bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis
Authors: Kurniawan Roy B , Siahaan Paulus P , Saputra Pandit BT , Arnindita Jannatin N , Savitri Cornelia G , Faizah Novia N , Andira Luqman H , D’Oria Mario , Eko Putranto J Nugroho , Alkaff Firas F 
Published: October 2024

Background: The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD). Methods: This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC). Results: This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR’s performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59–0.79], sensitivity 58.2% [95% CI: 45.3–71.0], specificity 72.6% [95% CI: 65.6–79.62], PPV 41.0% [95% CI: 31.2–50.7], NPV 82.7% [95% CI: 74.1–91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75–0.80], sensitivity 65.4% [95% CI: 41.6–89.2], specificity 77.7% [95% CI: 71.0–84.3], PPV 53.7% [95% CI: 47.3–60.1], NPV 83.91% [95% CI: 73.2–94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern. Conclusion: NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD (PROSPERO Registration No.: CRD42023486607).
Changes in the reactive hyperemia index after continuous and interval exercise
Authors: Sweet Daniel K , Patterson P Daniel , Reis Steven , Hostler Dave 
Published: October 2024

Introduction: High-intensity interval exercise (HIIE) is more effective than moderate-intensity interval exercise (MICE) for improving macrovascular function (e.g., flow-mediated dilation), but less is known regarding the effect of HIIE on microvascular function. We used peripheral artery tonometry to measure the reactive hyperemia index (RHI) and examine the acute effects of HIIE and MICE on microvascular function. Methods: Ten healthy participants (50% men, age: 26 ± 5 years, mass: 75.6 ± 15.1 kg, height: 170 ± 10 cm, body mass index: 26.0 ± 3.1 kg∙m–2) performed single bouts of HIIE and MICE cycling on separate occasions. The MICE protocol was 20 min at 60% of maximum power output. The HIIE protocol was a 12-min warm up at 50% of maximum power output immediately followed by an 8-min Tabata protocol where participants alternated between cycling at ⩾ 100% max power (20 sec) and rest (10 sec). The RHI was measured before, immediately after, and 1 h after exercise and compared by two-way repeated measures analysis of variance (condition [MICE, HIIE] and time [pre-, post-, and 1-h postexercise]). Results: Compared to baseline, RHI increased 1 h after MICE only ( p = 0.02). Heart rate was higher during MICE at 5 and 10 min ( p = 0.02) and higher during HIIE at min 20 ( p < 0.01). Conclusion: Within a sample of healthy adults, the RHI was improved 1 h after a single session of MICE but not HIIE. Future research is needed to determine the significance of the differential effects of exercise regimens on the macro- and microvasculature.
Relationship functioning and impact of health coverage models for parents of childhood cancer patients: A systematic review
Authors: Rygh Louisa , Marrow TyKera , Pate Debra Sue , Karlson Cynthia W. 
Published: October 2024

The current systematic literature review aimed to summarize and evaluate existing literature regarding parental relationship functioning during and after childhood cancer, with an exploratory evaluation regarding the impact of national health coverage model (proxy for finances). This review used MEDLINE, PsychInfo, Embase, and CENTRAL search database. Articles were reviewed ( N = 3060) against inclusion criteria, with 512 abstracts screened and 87 full-text retrieved and reviewed. Inclusion criteria: (1) childhood cancer, (2) measures parental relationship functioning, (3) English, and (4) new, empirical data. A modified version of the Downs and Black checklist was used to assess risk of bias. Narrative synthesis was used to present and discuss results. Final included articles ( N = 36) revealed mostly positive or neutral findings across parental relationship functioning subdomains within 6 months (T1) and after 6 months (T2) of childhood cancer diagnosis. Sexual intimacy was negatively impacted across timepoints. Parental stress was higher than norms at T1. Marital conflict and adjustment were also worse at T1 but returned to previous levels at T2. Some variability in parental relationship functioning was observed among the different health coverage models, but these differences were not significant. Results support systematic screening and systems-based parent support programs for families of children with cancer. Mixed-methods studies examining parental relationships longitudinally and utilizing operational definitions for out-of-pocket spending are needed.
Analysis of loading modes and rates on the mechanical responses of glass fiber weft-knitted biaxial tubular fabric reinforced composites
Authors: Zhou Mengmeng , Jiang Gaoming 
Published: October 2024

With the increasing demand for lightweight and high-strength tubes in the civil engineering, many researchers have investigated the weft-knitted biaxial tubular (WKBT) fabric reinforced composites due to their excellent mechanical properties. WKBT fabric is characterized by its seamless tubular reinforcement, with the warp yarns being straight in the axial direction and the weft yarns spinning in the circumferential direction. The mechanical response of WKBT fabric reinforced composites under three different loads (tensile load, puncture load, compression load) and three different rates (5, 10, 15 mm/min) are discussed in this paper. The results indicate that the mechanical properties and failure modes of WKBT fabric reinforced sheets are significantly affected by the glass fiber volume fraction. The concertina progressive folding is the energy absorption mode of WKBT fabric reinforced tubes under compressive load. The number of folds changes from two to three as the height of the tube increases. At the compression rate of 15 mm/min, the initial peak strength of the tubes increases by 28.14 % as their height (100, 150, 200 mm) of the tubes increases. The initial peak strength of the tubes increases by 72.78% as the compression rate increases to 200 mm height.
The Role of Intravascular Ultrasound in Limb Salvage: A Systematic Review and Meta-Analysis
Authors: Gee Allen , Tarricone Arthur , Lavery Lawrence A. , Wiley Karlo A. , Palmieri Noell , Sharma Samin , Krishnan Prakash 
Published: October 2024

Purpose The purpose of this study was to review the current literature of intravascular ultrasound (IVUS) use in real world cohorts inclusive of chronic limb threatening ischemia (CLTI) patients and compare the outcomes to patients imaged by angiography alone. Methods The systematic review was registered in Research Registry. A literature search was performed across 4 databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies. The primary outcomes examined were clinically driven target lesion revascularization (CD-TLR), amputation (including minor below the ankle and major above the ankle), all-cause mortality, limb salvage and mean balloon dilation. A random effects model was used when pooling outcomes to account for heterogeneity. Publication bias was determined using eggers test and illustrated on a funnel plot. Main Findings Six studies were included in this review, with a total of 1883 subjects with Rutherford 1-6. Among the 1883 subjects, 940 had Rutherford 4-6. IVUS was used in 1294 subjects and angiography alone was used in 589 subjects. Pooled analysis determined no significant association in IVUS + angiography with CD-TLR (O.R = 1.43 [CI: 0.80, 2.58]), all-cause amputation (O.R = 0.63 [CI: 0.34, 1.17]), and all-cause mortality (O.R = 0.63 [CI: 0.34, 1.17]). Sub analysis of subjects with CLTI, Rutherford classes 4-6 showed an association between IVUS + angiography use with limb salvage at 1 year, O.R = 2.22 [1.24, 3.97]. Conclusion The use of IVUS + angiography compared to angiography alone showed larger reference vessel diameter in both all-inclusive Rutherford classifications and the CLTI subset. The use of IVUS + angiography compared to angiography alone showed no difference in CD-TLR at 12 months, lower extremity amputation, and all-cause mortality for Rutherford 1-6. The use of IVUS + angiography compared to angiography alone in the CLTI subset analysis improved limb salvage.
Reliability and validity of five balance assessments battery in individuals with schizophrenia
Authors: Lin I-Chen , Chen Fu-Chen , Chen Chia-Hsiang , Chen Ming-De 
Published: October 2024

Purpose: This study examines the test-retest reliability, concurrent and discriminant validity of Star excursion balance test (SEBT), One-leg stance (OLS), Functional reach test (FRT), Timed up-and-go test (TUG), and Tandem walking test (TW) in individuals with schizophrenia. Methods: Thirteen participants with schizophrenia who had a history of falls and 13 age-matched controls with schizophrenia who had no history of falls received the five balance assessments battery to establish test-retest reliability. A force platform was administered to examine concurrent validity, while balance assessment performance between fallers and non-fallers was examined for discriminant validity. Conventional receiver operating characteristic curve analysis was used to estimate the optimal cutoff scores. Results: Based on the 95% confidence interval of the intraclass correlation coefficients (ICC), the test-retest reliability was good for SEBT and TUG (ICC = .92 −.99) but poor for TW (eyes open) (ICC = .15 −.74). Concurrent validity with force platform parameters showed a larger amount of significant correlations for SEBT (with rs = −.738∼-.392) and TUG (with rs = .401–.771) and low for OLS (with rs = −.494∼-.398). The discriminant validity was established for SEBT and TUG. The highest area under the curves (AUC >.8) was noted for SEBT and TUG, demonstrating better sensitivity and specificity. The cutoff score for specific assessment was also provided. Conclusion: The SEBT and TUG demonstrated better reliability and validity for examining the balance functions of individuals with schizophrenia. Furthermore, with the larger AUC, the SEBT and TUG showed superior performance in identifying fall risks.
Conservative treatment of cesarean scar pregnancy with the combination of methotrexate and mifepristone: A systematic review
Authors: Stabile Guglielmo , Vona Laura , Carlucci Stefania , Zullo Francesco , Laganà Antonio Simone , Etrusco Andrea , Restaino Stefano , Nappi Luigi 
Published: October 2024

Background: Cesarean scar pregnancy (CSP) has become more frequent as a direct consequence of the increased number of cesarean deliveries and the advances in imaging. Although some cases are characterized by spontaneous resolution, unrecognized or mishandled CSP has the potential to cause both fetal and maternal morbidity and mortality. However, due to its infrequency, there is no agreement on the best management. Objective: The purpose of this study was to evaluate the safety, the risks and effectiveness of medical therapy with methotrexate and mifepristone to better understand its role in CSP therapy. Design: This study is a systematic review. Data Sources and Methods: The electronic databases PubMed, Medline, and Scopus were comprehensively searched until December 2023. Medical Subject Headings terms (Cesarean scar pregnancy) AND (Methotrexate) AND (Mifepristone) AND (Medical Therapy) were used to identify the relevant records. Due to the rarity of this pathology, the studies included are all case reports or case series. The methodological quality of the included studies was assessed using the JBI Critical Appraisal Checklist for case reports. Results: We included in our review a total of seven cases reported in five manuscripts at the end of the screening process. Our review suggests that this type of combination treatment can be considered. The success rate is 71.4%. Treatment seems to be most effective when beta human chorionic gonadotropin (B-hCG) is below 5,000 mUi/ml and when the gestational sac is less than 20 mm. The absence of fetal heartbeat seems to be a positive prognostic factor for a positive outcome. Conclusion: Methotrexate and mifepristone administration can be considered as an alternative first-line effective treatment, especially in case of pregnancy with B-hCG <5,000 mUi/ml and when the gestational sac is less than 20 mm. It is important to individualize the management and treatment according to the clinical condition, the patient’s age, number of previous cesarean deliveries, willingness to have other children, and the physicians’ experience.
Optimizing the safety and efficacy of the awake venovenous extracorporeal membrane oxygenation in patients with COVID-19-related ARDS
Authors: Sklienka Peter , Burša Filip , Frelich Michal , Máca Jan , Vodička Vojtech , Straková Hana , Bílená Markéta , Romanová Tereza , Tomášková Hana 
Published: October 2024

Background: Maintaining the patient awake and not intubated during the venovenous extracorporeal membrane oxygenation (VV ECMO) reduces the risk of ventilation-induced lung injury in patients with ARDS. Currently, there is a lack of data on outcomes and complications associated with the awake ECMO approach. Objectives: To evaluate outcomes and the occurrence of complications of awake ECMO approach guided by local safety protocol comprising ultrasound-guided cannulation, argatroban-based anticoagulation, respiratory support, and routine sedation targeted to reduce respiratory effort and keeping nurse-to-patient ratio of 1:1. Design: A single-center retrospective case series analysis. Methods: Consecutive patients with COVID-19-related acute respiratory distress syndrome (ARDS) (CARDS) treated by full awake VV ECMO approach from April 2019 to December 2023 were eligible. Results: Our center treated 10 patients (mean age 54.7 ± 11.6 years) with CARDS with an awake ECMO approach. The reasons for awake ECMO included the presence of barotrauma in six patients, a team consensus to prefer awake ECMO instead of mechanical ventilation in three patients, and the patient’s refusal to be intubated in one case. Before ECMO, patients were severely hypoxemic, with a mean value of Horowitz index of 48.9 ± 9.1 mmHg and a mean respiratory rate of 28.8 ± 7.3 breaths per minute on high-flow nasal cannula or noninvasive ventilation support. The mean duration of awake VV ECMO was 558.0 ± 173.6 h. Seven patients (70%) were successfully disconnected from ECMO and fully recovered. Intubation from respiratory causes was needed in three patients (30%), all of whom died eventually. In total, three episodes of delirium, two episodes of significant bleeding, one pneumothorax requiring chest tube insertion, and one oxygenator acute exchange occurred throughout the 5580 h of awake ECMO. No complications related to cannula displacement or malposition occurred. Conclusion: The awake ECMO strategy guided by safety protocol appears to be a safe approach in conscious, severely hypoxemic, non-intubated patients with COVID-19-related ARDS.
Assessing the Use of Patient-Reported Outcome Measures in the Routine Clinical Care of Chronic Rhinosinusitis Patients: A Canadian Perspective
Authors: Kim Hugh Andrew Jinwook , Lee Daniel J. , Shin Dongho , Horton Garret , Gignac Monique , Lee John M. , Chan Yvonne 
Published: October 2024

Importance Chronic rhinosinusitis (CRS) is a common inflammatory disease of the paranasal sinuses with significant quality of life impairments. There is a need to implement outcome-based metrics to evaluate the outcomes of CRS treatment with endoscopic sinus surgery or biologics. Objective We aimed to understand Canadian otolaryngologists’ opinions on patient-related outcome measures (PROM) for CRS and identify potential barriers to implementation. Design Qualitative research. Setting and Participants A cross-sectional survey was distributed via the Canadian Society of Otolaryngology-Head and Neck Surgery and direct emailing. Measures Participants’ demographics, practice information, and opinions on PROM were collected. Results Of 346 (23%) Canadian otolaryngologists, 78 responded to the survey (26 rhinology fellowship–trained, 51 non-fellowship-trained, and 1 missing data). Thirty-eight responded that they collect PROM (69% with fellowship-trained, 39% non-fellowship-trained, P = .029). Regarding opinions on PROM, 74% of respondents agreed that it helps patients report their symptoms, 42% agreed that it improves the efficiency of the patient encounter, 54% agreed that it is easy for patients to understand, 62% agreed that it improves management and monitoring of clinical outcomes, and 71% disagreed that PROM is not helpful. Fellowship-trained otolaryngologists were 4 times more likely to agree that PROM improves management and monitoring of clinical outcomes ( P = .014), and no other differences in opinions were significant. The most-frequently-identified barriers to PROM usage were lack of time for 67% of respondents, difficulty integrating into clinical workflow for 64%, and lack of integration into the electronic medical record for 47%. If these barriers were addressed, 86% of respondents said they would use PROM in their practice. Conclusions and Relevance Despite the low uptake of PROM among otolaryngologists without rhinology fellowship, opinions were generally favorable. We identified barriers that, if addressed, may increase their use in clinical practice. As resource-limited therapies such as biologics become more prevalent in CRS management, PROM may find more applications in shared clinical decision making.
The Effect of Different Concentrations of Epinephrine in Otoendoscopic Surgery on Surgical Field Clarity: A Double-Blind, Randomized Study
Authors: Shu Wenying , Jin Tingting , Shi Jinya , Li Jingjie , Wang Zhaoyan 
Published: October 2024

Importance At present, there is no consensus on the concentration of epinephrine/physiological saline for subcutaneous injection into external auditory canal (EAC) under general anesthesia in otoendoscopic surgery. A randomized controlled trial (RCT) research is needed to provide reference, as this concentration can provide satisfactory surgical field clarity while maintaining patients’ hemodynamic stability. Objective Comparison of the effect of subcutaneous injection of different concentrations of epinephrine/physiological saline into EAC under general anesthesia in otoendoscopic surgery on surgical field clarity and hemodynamics. Design This double-blind, RCT study was about the effect of topical epinephrine injection in otoendoscopic surgery. Setting This study was conducted at a single institution. Participants This study included 168 patients conformed to the inclusion criteria. Intervention Patients were randomized to receive different concentrations of epinephrine/physiological saline injection (1:5000, 1:10,000, 1:20,000, or 1:40,000) into the junction of bone and cartilage at posterior wall of EAC during surgery. Main Outcome Measures Surgical field clarity was assessed with surgical field clarity grading scale and tympanic membrane flap flipping time. Hemodynamic changes were monitored by clinical parameters of blood pressure, heart rate, and ST segment of ECG. Results There were no statistically-significant differences in surgical field clarity grade ( P = .577) and tympanic membrane flap flipping time ( P = .490) among 4 concentration groups. Epinephrine injection did cause an increase in hemodynamic parameters when compared with baseline ( P < .05). Compared with the relatively-lower concentration groups (1:20,000 and 1:40,000), the relatively-higher concentration groups (1:5000 and 1:10,000) had more significant and long-lasting effect until 30 minutes after injection. Conclusions and relevance Four concentration groups of topical epinephrine injection in otoendoscopic surgery have the same effect on surgical field clarity. For the stability of patients’ hemodynamics, we would prefer to recommend the use of concentrations with minimal impact on hemodynamics, ranging from 1:20,000 to 1:40,000. Trial registration Clinical Trial Registry-China: ChiCTRI1800016647.
Magnitude of postpartum morbidity and associated factors in southeast Ethiopia, 2022: A facility-based cross-sectional study
Authors: Hussein Hasen Feisal , Alemu Solomon Seyife , Eshetu Derese , Mohammed Bedria , Nebi Eden , Israel Hana , Geneti Yomilan , Wedajo Lema Fikadu , Gebretsadik Woiynshet 
Published: October 2024

Objective: Maternal mortality in Ethiopia is estimated to be 205 per 100,000 live births, with postpartum morbidities expected to surpass maternal mortality substantially. Beside this, there is a lack of information on postpartum morbidities in the study area. Thus, the purpose of this study was to assess the magnitude of postpartum morbidities and associated factors in Bale Robe Town, southeast Ethiopia. Method: An institution-based cross-sectional study was employed among 371 from 1 April to 30 May 2022 among postpartum women attending postnatal care service in the Bale-Robe Town public health facilities. A face-to-face interviewer administered a structured questionnaire, and the participants were selected through a systematic random sampling technique. A bivariate analysis was performed to see the association between each independent variable and dependent variable, and variables with p-values less than 0.25 in the bivariate analysis were retrieved for multivariable analyses. A p-value of less than 0.05 indicated a 95% confidence interval as the level of statistical significance. Result: A total of 366 participants were involved in the study, giving us a response rate of 98.6%. The magnitude of postpartum morbidities among mothers was found to be 102 (27.9%), with a confidence interval of 95% CI: 23.3, 32.8. Women who hadn’t had antenatal care follow-up (AOR = 2.47, 95% CI: 1.36, 4.50), instrumental delivery (AOR = 2.69, 95% CI: 1.16, 6.26), unskilled birth attendant (AOR = 3.35, 95% CI: 1.06, 10.63), rural residence (AOR = 2.21, 95% CI: 1.26, 3.89), and current pregnancy-related morbidity or abnormality (AOR = 3.81, 95% CI: 2.00, 7.25) were significantly associated factors. Conclusion: This study revealed that the occurrence of postpartum morbidity in Bale Robe is a great health concern. Therefore, we recommend health professionals and health extension workers strengthen early detection and management of intrapartum abnormalities, give attention during instrumental deliveries, and strengthen skilled birth attendants.