bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Incidence of Cancers in Patients With Nonfunctional Adrenal Tumors: A Swedish Population-Based National Cohort Study
Authors: Patrova Jekaterina , Mannheimer Buster , Larsson Martin , Lindh Jonatan D , Falhammar Henrik 
Published: September 2024

Abstract

Context
It is unclear if nonfunctional adrenal tumors (NFAT) are associated with higher cancer incidence.

Objective
To analyze the cancer incidence in patients with NFAT.

Methods
In this national register-based retrospective cohort study, consecutive patients with NFAT identified in Sweden 2005-2019 and matched control individuals without adrenal tumors were followed up to 15 years. Outcome data were collected from national registers and adjusted for confounders. Both cases and controls were followed until newly diagnosed malignancy, death, or until 2019. Individuals with adrenal hormonal excess or prior malignancy were excluded.

Results
Among 17 726 cases, 10 777 (60.8%) were women, and the median age was 65 (IQR, 57-73) years. Among 124 366 controls, 69 514 (55.9%) were women, and the median age was 66 (IQR, 58-73) years. The incidence of any cancer was higher in patients with NFAT compared to controls (hazard ratio [HR] 1.35 95% CI 1.29-1.40; adjusted HR 1.31, 95% CI 1.26-1.37). NFAT was associated with a higher incidence of adrenal, thyroid, lung, stomach and small intestine, kidney, pancreatic, breast, and colorectal cancer. Sensitivity analyses did not change the overall results, but associations were not significantly increased after adjustment in patients with NFAT and appendicitis or gallbladder/biliary tract/pancreas disorders. Cancer incidence may have been underestimated by adjusting for unclear and benign tumors.

Conclusion
The incidence of cancer was increased in patients with NFAT. Long-term follow-up may be indicated.
Preoperative Multidisciplinary Team Huddle Improves Communication and Safety for Unscheduled Cesarean Deliveries: A System Redesign Using Improvement Science
Authors: Girnius Andrea , Snyder Candice , Czarny Heather , Minges Thomas , Stacey Michael , Supinski Tamara , Crowe John , Strong Judith , Josephs Sean A. , Zafar Muhammad A. 
Published: September 2024

BACKGROUND:
Optimal communication between care teams is a critical component in providing safe, timely, and appropriate patient care. Labor and delivery (L&D) units experience rapidly changing clinical scenarios often requiring escalation in care and unplanned cesarean deliveries (CDs). The University of Cincinnati Medical Center (UCMC) is a 550-bed academic level 4 maternal care center with a 13-bed L&D unit in Cincinnati, OH. There are approximately 2500 deliveries/y with a CD rate of 33%. The L&D unit is staffed with dedicated anesthesia personnel 24 hours a day. In our L&D unit, there was widespread dissatisfaction with multidisciplinary communication surrounding unscheduled CD. Near-miss safety events in our obstetric unit were attributed to preoperative communication failures. Initial surveys identified challenges in preoperative communication among nursing, anesthesiology, and obstetric teams leading to potential risk for compromised care.

METHOD:
Using the UC Health Performance Improvement Way, we first sought to understand the process leading up to unscheduled CD. Change ideas were developed based on observed failures in communication. Interventions were tested and refined through iterative plan-do-study-act (PDSA) cycles. One key intervention was the introduction of a bedside, multidisciplinary, patient-centered, pre-CD huddle attended by nursing, anesthesia, and obstetrics representatives using a standard checklist for critical information. Qualitative patient feedback was elicited to inform change efforts. We compared patient and procedure characteristics from the baseline and huddle implementation phases.

MEASURES:
Our primary outcome measure was the satisfaction of care team members with communication around unscheduled CD. A secondary outcome was the general anesthesia (GA) rate for unscheduled CD. Our key process measure was adherence to the preoperative huddle. We tracked decision-to-incision interval (DTI) as a balancing measure.

RESULTS:
Huddle adherence reached 96% for unscheduled CD within 6 months of testing and implementation. A combined survey of anesthesia, nursing, and obstetrics showed that satisfaction scores related to unscheduled CD communication improved from 3.3/5 to 4.7/5 after huddle implementation. The rate of GA use and the median DTI remained unchanged. Patients felt more engaged and reported positive experiences by being a part of the huddle discussion.

CONCLUSIONS:
In an academic obstetric unit, communication failures surrounding unscheduled CD were identified as a contributor to staff dissatisfaction and perception of safety risk. Implementation of a bedside multidisciplinary pre-CD huddle improved communication between teams and contributed to creating a culture of safety without causing significant delays in care.
Association Between Glycemic Variability and Persistent Acute Kidney Injury After Noncardiac Major Surgery: A Multicenter Retrospective Cohort Study
Authors: Kong Siyu , Ding Ke , Jiang Huili , Yang Fan , Zhang Chen , Han Liu , Ge Yali , Chen Lihai , Shi Hongwei , Zhou Jifang 
Published: September 2024

BACKGROUND:
While the relationship between glycemic variability (GV) and acute kidney injury (AKI) has been a subject of interest, the specific association of GV with persistent AKI beyond 48 hours postoperative after noncardiac surgery is not well-established.

METHODS:
This retrospective cohort study aimed to describe the patterns of different GV metrics in the immediate 48 hours after noncardiac surgery, evaluate the association between GV indices and persistent AKI within the 7-day postoperative window, and compare the risk identification capabilities of various GV for persistent AKI. A total of 10,937 patients who underwent major noncardiac surgery across 3 medical centers in eastern China between January 2015 and September 2023 were enrolled. GV was characterized using the coefficient of variations (CV), mean amplitude of glycemic excursions (MAGE), and the blood glucose risk index (BGRI). Multivariable logistic regression was used to examine the relationship between GV and AKI. Optimal cutoff values for GV metrics were calculated through the risk identification models, and an independent cohort from the INformative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database with 7714 eligible cases served to externally validate the risk identification capability.

RESULTS:
Overall, 274 (2.5%) of the 10,937 patients undergoing major noncardiac surgery met the criteria of persistent AKI. Higher GV was associated with an increased risk of persistent AKI (CV: odds ratio [OR] = 1.26, 95% confidence interval [CI], 1.08–1.46; MAGE: OR = 1.31, 95% CI, 1.15–1.49; BGRI: OR = 1.18, 95% CI, 1.08–1.29). Compared to models that did not consider glycemic factors, MAGE and BGRI independently contributed to predicting persistent AKI (MAGE: areas under the curve [AUC] = 0.768, P = .011; BGRI: AUC = 0.764, P = .014), with cutoff points of 3.78 for MAGE, and 3.02 for BGRI. The classification of both the internal and external validation cohorts using cutoffs demonstrated good performance, achieving the best AUC values of 0.768 for MAGE in the internal cohort and 0.777 for MAGE in the external cohort.

CONCLUSIONS:
GV measured within 48 hours postoperative period is an independent risk factor for persistent AKI in patients undergoing noncardiac surgery. Specific cutoff points can be used to stratify at-risk patients. These findings indicate that stabilizing GV may potentially mitigate adverse kidney outcomes after noncardiac surgery, highlighting the importance of glycemic control in the perioperative period.
Functional cardiac consequences of β-adrenergic stress-induced injury in a model of Duchenne muscular dystrophy
Authors: Earl Conner C. , Javier Areli J. , Richards Alyssa M. , Markham Larry W. , Goergen Craig J. , Welc Steven S. 
Published: September 2024

ABSTRACT
Cardiomyopathy is the leading cause of death in Duchenne muscular dystrophy (DMD); however, in the mdx mouse model of DMD, the cardiac phenotype differs from that seen in DMD-associated cardiomyopathy. Although some have used pharmacologic stress to stimulate injury and enhance cardiac pathology in the mdx model, many methods lead to high mortality with variable cardiac outcomes, and do not recapitulate the structural and functional cardiac changes seen in human disease. Here, we describe a simple and effective method to enhance the cardiac phenotype model in mdx mice using advanced 2D and 4D high-frequency ultrasound to monitor cardiac dysfunction progression in vivo. mdx and wild-type mice received daily low-dose (2 mg/kg/day) isoproterenol injections for 10 days. Histopathological assessment showed that isoproterenol treatment increased myocyte injury, elevated serum cardiac troponin I levels and enhanced fibrosis in mdx mice. Ultrasound revealed reduced ventricular function, decreased wall thickness, increased volumes and diminished cardiac reserve in mdx compared to wild-type mice. Our findings highlight the utility of challenging mdx mice with low-dose isoproterenol as a valuable model for exploring therapies targeting DMD-associated cardiac pathologies.
Impact of PIPAC-Oxaliplatin on Functional Recovery, Good Days, and Survival in a Refractory Colorectal and Appendiceal Carcinomatosis: Secondary Analysis of the US PIPAC Collaborative Phase 1 Trial
Authors: Waheed Muhammad Talha , Ruel Nora , Whelan Richard L. , Fakih Marwan , Fong Yuman , Deperalta Danielle , Merchea Amit , Sun Virginia , Krouse Robert , Dellinger Thanh H. , Raoof Mustafa 
Published: September 2024

Abstract
Background
Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a novel, minimally invasive, safe, and repeatable method to treat carcinomatosis. Evidence regarding the clinical benefit (quality of life and survival) of PIPAC compared with that of conventional standard therapy (ST) is lacking.

Methods
This is the secondary analysis of the phase 1 US-PIPAC trial for refractory colorectal and appendiceal carcinomatosis. A PIPAC cohort was compared with a retrospective cohort of consecutive patients receiving ST. The primary outcome was number of good days (number of days alive and out of the hospital). The secondary outcomes were overall survival (OS), progression-free survival (PFS), health-related quality of life (HRQoL), and objective functional recovery (daily step count).

Results
The study included 32 patients (PIPAC, 12; ST, 20) with similar baseline characteristics. Compared with the ST cohort, the PIPAC cohort had lower median inpatient hospital stays (> 24 h) within 6 months (0 vs 1; p = 0.015) and 1 year (1 vs 2; p = 0.052) and higher median good days at 6 months (181 vs 131 days; p = 0.042) and 1 year (323 vs 131 days; p = 0.032). There was no worsening of HRQoL after repeated PIPACs. Step counts diminished immediately after PIPAC but returned to baseline within 2–4 weeks. Kaplan–Meier analysis demonstrated a favorable association between receipt of PIPAC and OS (median, 11.3 vs 5.1 months; p = 0.036).

Conclusion
Compared with ST, PIPAC was associated with higher number of good days, reduced hospitalization burden, and longer OS without a negative impact on HRQoL with repeated PIPACs. These findings are foundational for evaluation of PIPAC in a randomized clinical trial.
Is One Plus One Always Two? Insuring Longevity Risk While Having Multiple Savings Accounts
Authors: Hurwitz Abigail , Sade Orly 
Published: September 2024

We investigate the consequences of holding multiple accounts for payout decisions at retirement. Using proprietary data of retirees’ annuitization decisions, we find that small accounts are more likely to be cashed out. We use occupation information as a proxy for wealth to disentangle income from the multiple-accounts effect. We show that individuals with high expected wages are more likely to annuitize overall but less likely to annuitize their small accounts (comparing to individuals with low wages). A laboratory experiment and an online experimental survey (with a large representative sample) suggest that the composition of multiple accounts affects the annuitization rates via the decisions regarding small versus large accounts. This paper was accepted by Camelia Kuhnen, finance. Funding: This work was supported by the Albertson-Waltuch Chair in Business Administration, the Kruger Center at the Hebrew University, the Think Forward Initiative, and the German-Israeli Foundation for Scientific Research and Development and by funding from the Center for Agriculture, Environment and Natural Resource. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.02489 .
Efficient Algorithms for a Class of Stochastic Hidden Convex Optimization and Its Applications in Network Revenue Management
Authors: Chen Xin , He Niao , Hu Yifan , Ye Zikun 
Published: September 2024

Stochastic Hidden Convex Optimization and Its Applications How to solve nonconvex optimization to global optimality is challenging and important for various applications. In “Efficient Algorithms for a Class of Stochastic Hidden Convex Optimization and Its Applications in Network Revenue Management,” Chen, He, Hu, and Ye designed three algorithms that converge to global optimality efficiently for a class of stochastic nonconvex optimization that admits implicit hidden convexity (there exists an inaccessible convex reformulation). In particular, the complexity of the proposed mirror stochastic gradient (MSG) method matches the optimal complexity of black-box first-order methods for stochastic convex optimization. The authors applied the proposed MSG algorithm to solve both passenger and air-cargo network revenue management problems considering the booking limit control policy. The extensive numerical experiments demonstrate the superior performance of MSG algorithm for booking limit control with higher revenue and lower computation cost than state-of-the-art bid-price-based control policies, especially when the variance of random capacity is large.
On (Random-Order) Online Contention Resolution Schemes for the Matching Polytope of (Bipartite) Graphs
Authors: MacRury Calum , Ma Will , Grammel Nathaniel 
Published: September 2024

Online Contention Resolution Schemes for the Matching Polytope of Graphs Online contention resolution schemes (OCRSs) are used to select a subset of elements, subject to feasibility constraints. Originally developed as a randomized rounding tool for constrained submodular optimization, OCRSs have found numerous applications in online resource allocation and stochastic optimization. This includes problems such as prophet inequalities, stochastic probing, auction design, and matching in a gig economy. In “On (Random-Order) Online Contention Resolution Schemes for the Matching Polytope of (Bipartite) Graphs,” Calum MacRury, Will Ma, and Nathaniel Grammel study OCRSs when the feasibility constraints are defined by graph matchings. The authors consider when the elements are sequentially presented in adversarial or random order, as well as when the graph is bipartite or general. In each combination of variants, the authors improve the state of the art, both in terms of algorithmic guarantees and impossibility results.
Association of Angina, Myocardial Infarction and Atrial Fibrillation-A Bidirectional Mendelian Randomization Study
Authors: Chen Lu , He Yan , Wang Ying , Liu Shijing , Li Qing , Chen Jiyu , Peng Zhiyun , Zhang Qian , Zeng Chen , Li Na , Zeng Yan , Xiong Yun , Li Wei , Zhou Haiyan 
Published: September 2024

Aims/Background Coronary heart disease (CHD) and atrial fibrillation (AF) exhibit a close relationship, yet the existing body of research predominantly relies on observational study methodologies, posing challenges in establishing causal relationships. The objective of our study is to investigate the causal linkages between coronary atherosclerosis (CAAs), angina pectoris, myocardial infarction (MI), and AF. Methods This study utilizes a two-sample Mendelian randomization (TSMR) methodology, leveraging genetic variation as a means of evaluating causality. Mendelian randomization is grounded in three primary assumptions: (1) the genetic variant is linked to the exposure, (2) the genetic variant is independent of confounding factors, and (3) the genetic variant influences the outcome solely through the exposure. Results The results of our study suggest a genetic predisposition in which CAAs, angina, and MI may enhance susceptibility to AF, while AF may reciprocally elevate the risk of CAAs. Conclusion In light of these findings, it is recommended that patients with CHD undergo regular cardiac rhythm monitoring, and that patients with AF receive anticoagulant and antiplatelet therapy whenever feasible. This study posits a practical implication for clinical practice.
Longitudinal trajectories of blood glucose and 30-day mortality in patients with diabetes mellitus combined with acute myocardial infarction: A retrospective cohort analysis of the MIMIC database
Authors: Deng Bowen , Liu Qingcheng , Qiao Liang , Lv Shun 
Published: September 2024

Background
Although blood glucose changes have been suggested to be a potential better target for clinical control than baseline blood glucose levels, the association of blood glucose changes with the prognosis in acute myocardial infarction (AMI) patients with diabetes mellitus (DM) is unclear. Herein, this study aimed to investigate association of short-term longitudinal trajectory of blood glucose with 30-day mortality in this population.

Methods
Data of AMI patients with DM were extracted from the Medical Information Mart for Intensive Care (MIMIC) database in 2003–2019 in this retrospective cohort study. The latent growth mixture modeling (LGMM) model was utilized to classify the 24-hour longitudinal trajectory of blood glucose of the patients. Kaplan-Meier (KM) curve was drawn to show 30-day mortality risk in patients with different trajectory classes. Univariate and multivariate Cox regression analyses were employed to explore the association of longitudinal trajectory of blood glucose within 24 hours after the ICU admission with 30-day mortality. Also, subgroups analysis of age, gender, and AMI types was performed. The evaluation indexes were hazard ratios (HRs) and 95% confidence intervals (CIs).

Results
Among 1,523 eligible patients, 227 (14.9%) died within 30 days. We identified 4 longitudinal trajectories of blood glucose, including class 1 (a low initial average blood glucose level with steady trend within 24 hours), class 2 (a high initial average blood glucose with gently decreased trend), class 3 (the highest initial average blood glucose with rapidly decreased trend) and class 4 (a high initial average blood glucose level with the trend that increased at first and then decreased). After adjusting for covariates, an average blood glucose level of ≥200 mg/dL was linked to higher risk of 30-day mortality, comparing to that of <140 mg/dL (HR = 1.80, 95%CI: 1.23–2.63). Comparing to patients whose longitudinal trajectory of blood glucose conformed to class 1, those with class 2 (HR = 2.52, 95%CI: 1.79–3.53) or class 4 (HR = 3.53, 95%CI: 2.07–6.03) seemed to have higher risk of 30-day mortality. Additionally, these associations were also significant in aged ≥60 years old, female, male, NSTEMI, and STEMI subgroups (all P<0.05).

Conclusion
A low level of average blood glucose at the ICU admission or reducing blood glucose to a normal level quickly with adequate measures in 24 hours after ICU admission may be beneficial for AMI patients with DM to reduce the risk of 30-day mortality. These findings may provide some information for further exploration on appropriate range of blood glucose changes in clinical practice.
Development of a breast cancer risk assessment and primary prevention pathway for women aged 30–39 years: Views of UK primary care providers on the role of primary care
Authors: Hindmarch Sarah , Gorman Louise , Usher-Smith Juliet A. , Woof Victoria G. , Howell Sacha J. , French David P. 
Published: September 2024

Background
Identifying women aged 30–39 years at increased risk of developing breast cancer would allow them to receive screening and prevention offers. For this to be feasible, the practicalities of organising risk assessment and primary prevention must be acceptable to the healthcare professionals who would be responsible for delivery. It has been proposed that primary care providers are best placed to deliver a breast cancer risk assessment and primary prevention pathway. The present study aimed to investigate a range of primary care provider’s views on the development and implementation of a breast cancer risk assessment and primary prevention pathway within primary care for women aged 30–39 years.

Methods
Twenty-five primary care providers working at general practices in either Greater Manchester or Cambridgeshire and Peterborough participated in five focus groups (n = 18) and seven individual interviews. Data were analysed thematically and organised using a framework approach.

Results
Three themes were developed. Challenges with delivering a breast cancer risk assessment and primary prevention pathway within primary care highlights that primary care are willing to facilitate but not lead delivery of such a pathway given the challenges with existing workload pressures and concerns about ensuring effective clinical governance. Primary care’s preferred level of involvement describes the aspects of the pathway participants thought primary care could be involved in, namely co-ordinating data collection for risk assessment and calculating and communicating risk. Requirements for primary care involvement captures the need to provide a training and education package to address deficits in knowledge prior to involvement. Additionally, the reservations primary care have about being involved in the management of women identified as being at increased risk are discussed and suggestions are provided for facilitating primary care to take on this role.

Conclusions
Despite optimism that primary care might lead a breast cancer risk assessment and primary prevention pathway, participants had a range of concerns that should be considered when developing such a pathway.