bluuebunny/crossref_metadata_2025_split huggingface dataset:
The obese population’s views on the symptoms and risks of chronic venous insufficiency - 2 (OBVIOUS-2) cross-sectional survey
Authors: Popplewell Matthew A , Mahesh Sindoora , Nandra Sandip , Juszczak Maciej , Ashby Helen , Wall Michael L 
Published: September 2024

Introduction Individuals with high body mass index (BMI) are more likely to have symptomatic LLVD than age matched populations with normal BMI. National priorities in venous disease set by the James Lind Alliance focus on improving access to healthcare and patient education. The aims of this study are to determine patient knowledge and potential burden of LLVD in a population of patients attending a UK, regional weight management service. Methods A postal questionnaire containing 12 questions relating to LLVD and obesity was distributed to the active list of patients under the weight management medical service at Dudley Group of Hospitals between May 2022-23. Respondents were provided with a stamped, addressed envelope to return the questionnaire. Ethical approval was granted by the Hampshire Research & Ethics Committee. Results Some 367 questionnaires were distributed to patients currently enrolled in specialist weight management services. 103 complete responses were received (28%), Most patients were between 50 and 70 years of age. 25% of patients already had a formal diagnosis of LLVD, with a further 84 (82%) reported signs or symptoms which may be related to LLVD. Almost half (49/103, 48%) had concerns over their skin quality with a similar proportion (25/103, 51%) having sought medical help. The majority (71/103, 69%) were unaware of the association between obesity and LLVD. Twelve participants had education regarding simple adjuncts designed to improve symptoms and/or prevent ulceration (emollients, dressings, stockings, or leg elevation). Four participants had previously undergone treatment for varicose veins. Conclusion In a population of patients accessing weight management services, we have demonstrated that a quarter of patients have already received a diagnosis of LLVD, however there is for a greater undiagnosed burden of LLVD in part due to lack of patient and possibly clinician awareness.
Prevalence of Abnormalities and Normal Variants in the Adolescent Knee on MRI in a Population-Based Cohort of 3800 Knees
Authors: Kemmeren Laura A.M. , Oei Edwin H.G. , van Middelkoop Marienke , Eygendaal Denise , Piscaer Tom M. 
Published: September 2024

Background: Many adolescents experience knee pain, and only some undergo detailed imaging. In this population, the prevalence of abnormalities and normal variants on magnetic resonance imaging (MRI) scans is unknown. Purpose: To investigate the prevalence of abnormalities and normal variants of the knee on MRI scans and their relationship with participant characteristics in the general young adolescent population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study was part of an open population-based cohort study that focuses on health, growth, and development from fetal life until adulthood. Between 2017 and 2020, adolescents aged 12 to 15 years underwent MRI of both knees. These MRI scans were assessed in a standardized way for abnormalities and normal variants to determine their prevalence. Logistic regression was used to analyze the presence of abnormalities and normal variants in relation to sex, height, weight, body mass index–standard deviation (BMI-SD), and ethnicity. Results: A total of 1910 participants (median age, 13.5 years; interquartile range, 13.4-13.7 years; 52% girls) were included in this study. Of them, 370 (19.4%) participants had at least 1 abnormality or normal variant. Bone marrow edema around the knee was the most prevalent finding, affecting 140 (7.3%) participants. In 107 (5.6%) participants, nonossifying fibromas were found. A total of 43 (2.3%) participants had characteristics of Osgood-Schlatter disease, 16 (0.8%) showed characteristics of Sinding-Larsen-Johansson syndrome, and osteochondritis dissecans was found in 13 (0.7%) participants. Variants such as discoid menisci were found in 40 (2.1%) participants and a bipartite patella in 21 (1.1%) participants. There were multiple associations between abnormalities or variants and participant characteristics, including bone marrow edema being more often present in boys (odds ratio [OR], 2.44; 95% CI, 1.69-3.52) and those with a lower BMI-SD (OR, 0.85; 95% CI, 0.73-0.98). Osgood-Schlatter and osteochondritis dissecans were more often present in boys (OR, 4.21 [95% CI, 2.01-8.85] and OR, 13.18 [95% CI, 1.71-101.58], respectively). Discoid menisci were associated with a non-Western ethnicity (OR, 2.06; 95% CI, 1.07-3.96) and higher BMI-SD (OR, 2.34; 95% CI, 1.76-3.11). Conclusion: Abnormalities and normal variants on MRI scans of the knees are common in adolescents. Physicians who are involved in the treatment of adolescents with knee pain need to be aware of this prevalence so that these children will not be overtreated or misdiagnosed.
Telelactation Within the Landscape of Breastfeeding Support: Experiences of Latina Parents
Authors: Alvarado Gabriela , Howell Khadesia , Waymouth Molly , Demirci Jill , Rogers Rhianna , Ray Kristin , Uscher-Pines Lori 
Published: September 2024

Background: Despite increasing breastfeeding initiation rates in the United States, disparities in breastfeeding continuation and exclusivity by race and ethnicity persist. Research Aim: We aimed to understand the perceptions and experiences of Latina parents who received access to telelactation, and assessed the implications of integrating telelactation into pediatric settings. Methods: This cross-sectional qualitative study drew from participants enrolled in a randomized controlled trial about breastfeeding support. We recruited 20 participants from among those participating in a randomized controlled trial assessing the effect of telelactation on breastfeeding outcomes. The study design was informed by an Equity-Centered Model and authentic entry. We conducted a thematic content analysis through an iterative approach, where we systematically generated themes to describe code application patterns. Results: We identified three themes: (1) telelactation within the broader landscape of breastfeeding support; (2) perceptions of telelactation support; and (3) recommendations on the use of telelactation in the context of pediatric care. We found that participants had an escalation approach for seeking breastfeeding support and propose a new model: Breastfeeding Support Escalation Protocol, which can be applied to lactation support in pediatric care. Parents’ perceptions and recommendations highlighted their desire for care coordination, expanded options for telelactation engagement, and care continuity, which are important reflections for pediatric offices considering integrating telelactation services into their practice. Conclusions: Latina parents found telehealth to be helpful and an acceptable alternative to in-person services. Pediatric offices can take steps toward becoming Breastfeeding-Friendly by partnering with telelactation services. More research is needed on the logistical implications and cost-effectiveness of telelactation services as part of the pediatric practice.
Clinical outcomes of patients receiving long-term fondaparinux for thrombotic antiphospholipid syndrome
Authors: Bor Buse , Doyle Andrew J , Bartoli-Abdou John K , Hackett Anthony , Collings Victoria , Omrani Fatima , Foskett Carl , Wareing Anne , Young Johanna , Breen Karen A , Hunt Beverley J 
Published: September 2024

Introduction Vitamin-K antagonists (VKA) are considered the first-line anticoagulants for thrombotic antiphospholipid syndrome (TAPS), particularly with triple positivity or arterial events. However, thrombotic recurrence remains high despite anticoagulation and other clinical issues may arise. Long-term parenteral anticoagulants may therefore be considered, however little is known about the viability of fondaparinux in this setting. Materials and Methods We describe the efficacy and safety of long-term fondaparinux for TAPS (>3-months duration) treated at a single centre in the UK. Clinical features and the outcomes of recurrence and bleeding were reviewed using electronic patient records. Results 46 patients were identified with history of either venous or arterial TAPS and a total 175 patient-years using fondaparinux (median duration 2.7 years/patient (IQR 1.4–4.8)). 43 (93%) had VKA as first-line anticoagulation with a median duration of 6.5 years (IQR 4.0 – 9.8). All patients received fondaparinux as second-to fourth-line anticoagulation. Thrombosis recurrence occurred in 1 (1%) patient (0.6 events/100-patient years). Major, clinically relevant non-major (CRNM) or minor bleeding occurred in 2 (7%), 5 (10.9%) and 8 (17.4%) patients respectively. Major/CRNM bleeding rates were 1.1 and 2.9 events/100-patient-years. Age >65years was associated with bleeding ( p = .047) and concurrent antiplatelets were associated with major/CRNM bleeding ( p = .011). Logistic regression showed increasing age was associated with bleeding (OR = 1.097, p = .009). Conclusions We suggest that fondaparinux may be used for TAPS when VKA is not appropriate. Thrombotic recurrence was infrequent, and the number of major bleeding events appeared comparable to conventional therapies.
Differences in Timely Goals of Care Discussions in Nursing Homes Among Black Residents
Authors: Kang Jung A. , Dick Andrew W. , Glance Laurent G. , Dhingra Lara , Stone Patricia W. 
Published: September 2024

Background In the United States, disparities persist in end-of-life care outcomes between Black and White nursing home (NH) residents, particularly concerning infection-related management. Timely goals of care (TGOC) discussions are crucial for improving end-of-life outcomes but exhibit racial variations within NHs that are not well understood. Objectives Examine the association between the proportion of Black residents within NHs and TGOC discussion related to infection management. Design A national analysis of palliative care survey data from NHs with the Minimum Dataset 3.0 and administrative data. Setting/Subjects 892 NHs representing a weighted sample of 14,981 facilities. Measurments TGOC discussions related to infection management were quantified using an index score from the palliative care survey (range: 0-18). Multivariable analyses assessed the association between the proportion of Black residents (≤2%, 2.1%–15%, >15%) and TGOC index scores. Results The majority of NHs were for-profit, chain-affiliated, urban facilities with fewer than 100 beds, serving both Medicare and Medicaid beneficiaries. In stratified analyses, NHs with 2.1%–15% (−0.97 score; 95%CI -1.86, −0.07; P < .05) and 15% or more Black residents (−3.86 score; 95%CI -6.62, −1.10; P < .01) showed lower TGOC index scores compared to NHs with 2% or fewer Black residents in the West. NHs with 2.1%–15% Black residents had 1.29 lower TGOC index scores compared to NHs with 2% or fewer Black residents (95%CI -2.51, −0.07; P < .05) in the Northeast. Conclusions TGOC discussions in US NHs are influenced by the proportion of Black residents, highlighting the need for targeted interventions to address regional disparities and improve end-of-life care equity.
Incidence and Risk Factors of Hypomagnesemia in Patients With Bone Metastasis From Solid Malignancies Treated With Denosumab: A Retrospective Chart Review
Authors: Donkor Kofi N. , Lee Jane S. , Hana Myrna M. , Jeong Sehyun 
Published: September 2024

Background: Hypomagnesemia is associated with poor clinical outcomes in cancer patients. Patients with bone metastasis from solid malignancies receiving denosumab (Dmab) to prevent skeletal-related events often receive concurrent antineoplastic agents for cancer treatment. The incidence and risk factors of hypomagnesemia in patients receiving Dmab and the optimal frequency of monitoring serum magnesium (Mg) levels have not been studied in these patient populations. Objective: The objective is to investigate the incidence and potential risk factors of hypomagnesemia and the optimal frequency of monitoring serum Mg levels. Methods: A retrospective chart review identified patients with solid malignancies with bone metastases treated with Dmab at the Loma Linda University Cancer Center between January 2013 and February 2024. The incidence of hypomagnesemia was determined using the number of patients with hypomagnesemia and the total number of patients in the study. Univariate and multivariate logistic regression analyses identified risk factors for hypomagnesemia. Results: Hypomagnesemia was observed in 19% (29/153) of patients, the majority of whom were on concurrent antineoplastic agents with ≥15% hypomagnesemia incidence (high-hypomagnesemic antineoplastics) or nonantineoplastic drugs with documented cases or incidence of hypomagnesemia (hypomagnesemic nonantineoplastics) in addition to high-hypomagnesemic antineoplastics. Multivariate analysis showed increased odds of developing hypomagnesemia with high-hypomagnesemic antineoplastics (odds ratio [OR]: 174.93, 95% confidence interval [CI]: 12.82 to 387.43, P < 0.001); hypomagnesemic nonantineoplastics plus high-hypomagnesemic antineoplastics (OR: 210.09, 95% CI: 11.80 to 3740.12, P < 0.001); and Mg level ≤ 0.85 prior to Dmab administration (OR: 16.79, 95% CI: 2.30 to 122.41, P = 0.005). Conclusion and relevance: This study describes the incidence and potential risk factors for hypomagnesemia in patients with solid malignancies and metastatic bone disease treated with Dmab. This study’s findings provide additional clinical insight into potential risk factors for hypomagnesemia and the need for more frequent serum Mg level monitoring of at-risk patients. Future prospective studies are needed to determine the exact frequencies most appropriate in monitoring serum Mg levels in this group of patients.
Survival Dynamics in Advanced Ovarian Cancer: R2 Resection Versus No-Surgery Paths Explored
Authors: Pitsikakis Konstantinos , DeJong Diederick , Kitsos-Kalyvianakis Konstantinos , Mamalis Marios Evangelos , Quaranta Michela , Shavee Aishath , Wahab Alina , Thangavelu Amudha , Broadhead Timothy , Nugent David , Kalampokis Evangelos , Laios Alexandros 
Published: September 2024

Background Cytoreductive surgery is critical for optimal tumor clearance in advanced epithelial ovarian cancer (EOC). Despite best efforts, some patients may experience R2 (>1 cm) resection, while others may not undergo surgery at all. We aimed to compare outcomes between advanced EOC patients undergoing R2 resection and those who had no surgery. Methods Retrospective data from 51 patients with R2 resection were compared to 122 patients with no surgery between January 2015 and December 2019 at a UK tertiary referral centre. Progression-free survival (PFS) and overall survival (OS) were the study endpoints. Principal Component Analysis and Term Frequency – Inverse Document Frequency scores were utilized for data discrimination and prediction of R>2 cm from computed tomography pre-operative reports, respectively. Results No statistical significance was observed, except for age (73 vs 67 years in the no- surgery vs R2 group, P: .001). Principal Components explained 34% of data variances. Reasons for no surgery included age, co-morbidities, patient preference, refractory disease, patient deterioration or disease progression, and absence of measurable intra- abdominal disease). The median PFS and OS were 12 and 14 months for no-surgery, vs 14 and 26 months for R2 ( P: .138 and P: .001, respectively). Serous histology and performance status independently predicted PFS in both no-surgery and R2 cohorts. In the no-surgery cohort, serous histology independently predicted OS, while in the R2 cohorts, both serous histology and adjuvant chemotherapy were independent prognostic features for OS. The bi-grams “abdominopelvic ascites” and “solid omental” were amongst those best discriminating between R>2 cm and R1-2 cm. Conclusions R2 resection and no-surgery cohorts displayed unfavourable prognosis with a notable degree of uniformity. When cytoreduction results in suboptimal results, the survival benefit may still be higher compared to those who underwent no surgery.
Effect of zoledronic acid and pamidronate on renal function
Authors: Koss Katherine , Kocek Melissa , King Tiffany , Hornung Monika 
Published: September 2024

Background There is limited data on the effect bisphosphonates have on renal function and the use of bisphosphonates in patients with baseline renal dysfunction. Objective The purpose of this study was to determine the incidence of acute kidney injury (AKI) in patients after receiving zoledronic acid or pamidronate. Methods A retrospective cohort analysis was conducted of patients who received one dose of a bisphosphonate, either zoledronic acid or pamidronate. The primary objective of this study was to determine the incidence of AKI after bisphosphonate administration. Baseline characteristics were compared, and unadjusted analyses of primary and secondary outcomes were completed using Pearson's chi-square or Fisher's exact test for categorical data and Mann-Whitney U test for continuous data. Results There was no difference found in AKI incidence between zoledronic acid and pamidronate (17.1% vs. 15.0%; p = 1.00). Additionally, there was no difference found in AKI incidence between patients with baseline renal dysfunction and those without, (25.0% vs. 15.0%; p = 0.322). There were no differences observed in either corrected calcium within seven days or serum creatinine (SCr) within 30 days returning to baseline after administration, nor were there differences in fever or hypophosphatemia incidences. Conclusion Bisphosphonates may be used to treat hypercalcemia of malignancy in patients with and without renal dysfunction. AKI may occur post infusion; however, long-term effects on renal function are infrequent when hydrating patients prior to administration and adhering to the manufacturer's recommended infusion rate.
Tensile testing in feline ventral abdominal coeliotomy closure with different sizes of polydioxanone suture material: a biomechanical study
Authors: Jaenich Sebastian , Bartkowiak Tomasz , Jopek Hubert , Brunnberg Mathias , Slunsky Pavel 
Published: September 2024

Objectives The aim of this study was to evaluate, in vitro, the load and type of failure of the sutured ventral abdominal fascia of cats with different sizes of suture material made of polydioxanone (PDX) (2-0, 3-0, 4-0, 5-0 USP). Methods A total of 32 samples of the ventral abdominal wall from 16 cadaveric cats were harvested using an hourglass-shaped template. The samples were sectioned longitudinally along the linea alba and then sutured together in a continuous pattern using four different randomly assigned sizes of pdx suture material (2-0, 3-0, 4-0, 5-0 USP). A universal testing machine was used for linear distraction of the samples. The tensile strength and type of failure were recorded and analysed. Three types of failure were defined: suture material failure (S), suture line failure (T1) and failure of the abdominal wall further away from the linea alba (T2). Results The frequency of suture material failure decreased with increasing suture size. Suture size 5-0 failed due to a S failure in 6/8 samples, PDX 4-0 failed in 2/8 samples and PDX 3-0 failed in only 1/8 samples. However, PDX 2-0 failed due to only T1 or T2 failures, with both failures being almost equally represented. No statistically significant differences in the load to failure between PDX 2-0, 3-0 and 4-0 were noted ( P >0.05). The risk of suture failure increased with decreasing suture size diameter. Conclusions and relevance PDX 2-0 and 3-0 can be used without reservation for the closure of ventral midline coeliotomy in cats. Although there was no statistically significant difference between PDX 2-0, 3-0 and 4-0, PDX 4-0 showed a higher probability for suture breakage and should be used only after careful consideration of the patient while clinical evaluation is pending. Pdx 5-0 cannot be recommended as a safe suture size for this type of surgical closure.
Role of Interleukin-17 in Predicting Activity of Rheumatoid Arthritis and Systemic Lupus Erythematosus
Authors: Samaan Sara F , Taha Sara I , Mahmoud Fatma A , Elsaadawy Yara , Khalil Salma A , Gamal Dalia M 
Published: September 2024

Background: Although high serum levels of interleukin (IL)-17 and its producing cells have been found in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in earlier research, it is still unclear how these findings relate to disease activity. Objectives: This study examines the link between serum levels of IL-17 and the activity of both RA and SLE. Design: This pilot case–control study included 100 patients with RA, 100 with SLE, and 100 healthy controls. Methods: The Disease Activity Score-28 (DAS28) scores assessed the activity of RA, whereas the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores assessed SLE activity. All participants’ data were compared and correlated. Results: Serum levels of IL-17 were significantly higher in RA and SLE patients compared with the controls ( P < .001) and showed significantly positive correlations ( P < .001) with rheumatoid factor titer, anti-cyclic citrullinated peptide (anti-CCP) and DAS28 score among the RA patients. Although among SLE patients, they were significantly positively correlated ( P < .001) with anti-double-stranded DNA (anti-ds DNA) levels and the SLEDAI-2K scores, the best cut-off value of IL-17 for predicting moderate and high disease activity was > 175 pg/mL among RA patients and > 95 pg/mL among SLE patients. Conclusions: There is a significant correlation between RA and SLE activity and serum levels of IL-17. This discovery emphasizes IL-17 as a potential therapeutic target.
Patient and family views on research priorities and design of clinical trials and research studies in pediatric multiple sclerosis
Authors: O’Donnell Ellen , Schuette Allison , Waltz Michael , Aaen Gregory , Benson Leslie , Gorman Mark , Lotze Timothy , Mar Soe , Ness Jayne , Rodriguez Moses , Tillema Jan-Mendelt , Schreiner Teri , Wheeler Yolanda , Casper T Charles , Chitnis Tanuja 
Published: September 2024

Background and Objectives: This survey study aimed to (1) identify patient/family research priorities in pediatric-onset multiple sclerosis (POMS), and (2) delineate optimized methods for research study/clinical trials design, engagement, and implementation. Methods: Participants were as follows: (1) parents of a child (<18 years) with POMS enrolled in a national registry, (2) adolescents (13–17 years) with POMS in the registry, and (3) adults (18–40 years) with POMS receiving care at a registry affiliated clinic. Of 293 eligible participants, 192 completed surveys. Results: Experiences with health care and medications were generally positive but there remain areas of priority improvement. Incentives to participate in clinical trials included medications previously tested and in pill form, bloodwork/study visits required ⩾ every 3 months, cognitive testing ⩽1 hour, compensation for travel and time, ability to continue current multiple sclerosis (MS) medication, option to take study medication if on placebo, and individualized study feedback. Priorities for clinical research were (1) psychosocial impact, (2) cognitive/academic impact, (3) environmental risk, and (4) nutrition. Conclusions: Results highlighted the importance of a holistic approach to study design and a focus on the impact of disease on daily life to best engage patients and families in POMS clinical trials and research.