bluuebunny/crossref_metadata_2025_split huggingface dataset:
ECMO support may be associated with improved survival in tuberculosis associated severe ARDS
Authors: Nalbant Bahar , Buhlmann Alix , Wild Lennart , Bode Christian , David Sascha , Seeliger Benjamin , Stahl Klaus 
Published: October 2024

Abstract

Background
Data describing outcome of extracorporeal membrane oxygenation (ECMO) support in Tuberculosis (Tbc)-associated acute respiratory distress syndrome (ARDS) remain sparce and are mostly confined to singular case reports. The aim of this case series was to analyze intensive care unit (ICU) survival in patients with Tbc-associated ARDS receiving ECMO support and to compare those to patients not receiving ECMO.
Case presentation
ICU survival was analyzed retrospectively in 14 patients treated for Tbc-associated ARDS at three ECMO-referral university hospitals (Hannover Medical School, University Hospital Bonn (both Germany) and University Hospital Zurich (Switzerland)) during the last 14 years, of which eight patients received additional veno-venous (vv) ECMO support and six standard care only.
ICU survival was significantly higher in patients receiving additional ECMO support (62.5%, n=5/8) compared to those that did not (16.7%, n=1/6) (p=0.021). ECMO support was associated with reduced ICU mortality (Hazard ratio adjusted for baseline SOFA score [adj. HR] 0.125 (95% confidence interval (CI): 0.023-0.689), p=0.017). Median (IQR) time on ECMO and invasive ventilation in the ECMO group were 20 (11-26) and 37 (27-53) days, respectively. Major bleeding defined as transfusion requirement of 4 units of blood or more or surgical and/or radiologic intervention occurred only in one patient, in whom pulmonary bleeding was fatal. Thromboembolic events occurred in none of the ECMO patients.
Discussion and Conclusions:
This retrospective analysis from three large ECMO centers with similar SOPs suggests ECMO support as a feasible approach in patients with severe Tbc-associated ARDS. Although affiliated with extended runtimes, ECMO might be associated with improved survival in those patients. ECMO support should thus be considered in Tbc-associated ARDS to enable lung protective strategies during prolonged lung recovery.
What patients and their families want to know before and after ICU tour for lung cancer surgery: a qualitative study
Authors: CHEN Dihong , DIAO Li , YANG Qianxue , PENG Tingting , FAN Yaxu , YUAN Lei , LIU Yan , TIAN Yongming , TAO Wenjuan 
Published: October 2024

Abstract

Background:Information asymmetry between healthcare providers and patients leads to low treatment participation and compliance, low admission satisfaction, and medical disputes. To provide a comprehensive understanding of the information needs of patients who undergoing lung cancer surgery before entering the intensive care unit (ICU), as well as the information needs from their caregivers.Methods:Under a qualitative study design, 27 lung cancer surgery patients and their family members in the Lung Cancer Center of West China Hospital of Sichuan University were selected by purposive sampling for semi-structured interviews. Content analysis was employed using NVivo12.0 software.Results: By extracting the important nodes in the semi-structured interview, the information needs of patients with lung cancer surgery and their family members were divided into two first-level nodes, four second-level nodes, and 13 third-level nodes to construct the ICU pre-experience information demand model.Conclusion:Patients undergoing lung cancer surgery and their families have limited access to ICU information, and medical personnel happen to be the main source of information support.Implications:Based on the findings of this study, an ICU pre-experience model will beexplored and established based on the information needs of patients and their families during the peri-ICU period as the benchmark and the key nodes of patients' treatment in the ICU as the time axis to decrease the anxiety of patients and their families, reduce medical disputes, and bolster their satisfaction with ICU nursing work.Reporting Method (if applicable):This study adhered the SRQR guidelines.Patient or Public Contribution:Overall,27 lung cancer patients and their family members were selected through purposive sampling.
Clinical predictive model of new-onset atrial fibrillation in patients with acute myocardial infarction after percutaneous coronary intervention
Authors: Wu Xiao-Dan , zhao Wei , Wang Quan-Wei , Yang Xin-Yu , Wang Jing-Yue , Yan Shuo , Tong Qian 
Published: October 2024

Abstract

Background
New-onset atrial fibrillation (NOAF) is associated with increased morbidity and mortality. Despite identifying numerous factors contributing to NOAF, the underlying mechanisms remain uncertain. This study introduces the triglyceride-glucose index (TyG index) as a predictive indicator and establishes a clinical predictive model.
Materials and Methods
We included 551 patients with acute myocardial infarction (AMI) without a history of atrial fibrillation (AF). These patients were divided into two groups based on the occurrence of postoperative NOAF during hospitalization: the NOAF group (n = 94) and the sinus rhythm (SR) group (n = 457). We utilized a regression model to analyze the risk factors of NOAF and to establish a predictive model. The predictive performance, calibration, and clinical effectiveness were evaluated using the receiver operational characteristics (ROC), calibration curve, decision curve analysis, and clinical impact curve.
Results
94 patients developed NOAF during hospitalization. TyG was identified as an independent predictor of NOAF and was significantly higher in the NOAF group. Left atrial (LA) diameter, age, the systemic inflammatory response index (SIRI), and creatinine were also identified as risk factors for NOAF. Combining these with the TyG to build a clinical prediction model resulted in an area under the curve (AUC) of 0.780 (95% CI: 0.888, 0.358). The ROC, calibration curve, decision curve, and clinical impact curve demonstrated that the performance of the new nomogram was satisfactory.
Conclusion
By incorporating the TyG index into the predictive model, NOAF after AMI during hospitalization can be effectively predicted. Early detection of NOAF can significantly improve the prognosis of AMI patients.
Association between the monocyte-to-high-density lipoprotein cholesterol ratio and adult psoriasis: evidence from the NHANES
Authors: xue zhiwei , Liu Peng , Cao Jian , Mou Jian-Hui , Wang Rui 
Published: October 2024

Abstract

Background
Psoriasis is a representative chronic inflammatory and hereditary disease. There was a significant association between the monocyte to high-density lipoprotein cholesterol (MHR) ratio and the psoriasis area and severity index (PASI) score. The correlation between MHR and psoriasis has not been well investigated. The authors sought to examine the correlation between the MHR and psoriasis in adult individuals living in the U.S.
Methods
This study used cross-sectional data from the NHANES conducted between 2009 and 2014. The data included information on persons aged 20 years or older in the U.S. Sample-weighted logistic regression and stratified subgroup analysis were employed.
Results
This study analyzed a total of 15,895 participants. There is a positive correlation between an increased MHR and a greater occurrence of psoriasis. When other confounding variables were controlled for, a significant correlation between the MHR and psoriasis was found (OR,1.364;95%CI，1.026-1.815). Based on subgroup analysis and interaction testing (p for interaction > 0.05), no statistically significant association was seen between sex, education level, diabetes, race, smoking status, coronary artery disease, age, congestive heart failure, and stroke.
Conclusion
The results revealed a positive association between the MHR and psoriasis. These findings suggest that the MHR could serve as a useful tool for identifying individuals who are more susceptible to developing psoriasis.
Symptom networks of multidimensional symptom experiences in breast cancer survivors: A network analysis
Authors: Muhetaer Sulaiman , Mijiti Peierdun , Aierken Kaibinuer , Jingjing Wei 
Published: October 2024

Abstract

Objectives
We aimed to construct a symptom network for breast cancer patients, identify its core symptoms, and explore symptom clusters. This network approach may provide valuable insights for precise interventions to improve the overall quality of life in breast cancer patients.
Methods
A total of 462 eligible breast cancer patients were recruited. The severity of patients' symptoms was measured using the EORTC QLQ-C30 Chinese version scale and Zung Self-Rating Depression and Anxiety Scale. A regularized partial correlation network was established, and central symptoms were identified using Strength centrality.
Results
The strongest associations were observed between NV-AP (weight = 0.39), Dep-Anx (weight = 0.38), PA-DY (weight = 0.21), and Anx-SL (weight = 0.20). Fatigue was the most prevalent symptom among breast cancer patients, and fatigue was consistently the central symptom in the network, in addition to anxiety, appitie loss, and pain. DAG indicated that fatigue might influence overall symptoms in breast cancer patients. Three syomtom clusters were indentified: emotional symptoms (depression, anxiety, and insomnia), gastrointestinal symptoms (nausea/vomiting, diarrhea, and loss of appetite), and somatic symptoms (fatigue, pain, and dyspnea).
Conclusions
Fatigue, depression, and anxiety are highly prevalent and central symptoms in breast cancer patients. It is crucial to screen and provide early treatment for these symptoms to effectively manage them and enhance the overall quality of life for breast cancer patients. Future studies should focus on conducting longitudinal research to establish dynamic networks and investigate causal relationships between these symptoms.
Differentiating PCOS from Anovulatory Cycles in Adolescents: A Comprehensive Evaluation of FAI, SHBG, and LH/FSH Ratio
Authors: OZER Emre , TAŞ Demet , GÜNDOĞAN Seçil ÇAKIR , BOYRAZ Mehmet , GÜRBÜZ Fatih 
Published: October 2024

Abstract

Background
Menstrual irregularities are common among adolescents, often linked to anovulatory cycles. This study aims to establish diagnostic cut-off values for Polycystic Ovary Syndrome (PCOS) and differentiate these from anovulatory dysfunction in adolescents. Additionally, we assessed the sensitivity of using the Free Androgen Index (FAI) and Sex Hormone Binding Globulin (SHBG) in diagnosing PCOS.
Methods
This study included 305 adolescents presenting with oligomenorrhea at a tertiary center. Data were analyzed statistically and Receiver operating characteristic (ROC) curves were plotted to evaluate diagnostic performance.
Results
Of the 305 patients, 229 (75%) had anovulatory cycles and 36 (11.8%) had PCOS. The mean FAI values for anovulatory cycles, PCOS, and hyperinsulinism were 3.5 ± 2, 8.0 ± 5, and 8.3 ± 4, respectively (p < 0.001). A significant positive correlation was found between FAI and both HOMA-IR (r = 0.389; p < 0.001) and BMI (r = 0.499; p < 0.001). ROC analysis determined the LH threshold of 9.7 U/L and LH/FSH ratio threshold of 2.62 as predictive markers for PCOS.
Conclusions
Anovulatory cycles are the most frequent cause of menstrual irregularities in adolescents, with hyperandrogenism being crucial for diagnosing PCOS. The FAI may be unreliable for PCOS diagnosis due to similar values in adolescents with hyperinsulinemia and obesity. Lower SHBG levels in hyperinsulinemic obese adolescents further complicate the use of FAI, indicating that glucose/insulin metabolism significantly influences FAI/SHBG levels. Comprehensive diagnostic criteria, including androgen levels, LH/FSH ratio, SHBG, FAI levels, and ovarian ultrasound, are essential for accurate PCOS diagnosis.
More similarity than difference: comparison of within- and between-sex variance in early adolescent brain structure
Authors: Torgerson Carinna , Bottenhorn Katherine , Ahmadi Hedyeh , Choupan Jeiran , Herting Megan M. 
Published: October 2024

Abstract

Background
Adolescent neuroimaging studies of sex differences in the human brain predominantly examine mean differences between males and females. This focus on between-groups differences without probing relative distributions and similarities may contribute to both conflation and overestimation of sex differences and sexual dimorphism in the developing human brain.
Methods
We aimed to characterize the variance in brain macro- and micro-structure in early adolescence as it pertains to sex at birth using a large sample of 9-11 year-olds from the Adolescent Brain Cognitive Development (ABCD) Study (N=7,723). Specifically, for global and regional estimates of gray and white matter volume, cortical thickness, and white matter microstructure (i.e., fractional anisotropy and mean diffusivity), we examined: within- and between-sex variance, overlap between male and female distributions, inhomogeneity of variance via the Fligner-Killeen test, and an analysis of similarities (ANOSIM). For completeness, we examined these sex differences using both uncorrected (raw) brain estimates and residualized brain estimates after using mixed-effects modeling to account for age, pubertal development, socioeconomic status, race, ethnicity, MRI scanner manufacturer, and total brain volume, where applicable.
Results
The overlap between male and female distributions was universally greater than the difference (overlap coefficient range: 0.585 - 0.985) and the ratio of within-sex and between-sex differences was similar (ANOSIM R range: -0.001 - 0.117). All cortical and subcortical volumes showed significant inhomogeneity of variance, whereas a minority of brain regions showed significant sex differences in variance for cortical thickness, white matter volume, fractional anisotropy, and mean diffusivity. Inhomogeneity of variance was reduced after accounting for other sources of variance. Overlap coefficients were larger and ANOSIM R values were smaller for residualized outcomes, indicating greater within- and smaller between-sex differences once accounting for other covariates.
Conclusions
Reported sex differences in early adolescent human brain structure may be driven by disparities in variance, rather than binary, sex-based phenotypes. Contrary to the popular view of the brain as sexually dimorphic, we found more similarity than difference between sexes in all global and regional measurements of brain structure examined. This study builds upon previous findings illustrating the importance of considering variance when examining sex differences in brain structure.
Assessment of Serum Survivin in Women with Placenta Previa and Accreta Spectrum: A Cross-sectional Study
Authors: Yilmaz Nevin , Bakirci Isil Turan , Sahin Busra , Bolluk Gokhan , Can Esra , Dedeakayogullari Huri 
Published: October 2024

Abstract

Background
This study aimed to assess maternal serum survivin levels in women with placenta previa, with and without placenta accreta spectrum (PAS), to understand its role in abnormal placental adherence and invasion.
Methods
In this prospective cross-sectional study, we enrolled 84 pregnant women categorized into control (n = 42), placenta previa (n = 24), and PAS (n = 28) groups. Serum survivin levels were quantitatively determined using ELISA, and statistical analyses were performed using ANOVA and post-hoc tests.
Results
A significant elevation in serum survivin levels was observed in the placenta previa and PAS groups compared to the controls (p < 0.05), suggesting that survivin plays a role in the pathophysiological response to abnormal placental adherence and invasion.
Conclusions
Elevated serum survivin levels may serve as an early biomarker for the diagnosis and management of placenta previa and PAS, aiding in the planning and timing of surgical interventions and the selection of appropriate surgical centers.
Central nervous system relapse after allogeneic HCT in FLT3-mutated AML
Authors: Kouidri Khouloud , Acker Fabian , Toenges Rosa , Pfaff Saskia , Lindner Sarah , Riemann Julia , Werth Marek , Ajib Salem , Lang Fabian , Steffen Björn , Oellerich Thomas , Serve Hubert , Cremer Anjali , Bug Gesine 
Published: October 2024

Abstract

Central nervous system (CNS) relapse in acute myeloid leukemia (AML) is rare, but prognostically extremely unfavorable and associated with very high mortality rates. Aim of our single-center study was to define risk factors for CNS relapse in patients with FLT3-mutated AML after allogeneic hematopoietic cell transplantation (HCT) and to determine the impact of pre-emptive or salvage therapy with FLT3-inhibitors (FLT3i) on occurrence of CNS relapse and overall prognosis. We analyzed 39 FLT3-mutated AML patients who were treated with intensive induction therapy and consecutively underwent HCT at our institution. We observed that the remission status before HCT was strongly associated with relapse probability. Notably, FLT3-mutated AML showed a high propensity for CNS relapse with a cumulative incidence of 50% (95% confidence interval [CI], 16–77) at 2 years in non-responders pre-HCT compared to 0% in responders (cause-specific hazard ratio, 24.5, 95% CI, 2.9-206.2; p = 0.003). This was not abrogated by pre-emptive or salvage therapy with FLT3i in first relapse. Targeted therapies prior to transplant, use of intrathecal chemoprophylaxis or closer monitoring may be considered in patients with FLT3-mutated AML with active disease prior to HCT in order to prevent CNS relapse. Additionally, CNS directed induction therapies may be indicated.
A Combined School Survey and Reactive Case Detection Reveals Minimal Local Transmission of Malaria in the Highlands Region of Papua New Guinea 2019
Authors: Seidahmed Osama , Kurumop Serah , Wawaga Elizabeth , Kualawi Melvin , Siba Valentine , Jamea Sharon , Ura Yangta , Makita Leo , Pomat William , Hetzel Manuel W. 
Published: October 2024

Abstract

Background
The Highlands of Papua New Guinea are non-endemic for malaria compared to the rest of the country. This study aimed to explore the local transmission of malaria in the Highlands through a cross-sectional school survey coupled with reactive case detection.
Methods
Between July and November 2019, 5575 students and 1048 household members were screened for malaria using Rapid Diagnostic Tests, subsequently validated by light microscopy. In addition, an analysis of malaria cases (2017 to 2019) was conducted across 33 health facilities within the catchment areas of the surveyed schools and households.
Results
Thirteen individuals were diagnosed with malaria: eleven with Plasmodium falciparum (five students, six household members) and two with P. vivax (one student, one household member); all were aged ten years or older. Malaria prevalence was 0.09% [95% CI: 0.03, 0.3] among students and 1.7% [95% CI: 0.3, 9.1] among household members. Eleven positive individuals (84%) reported recent travel, mainly to lower-altitude endemic areas. Long-Lasting Insecticidal Nets were used by 34.8% [95% CI: 28.7, 40.8] of household members. The average annual malaria incidence in the catchment areas was 3.7 cases per 1000 [95% CI: 2.6, 5.3] among the general population, while children under 15 years accounted for 19% [95% CI: 14, 27] of the positive cases.
Conclusions
Local malaria transmission appears to be minimal in the surveyed Highlands areas. Strengthening surveillance-response system to control imported cases and stop local foci could support malaria elimination in PNG. However, effective operational triggers for re-active case finding remain to be determined.
Assessment of Cardio-Oncology Knowledge and Practice among Healthcare Providers in Saudi Arabia: A Comprehensive Nationwide Survey
Authors: Badreldin Hisham A. , Alsuhebany Nada , Alfehaid Lama , Alzahrani Mohammed , Aldoughaim Maha , Alrajhi Abdullah M. , Alsufyani Jumanah , Elsherif Dania , Alshammari Kanan 
Published: October 2024

Abstract

Introduction: The evolving field of oncology necessitates effective management of cancer-related cardiovascular diseases. In Saudi Arabia, the incidence of cancer is rising, and there is a critical need for cardio-oncology services to address cancer treatment-related cardiovascular toxicity. This study aimed to evaluate the knowledge and practices of healthcare providers (HCPs) in Saudi Arabia regarding cardio-oncology.
Methods: A cross-sectional study was conducted from January to April 2024 using an online survey targeting cardiologists, oncologists, and clinical pharmacists. The survey assessed demographics, perceptions of cardio-oncology, availability of services, and current practices. Data were analyzed using descriptive statistics, chi-squared tests, and bivariate analyses.
Results: The survey received responses from 116 HCPs, including cardiologists (63.79%), oncologists (23.28%), and clinical pharmacists (12.93%). Most participants had over six years of experience, and only one had formal cardio-oncology training. While 84.48% recognized the importance of managing cardiac complications in cancer patients, only 42.24% were familiar with existing guidelines. Limited training programs and institutional resources were significant barriers to implementing cardio-oncology services. Despite agreement on the need for cardiotoxicity management, only one-third recommended cardioprotective agents as standard care.
Conclusion: There is a notable deficiency in formal training and resources for cardio-oncology in Saudi Arabia. To bridge this gap, integrating cardio-oncology into training programs, establishing institutional guidelines, and adopting multidisciplinary care models are crucial. These measures will enhance the quality of care for cancer patients and improve their cardiovascular outcomes.
3D in vitro Modelling of Post-Partum Cardiovascular Health reveals Unique Characteristics and Signatures following Hypertensive Disorders in Pregnancy
Authors: Ming Clara Liu Chung , Pienaar Dillan , Ghorbanpour Sahar , Chen Hao , Roberts Lynne Margaret , Cole Louise , McGrath Kristine C , Padula Matthew P , Henry Amanda , Gentile Carmine , McClements Lana 
Published: October 2024

Abstract

Background
Hypertensive disorders of pregnancy (HDP) affect 2–8% of pregnancies and are associated postpartum with increased cardiovascular disease (CVD) risk, although mechanisms are poorly understood.
Methods
Human iPSC-derived cardiomyocytes, cardiac fibroblasts and coronary artery endothelial cells were tri-cultured to form cardiac spheroids (CS) in collagen type-1 hydrogels containing 10% patient plasma collected five years postpartum (n = 5 per group: normotensive control, gestational hypertension (GH) and preeclampsia (PE). Plasma-treated CS were assessed for cell viability and contractile function and subjected to immunofluorescence staining and imaging. A quantitative proteomic analysis of plasma samples was conducted (controls n = 21; GH n = 5; PE n = 12).
Results
Contraction frequency (CF) was increased in PE-treated CS (CF:45.5 ± 3.4 contractions/minute, p < 0.001) and GH-treated CS (CF:45.7 ± 4.0 contractions/minute, p < 0.001), compared to controls (CF = 21.8 ± 2.6 contractions/minute). Only PE-treated CS presented significantly increased fractional shortening (FS) % (9.95 ± 1.8%, p < 0.05) compared to controls (3.7 ± 1.1%). GH-treated CSs showed a reduction in cell viability (p < 0.05) and an increase in α-SMA expression (p < 0.05). Proteomics analysis identified twenty differentially abundant proteins, with hemoglobin A2 being the only protein perturbed in both GH and PE versus control (p < 0.05).
Conclusions
Using innovative patient-relevant CS platforms led to the discovery of biomarkers/targets linked to cell death signaling and cardiac remodeling in GH-induced CVD and vascular/endothelial cell dysfunction in PE-induced CVD.