bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Practice, Trends and Attitudes of Rheumatologists Towards Glucocorticoids Use for Rheumatoid Arthritis (GURANTEE): A National Cross-sectional Survey Across China
Authors: Xiao Shiyu , Xie Wenhui 
Published: November 2024

Background: There were mixed practices and attitude towards glucocorticoids (GC) use for rheumatoid arthritis (RA). We aimed to investigate current practices, changes, and perceptions of rheumatologists regarding GC use in RA patients. Methods: A cross-sectional survey was conducted using a structured questionnaire between April and August 2023. Rheumatologists from 31 province-level regions of Mainland China were invited to participate. Chi-squared tests were adopted to investigate the differences by sociodemographic characteristics. Results: 1,717 rheumatologists from 598 hospitals completed the survey with a response rate of 92%. Up to 60% of participants expressed currently infrequent initiation of GC co-therapy with csDMARDs (hardly ever 7.0%; occasionally 24.6%; sometimes 29.1%), accompanied by a decline of frequency over time reported in 64.2%. Regarding attitudes towards bridging therapy with GC, 604 (35.2%) participants supported this approach, 468 (27.3%) opposed it, and 645 (37.6%) remained inconclusive. Time to GC discontinuation in context of csDMARDs was commonly reported within 6 months in current practice which has been narrowed over time. Reasons for chronic GC use were mostly reported due to suboptimal disease control, followed by the need of RA complications, and pre-existing comorbidities. After failure of GC cessation, majority of respondents (84.4%) would escalate RA therapy (commonly by addition of JAK inhibitors, TNF inhibitors), which usually or often facilitated the GC cessation. The most frequently reported advantages and weaknesses of GC were rapid and strong efficacy, adverse events, respectively. Regarding long-term low-dose GC use for RA, the percentage of respondents who supported, opposed, or depended on the situation were 15.9%, 17.2%, and 66.9%, respectively. Conclusion: The current data demonstrate that GC initiation for RA treatment is not as frequent as before and the awareness of GC discontinuation is growing in current practice. Attitudes towards GC co-therapy with csDMARDs vary considerably and long-term low-dose GC use remain situation dependent.
Analytical Performance of a Novel, Fully Automated Multiplexed Microarray Immunoassay Prototype for the Simultaneous Detection of Fifteen Autoantibodies Associated with Connective Tissue Diseases
Authors: Gomez Gerber , Bijlsma Daphne , Lukasik Ewa , Hausmann Michael , Fischer Christian , Ghillani-Dalbin Pascale , Miyara Makoto , Moreau Emmanuel 
Published: November 2024

Background: There is currently a limited offer of automated multi-analyte tests for autoantibody testing in autoimmune connective tissue diseases (CTD). We assessed the analytical performance of a novel, single-use, multiplexed microarray immunoassay prototype (MosaiQ AiPlex CTDplus), used with the fully automated MosaiQⓇ system, for the simultaneous detection of fifteen autoantibodies associated with CTD, compared with selected CE-marked devices. Methods: Banked human serum samples, characterized as reactive to ≥ 1 autoantibody or non-reactive were included. Reactive samples were characterized with FIDIS™ Connective Profile (Theradiag) for CENP B, Jo-1, Ribosomal P, Scl-70, Sm, Sm/RNP, SS-A 60, TRIM21 (SS-A 52), SS-B and U1RNP; EliA CCP (Phadia) for CCP2, QUANTA LiteⓇ Chromatin (Werfen) for Chromatin, QUANTA FlashⓇ DFS70* (Werfen) for DFS70, Anti-dsDNA-IgG-ELISA (DRG) for dsDNA, and Immunodot (Euroimmun) for RNA polymerase III (RNAP III). For CCP2, only reactive samples were included. For the remaining analytes, non-reactive samples were characterized using immunofluorescence (ANA-Ro IgG FLUORESCENT HEp-2000Ⓡ; Immuno Concepts, Germany) and ANAscreen ELISA (ORGENTEC-Diagnostika-GmbH, Germany). Each individual non-reactive sample was tested with the investigational device once; reactive samples were tested in duplicates. Positive percentage agreement (PPA) and negative percentage agreement (NPA) for individual analytes were calculated. For CCP2 only PPA is presented as no negative samples were included. Results: Compared with relevant devices, the investigational prototype showed PPA ranging from 75% for chromatin to 99% for SS-A 60 and TRIM21. NPA ranged from 95% for chromatin, RNAP III, Scl-70 and Sm to 100% for DFS70, SS-A 60 and TRIM21. Performance details are shown in the Table. Conclusions: The investigational prototype demonstrated substantial agreement with the compared CE-marked devices. Further studies will allow for expanded performance assessment of the investigational device. This fully-automated multiplexed platform has the potential to contribute to optimizing CTD evaluation by simplifying complex testing pathways and analyzing large number of samples per day.
On the assessment of the ability of measurements, nowcasts, and forecasts to track changes
Authors: Rieger Jonas , Liu Bolin , Saugel Bernd , Grothe Oliver 
Published: November 2024

Abstract
Background
Measurements, nowcasts, or forecasts ideally should correctly reflect changes in the values of interest. In this article, we focus on how to assess the ability of measurements, nowcasts, or forecasts to correctly predict the direction of changes in values - which we refer to as the ability to track changes (ATC).

Methods
We review and develop visual techniques and quantitative measures to assess ATC. Extensions for noisy data and estimation uncertainty are implemented using bootstrap confidence intervals and exclusion areas.

Results
We exemplarily illustrate the proposed methods to assess the ability to track changes for nowcasting during the COVID-19 pandemic, patient admissions to an emergency department, and non-invasive blood pressure measurements. The proposed methods effectively evaluate ATC across different applications.

Conclusions
The developed ATC assessment methods offer a comprehensive toolkit for evaluating the ATC of measurements, nowcasts, and forecasts. These techniques provide valuable insights into model performance, complementing traditional accuracy measures and enabling more informed decision-making in various fields, including public health, healthcare management, and medical diagnostics.
Sirolimus-induced pulmonary toxicity without recurrence more than 8 years after everolimus replacement in a renal transplant patient with recurrent skin SCC: a case report
Authors: Ghasemi Golsa , Shahidi Shahrzad 
Published: November 2024

Abstract
Background
Interstitial Pneumonitis (IP) is one of the pulmonary complications associated with mammalian Target of Rapamycin-Inhibitors (mTOR-Is). Sirolimus and everolimus belong to mTOR-Is. According to studies, IP is caused by both.

Case presentation
This is a case report in a kidney transplant recipient. We want to present a case of IP after 50 months of sirolimus consumption. Sirolimus was discontinued, and cyclosporine was started. Thirty-seven months later, everolimus was prescribed as an alternative to cyclosporine due to the recurrence of skin Squamous Cell Carcinoma (SCC). Fortunately, no respiratory manifestations were seen after more than 8 years of everolimus consumption.

Conclusions
In conclusion, in cases with sirolimus-induced IP, discontinuation of sirolimus and replacement with everolimus are recommended after resolving clinical symptoms and pulmonary lesions.
Perspective on patient-centered communication: a focus group study investigating the experiences and needs of nursing professionals
Authors: Mielke Kendra , Frerichs Wiebke , Cöllen Katja , Lindig Anja , Härter Martin , Scholl Isabelle 
Published: November 2024

Abstract
Background
Delivering high quality care tailored to patients’ needs necessitate patient-centered communication. High physical and mental workload, as well as organizational barriers, contribute to challenges nurses face in patient-centered communication. Participation in a communication skills training can help nurses to improve their patient-centered communication skills. Thus, the aim of this study was to investigate the experiences of nursing professionals in patient-centered communication and delineate the requisite content for a communication skills training.

Methods
We conducted focus group interviews with nursing professionals working at an academic medical center in Germany. The focus group interviews were audio-recorded and transcribed verbatim. Data analysis was performed using Kuckartz’s qualitative content analysis.

Results
31 nursing professionals from diverse medical disciplines (e.g., pediatrics, obstetrics, cardiology, neurology, oncology) participated in the study, unveiling a spectrum of communication experiences, including organizational and system-related challenges, constraints induced by the COVID-19 pandemic, management of personal emotions, and communication challenges with patients and relatives. They also identified aspects they experienced as beneficial for patient-centered communication (e.g., allocating sufficient time, being authentic, providing clear information). Furthermore, participants identified specific aspects, which should be included in a patient-centered communication skills training.

Conclusion
The findings suggests that not only nurses from oncology and intensive care, but also from other medical disciplines, experience significant communication challenges with patients and relatives. Applying patient-centered aspects of communication was considered beneficial for effective communication. The needs identified through participants’ experiences (e.g., core communication skills and strategies, handling escalating situations, and discussing serious illness, death and dying) informed the development of a patient-centered communication skills training specifically tailored for nursing professionals across diverse medical disinclines in Germany.
Coronary artery calcium on lung cancer radiation planning CT aids cardiovascular risk assessment
Authors: Lui Matthew , Kim Noah , Zaghlol Raja , Joolharzadeh Pouya , Deych Elena , Robinson Clifford , Badiyan Shahed , Woodard Pamela K. , Mitchell Joshua D. 
Published: November 2024

Abstract
Background
Patients with non-small cell lung cancer (NSCLC) undergoing thoracic radiation are at high cardiovascular risk. Semiquantitative assessment of coronary artery calcification (CAC) on baseline planning non-gated chest computed tomography (CT) scans may help further risk stratify patients.

Objectives
This study aimed to characterize the association between CAC and major adverse cardiovascular events (MACE; myocardial infarction or stroke) and assess the utility of semiquantitative assessment of CAC.

Methods
Patients with NSCLC with non-contrast planning chest CT scans were evaluated for CAC. Planning scans were visually graded using the CAC-DRS method, stratifying patients into no, mild, moderate, and severe CAC groups. Demographics, comorbidities, and radiation treatment characteristics were gathered, and CAC groups were assessed for the incidence of MACE after initiation of radiation therapy.

Results
Out of 137 patients, 39 patients had no CAC, and 98 patients had any CAC (38 with mild CAC, 34 with moderate CAC, and 26 with severe CAC). There was 1 MACE event in the no CAC group and 11 in patients with any CAC. The presence of CAC was associated with increased MACE compared to no CAC (p = 0.034). Semiquantitative CAC analysis correlated with formal CAC scoring.

Conclusion
There is a significantly lower incidence of MACE in patients with no CAC on planning CT compared to patients with higher burdens of CAC. CAC burden is an important risk factor for adverse cardiovascular events in patients with NSCLC undergoing thoracic radiation. Semiquantitative CAC scoring may be a useful proxy when formal CAC scoring is unavailable.
Clinical outcomes after extra-articular resection of hip joint tumour using a custom-made osteotomy guide and 3D-printed endoprosthesis with posterior column preserved
Authors: Yan Xiaobo , Wang Keyi , Huang Xin , Lin Nong , Liu Meng , Ren Ying , Ye Zhaoming 
Published: November 2024

AimsFor rare cases when a tumour infiltrates into the hip joint, extra-articular resection is required to obtain a safe margin. Endoprosthetic reconstruction following tumour resection can effectively ensure local control and improve postoperative function. However, maximizing bone preservation without compromising surgical margin remains a challenge for surgeons due to the complexity of the procedure. The purpose of the current study was to report clinical outcomes of patients who underwent extra-articular resection of the hip joint using a custom-made osteotomy guide and 3D-printed endoprosthesis.MethodsWe reviewed 15 patients over a five-year period (January 2017 to December 2022) who had undergone extra-articular resection of the hip joint due to malignant tumour using a custom-made osteotomy guide and 3D-printed endoprosthesis. Each of the 15 patients had a single lesion, with six originating from the acetabulum side and nine from the proximal femur. All patients had their posterior column preserved according to the surgical plan.ResultsPostoperative pathological assessment revealed a negative surgical margin was achieved in all patients. At final follow-up, 13.3% (2/15) died and no recurrence occurred. The overall survival was 81.7% at five years. None of the patients showed any signs of aseptic loosening, and no wound healing issues were observed. In total, 20% (3/15) developed complications, with two cases of early hip dislocation and one case of deep infection. The cumulative incidence of mechanical and non-mechanical failure in this series was 13.7% and 9.3%, respectively, at five years. In this cohort, the mean time to full weightbearing was 5.89 (SD 0.92) weeks and the mean Musculoskeletal Tumor Society score was 24.1 (SD 4.4).ConclusionFor patients with a hip joint tumour who met the inclusion criteria and were deemed suitable for posterior column preservation, a custom-made osteotomy guide combined with 3D-printed endoprosthesis is worth performing when treating patients who require extra-articular resection of the hip joint, as it can achieve adequate margin for local control, maximize bone preservation to maintain pelvic ring integrity, reduce the risk of complications by simplifying the surgical procedure, and allow for more precise reconstruction for better function.Cite this article: Bone Jt Open 2024;5(11):1027–1036.
Banka humanog mlijeka u Hrvatskoj: prva iskustva
Authors: Ćepulić Branka Golubić , Novoselac Jurjana , Bošnjak Anita Pavičić , Leskovar Ivana , Gojčeta Koraljka , Rimac Vladimira 
Published: November 2024

Darovano humano mlijeko je najbolja zamjena za majčino mlijeko u okolnostima kad ona ne može hraniti svoje dijete. Sigurno ikvalitetno darovano humano mlijeko osiguravaju banke humanog mlijeka. S tim ciljem u Hrvatskoj banci tkiva i stanica Kliničkogbolničkog centra Zagreb osnovana je Banka humanog mlijeka u siječnju 2020. Rad Banke u skladu je sa Zakonom o primjeni ljudskihtkiva i stanica. U ovom radu prikazujemo rezultate njenog rada od otvaranja do lipnja 2020. godine. Iz logističkih razloga uzrokovanih epidemijom COVID-19 i potresom u Zagrebu Banka humanog mlijeka nije prikupljala mlijeko 43 dana.Mlijeko je darovala 31 majka. Medijan dobi bio je 31 godina a 81% ih je bilo visokoobrazovanih. U 52% slučajeva majke su počeledarivati mlijeko tri mjeseca nakon porođaja. Najviše darivateljica darovalo je mlijeko samo jedan put (45%). Medijan razdoblja darivanja bio je 46 dana. Većina (52%) darivateljica rodilo je prvi put, u očekivanom terminu porođaja (94%), djecu porođajne mase>2 500 gr. Samo troje od njihove djece (9%) bilo je na intenzivnom liječenju. Ukupno je prikupljeno 175,5 L mlijeka (prosječno5,7 L/darivateljici), od kojih je 151,5 L zadovoljilo zahtjeve ulazne kontrole kakvoće, a 141 L je bila i pasterizirana. Kritičan broj vijabilnih, aerobnih i fakultativnih bakterija imalo je 32,6% mješavina mlijeka pripremljenih za pasterizaciju, a nakon nje 8,9%. Za kliničkuprimjenu izdano je 78,7 L u tri jedinice intenzivnog liječenja novorođenčadi. Već u prvim mjesecima rada Banka humanog mlijekapokazala je važnost svog djelovanja. Kako bi mogli zadovoljiti potrebe za darovanim humanim mlijekom na nacionalnoj razini,potrebno je trajno podučavati/educirati majke o važnosti humanog mlijeka i promicati njegovo darivanje.
Roditeljstvo/skrbništvo, djeca i obitelj – klinički pristup
Authors: Begovac Ivan , Majić Gordan , Tripković Mara , Pleština Silvana 
Published: November 2024

Svako se dijete rađa i živi u određenom socijalnom kontekstu, intenzivnih socijalnih interpersonalnih relacija, većinom unutar obiteljskog konteksta. Primjereno roditeljstvo/skrbništvo i partnerstvo u obitelji karakterizira: dobra suradnja partnera, otvorena, direktna komunikacija, s jasnim i iskrenim neverbalnim izrazima, kontinuitet i koherencija u odnosima, čvrstoća, ali i fl eksibilnostobiteljskog sustava u cjelini. U literaturi postoje različiti modeli dijagnostike obitelji, a ovise o teorijskom usmjerenju pojedinog pravca. Potrebna je integracija različitih psihodinamskih, sustavnih i kognitivno bihevioralnih smjerova i terapija. Nekad je dovoljno upraksi od strane različitih stručnjaka (dječji i adolescentni psihijatri, pedijatri, drugi suradni stručnjaci) se samo orijentirati na progresivne tendencije cijele obitelji, odnosno pružiti suportivni terapijski stav roditeljstvu/skrbništvu
IMMUNOGLOBULIN E
Authors: Džajić Anica , Petković Giorgije , Šegović Mateja 
Published: November 2024

Cilj j e usporediti vrijednosti biomarkera alergije, ukupnog IgE-a (uIgE), specifi čnog IgE-a (sIgE), indeksa specifi čnog IgE-a (IsIgE) prema alergenu trave rdobrade Dactilis glomerata (Dac g) i eozinofi lnih granulocita u sezoni cvatnje i izvan nje. Odabrana su djecas dokazanom preosjetljivošću na alergene rdobrade (N=80). Svrstana su u dvije skupine. Skupina 1: djeca obrađena u sezoni peludacije (N=64). Skupina 2: djeca obrađena izvan sezone peludacije (N = 16). Koncentracija odabranih parametara određena je standardiziranim laboratorijskim postupcima. Vrijednosti svih ispitivanih biomarkera alergije, osobito sIgE-a i IsIgE-a, bile su statistički značajno veće u skupini djece testirane u sezoni cvjetanja rdobrade nego izvan nje (p<0,05). Posljedično tome je i korelacija izmeđubiomarkera bila bolja u sezoni izloženosti uzročnome alergenu. Dobiveni rezultati upućuju na to da bi biomarkere alergija, a osobitosIgE-a i IsIgE-a trebalo određivati u vrijeme izloženosti alergenu Dac g.
Diagnostic value of markers of oxidative stress and metabolic disorders in preterm infants in the early neonatal period
Authors: Pavlyshyn Halyna , Sarapuk Iryna , Kozak Kateryna , Klishch Olga 
Published: November 2024

The aim of the study was to evaluate the markers of oxidative stress and metabolic disorders in preterm infants and to examine their association with short-term outcomes in the early neonatal period to identify the predictors of unfavourable outcome. The study included 46 preterm infants, gestational age ≤32 weeks, in the early neonatal period, i.e. group 1 of 12 infants with lethal outcome and group 2 of 34 preterm infants with favourable outcome. Markers of metabolic disorders, oxidative stress and antioxidant system were analysed in cord blood and urine on the first/second day of life. Evaluation of oxidative (8-isoprostane) and antioxidant system (catalase and superoxide dismutase (SOD) activity) and metabolic (lactate, pyruvate, lactate to pyruvate ratio (LPR), NAD+/NADH) stress parameters confirmed energy imbalance and presence of tissue hypoxia in preterm newborns with adverse outcomes. The following risk factors of unfavourable prognosis in preterm infants in the early neonatal period were identified: asphyxia (p=0.038), early-onset sepsis (p=0.003), intraventricular haemorrhage (p=0.029), hyperlactatemia (p=0.013), increased pyruvate level (p=0.002), increased LPR (p=0.008), decreased catalase (p=0.003) and SOD (p=0.001) activity. Logistic regression indicated that mortality rate was positively related to asphyxia, early-onset sepsis and lactate level, and negatively related to SOD activity. In conclusion, intensive oxidative and metabolic stress in preterm infants is associated with adverse outcomes in the early neonatal period. A combination of asphyxia and early-onset sepsis together with high lactate level and decreased SOD activity is a predictor of unfavourable out- come in the early neonatal period.
Opekline dječje šake
Authors: Barčot Zoran , Kralj Rok , Barčot Lidija 
Published: November 2024

Opekline šake u djece su relativno česte, uzrokovane pri dodiru s vrelim površinama, vrućom vodom, pirotehnikom i plamenom.Pravilnim konzervativnim ili operacijskim pristupom njihovom liječenju uz fizikalnu terapiju mogu se izbjeći ili smanjiti funkcijske iestetske posljedice. Neurovaskularna ugroza jedna je od najtežih komplikacija cirkumferentnih i dubokih opeklina šake i zahtijevahitnu dekompresiju. Površne opeklinske ozljede i veći dio opeklina djelomične debljine kože dobro zacjeljuju uz pomoć različitihobloga za epitelizaciju. Dio opeklina djelomične i sve opekline pune debljine kože, zbog opsežnosti gubitka tkiva, zahtijevaju kirurškipristup i primjenu autolognih kožnih transplantata, kožnih režnjeva ili dermalnih regeneracijskih predložaka. Ekscizija u blijedojstazi nožem ili hidrokirurškim sustavom, dobra hemostaza, transplantati djelomične debljine kože s vlasišta ili bedra, uz potporukondicionirane plazme obogaćene trombocitima i uređaja za cijeljenje rana negativnim tlakom pristup su koji u pravilu daje dobrerezultate liječenja u djece. Dostupni dermalni regeneracijski predlošci svojom građom i potporom cijeljenju kvalitetnije nadomještaju dermalni sloj uz jednake ili bolje konačne funkcijske i estetske rezultate. U nedostatku periosta ili tetivnih ovojnica nakon debridmana opeklinske rane šake izbor je primjena kožnih režnjeva. Unutar prva 24 sata nakon opeklinske ozljede treba započeti s fizikalnom terapijom aktivnim i pasivnim vježbama. Ožiljci i kontrakture nakon liječenja opeklina šake mogu dovesti do djelomičnoggubitka funkcije šake. Osim kirurškog, multimodalni pristup uključuje primjenu masaže, silikonskih preparata, kompresivnih rukavica i laserske tretmane PDL i CO2 frakcijskim ablacijskim laserom. Najčešće tehnike plastične kirurgije kod operacijskih korekcija opeklinskih ožiljaka na dječjoj šaci su lokalni transpozicijski i klizni režnjevi te transplantati pune debljine kože.
Profi laktička gonadektomija u djece s miješanom gonadnom disgenezom – prikaz devetogodišnje djevojčice
Authors: Antabak Anko , Blažević Andrea , Papeš Dino , Bulić Krešimir , Bogović Marko 
Published: November 2024

Gonadna disgeneza embrionalna je anomalija gonada. Može biti čista (Turnerov sindrom) ili miješana (mozaicizam). Miješani obliks lozom stanica u kojoj se nalazi Y spolni kromosom, sklon je pojavi gonadoblastoma u displastičnim gonadama. U takve djece indicirano je učiniti profi laktičku bilateralnu gonadektomiju, prije maligne alteracije. Stoga je važna rana dijagnoza miješane gonadne disgeneze. No djeca s gonadnom disgenezom različitih su fenotipskih osobina, katkad potpuno neupadljiva u predpubertetskoj dobi. U radu prikazujemo fenotipski neupadljivu, tek nešto nižeg rasta devetogodišnju djevojčicu s miješanom gonadnomdisgenezom, kojoj smo načinili profi laktičku laparoskopsku gonadektomiju. Zaključno, miješana gonadna disgeneza može se očitovati jedino niskim rastom u djece predpubertetske dobi.