bluuebunny/crossref_metadata_2025_split huggingface dataset:
A National Retrospective Cohort Study Comparing the Effects of Cefepime Versus Piperacillin-Tazobactam on the Development of Severe Acute Kidney Injury in Patients With Septic Shock
Authors: Patanwala Asad E , Nix David E , Hills Thomas E , Erstad Brian L 
Published: December 2024

Abstract

Background
Cefepime and piperacillin-tazobactam are commonly used broad-spectrum antibiotics used to treat patients with potential gram-negative bacterial sepsis. Piperacillin-tazobactam has been shown to be associated with acute kidney injury (AKI). However, it has not been compared with cefepime in patients with septic shock. We compared the effects of cefepime and piperacillin-tazobactam on the incidence of severe AKI in patients with septic shock.

Methods
This was a retrospective, multicenter, inverse probability-of-treatment weighted cohort study conducted in 220 geographically diverse community and teaching hospitals across the United States. Adult patients were included if they had septic shock on hospital admission and received cefepime or piperacillin-tazobactam. The proportions of patients in whom stage 3 AKI occurred during hospitalization were compared between groups.

Results
Of the 8427 patients included in the final cohort, 4569 received cefepime and 3858 received piperacillin-tazobactam. Patients had a mean (SD) age of 66.2 (15.2) years, and 45.3% were female; the mean (SD) estimated glomerular filtration rate was 48 (24) mL/min/1.73 m2 on the day of admission. In the weighted cohort, stage 3 AKI occurred in 9.9% receiving cefepime and 9.8% receiving piperacillin-tazobactam (odds ratio, 0.98 [95% confidence interval, .84–1.15]; P = .82). In terms of secondary outcomes, there was no significant difference between cefepime and piperacillin-tazobactam with regard to renal replacement therapy, in-hospital death, major adverse kidney events, stage 1 AKI, stage 2 AKI, maximum recorded serum creatinine, or hospital length of stay

Conclusions
Among hospitalized patients with septic shock, there was no difference between cefepime and piperacillin-tazobactam in the occurrence of severe AKI.
Community-Acquired Respiratory Virus Infections: A Threat to Long-Term Survivors After Allogeneic Stem Cell Transplant?
Authors: Piñana José Luis , Carbonell-Asins Juan A , Gómez Dolores , Montoro Juan , Pérez Ariadna , Hernani Rafael , Chorão Pedro , Hernández-Boluda Juan Carlos , Navarro David , Solano Carlos 
Published: December 2024

Abstract

Background
Studies on late community-acquired respiratory virus (CARV) infections in long-term allogeneic hematopoietic stem cell transplantation (allo-HCT) survivors are scarce, creating knowledge gaps on the epidemiology, risk of progression to lower respiratory tract disease (LRTD), and conditions linked to poor outcomes.

Methods
We included consecutive CARV infection episodes occurring up to 6 months after allo-HCT registered in our database from December 2013 to June 2023 at 2 Spanish transplant centers.

Results
Among 426 allo-HCT recipients, 1070 CARV episodes were recorded, 791 (74%) with only upper respiratory tract disease (URTD) and 279 (15%) progressing to LRTD, at a median of 18.6 months post-transplant. The most common CARVs were rhinovirus, respiratory syncytial virus (RSV), and influenza. The LRTD progression rate was 26%, with a 4.9% all-cause mortality rate at 100 days post-CARV detection. Risk factors for LRTD progression included graft-versus-host disease prophylaxis (odds ratio [OR] 3.08), corticosteroid use (0.1 to &lt;30 mg/day: OR 2.44; ≥30 mg/day: OR 5.19), absolute lymphocyte count (ALC) &lt;1 × 10^9/L (OR 1.60), fever at CARV screening (OR 4.27), RSV (OR 2.46), and human metapneumovirus (HMPV) (OR 2.76). Risk factors for 100-day all-cause mortality included human leukocyte antigen (HLA) mismatch (hazard ratio [HR] 2.49); corticosteroid use (0.1 to &lt;30 mg/day: HR 3.87; ≥30 mg/day: HR 5.77); ALC &lt;1 × 10^9/L (HR 2.44); neutropenia &lt;0.5 × 10^9/L (HR 6.74), and age ≥40 years (HR 4.85).

Conclusions
Recipients with profound and prolonged immunosuppression remain at risk for severe CARV infection outcomes late after allo-HCT, necessitating intensive clinical monitoring for respiratory symptoms.
Urine complement-related proteins in IgA nephropathy and IgA vasculitis nephritis, possible biomarkers of disease activity
Authors: Nurmi Mazdak Sanaei , Pérez-Alós Laura , Garred Peter , Fellström Bengt , Gabrysch Katja , Lundberg Sigrid 
Published: December 2024

ABSTRACT

Introduction
The activation of the complement system plays an important role in the pathogenesis of IgA nephropathy (IgAN). Our primary aim was to evaluate a range of complement-related proteins, including pentraxin-3 (PTX-3), in blood and urine at diagnosis and their association with disease activity in the kidney biopsy, eGFR, albuminuria, and outcome. Our secondary aim was to compare the same biomarkers between patients with IgAN and IgA vasculitis with renal involvement (IgAVN).

Methods
In a longitudinal Swedish cohort of 96 patients with IgAN (n = 65) or IgAVN (n = 31), with a median follow-up time of 10.8 years, we analysed mainly lectin-pathway-related proteins and PTX-3 in plasma and urine (u) samples stored at the time of kidney biopsy. Outcome was defined by the GFR slope or by the combined outcome of 50% loss of eGFR or end-stage kidney disease (ESKD).

Results
Patients with detectable vs undetectable u-PTX-3 and u-mannose-binding lectin (MBL) more frequently had mesangial hypercellularity, endocapillary proliferation, and crescents in their kidney biopsy. u-C4c levels were higher in patients with advanced tubulointerstitial fibrosis, and u-C4c was also an independent predictor of a more severe eGFR slope. There were no differences in the levels of biomarkers between patients with IgAN and IgAVN.

Conclusion
u-PTX-3 and u-MBL might be biomarkers of an active proliferative stage of the disease, while higher u-C4c levels indicate more chronic lesions in both IgAN and IgAVN. These results must, however, be confirmed in larger and multiethnic cohorts.
Performance of higher-order networks in reconstructing sequential paths: from micro to macro scale
Authors: Teo Kevin , Arnold Naomi , Hone Andrew , Kiss István Zoltán 
Published: December 2024

Abstract
Activities such as the movement of passengers and goods, the transfer of physical or digital assets, web navigation and even successive passes in football, result in timestamped paths through a physical or virtual network. The need to analyse such paths has produced a new modelling paradigm in the form of higher-order networks which are able to capture temporal and topological characteristics of sequential data. This has been complemented by sequence mining approaches, a key example being sequential motifs measuring the prevalence of recurrent subsequences. Previous work on higher-order networks has focused on how to identify the optimal order for a path dataset, where the order can be thought of as the number of steps of memory encoded in the model. In this article, we build on these approaches to consider which orders are necessary to reproduce different path characteristics, from path lengths to counts of sequential motifs, viewing paths generated from different higher-order models as null models which capture features of the data up to a certain order, and randomize otherwise. Furthermore, we provide an important extension to motif counting, whereby cases with self-loops, starting nodes and ending nodes of paths are taken into consideration. Conducting a thorough analysis using path lengths and sequential motifs on a diverse range of path datasets, we show that our approach can shed light on precisely where models of different order overperform or underperform, and what this may imply about the original path data.
Demographic analysis of survival trends in squamous cell carcinoma of the upper 1/3 of the esophagus: a population-based study
Authors: Travis Dylan , Nnawuba Kingsley , Vellanki Sruthi , Robinson Samantha , Jensen Hanna , Trikannad Anup Kumar 
Published: December 2024

Abstract
Esophageal malignancies, constituting 3% of global cancers, pose significant health challenges with poor survival rates. Squamous Cell Carcinoma (SCC) and Adenocarcinoma (AC) are predominant subtypes, with shifting incidences globally. This analysis will focus primarily on the demographics of survival trends for Squamous cell carcinoma of esophagus (SCCE). This retrospective study, utilizing the SEER database, examined demographic factors influencing survival trends in SCC of the upper esophagus. Variables included age, sex, race, income, and rurality. Statistical analyses included chi-square tests and multivariable models, specifically logistic regression and conditional inference tree models. A total of 2821 patients were included in this study. Demographic disparities were evident with race (p &lt; 0.001), age (p = 0.002), and sex (p = 0.048) significantly impacting survival when holding other variables constant, with Non-Hispanic Black individuals exhibiting the greatest odds of mortality compared to other racial groups. Median household income (p = 0.344) and Rural-Urban Continuum (p = 0.100) were not significantly associated with improved survival rates when controlling for other demographics. Our findings align with previous research on sex-based survival disparities and racial variations in SCCE incidence and outcomes. Socioeconomic and biological factors contribute to these disparities, highlighting the need for tailored interventions and equitable healthcare access. Understanding demographic determinants in SCCE survival is crucial for personalized treatment and policy reforms to address disparities. Future research should focus on prospective, diverse cohorts to further elucidate these complex interactions and improve esophageal SCCE management and outcomes.
Diverse Phenotypes, Consistent Treatment: A Study of 30 997 South Asian and White Inflammatory Bowel Disease Patients Using the UK Inflammatory Bowel Disease BioResource
Authors: Balarajah Sharmili , Martinez-Gili Laura , Alexander James Leslie , Mullish Benjamin Harvey , Perry Robert William , Li Jia V , Marchesi Julian Roberto , Parkes Miles , Orchard Timothy Robin , Hicks Lucy Charlotte , Williams Horace Richard Timothy 
Published: December 2024

Abstract

Background
Studies in the UK and North America have suggested a distinct disease profile in South Asians compared to that of White populations. Disparities in the medical and surgical management of IBD in minority ethnic groups (including Black Americans and Asians) in the US have been shown, while data from Europe, including the UK, have been lacking. This study sought to evaluate South Asian (SA) and White (WH) inflammatory bowel disease (IBD) phenotypes, and to explore treatment approach variations between these cohorts in the UK using the IBD BioResource database.

Design
Differences between WH and SA IBD patients were analysed using demographic, phenotypic and outcome data. Drug utilisation patterns and surgical outcomes were assessed in propensity score-matched (PSM) cohorts with multivariable logistic regression, Cox regression and Kaplan-Meier analysis.

Results
30,997 eligible patients were included. UC was the predominant disease subtype in SA (p&lt;0.001). SA were younger at diagnosis (p&lt;0.001), had a male preponderance (p&lt;0.001), and were less likely to have a smoking history at diagnosis. The SA CD phenotype differed from WH, with less ileal (SA 30.3%, WH 38.4%, p=0.008) and stricturing (SA 16.9%, WH 25.6%, p&lt;0.001) disease, but more perianal disease (SA 38.5%, WH 32.2%, p=0.009). More SA UC patients had extensive disease (SA 41.7%, WH 34.1%, p&lt;0.001). In PSM cohorts, comparing treatments, there were no differences in 5-aminosalicylate, corticosteroid, thiopurine, anti-TNF or vedolizumab use. Survival analysis in matched cohorts showed no difference in time to surgery (CD) or colectomy (UC), and SA ethnicity was not associated with a difference in risk of surgery/colectomy.

Conclusion
Demographic and phenotypic differences exist between UK SA and WH IBD patients, highlighting distinct ethnicity-related variance, and the need for a research focus on under-represented populations. In comparing matched SA and WH patients, no disparity in medical and surgical IBD therapy in UK healthcare has been demonstrated: treatment is consistent regardless of ethnicity.
Non-invasive myocardial work in severe aortic regurgitation: implications for post-operative left ventricular dysfunction
Authors: Tan Yu-Ting , Wang Yao-Ling , Abulipizi Abudukadier , Ji Xiang , Zhang Rui-Ze , Zhao Ruo-Han , Hou Quan-Fei , Liu Tian-Shu , He Shu-Kun , Shi Jia-Wei , Li Yu-Man , Fang Ling-Yun , Zhang Li , Qiu Li , Zhang Jing , Xie Ming-Xing , Wang Jing 
Published: December 2024

Abstract

Aims
Non-invasive myocardial work offers a promising echocardiographic method to evaluate left ventricular (LV) function as it integrates myocardial deformation and afterload. The study sought to investigate the association of myocardial work indices with post-operative LV dysfunction in patients with chronic severe aortic regurgitation (AR).

Methods and results
Pre-operative LV ejection fraction (LVEF), LV global work index (LV GWI), LV global constructive work (LV GCW), LV global wasted work (LV GWW), and LV global work efficiency (LV GWE) were measured. Post-operative LV dysfunction was defined as LVEF &lt; 50% at 12 months after surgery. One hundred and forty-one patients with chronic severe AR and preserved LVEF (52 (42–58) years; 74.5% men) who underwent aortic valve surgery were studied. Twenty-six patients (18%) developed post-operative LV dysfunction. Patients with post-operative LV dysfunction had lower LV GWI, LV GCW, and LV GWE compared with those without (all P &lt; 0.05). In multivariate analysis, LV GWI (adjusted odds ratio (OR): 0.99; 95% CI: 0.98–1.00; P &lt; 0.001), and LV GCW (adjusted OR: 0.99; 95% CI: 0.99–1.00; P &lt; 0.001) were associated with post-operative LV dysfunction. Moreover, a multivariate logistic regression model with LV GWI (Akaike information criterion = 108.023, Bayesian information criterion = 119.818, C-statistics = 0.836) showed the best capability in predicting post-operative LV dysfunction. The comparative analysis of C-statistics across the three models—LV GWI, LV GCW, and LV GLS—did not reveal statistically significant differences (all P &gt; 0.05).

Conclusion
In patients with chronic severe AR and preserved LVEF, impaired myocardial work indices are associated with post-operative LV dysfunction. Myocardial work has potential value for risk stratification and surgical decision-making in such a population.
Estimating inflammatory risk in atherosclerotic cardiovascular disease: plaque over plasma?
Authors: Annink Maxim E , Kraaijenhof Jordan M , Beverloo Cheyenne Y Y , Oostveen Reindert F , Verberne Hein J , Stroes Erik S G , Nurmohamed Nick S 
Published: December 2024

Abstract
Inflammation is an important driver of disease in the context of atherosclerosis, and several landmark trials have shown that targeting inflammatory pathways can reduce cardiovascular event rates. However, the high cost and potentially serious adverse effects of anti-inflammatory therapies necessitate more precise patient selection. Traditional biomarkers of inflammation, such as high-sensitivity C-reactive protein, show an association with cardiovascular risk on a population level but do not have specificity for local plaque inflammation. Nowadays, advancements in non-invasive imaging of the vasculature enable direct assessment of vascular inflammation. Positron emission tomography (PET) tracers such as 18F-fluorodeoxyglucose enable detection of metabolic activity of inflammatory cells but are limited by low specificity and myocardial spillover effects. 18F-sodium fluoride is a tracer that identifies active micro-calcification in plaques, indicating vulnerable plaques. Gallium-68 DOTATATE targets pro-inflammatory macrophages by binding to somatostatin receptors, which enhances specificity for plaque inflammation. Coronary computed tomography angiography (CCTA) provides high-resolution images of coronary arteries, identifying high-risk plaque features. Measuring pericoronary adipose tissue attenuation on CCTA represents a novel marker of vascular inflammation. This review examines both established and emerging methods for assessing atherosclerosis-related inflammation, emphasizing the role of advanced imaging in refining risk stratification and guiding personalized therapies. Integrating these imaging modalities with measurements of systemic and molecular biomarkers could shift atherosclerotic cardiovascular disease management towards a more personalized approach.
Surgical valve replacement in adults late after total cavo-pulmonary connection/Fontan procedure
Authors: Lisignoli Veronica , Iannaccone Giulia , Murphy Michael , Kacar Polona , Moscatelli Sara , Li Wei , Shore Darryl , Gatzoulis Michael A , Montanaro Claudia 
Published: December 2024

Abstract

OBJECTIVES
There is dearth of data on long-term outcomes of systemic semilunar (SS) or atrioventricular (AV) valve operation in adult patients with a Fontan circulation. We describe a single-centre experience of adults who underwent valve surgery late after a Fontan procedure.

METHODS
We retrospectively reviewed all patients with a Fontan circulation who had a reoperation for severe valve disease during adulthood in our centre. Demographic, anatomical, clinical and periprocedural data and long-term outcome were retrospectively retrieved from our dedicated electronic hospital database and examined.

RESULTS
Out of 233 adults with a Fontan operation, 8 (7 males [88%]) had valve surgery during the study period. Indication for surgery was severe symptomatic valve regurgitation in all patients (of the SS valve in seven cases and of the left AV valve in 1). Mechanical prosthesis was implanted in all cases. At a median follow-up of 10 years (interquartile range 5–20), one patient died due to hepatitis C virus infection. All the remaining 7 patients experienced a significant improvement of the New York Heart Association class compared to the pre-operative state (P = 0.015); echocardiography showed stable systemic ventricle ejection fraction in absence of volume overload (50.1 ± 7.9% vs 51.6 ± 8.7%, P = 0.399) and well-functioning prostheses. No patient needed further operation nor heart transplantation.

CONCLUSIONS
Surgical SS valve replacement late after a Fontan operation in highly selected adult patients with valvular regurgitation performed in a tertiary dedicated centre resulted to be safe in our population and conveyed clinical benefit. Close monitoring of all Fontan patients developing valvular dysfunction is warranted, whereas future prospective research may refine selection criteria, optimal timing and outcomes.
Overall survival, cause of death and time interval between diagnosis and death after Stanford type B acute aortic dissection (TBAAD)
Authors: Becker Daniel , Slongo Alexander , Yildiz Murat , Mosbahi Selim , Bosiers Michel Joseph , Jungi Silvan , Schoenhoff Florian , Kotelis Drosos , Makaloski Vladimir 
Published: December 2024

Abstract

OBJECTIVES
This study aimed to assess survival rates and the causes of both early and late mortality in patients with Stanford type B acute aortic dissection (TBAAD)

METHODS
A retrospective analysis was conducted on all consecutive patients presenting with TBAAD from 2000 to 2018 at a single tertiary care centre. The primary end-point was early (&lt;3 months) and late (&gt;3 months) survival following TBAAD, with causes of both early and late mortality evaluated.

RESULTS
A total of 274 patients, with a mean age of 64 ± 13 years, were included. Among these, 155 patients (57%) presented with uncomplicated TBAAD, including 52 (19%) identified as high-risk, and 119 patients (43%) had complicated TBAAD. Early aorta-related mortality occurred in 9 patients (3.3%), all within the complicated TBAAD group. The median follow-up period for the entire cohort was 8.5 years [95% confidence interval (CI) 7.6–11.2]. Long-term survival was significantly higher in patients with uncomplicated TBAAD compared to those with complicated TBAAD (P &lt; 0.001). Both complicated and high-risk uncomplicated TBAAD cases required significantly more interventions in the chronic phase (&gt;3 months) compared to uncomplicated TBAAD cases [hazard ratio (HR) 9.8, 95% CI 6.4–15.4, P &lt; 0.001; HR 3.3, 95% CI 2.1–5.1, P &lt; 0.001).

CONCLUSIONS
Complicated TBAAD presents the greatest risk for aorta-related mortality and interventions. Patients with high-risk uncomplicated TBAAD are also notable for an increased rate of aorta-related mortality and interventions. Thorough evaluation of clinical and anatomical characteristics is essential for determining the optimal therapeutic approach.
Palatal rugae change shape following orthodontic treatment: a comparison between extraction and non-extraction borderline cases using fractal analysis and 3D superimposition
Authors: Makrygiannakis Miltiadis A , Konstantonis Dimitrios , Vastardis Heleni , Athanasiou Athanasios E , Halazonetis Demetrios J 
Published: December 2024

Abstract

Introduction
Palatal rugae are used as anatomical landmarks on the hard palate, in various clinical applications; in forensics, for insertion of mini-screws, and for superimposition. There is ambiguous evidence on whether they change during orthodontic treatment and to what extent. Therefore, we investigated changes in the shape, complexity, and area occupied by palatal rugae following orthodontic treatment with and without extractions.

Materials and methods
Pre- and post-treatment plaster models of maxillae of 28 cases involving first premolar extractions (17 females and 11 males) and 33 non-extraction cases (19 females and 14 males) were scanned and analysed. All participants were selected from a parent sample via discriminant analysis and represent borderline cases. We applied mesh cropping, ball pivoting, distance mapping, contour cropping of rugae, best-fit superimposition, fractal dimension (FD) analysis, and creation of rugae’s convex hull area with Viewbox 4 software. The average distance between the closest points of the outlines of pre- and post-treatment palatal rugae (indicating shape change in the set of rugae), disparity in their pre- and post-treatment FDs (reflecting the complexity of their shapes), area occupied by rugae, arch depth, and size of palatal surface were then computed.

Results
The medians of the average distance between pre- and post-treatment outlines after best-fit superimposition were 0.39 mm (interquartile range [IQR]: 0.34–0.51) and 0.27 mm (IQR: 0.22–0.34) mm for the extraction and non-extraction groups, respectively (P &lt; 0.001). The median pre-treatment FDs were 1.497 (IQR: 1.481–1.521) for the extraction group and 1.481 (IQR: 1.456–1.509) for the non-extraction group, whereas their median post-treatment FDs were 1.502 (IQR: 1.472–1.532) and 1.489 (IQR: 1.469–1.501), respectively. The differences between pre- and post-treatment fractal dimensions were not found to be significant, neither within each group, nor across the groups. On the other hand, the surface area occupied by rugae showed a median increase of 14.7 mm2 (IQR: 0.0–46.5) (P = 0.003) following non-extraction treatment only.

Conclusion
Palatal rugae change shape during orthodontic treatment, but their shape complexity, as measured by fractal dimensions, remains unaltered. Extraction treatment exerts a more pronounced effect in shape change compared to treatment without extractions. Nevertheless, non-extraction orthodontic treatment increases the surface on which rugae lie, as measured by means of the convex hull. Although the alterations may appear minor, it is necessary to exercise caution and prudence when employing rugae for superimposition and forensic dentistry purposes.