducted by integrating RNA sequencing (RNAseq) datasets of YTH family genes and clinical information at the pan-cancer level. Results: YTH family genes were significantly differentially expressed in most of the cancers, particularly increased in Gastrointestinal cancers, and decreased in Endocrine and Urologic cancers. In addition, they were observed to be associated with overall survival (OS) and disease-specific survival (DSS) with various extent, especially in lower grade glioma (LGG), thyroid cancer (THCA), liver hepatocellular carcinoma (LIHC) and kidney clear cell carcinoma (KIRC), so were some “writers” (METLL3, METLL14, WTAP) and “erasers” (FTO, ALKBH5). Further survival analysis illustrated that YTH family genes specifically YTHScore constructed by combining 5 YTH family genes, as well as RWEScore calculated by combining genes from “readers”-“writers”-“erasers” could dramatically distinguish tumor prognosis in 4 representative cancers. As expected, YTHScore presented an equally comparable prognostic classification with RWEScore. Finally, analysis of immune signatures and clinical characteristics implied that, the activity of the innate immune, diagnostic age, clinical stage, Tumor-Node-Metastasis (TNM) stage and immune types, might play specific roles in modulating tumor prognosis. Conclusions: The study demonstrated that YTH family genes had the potential to predict tumor prognosis, in which the YTHScore illustrated equal ability to predict tumor prognosis compared to RWEScore, thus providing insights into prognostic biomarkers and therapeutic targets at the pan-cancer level.
Platelet-Rich Plasma Inhibits Breast Cancer Proliferation
Authors: Han Chao , Chen Caiping , Lu Ning , Xue Li , Xing Dan , Wu Wanxin , Li Wang , Lu Xiang 
Published: November 2024

Background: Platelet-rich plasma (PRP) helps promote wound healing, but it is unclear whether it stimulates breast cancer cell proliferation, which restricts its application in breast cancer patients. This article explored the effect of PRP on breast cancer cell proliferation through preclinical experiments. Method: We cultivated MDA-MB-231 breast cancer cells with PRP in vitro. Subsequently, we employed Cell Counting Kit-8 (CCK-8) assays to assess their proliferation ability, wound healing assays to evaluate their migration ability, and Transwell assays to detect their invasion ability. Mouse breast cancer 4T1 cells were subcutaneously inoculated into nude mice. After tumor formation, PRP was injected around each tumor. Tumor size was measured. After 15 days, the tumors were surgically removed. Immunohistochemistry was used to detect key proteins involved in proliferation and apoptosis. Results: PRP inhibited the proliferation, migration, and invasion of MDA-MB-231 in vitro. After PRP was injected around tumors in nude mice, tumor growth slowed, Ki67 and phospho-histone H3 (pHH3) expression decreased, and Caspase 3 and Poly (adenosine diphosphate-ribose) polymerase 1 (PARP1) expression increased. Conclusion: The PRP inhibits the proliferation of breast cancer MDA-MB-231 and 4T1 cells.
Utilization Fraction of Ambulatory Hand Procedures: Cost-Reduction Through Surgical Instrument Tray Optimization
Authors: Onuh Ogechukwu C. , Cassidy Michael F. , Tran David L. , Brydges Hilliard T. , Dorante Miguel I. , Laspro Matteo , Muller John , Guo Lifei , Agrawal Nikhil A. , Chiu Ernest S. 
Published: November 2024

Background: Our objective is to evaluate the utilization fraction (UF) of surgical instruments during a commonly performed ambulatory hand surgery case as an avenue for cost reduction, increased operating room efficiency, and systems quality improvement. Methods: The total number of instruments opened at the start of the case was recorded followed by instruments being divided into those used and not used during the procedure. Total sterile processing costs were estimated at $1.56 per instrument according to data from our institution’s central sterilization processing (CSP) department. Results: Nineteen hand procedures performed by 2 surgeons were included in this study. An average of 120.1 ± 10.9 instruments were opened at the start of each case, while an average of 12.6 ± 5.4 instruments were used per case (Figure 1). This yielded an UF of 10.7% ± 4.8%. Using our internal CSP estimate, we calculated an annual cost of $16 863 to reprocess the current hand tray (Figure 2). Using literature data, this cost ranged from $5 513 to $34 484 annually. The same cost calculations were performed for the theoretical optimized tray (incorporating instruments used at least 20% of the time when opened) containing 23.2 instruments. The annual reprocessing cost of this new tray according to CSP data was $3 260, demonstrating a cost-reduction of $13 603 or 80.7% (Figure 2). Conclusions: Evaluation of pre- and peri-operative processes is a valuable technique to mitigate increasing healthcare costs and reduce unnecessary healthcare spending, with broad applicability to multiple surgical subspecialties and procedures.
Financial Toxicity Among Patients With Traumatic Finger Amputation: A Retrospective Study
Authors: Agbafe Victor , Sears Erika D. , Gaines Clarice E. , Billig Jessica I. 
Published: November 2024

Background: Patients face increasing financial toxicity (FT), defined as emotional distress due to the cost of medical treatment. However, little is known regarding FT in the context of upper extremity trauma. Methods: We surveyed patients who sustained traumatic finger amputation (October 21, 2011-January 1, 2021). We collected patient-reported financial distress using the Comprehensive Score for Financial Toxicity (COST-11), where a lower score indicates worse FT. We also collected data of patients’ perceptions regarding the costs of their treatment. We used linear regression to assess patient-level characteristics associated with FT as measured by the COST-11 score. Results: Of the 191 eligible patients, 46 patients completed the survey (response rate of 24%). A total of 41 respondents (89%) received an initial treatment of revision amputation, with the remaining patients receiving a semi-occlusive dressing. Patients with commercial insurance had significantly lower COST-11 scores (ie, worse FT) than patients with Medicare (β = 7.5, 95% CI: 0.5 to 14.5) and Worker’s Compensation (β = 8.7, 95% CI: 1.8 to 15.6). Patients who were single/never married had significantly worse FT (β = −11.3, 95% CI: −18.7 to −3.9). Approximately 35% (n = 16) reported that the costs were higher than expected. More than a third of patients (39%) reported decreasing spending on basic items, such as food, at least once since surgery. Conclusion: Patients face FT when obtaining surgery following traumatic finger amputation. Variation in the FT is associated with type of insurance and marriage status, highlighting how underinsurance and social support likely affect the overall economic well-being of patients.
Chatbot Demonstrates Moderate Interrater Reliability in Billing for Hand Surgery Clinic Encounters
Authors: Latario Luke D. , Fowler John R. 
Published: November 2024

Background: Artificial intelligence offers opportunities to improve the burden of health care administrative tasks. Application of machine learning to coding and billing for clinic encounters may represent time- and cost-saving benefits with low risk to patient outcomes. Methods: Gemini, a publicly available large language model chatbot, was queried with 139 de-identified patient encounters from a single surgeon and asked to provide the Current Procedural Terminology code based on the criteria for different encounter types. Percent agreement and Cohen’s kappa coefficient were calculated. Results: Gemini demonstrated 68% agreement for all encounter types, with a kappa coefficient of 0.586 corresponding to moderate interrater reliability. Agreement was highest for postoperative encounters (n = 43) with 98% agreement and lowest for new encounters (n = 27) with 48% agreement. Gemini recommended billing levels greater than the surgeon’s billing level 31 times and lower billing levels 10 times, with 4 wrong encounter type codes. Conclusions: A publicly available chatbot without specific programming for health care billing demonstrated moderate interrater reliability with a hand surgeon in billing clinic encounters. Future integration of artificial intelligence tools in physician workflow may improve the accuracy and speed of billing encounters and lower administrative costs.
Lyme disease chemoprophylaxis prescribing before and after pharmacist prescriptive authority in Nova Scotia
Authors: Bell Madison , Ramsey Tasha , Trenaman Shanna , Hatchette Todd , Campbell Samuel , Bishop Andrea , MacInnis Melanie , Hurley Katrina , Black Emily 
Published: November 2024

Background: Lyme disease is a bacterial infection transmitted to humans through bites from infected Ixodes species of ticks. Prophylaxis with a single dose of oral doxycycline following a bite from an infected tick reduces the risk of developing Lyme disease. Pharmacists in Nova Scotia (NS) were among the first in Canada to prescribe for this indication. The primary objective of this study is to describe experiences with pharmacist prescribing of prophylaxis after tick bites in NS. Methods: A retrospective cohort study was performed using health administrative data 16 months before and after pharmacists were authorized to prescribe Lyme disease chemoprophylaxis (August 1, 2021). All dispensations of a single dose of oral doxycycline from a community pharmacy in NS were included. Data collected included prescriber type, date, and county of dispensation. Comparisons of dispensations were completed before and after pharmacists gained prescriptive authority and relative to other prescribers. Dispensations were described descriptively. Results: Over the study period, 12,549 single-dose doxycycline prescriptions were dispensed in NS: 3900 prescriptions were dispensed before pharmacist prescribing authorization for this indication occurred and 8649 were dispensed after. Pharmacists prescribed 61.3% of all single-dose doxycycline prescriptions following implementation of prescribing authority. Discussion: An increase in single-dose doxycycline prescriptions was observed in NS. Pharmacists have become the primary prescribers for Lyme disease chemoprophylaxis in the province. Conclusion: Patients were willing to be assessed for chemoprophylaxis after tick exposure by pharmacists, and pharmacist prescribing for this indication suggests increased access to post-tick exposure care.