bluuebunny/crossref_metadata_2025_split huggingface dataset:
Veno‐venous extracorporeal membrane oxygenation for severe COVID‐19 associated acute respiratory distress syndrome: A retrospective, nationwide, Danish cohort study
Authors: Pedersen Finn Møller , Grønlykke Lars , Eschen Camilla Tofte , Adelsten Janne , Madsen Søren Aalbæk , Sørensen Marc , Gjedsted Jakob , Møller‐Sørensen Peter Hasse , Nielsen Jonas , Christensen Steffen , Nielsen Dorthe Viemose , Jørgensen Vibeke Lind 
Published: October 2024

AbstractBackgroundSevere acute respiratory syndrome (ARDS) may require veno‐venous extracorporeal membrane oxygenation (V‐V ECMO). The aim of this study was to provide data on patient selection and outcome in a nationwide cohort study of patients with COVID‐19 associated ARDS supported with V‐V ECMO.MethodsWe identified all patients with COVID‐19, who were supported with V‐V ECMO in Denmark from March 10, 2020, to December 31, 2021, and retrieved data on patients who were referred to‐ and accepted for ECMO, demographics, outcome data, and complications. Risk factors for mortality were analysed using multivariate Cox regression analysis.ResultsDuring the study period, 1836 patients were admitted to Danish intensive care units (ICUs). In the same period, there were 197 enquiries for ECMO of whom 118 patients were considered eligible. Overall, 71 patients were cannulated for ECMO; three patients were cannulated for veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) due to right sided heart failure and 68 patients were cannulated for V‐V ECMO. Two patients accepted for V‐V ECMO died during cannulation. The median age was 55 years (IQR 45–60) and 66% were males. The median duration of ECMO support was 13 days (IQR 7–21), mechanical ventilation median 26 days (IQR 14–42), ICU stay median 34 days (IQR 17–46), and length of hospital stay median 41 days (IQR 25–56). Ninety‐day mortality was 43%. Age of 60 years or more was associated with an increased risk of mortality. Pre‐existing hypertension was associated with a decreased risk of mortality.ConclusionA nationwide, Danish cohort study of 68 COVID‐19 patients supported with V‐V ECMO, showed a 90‐day survival of 43%, which is in accordance with reports from comparable cohorts. Age of 60 years or more was associated with an increased risk of mortality. Pre‐existing hypertension was associated with a decreased risk of mortality.
Accuracy of estimating equations for the assessment of glomerular filtration rate in critically ill patients versus outpatients
Authors: Kiss Katalin , Saeed Aso , Ricksten Sven‐Erik , Bragadottir Gudrun 
Published: October 2024

AbstractBackgroundEstimating equations for the assessment of glomerular filtration rate (GFR) have been poorly investigated in the critical care setting. We evaluated the agreement between the GFR measured with 51CrEDTA/iohexol (mGFR) and four estimating equations based on serum concentrations of creatine and/or cystatin C (eGFR) in two cohorts: critically ill patients and outpatients with normal‐to‐moderately reduced GFR.MethodsForty‐three patients in the critical care group and 48 patients in the outpatient group were included. GFR was measured (mGFR) by plasma infusion clearance of 51Cr‐EDTA/iohexol (critical care group) and the single injection, one‐sample plasma 51Cr‐EDTA clearance technique (outpatients). The following estimating equations (eGFR) were used: the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equation for creatinine (CKD‐EPICr), cystatin C (CKD‐EPICys C), creatinine+cystatin C (CKD‐EPICr + Cys C) and the Lund‐Malmö creatinine+cystatin C equation (LMCr + Cys C). Agreement between mGFR and eGFR was assessed by the Bland–Altman method and accuracy by calculating P30 and P10.ResultsIn the critically ill group, the bias between the estimating equations and mGFR was −3.6 to 2.8 mL/min/1.73 m2, while the error was 121%–127% and the accuracy (P30) 33%–40%. In the outpatients, the bias between the estimating equations and mGFR was −13.0 to 7.6 mL/min/1.73 m2, while the error was 31%–41% and the accuracy (P30), 67%–96%.ConclusionsAll four equations performed poorly in assessing GFR in the critically ill cohort with an unacceptably high error and low accuracy in contrast to the outpatient group. To accurately assess GFR in critically ill patients, GFR must be measured not estimated.Editorial CommentFor the assessment of glomerular filtration rate (GFR), it can be measured directly, but is frequently estimated using a point measure of serum creatinine concentration. In this study, ICU case GFR estimations, by different adjusted equations, done also for a cohort of outpatients, showed that these serum creatinine‐based estimations for ICU cases are not highly precise or reliable.
Increasing prevalence of galactose‐α‐1,3‐galactose sensitization in the Danish general adult population
Authors: Leth‐Møller Katja Biering , van Hage Marianne , Apostolovic Danijela , Sørensen Jennifer Astrup , Vestergaard Christian , Madsen Flemming , Kjær Lene Jung , Hansen Torben , Jonsson Anna , Thomsen Simon Francis , Linneberg Allan 
Published: October 2024

AbstractBackgroundAlpha‐gal syndrome is a novel food allergy to the oligosaccharide galactose‐α‐1,3‐galactose (alpha‐gal) present in mammalian meat. Tick bites are considered an important route of sensitization to alpha‐gal. Data on alpha‐gal sensitization in the general population is scant. We utilized a unique data source of repeated population‐based health examination studies to assess prevalence, time trends, risk factors, and characteristics of alpha‐gal sensitization.MethodsAlpha‐gal sensitization was assessed in >11.000 adults from four health examination studies of randomly invited residents in the Copenhagen region conducted in 1990–1991, 2011–2012, 2012–2015, and 2016–2017. Alpha‐gal sensitization was defined as serum specific IgE (sIgE) to alpha‐gal ≥0.1 kUA/L; ≥0.35 kUA/L; ≥0.7 kUA/L; ≥3.5 kUA/L. The population was characterized according to genetically determined ABO blood group, aeroallergen sensitization, and pets at home.ResultsThe prevalence of sIgE to alpha‐gal ≥0.1 kUA/L was 1.3% in 1990–1991, 3.7% in 2012–2015 and 3.2% in 2016–2017. Of those sensitized to alpha‐gal >97% reported to consume red meat at least once a week, even for sIgE to alpha‐gal ≥3.5 kUA/L. Male sex, older age, aeroallergen sensitization, cat at home, and blood group A were associated with increased odds of alpha‐gal sensitization. The known protective effect of blood group B was confirmed.ConclusionIn this general adult population, the prevalence of alpha‐gal sensitization had doubled from 1990–1991 to 2016–2017. This could potentially be due to increased tick exposure and an increased atopic predisposition.
Show and slow codes: A historical analysis of clinicians' adaptations to ethical overreach
Authors: Baker Robert 
Published: October 2024

AbstractAfter briefly reviewing the historical development and ethical regulation of resuscitative technologies, this study probes why clinicians engage in the morally problematic practice of show and slow coding and why hospitals tolerate it? Studies conducted in 1995 and 2020 indicate that conscientious clinicians engage in these practices to protect their patients from abusive or futile resuscitation. And hospitals' clinical cultures tolerate these practices to protect conscientious clinicians from censure, dismissal, delicensing, or legal prosecution for withholding or withdrawing abusive or futile resuscitative technologies without prior patient or surrogate consent. Show and slow coding evolved in American clinical cultures in the second half of the 20th century when closed‐chest cardiac massage, defibrillators, ventilators, and other resuscitative technologies raised seemingly novel ethical questions. To address these questions, bioethics commissions, healthcare societies, lawmakers, and a Roman Catholic Pope developed ethics standards requiring clinicians to obtain patient or surrogate consent before withholding or withdrawing resuscitative technologies. They thus conferred on patients an implicit right of resuscitation even if it was abusive and/or futile. Conscientious clinicians circumvented this implicit right by show and slow coding to protect patients from abusive resuscitation. Recognizing clinicians' benign intent, hospitals' clinical cultures tolerate show and slow coding as acts of conscience, akin to civil disobedience. Thus, rescinding ethics standards and laws requiring prior patient/surrogate consent for non‐resuscitation or for cessation of resuscitative technologies decisions should end show/slow coding. Such a reform should also recognize clinicians' right of conscientious refusal to perform CPR.
Comparison of HLA‐haploidentical donors with post‐transplant cyclophosphamide versus HLA‐matched unrelated donors in peripheral blood stem cell transplantation for acute myeloid leukaemia
Authors: Moriguchi Makoto , Nakamae Hirohisa , Nishimoto Mitsutaka , Sugita Junichi , Yanada Masamitsu , Toubai Tomomi , Hasegawa Yuta , Hino Masayuki , Nishida Tetsuya , Kurita Naoki , Sawa Masashi , Fukuda Takahiro , Jinguji Atsushi , Ota Shuichi , Matsuoka Ken‐ichi , Eto Tetsuya , Hiramoto Nobuhiro , Ando Toshihiko , Kawamura Koji , Kanda Yoshinobu , Atsuta Yoshiko , Ohbiki Marie , Nakasone Hideki , Konuma Takaaki 
Published: October 2024

SummaryHLA‐haploidentical haematopoietic cell transplantation with post‐transplant cyclophosphamide (PTCy‐haplo) is emerging as an effective alternative due to donor availability and safety. We conducted a nationwide retrospective study comparing the outcomes of PTCy‐haplo with both anti‐thymocyte globulin (ATG)‐free and ATG‐administered matched unrelated donors (MUD) transplantation, using peripheral blood stem cells as the first transplantation for acute myeloid leukaemia (AML). Our study showed a lower and slower haematopoietic recovery and a higher incidence of infection‐related deaths after PTCy‐haplo than after MUD transplantation. In addition, we revealed an increased risk of acute and chronic graft‐versus‐host disease (GVHD) in ATG‐free MUD transplantation in comparison to PTCy‐haplo. For grades III–IV acute GVHD, the hazard ratio (HR) was 2.71 (95% CI, 1.46–5.01), and for extensive chronic GVHD, the HR was 3.11 (95% CI, 2.07–4.68). There was no significant difference regarding overall survival amongst the groups. In addition, GVHD‐free relapse‐free survival (GRFS) was lower in ATG‐free MUD transplantation than in PTCy‐haplo (HR, 1.46; 95% CI, 1.17–1.82). Notably, ATG‐administered MUD transplantation showed no significant difference in GRFS from PTCy‐haplo, negating the advantage of PTCy. Our results suggest that PTCy‐haplo could be viable for AML patients without an HLA‐matched related donor.
Association of Radioactive Iodine Administration With Outcome Among Patients With Low‐Risk Differentiated Thyroid Cancer: A Real‐World Data Analysis
Authors: Xu Yang , Huang Peiyin , Wang Liying , Ke Najun , Guo Fangting , Su Lijia , Shen Qingbao , Lin Tintin , Huang Kunzhai , Zhang Yi , Xiao Fangsen 
Published: October 2024

ABSTRACTObjectiveDespite the generally favourable long‐term prognosis of low‐risk differentiated thyroid cancer (DTC), questions remain about disease‐free survival (DFS) after initial treatment, particularly regarding the use of radioactive iodine (RAI). Although there are RCT trial confirming that RAI ablation therapy is not superior to follow‐up in terms of the 3‐year DFS rate in low‐risk thyroid cancer, its longer‐term prognosis remains to be established. The objective of this study was to assess the impact of RAI ablation on the presence of structural persistent/recurrent disease in patients with low‐risk DTC.MethodsWe retrospectively identified 720 low‐risk DTC patients who had undergone total or near‐total thyroidectomy (TT) at a tertiary medical centre between January 2008 and July 2018. Propensity scores were calculated using a multivariable logistic regression model that accounted for age, sex, tumour size, neck dissection, multifocality, capsular invasion and lymph node (LN) metastasis. We compared DFS between patients who received RAI and those who did not using log‐rank tests and multivariate Cox analyses. Subgroup analyses were also conducted.ResultsOf the total cohort, 180 (25.0%) patients received RAI, while 540 (75.0%) did not before matching. The median follow‐up duration was 59.5 months. After matching, the RAI group comprised 135 (39.8%) patients and the non‐RAI group comprised 204 (60.2%) patients. In the entire cohort, the 5‐year DFS rate was 97.6% for patients receiving RAI compared to 96.8% for those not receiving RAI (p = 0.704). In the matched cohort, the rates were 98.5% and 95.6%, respectively (p = 0.090). Matched multivariate Cox analysis demonstrated that RAI was neither significantly nor independently associated with DFS (hazard ratio [HR] = 0.29; 95% CI 0.06–1.37; p = 0.118). Further subgroup analyses reaffirmed that RAI ablation did not significantly reduce the risk of developing structural persistent/recurrent disease.ConclusionAdministering RAI ablation following TT did not result in improved DFS for low‐risk DTC patients. Our findings suggest that decisions regarding RAI should be made judiciously to avoid overtreatment in this clinical scenario.
Screen Time, Nature, and Development: Baseline of the Randomized Controlled Study “Screen‐free till 3”
Authors: Schwarz Silke , Krafft Hanno , Maurer Tobias , Lange Silke , Schemmer Juliane , Fischbach Thomas , Emgenbroich Anke , Monks Sean , Hubmann Michael , Martin David 
Published: October 2024

ABSTRACTIn the first years of life, increased screen media use is presumably associated with health consequences and developmental impairments. “Screen‐free till 3” is a prospective Germany‐wide randomized intervention study, started in May 2022 with a duration of 3 years. In the intervention group, 2581 pediatric practices received stickers, which were systematically placed in the screening booklet of all children, along with advice to parents to keep children free from screens until the age of 3. A volunteer sample of 17,436 parents received an invitation to take part in the preinterventional questionnaire. The outcomes were parents' internet use (CIUS test), parental screen time in the presence of children, time of screen media in the background, and children's development. Four thousand twenty‐one parents answered the questionnaire. 16.7% of mothers and 31.0% of fathers reached the CIUS score of an internet‐related disorder. Parents whose children use screen media at an early age had significantly higher CIUS values on average (M = 4.07) than the parents of children who do not yet have any screen time (p < 0.001). Combined developmental characteristics show a negative correlation with parental screen time (p < 0.001). Time spent in nature was positively associated with development (p < 0.001). The evaluation of the survey shows that screen media is to a large extent used on a daily basis. The study confirms the assumption that high screen media use by parents is linked to higher screen media use by children and also has a negative impact on child development.Trial Registration: Number: RKS00032258; https://drks.de/search/en/trial/DRKS00032258
Breaking from the past? Environmental narratives, logics of power, and the (re)production of food insecurity in South Sudan
Authors: Sennesael Francois , Verhoeven Harry 
Published: October 2024

AbstractSkyrocketing commodity prices and conflict‐induced mass hunger in recent years have resuscitated discussions about why famines frequently reoccur in specific spaces of vulnerability. Intervention efforts still too often isolate food (in)security from its interwovenness in the political economy of water and energy and from the role of ideas in forging these interconnections across long time periods. Using (South) Sudanese history to rethink the causes of recurrent food insecurity, we underscore the need to analyse how political elites imagine the role of the water–energy–food nexus and associated environmental narratives in consolidating power. South Sudan's 2011 secession (from Sudan) marked the culmination of a struggle against a state that insurgents regarded as having starved its citizens. However, since independence, its leaders have replicated the nostrum they once combatted: Sudanese resources must ‘feed the world’. A fixation with inserting water, energy, and food resources into global markets infuses their strategy, even if such an approach will not engender food abundance.
Evidence‐Based Data on the Diagnostic Role and Clinical Usefulness of [18F]FDG PET/CT in Endocarditis and Cardiac Device Infections
Authors: Caporali Elena , Paone Gaetano , Moschovitis Giorgio , De Perna Maria Luisa , Lo Priore Elia , Bernasconi Enos , Pedrazzini Giovanni , Treglia Giorgio 
Published: October 2024

ABSTRACTInfective endocarditis and infection of cardiac devices are conditions characterized by high morbidity and mortality, thus requiring a prompt diagnosis. Advanced imaging modalities are often required in the management of infectious endocarditis according to guidelines. The aim of this review is to collect and describe evidence‐based knowledge about the diagnostic role and clinical usefulness of [18F]FDG PET/CT in endocarditis and cardiac device infections based on published systematic reviews and meta‐analyses on this topic and on recent guidelines. [18F]FDG PET/CT is recommended only in selected cases. This imaging method has good diagnostic accuracy in detecting prosthetic valve endocarditis and cardiac device infection. Furthermore, it can identify extra‐cardiac infectious foci changing the clinical management in a significant percentage of cases.
Teacher‐Student Rapport: An Essential Mediator in Creating a Learning Climate Conducive to Psychological Well‐Being of Chinese Students
Authors: Cao Yue 
Published: October 2024

ABSTRACTThe success of students is closely tied to their well‐being and those students with high degrees of well‐being are more likely to excel in academic environments. Accordingly, the internal and external factors that cause positive changes in students' mental states and lead them to higher levels of psychological well‐being (PWB) need to be divulged. In response to this necessity, many scholars have explored the internal and external predictors of students' PWB such as teacher–student rapport (TSR) and learning climate in different educational domains. To narrow these gaps, this research inspects the role of TSR as a mediator in creating a learning climate conducive to PWB of Chinese Students. To do so, three scales were given to 588 Chinese students, among them 560 were valid. Then, structural equation modelling (SEM) was performed to analyse participants' answers. The results disclosed strong and close connections between TSR, learning climate and students' PWB. The results also uncovered that TSR was a significant mediator between learning climate and PWB. The outcomes of this investigation might be illuminating for teachers, teacher trainers and educational managers.
Hymer and the theory of the MNE: A commentary by John Cantwell
Authors: Cantwell John 
Published: October 2024

AbstractThis article provides a commentary on the paper by Pitelis and Piteli on Hymer as the pioneer of the theory of the multinational enterprise (MNE). I suggest that Stephen Hymer and his contemporary, John Dunning, also laid the foundation for an analysis of an international business (IB) system, which reaches well beyond the theory of the MNE and its strategy. I argue firstly that early IB theories, including Hymer's, which emerged from the late 1950s onwards, mostly had a holistic view of the IB system, of which the MNE was just one element. Secondly, I contend that both Hymer and Dunning developed from the outset some seminal ideas on the interrelationships that exist between the MNE and its strategy, on the one hand, and the wider economic and social environment in which firms are embedded, on the other. I suggest that Dunning's eclectic paradigm was intended as a framework for the study of the IB system in its entirety as a complex, relational system. Thirdly, while Hymer's ideas on cross‐border geographic hierarchy, uneven development and IB were highly original and remain relevant today, they need to be substantially updated and revised in the current IB context, as opposed to the context which prevailed in the IB system of the 1950s through to the 1970s.
A deep‐learning‐based histopathology classifier for focal cortical dysplasia (FCD) unravels a complex scenario of comorbid FCD subtypes
Authors: Vorndran Jörg , Blümcke Ingmar 
Published: October 2024

AbstractObjectiveRecently, we developed a first artificial intelligence (AI)‐based digital pathology classifier for focal cortical dysplasia (FCD) as defined by the ILAE classification. Herein, we tested the usefulness of the classifier in a retrospective histopathology workup scenario.MethodsEighty‐six new cases with histopathologically confirmed FCD ILAE type Ia (FCDIa), FCDIIa, FCDIIb, mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy (MOGHE), or mild malformations of cortical development were selected, 20 of which had confirmed gene mosaicism.ResultsThe classifier always recognized the correct histopathology diagnosis in four or more 1000 × 1000‐μm digital tiles in all cases. Furthermore, the final diagnosis overlapped with the largest batch of tiles assigned by the algorithm to one diagnostic entity in 80.2% of all cases. However, 86.2% of all cases revealed more than one diagnostic category. As an example, FCDIIb was identified in all of the 23 patients with histopathologically assigned FCDIIb, whereas the classifier correctly recognized FCDIIa tiles in 19 of these cases (83%), that is, dysmorphic neurons but no balloon cells. In contrast, the classifier misdiagnosed FCDIIb tiles in seven of 23 cases histopathologically assigned to FCDIIa (33%). This mandates a second look by the signing histopathologist to either confirm balloon cells or differentiate from reactive astrocytes. The algorithm also recognized coexisting architectural dysplasia, for example, vertically oriented microcolumns as in FCDIa, in 22% of cases classified as FCDII and in 62% of cases with MOGHE. Microscopic review confirmed microcolumns in the majority of tiles, suggesting that vertically oriented architectural abnormalities are more common than previously anticipated.SignificanceAn AI‐based diagnostic classifier will become a helpful tool in our future histopathology laboratory, in particular when large anatomical resections from epilepsy surgery require extensive resources. We also provide an open access web application allowing the histopathologist to virtually review digital tiles obtained from epilepsy surgery to corroborate their final diagnosis.