bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Impact of Multidisciplinary Cancer Consultations on Cancer Quality Metrics
Authors: Sanchez Janeth I. , Doose Michelle , Zeruto Chris , Chollette Veronica , Gasca Natalie , Singla Anand , Weaver Sallie J. 
Published: September 2024

Objective:
Multidisciplinary cancer consultations play a critical role in the delivery of quality cancer care by promoting treatment planning and collaborative decision-making. The objective of this study was to evaluate associations between multidisciplinary cancer consultations and receipt of guideline-recommended adjuvant treatments among breast, colorectal, or non-small cell lung cancer patients and assess these associations between and within racial and ethnic groups.

Methods:
This is a population-based retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER), Medicare-linked data (2006–2016) to identify Medicare beneficiaries diagnosed with nonmetastatic breast, colorectal, or non-small cell lung cancer. Multidisciplinary cancer consultation was based on encounters with 2 or more oncology providers within 2 months of diagnosis. Cancer quality metrics assessed included receipt of guideline-recommended adjuvant cancer treatment for each cancer type.

Results:
Patients with multidisciplinary cancer consultations were more likely to receive adjuvant cancer treatment compared with patients without multidisciplinary cancer consultations within racial and ethnic groups. However, non-Hispanic Black and Hispanic breast cancer patients with multidisciplinary cancer consultations were 24% and 41% less likely to receive hormone and radiation therapy, respectively, compared with NHWs with multidisciplinary cancer consultations.

Conclusions:
Patients with multidisciplinary cancer consultations were more likely to receive adjuvant cancer treatment, but racial and ethnic disparities in cancer care persist. Multidisciplinary cancer consultations are likely an important, but not fully sufficient, contributor to the receipt of adjuvant cancer treatment and may be a tool in the implementation of multipronged, team-based cancer care delivery models to reduce inequities in cancer-related outcomes.
Efficacy and Safety of Abemaciclib in Combination With Endocrine Therapy for HR+/HER2− Advanced or Metastatic Breast Cancer
Authors: Qureshi Zaheer , Jamil Abdur , Fatima Eeshal , Altaf Faryal , Siddique Rimsha 
Published: September 2024

Objectives:
Breast cancer, particularly the hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) subtype, remains a major global health concern. Abemaciclib, a CDK4/6 inhibitor, has shown promising results in treating advanced cases. This study comprehensively assesses the efficacy and safety of abemaciclib in combination with endocrine therapy for HR+/HER2− advanced or metastatic breast cancer.

Methods:
Following PRISMA guidelines, a systematic review and meta-analysis was conducted. A thorough literature search was conducted on PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov til December 2023. Inclusion criteria encompassed randomized controlled trials and retrospective cohort studies reporting on abemaciclib in approved doses, either as monotherapy or in combination. Outcome assessments included progression-free survival (PFS), overall response rate (ORR), side effects/adverse effects (SE/AE), and overall survival (OS). Quality assessment utilized Cochrane’s revised risk of bias tool and Newcastle-Ottawa scale.

Results:
Pooled results of 22 studies involving 14,010 patients revealed that abemaciclib significantly improved PFS (hazard ratio=0.53; 95% CI: 0.48-0.59; P=0.00; I2=0%), ORR (risk ratio=2.31; 95% CI: 1.93-2.75; P=0.00; I2=0%), and OS (risk ratio=0.76 (95% CI: 0.65-0.87; P=0.001; I2=0%). However, abemaciclib increased the risk of adverse events in the fulvestrant and nonsteroidal aromatase inhibitor (NSAI) combinations, respectively.

Conclusions:
Abemaciclib, particularly in combination with fulvestrant, emerges as an effective therapeutic option for HR+/HER2− advanced or metastatic breast cancer, improving PFS and OS. The higher toxicity profile warrants cautious use, especially in treatment-naive patients.
Health-related quality of life (HRQL) assessments in a 52-week, double-blind, randomized, placebo-controlled phase III study of resmetirom (MGL-3196) in patients with metabolic dysfunction–associated steatohepatitis (MASH) and fibrosis
Authors: Younossi Zobair M. , Stepanova Maria , Racila Andrei , Henry Linda , Labriola Dominic , Taub Rebecca , Nader Fatema 
Published: September 2024

Background and Aims:
Resmetirom, liver-directed thyroid-hormone receptor-β agonist, received approval for metabolic dysfunction–associated steatohepatitis (MASH) treatment. We assessed health-related quality of life (HRQL) in patients with MASH treated with resmetirom.

Approach and results:
Patients with MASH/NASH without cirrhosis and with confirmed/suspected fibrosis were enrolled in a 54-month double-blind randomized placebo-controlled phase III clinical trial with serial biopsy assessments at baseline and week 52 (MAESTRO-NASH, NCT03900429). HRQL was assessed using Chronic Liver Disease Questionnaire-NASH (CLDQ-NAFLD) and Liver Disease Quality of Life (LDQOL). Baseline HRQL score changes by treatment group (resmetirom 80 mg, resmetirom 100 mg, or placebo) and histological response (improvement of fibrosis without worsening of NAS or resolution of MASH/NASH without worsening of fibrosis) were compared after 52 weeks. Included were 966 intention-to-treat patients: 323 received resmetirom 100 mg, 322 resmetirom 80 mg, and 321 placebo. By weeks 24 and 52, patients receiving 80 or 100 mg resmetirom experienced HRQL improvement in CLDQ-NAFLD Worry domain (mean +0.21 to +0.24, p < 0.05). At week 52, subjects who met histologic endpoints after treatment with resmetirom (100 mg and 80 mg pooled) experienced HRQL improvement in CLDQ-NAFLD Worry +0.46 (41% met minimal clinically important difference [MCID]), LDQOL domains: Role Emotional +3.0 (28% met MCID), Health Distress +8.1 (38% MCID), Stigma +3.5 (39% MCID), and total LDQOL +2.2 (35% MCID) (all p < 0.05). Similar improvements were noted in histologic responders from 100 mg or 80 mg resmetirom groups when separated—no improvements in placebo or nonresponders. Baseline F3 histologic responders had similar/more pronounced HRQL improvements.

Conclusions:
Patients with MASH/NASH with fibrosis improvement or the resolution of MASH with resmetirom experienced clinically meaningful and statistically significant HRQL improvements.
Juvenile primary hypertension is associated with attenuated macro- and microvascular dilator function independently of body weight
Authors: Kos Martina , Nađ Tihana , Stupin Ana , Drenjančević Ines , Kolobarić Nikolina , Šušnjara Petar , Mihaljević Zrinka , Damašek Mia , Pušeljić Silvija , Jukić Ivana 
Published: September 2024

Objective:
Hypertension has become a global medical and public health issue even in childhood. It is well accepted that hypertension is associated with impaired endothelium-dependent vascular reactivity in adult patients. However, there is a lack of data on hypertension-related endothelial dysfunction in hypertensive children. Thus, present study aimed to evaluate the association of primary hypertension in the pediatric population with macro- and microvascular function, and to assess the potential role of oxidative stress in that connection.

Methods:
Fifty-two children were enrolled in this study; 26 normotensive (NT) and 26 with primary hypertension (HT), both sexes, 9–17 years old. In addition to anthropometric, hemodynamic and biochemical measurements, peripheral microvascular responses to occlusion (postocclusive reactive hyperemia, PORH), local heating (local thermal hyperemia, LTH), iontophoretically applied acetylcholine (AChID) and sodium nitroprusside (SNPID) were evaluated by laser Doppler flowmetry (LDF). Furthermore, brachial artery flow-mediated dilation (FMD) was measured and biomarker of oxidative stress was determined.

Results:
PORH, AChID and LTH were impaired in hypertensive compared to normotensive children, while SNPID did not differ between groups. FMD was decreased in hypertensive compared to normotensive children. Serum concentration of 8-iso-PGF2α was significantly elevated in hypertensive compared to normotensive children.

Conclusion:
Even in childhood, primary hypertension is associated with attenuated endothelial function and reduced endothelium-dependent responses to various physiological stimuli. Juvenile hypertension is related to increased level of vascular oxidative stress. All changes are independent of BMI.
Defining childhood hypertension: is it too complicated? An evaluation of the potential impact of different approaches in an Australian paediatric population
Authors: Larkins Nicholas G. , Choong Catherine , Schlaich Markus , Quinlan Catherine , Mynard Jonathan P. , Kim Siah , Mori Trevor A. , Beilin Lawrence J. 
Published: September 2024

Objectives:
Current American Academy of Pediatrics (AAP) and European Society of Hypertension (ESH) thresholds defining hypertension in children use blood pressure (BP) normalised to age, sex and height. However, scare data exists regarding the relative importance of these variables to accurately model the 95th quantile of BP. We hypothesised that height alone may fit the population data equally well compared to more complex definitions. We also compare the potential impact of various thresholds for defining hypertension in an Australian population.

Methods:
Longitudinal data from the Raine Study were used, with 2248 participants contributing 7479 valid BP values across the 3/5/10/14/17-year study visits. BP was measured after 5 min rest, ≥3 times at each visit, using a Dinamap device. Quantile regression was used to predict the 95th percentile of BP, with nonlinear modelling of covariates through restricted cubic spline terms.

Results:
At a single visit, 6–16% of young children exceeded the ESH threshold and 12–23% the AAP threshold. The transition to fixed thresholds (≥13 years AAP, ≥16 years ESH), increased the number of males (AAP only) and reduced the number of females considered hypertensive. A quantile regression model constructed with Raine Study data using height-only as the explanatory variable better predicted BP than the respective model using age-only (or a combination of the two).

Conclusions:
There may be large differences in the prevalence of hypertension according to AAP and ESH criteria, with a marked sex-discrepancy emerging from the point of fixed threshold application in adolescence. It may not be necessary to normalise BP by both age and height, the latter being a better predictor of childhood BP. Simpler methods may be preferable in clinical practice but require validation against clinical outcomes.
Renal adaptation in pre-obesity patients with hypertension
Authors: Bosch Agnes , Rauh Manfred , Striepe Kristina , Schiffer Mario , Schmieder Roland E. , Kannenkeril Dennis 
Published: September 2024

Background and hypothesis:
Obesity aggravates the risk to develop chronic kidney disease in hypertensive patients. Whether pre-obesity already impairs renal function, renal perfusion and intraglomerular hemodynamics in hypertensive patients is unknown.

Methods:
Renal hemodynamic profiles were measured using steady state input clearance (infusion of para-amino-hippuric acid and inulin) in 36 patients with primary arterial hypertension stage 1–2 without antihypertensive medication. Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated. The study population was divided into two groups based on median of waist circumference (WC) (96 cm) (pre-obesity and non-obesity group1) and median of body mass index (BMI) (26.5 kg/m2) (pre-obesity and non-obesity group2), respectively.

Results:
All patients were males, non-smoking, aged 36 ± 10 years, with an office blood pressure of 145 ± 8.6/89 ± 11.8 mmHg. None of the patients had cardiovascular disease. Patients from the pre-obese group 1 showed lower glomerular filtration rate (GFR), lower renal plasma flow (RPF) and lower IGP compared to the non-obese group1. Renal vascular resistance (RVR) and RA were higher in the pre-obese group1 compared to the non-obese group1. Similar differences in the hemodynamic profile were found for patients in the pre-obesity group2 compared to the non-obesity group2.

Conclusion:
The renal hemodynamic profile in hypertensive patients with pre-obesity, irrespective whether defined by WC or BMI, was characterized by a reduced GFR and RPF and by an increased RVR preferentially at the preglomerular site. Our results suggest that hypofiltration is the first phase of renal adaptation in pre-obesity hypertension.

Clinical trial registration:

www.clinicaltrials.gov: NCT02783456.
Barriers and facilitators to home blood pressure monitoring in women with pregnancies complicated by hypertensive disorders: a qualitative study
Authors: Kovell Lara C. , Denu Mawulorm , Revoori Ritika , Sadaniantz Katherine , Staples Brooke , Chiriboga Germán , Forrester Sarah N. , Lemon Stephenie C. , Moore Simas Tiffany A. , Person Sharina , McManus David D. , Mazor Kathleen M. 
Published: September 2024

Background/objective:
Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality in the US. Improved diagnosis and treatment of HDP may be achieved through home blood pressure monitoring (HBPM). However, there are challenges to effective HBPM during pregnancy. This qualitative study was conducted to explore patients’ perspectives and experiences with HBPM.

Methods:
Pregnant or recently postpartum women with HDP (≥18 years) were recruited from an academic medical center to virtual focus groups from March to September 2023. The discussions centered on experiences with HDP and barriers and facilitators to HBPM. Qualitative thematic analysis was performed.

Results:
Among 20 participants, the mean age was 33.8 (SD 5.9) years, with 35% Hispanic and 35% Black/African–American. Facilitators to HBPM included understanding the parameters/purpose of HBPM, prior experience with healthcare/duration of hypertension, free access to HBPM equipment and decision support, creating a routine, external support/counseling (e.g., partner/healthcare/family), and technology support. Barriers to HBPM included uncertainty/lack of training about the HBPM process, accessing/using HBPM equipment, the belief that clinic monitoring was sufficient/achieving good control, and activation barriers to making HBPM a priority (e.g., fear of affirming the diagnosis, higher priorities/life stressors).

Conclusion:
Many of the barriers to HBPM in pregnancy can be overcome through patient education/counseling, technology support, clinician/family reinforcement, and better access to validated blood pressure monitors. Given the importance of HBPM in improving outcomes for HDP, it is important for healthcare providers and policy makers to work to reduce barriers and amplify facilitators to HBPM for better adoption.
Recreational beach tennis training reduces ambulatory blood pressure in adults with hypertension: a randomized clinical trial
Authors: Ferrari Rodrigo , de Oliveira Carpes Leandro , Betti Domingues Lucas , Mallmann Schneider Vinícius , Leal Rodrigo , Tanaka Hirofumi , Jung Nathalia ,   The BAH Study Groupb
Published: September 2024

Objective:
To determine the effect of 12 weeks of beach tennis training on 24-h ambulatory blood pressure in adults with essential hypertension.

Methods:
This was a randomized, single-blinded, two-arm, parallel superiority trial. Forty-two participants aged 35–65 years with a previous diagnosis of hypertension were randomized into 12 weeks of beach tennis training group (two sessions per week lasting 45–60 min) or a nonexercising control group. Ambulatory 24 h (primary outcome) and office blood pressure, heart rate at rest, cardiorespiratory fitness, and muscle strength were assessed at baseline and after the intervention period. Generalized estimating equation analyses were employed to examine the main effects of the interventions.

Results:
In the beach tennis group, night-time systolic (−9 mmHg, P = 0.023), diastolic (−4 mmHg, P = 0.026), and mean arterial pressure (−7 mmHg, P = 0.023) decreased after 12 weeks of training. The office SBP/DBP (−6 mmHg, P = 0.016/−6 mmHg, P = 0.001) also decreased in the beach tennis group. Heart rate at rest decreased in the beach tennis group (−4 bpm, P = 0.012) but increased in the control group (6 bpm, P = 0.005). The lower and upper limb muscle strength increased in the beach tennis group after training. However, no such changes were observed in the control group.

Conclusion:
A 12-week recreational beach tennis training significantly reduced office and ambulatory BP among untrained adults with essential hypertension. Additionally, participation in this sport has led to improvements in physical fitness and overall cardiovascular risk profiles.
This clinical trial was registered at Clinicaltrials.gov (NCT03909321).
Daytime actisensitivity predicts nocturnal dipping patterns and morning surge in blood pressure: the Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective study
Authors: Tomitani Naoko , Hoshide Satoshi , Kanegae Hiroshi , Kario Kazuomi ,   the HI–JAMP Study Group
Published: September 2024

Background:
Ambulatory blood pressure (BP) is influenced by physical activity and the BP response to physical activity (actisensitivity) differs between individuals. This study investigated associations between daytime actisensitivity and nighttime BP dipping status and morning BP surge.

Methods:
Twenty-four-hour ambulatory BP monitoring (ABPM) with simultaneously monitored physical activity using a multisensor all-in-one device (TM-2441; A&D Company) was performed at baseline in HI-JAMP study participants. Those with complete BP measurements and complete physical activity monitoring data were included in this analysis. Actisensitivity was calculated as the slope of the regression line between daytime SBP and log-transformed physical activity over a 5 min period before each BP reading. Hyper and negative reactivity were defined as actisensitivity greater than 90th and less than 10th percentile, respectively.

Results:
Data from 2692 individuals (mean age 69.9 ± 11.9 years; mean BMI 24.8 ± 4.1 kg/m2, 53.6% men) were analyzed. Those with hyper reactivity had a high prevalence of the extreme dipper pattern of nighttime BP and exaggerated morning BP surge; those with negative reactivity had higher nighttime BP and a riser pattern of nighttime BP. Results remained significant after adjusting for 24-h physical activity. Differences in diurnal BP variability based on actisensitivity were augmented in individuals aged at least 75 years.

Conclusion:
This study is the first to investigate associations between actisensitivity and 24-h ambulatory BP profiles using an all-in-one multisensor device in a large real-world population. The associations seen between either hyper or negative actisensitivity and abnormal diurnal BP variability, especially in the elderly, could contribute to increased cardiovascular event risk.

Clinical Trial Registration:
University Hospital Medical Information Network Clinical Trials Registry, UMIN000029151 (HI-JAMP study).
Ocular bee sting injury: case report
Authors: Bertazzi Luiza C. , Iguma Juliana I. , Chen Hanny Rui Qi , Langella Eugênia Diniz Adán , Teixeira Ivan Corso 
Published: September 2024

Introduction:
Eye accidents caused by bee stings are uncommon and little reported worldwide. There is still no protocol to be followed in these situations that need to be individualized. A case is reported of a bee sting remaining inside the lens of a middle-aged man that was surgically removed without phacoemulsification, which kept the patient's accommodation and good sight.

Patient and Clinical Findings:
A 41-year-old man presented with red left eye, low visual acuity, and pain after being stung by bees all over his body, including his left eye. There was a lot of inflammation and corneal edema that did not allow complete visualization.

Diagnosis, Intervention, and Outcomes:
After starting clinical treatment, it was possible to visualize the sting inside the patient's lens. Conservative surgery was proposed with the removal of the stinger keeping the patient's lens clear. After 6 months, he presented visual acuity with no correction of 0.1 logMAR in both eyes and J1 without high intraocular pressure, but corneal endothelial specular microscopy demonstrated significant endothelial loss such as a consequence poison of the sting.

Conclusions:
There is still a lack of cases in the literature that could assist in a protocol in cases of intraocular bee sting. What is known is that each patient must be individualized, and in this situation, it was possible to conduct the event while maintaining the lens and the patient's accommodation capacity.
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Field Setting: A Case Report From China
Authors: Li Xixi , Xie Nan , Zhou Tong , Yang Bo 
Published: September 2024

BACKGROUND:
The widespread use of agricultural machinery in China has increased the incidence of agricultural machinery-related injuries, posing challenges to on-site medical rescue. This study explores resuscitative endovascular balloon occlusion of the aorta (REBOA) as a life-saving intervention for a patient with severe trauma from agricultural machinery.

CASEPRESENTATION:
This study reviews the emergency medical response for a 70-year-old male who suffered machinery entanglement injuries in an agricultural field in western China. The intervention involved a tiered multidisciplinary medical response, including the implementation of REBOA.

CONCLUSION:
This case demonstrates the successful use of REBOA in the prehospital setting in China. While prehospital REBOA use is rare, it is increasingly reported in both military and civilian contexts in austere environments in different countries. Further research is required to validate the feasibility and efficacy of REBOA as a prehospital resuscitation strategy.
Corticosteroid-induced bradycardia following high-dose methylprednisolone administration: a case report
Authors: Zkib Jwil , Sattout Raneem , Faour Sabah , Haddad Sultaneh , Bassut Ranim , Swed Wajd , Hritani Shahd , Mansouer Milad , Ghabally Mike 
Published: September 2024

Introduction:
Besides their wide use in the clinical field due to their anti-inflammatory and immune-modulating effect, corticosteroids still have a lot of adverse effects. The most common adverse effects are hyperglycemia, hypertension, osteoporosis, psychosis, immunosuppression, weight gain, and hyperlipidemia. Another important side effect is cardiac arrhythmias.

Case presentation:
We report a case of a 43-year-old woman with multiple sclerosis who developed symptomatic bradycardia after 3 days of treatment with a high dose of methylprednisolone. The patient received a dose of atropine and her bradycardia resolved after 36 h of stopping methylprednisolone.

Discussion:
While tachyarrhythmias are more common, bradyarrhythmias such as bradycardia and premature atrial or ventricular contraction are rare but crucial to be considered.

Conclusion:
Corticosteroid-induced bradycardia is usually in sinus rhythm and has an unknown etiology, possibly occurring at high and low doses. The majority of cases in the literature were asymptomatic and resolved spontaneously.