bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological Temporal Trends of Opportunistic Infections and Mortality Rates Among Hospitalized HIV/AIDS Patients: A Retrospective Study in Beijing, China (2012-2022)
Authors: Xu Manman , Ji Shan , Li Tongzeng 
Published: October 2024

Abstract

HIV-associated opportunistic infections (OIs) continue to pose significant challenges in the management of HIV/AIDS patients, influencing hospitalization rates and mortality outcomes. This retrospective study aimed to assess the spectrum of OIs and epidemiological temporal trends among inpatient HIV/AIDS cases at Beijing You'an Hospital from 2012 to 2022.Clinical data of HIV-infected inpatients were analyzed to evaluate the prevalence of OIs, incidence rates, and mortality rates associated with these infections over an 11-year period.Among 10,316 hospitalized HIV/AIDS patients, tuberculosis (18.3%) and Pneumocystis pneumonia (PCP) (15.3%) were the most common OIs. Over time, a significant decline in the incidence of PCP (from 23.8% in 2012 to 14.7% in 2022, p < 0.05) and tuberculosis (from 23.8% to 7.4%) was observed. Conversely, the incidence of nontuberculous mycobacterial (NTM) infections increased (from 0.3% to 2.7%, p < 0.01). Overall in-hospital mortality rate among HIV patients decreased from 5.5% to 2.1% (p < 0.05) during the study period, with a notable decline in PCP-associated mortality (from 9.2% to 4.1%). The study highlights shifting trends in the epidemiology of OIs among hospitalized HIV/AIDS patients, attributed partly to the widespread use of antiretroviral therapy. Despite declining mortality rates overall, PCP remains a significant contributor to in-hospital mortality among HIV-infected individuals, emphasizing the ongoing need for targeted interventions in managing these infections.
Sleeve Resection of the Bronchus, Pulmonary Artery, and Superior Vena Cava Reconstruction for Locally Advanced Non-Small Cell Lung Cancer: A Single-Center Retrospective Study
Authors: Huang Kai-li , Li Pengfei , Qiang Wu , Wen Li , Tang Xiaojun , Zhou qinghua 
Published: October 2024

Abstract

Background
Combined sleeve resection of the bronchus, pulmonary artery (PA), and reconstruction of the superior vena cava (SVC) is occasionally indicated in the treatment of non-small cell lung cancer. However, simultaneous reconstruction of the SVC, sleeve resection of the bronchus and PA for right upper lobe central-type lung cancers presents significant technical challenges for surgeons. In this study, we describe our experience with this surgical procedure and the associated clinical outcomes.
Methods
From 31st January 2014 to 30th December 2023, 15 patients confirmed with non-small cell lung cancer (NSCLC) who underwent SVC resection combined with sleeve resection of the bronchus and/or PA following induction treatment were enrolled in this stuy. The surgical approaches employed included mid-sternal incision in 4 patients (26.7%), right posterolateral thoracotomy in 6 patients (40%), and two-step surgical approach (initially via a mid-sternal incision followed by a right posterolateral thoracotomy) in 5 cases (33.3%). Among these patients, 7 (46.7%) cases underwent simultaneous SVC reconstruction and double sleeve resection (bronchus and PA), 3 (20%) underwent simultaneous SVC reconstruction and double sleeve resection (bronchus and PA) with carina reconstruction, 4 (26.7%) underwent simultaneous SVC reconstruction and bronchus sleeve resection, and 1 (6.7%) underwent SVC reconstruction and PA plasty. Systemic lymphadenectomy was performed in all patients.
Results
All resections were completely resectable (R0). Histological analysis revealed 7 patients (46.7%) were adenocarcinoma and 8 (53.3%) patients were squamous cell carcinoma. Besides, 1 (6.7%) patient was classified as stage pT4N0M0-IIIA, 12 (80%) patients as stage pT4N2M0-IIIB, and 2 (13.3%) patients as stage pT4N3M0-IIIC. No perioperative deaths occurred. The major complication rate was 40% after surgery. The median follow-up duration was 29 months, and the overall survival rates at 1, 3, and 5 years were 80%, 28.6%, and 28.6%, respectively.
Conclusions
Combined resections of the bronchus, PA and SVC are technically feasible and safe for patients with locally advanced NSCLC. For carefully selected patients, this extended resection surgery may lead to favorable long-term survival.
Thumb Metacarpal Reconstruction for Giant Cell Tumor of Bone Using Tricortical Iliac Crest Autograft: A Case Report
Authors: Bohlen Hunter L. , Smith Eric , Lee David , Stitzlein Russell , Rafijah Gregory 
Published: October 2024

Abstract

Background
Giant cell tumor of bone is a benign, aggressive tumor. Giant cell tumor of bone typically presents within the metaphysis/ epiphysis of long bones, however in 1.7-4% of cases, it is found in the hand, with metacarpal involvement in 14.5% of hand cases. Treatment for giant cell tumor of bone ranges from curettage and grafting to wide excision, reconstruction, and amputation in severe cases. Given the morbidity associated with wide excisions of the hand, and the importance of the hand for daily function, advances in reconstructive techniques.
Case Report
This report describes a 19-year-old male with GCTB of the entire thumb metacarpal, treated with a unique one stage wide excision followed by metacarpal reconstruction using a tricortical iliac crest autograft. Using a dorsal approach, the mass was resected. A tricortical iliac crest autograft was harvested and contoured to fit the metacarpal defect. After decortication of the trapezial and proximal phalanx articular surfaces, the graft was fixed to the distal trapezium and proximal phalanx base using two locking plates to achieve fusion of the carpometacarpal and metacarpophalangeal joints.
Conclusions
Here we present a focused discussion of treatment considerations for this complicated problem given the importance of the thumb and increased forces across the metacarpophalangeal joint in a young laborer. At 13-month follow up, radiographs demonstrated complete graft incorporation with stable hardware. The patient achieved functional range of motion and grip strength, allowing him to return to work as a laborer without restriction. This technique is a novel, reproducible option for patients with tumors requiring wide resection and reconstruction of the thumb, as the contour of the iliac crest closely matches that of the thumb metacarpal.
Application and effectiveness of blended learning in medical imaging via the technology acceptance model
Authors: Sun Xiaofen , Wan Jianghua , Li Zhiqun , Tu Rong , Lin Juan , Li Xiaohua , Chen Jianqiang 
Published: October 2024

Abstract

Blended learning, a combination of online learning and face-to-face instruction, is becoming an increasingly important component of higher education technology. However, there is currently insufficient research addressing students' perceptions of blended learning. Our study aims to investigate the satisfaction and behavioral intentions of students with blended learning in medical imaging. We employed the Technology Acceptance Model (TAM), which includes four independent variables, to evaluate students' satisfaction and behavioral intentions toward blended learning. The data were collected through the TAM survey, with questionnaires randomly distributed to the students participating in the "Medical Imaging" blended course at Hainan Medical University. A total of 145 valid questionnaires were returned and analysed via SPSS and Smart-PLS 3.3.3. Detailed results. Our results indicate that the practical application of blended learning has a positive and constructive impact and is worth promoting in higher education institutions. The empirical findings could also contribute to the integration of the TAM model to increase the effectiveness of blended learning for students.
Identification of benign from malignant small renal tumors: Is there a possible role of T1 mapping?
Authors: Zhong Lianting , Lian Danlan , Ding Yuqin , Guo Jiefeng , Lin Weifeng , Qu Xiaobo , zhou jianjun 
Published: October 2024

Abstract

Background: Differentiating benign from malignant small renal tumors can help to guide clinical decision-making. T1 mapping enables quantitative assessment of T1 relaxation time and may help to evaluate tumor properties. This study aimed to investigate the possible utility of T1 mapping for quantificationally distinguishing benign from malignant small solid renal tumors.
Methods: The data set used in this retrospective study, consisting of 99 patients with 99 small renal masses (≤4 cm). 78 malignant small renal tumors and 21 benign tumors respectively. Quantitative variables (including pre- and post- T1 mapping) were calculated and compared between different renal tumors. The clinical features and image qualitative characteristics were recorded accordingly. Univariate and multivariate logistic regression models were used to identify independent influencing factors. The diagnostic accuracy of independent influencing factors was represented with the area under the receiver operating characteristic curve (AUC).
Results: The pre-contrast T1 mapping (T1) and the ratio of T1 reduction in malignance were higher than those in benign small renal tumors, while post-contrast T1 mapping was lower (all P < 0.025). In the multivariable logistic regression, the patient’s gender (odds ratio (OR) = 4.987, P = 0.008), patient’s age (OR = 2.026, P = 0.020), and T1 (OR = 3.652, P = 0.001) were independent predictors. For the identification of benign renal tumors, the T1 demonstrated moderate diagnostic efficiency with an AUC of 0.697 (0.596-0.785), a sensitivity of 51.28%, and a specificity of 100% (P < 0.000). The T1+ gender + age model achieved an AUC of 0.832 (0.743-0.899), a sensitivity of 60.26%, and a specificity of 95.26%.
Conclusion: Quantitative T1 mapping parameters may provide an added value in noninvasively distinguishing small benign renal tumors from renal cell carcinoma (RCC).
Blood transcriptomic analysis reveals novel hub gene pathways associated with serum galactose-deficient IgA1 level in IgA nephropathy
Authors: Liu Youxia , Li Hongfen , Wang Fanghao , Xing Yue , Jia Junya , Yan Tiekun 
Published: October 2024

Abstract

Background
We sought to identify the differentially expressed genes (DEG) and biological pathways in blood B cells involved in the production of galactose-deficient IgA1 (Gd-IgA1) levels in IgA nephropathy (IgAN).
Methods
Deep sequencing on RNA isolated from B cells was used for microarray validation. The relationship between target mRNA expressions and Gd-IgA1 levels in serum were also studied.
Results
The mean Gd-IgA1 level in the high Gd-IgA1 group was 12.377 ± 2.081 µg/mL, while in the low Gd-IgA1 group, it was 3.876 ± 1.636 µg/mL. We identified a total of 5,319 DEGs in our analysis, with 3,863 genes showing upregulation and 1,456 genes showing downregulation in the high Gd-IgA1 group compared to the low Gd-IgA1 group. GO enrichment analysis showed the upregulated genes in the high Gd-IgA1 group were predominantly associated with processes such as platelet degranulation, blood coagulation, hemostasis, platelet activation, and platelet aggregation. Additionally, KEGG pathway analysis revealed that the upregulated genes in the high Gd-IgA1 group were notably enriched in several key pathways, including platelet activation, gap junction, focal adhesion, ECM-receptor interaction, and the Rap1 signaling pathway. Functional analysis suggested that IgAN patients with high Gd-IgA1 levels exhibited platelet activation. Furthermore, we explored the association between CD62P expression in platelet and Gd-IgA1 levels in patients with IgAN. Our findings revealed that patients with higher CD62P expression also had higher levels of Gd-IgA1. By comparing our transcriptomic data with positional candidate genes identified in these GWAS, we identified 9 overlapping genes. Among the overlapping genes upregulated in the high Gd-IgA1 group were ITGAX, FCRL3, TNFRSF13, RELA, and DEFA1.
Conclusions
The results demonstrate that dysregulated genes in the blood cells of patients with high Gd-IgA1 levels in IgAN are enriched in pathways related to platelet activation. This finding suggests that activated platelets may play a crucial role in the mechanisms underlying the increased production of Gd-IgA1 in IgAN.
Air Embolism Prevention in ECMO Systems: An in Vitro Study on CVC Lumen Protection
Authors: Franco Danilo , Krašna Nejc , Novak Robert , Esposito Giovanni , Izzo Raffaele , Belohlavek Jan , Noc Marko , Goslar Tomaz 
Published: October 2024

Abstract

Air embolism can complicate extracorporeal membrane oxygenation (ECMO), as the negative pressure in the venous system can unintentionally draw in air. This air can disrupt pump function or enter the patient through the oxygenator, resulting in systemic air embolism. To examine this risk, a circuit model was created to study air entry through the central venous catheter (CVC) and its impact on ECMO performance at varying pump speeds in a veno-venous configuration. The research revealed that the unprotected lumen of the CVC is a potential air entry point. A closed three-way stopcock or clave effectively protects against this risk. Importantly, even small amounts of air produce a distinct hissing sound, serving as an early warning sign. At a pump speed of 4500 revolutions per minute (rpm), just 1 ml of air can pass through the oxygenator into the arterial portion, and 25 ml of air can halt the pump entirely. In conclusion, safeguarding the CVC with appropriate valves and being attentive to sounds in the circuit are critical measures to prevent air embolism during ECMO.
Surgical Parameters Affecting Procedure Duration of Hysteroscopic Fibroid Resection: Results of a Retrospective Longitudinal Study
Authors: Riemma Gaetano , Vitale Salvatore Giovanni , Lipták Márton György , Ciebiera Michal , Boldogh Bence Zoltán , Mereu Liliana , Kovács Kincső Sára , Török Péter 
Published: October 2024

Abstract

Purpose
To identify and analyze the main surgical parameters affecting the operative time of hysteroscopic fibroid resection.
Methods
This retrospective observational study included 65 cases of outpatient hysteroscopic fibroid resection performed between March 2021 and May 2023 in outpatient office setting. Patients aged 18–50 with various indications such as infertility, recurrent pregnancy loss, or abnormal uterine bleeding (AUB) were included. The operative time, fibroid size, FIGO classification, and fibroid localization were recorded and analyzed using ANOVA, chi-square test, and linear regression models.
Results
The average operative duration for all surgeries was 557.41 (± 449.52) seconds. A significant correlation between fibroid size and operative time was found in FIGO 0 (p = 0.0003) and FIGO 1 (p < 0.0001) subgroups, with weaker correlation in FIGO II (p = 0.039). FIGO I surgeries took significantly longer than FIGO 0 (p = 0.044), and fundal fibroids were associated with longer operative times compared to posterior fibroids (p = 0.0329).
Conclusion
The size and FIGO classification of fibroids significantly influence operative time during hysteroscopic resection. Smaller and more accessible fibroids (FIGO 0 and 1) are resected faster than those embedded deeper in the uterine wall (FIGO 2). Detailed preoperative evaluation of fibroid characteristics can better predict operative time, aiding in patient preparation and optimized analgesia and perioperative planning as well as optimizing the use of operating theater. Further studies with larger sample sizes are recommended to validate these findings and explore additional influencing factors.
Predictors of failure to rescue in surgical rescue
Authors: Ogawa Katsuhiro , Miyamoto Yuji , Hisano Yuki , Maeda Yuto , Ohuchi Mayuko , Hiyoshi Yukiharu , Ida Satoshi , Iwatsuki Masaaki , Baba Yoshifumi , Baba Hideo 
Published: October 2024

Abstract

Purpose: To determine the current status of surgical rescue (SR) and examine the predictors of failure to rescue (FTR). In acute care surgery, predictors of FTR have only been reported in patients with trauma, not in SR.
Methods: This retrospective study included 142 patients who underwent emergency surgery at our institution between April 2019 and March 2023. The primary outcome was the identification of the FTR predictors using logistic regression analysis. The secondary outcome was the development of a Surgical Rescue Severity Score (SRSS) using these SR predictors and long-term outcomes.
Results: The patients were divided into survival and mortality groups (122 and 20, respectively). American Society of Anesthesiologists Physical Status (ASA-PS) and quick sequential organ failure assessment (qSOFA) scores were higher in the mortality group. In contrast, the survival group included more cases of SR necessitated by surgical treatment. In multivariate analysis, ASA-PS ≥ 3 (odds ratio [OR], 5.3; 95% confidence interval [CI] 1.2–36), complications caused by non-surgical therapy (OR, 5.5; 95% CI 1.8–19), and qSOFA score ≥ 2 (OR, 4.5; 95% CI 1.3–17) were independent prognostic factors. The total risk factors for FTR obtained in the multivariate analysis were calculated and established as the SRSS. The long-term prognosis of SR was examined and stratified by the SRSS (P = 0.0001).
Conclusion: Predictors of FTR in SR were ASA-PS ≥ 3, qSOFA score ≥ 2, and complications caused by non-surgical therapy. The SRSS stratified the short- and long-term prognoses of SR and predicted prognoses preoperatively.
Transbronchial Lung Cryobiopsy for Interstitial Lung Disease: Early Experience, Learning Curve, and the Impact of Sedation on Complication Rates at a Single Centre in Japan
Authors: Kaburaki Shota , Tanaka Toru , Kamio Koichiro , Tanaka Yosuke , Kasahara Kazuo , Seike Masahiro 
Published: October 2024

Abstract

Background
Transbronchial lung cryobiopsy (TBLC) has emerged as a promising diagnostic tool for interstitial lung disease (ILD). This study aimed to assess the initial experience, procedural learning curve, and influence of sedative medications on complication rates, particularly bleeding and pneumothorax, in the implementation of a TBLC program for ILD diagnosis.
Methods
In this retrospective cohort study, we analysed 119 patients who underwent TBLC at Nippon Medical School Hospital from April 2021 to March 2024. Procedural times, complication rates, and histopathological outcomes were evaluated. The learning curve was assessed using cumulative sum (CUSUM) analysis, focusing on procedure time and biopsy yield. The association between sedative medication dosages and bleeding risk was also examined.
Results
The overall diagnostic yield was high, with alveolar tissue obtained in 97.5% of cases and a definitive pathological diagnosis achieved in 81.5% of patients. CUSUM analysis revealed a proficiency threshold at approximately 56 cases, with improved efficiency and biopsy yield in the consolidation phase. Fentanyl dosage was significantly associated with reduced bleeding complications (OR 0.51, 95% CI 0.27–0.97, p = 0.041).
Conclusions
TBLC is a safe and effective diagnostic tool for ILDs, with a manageable learning curve for procedural efficiency. Sedation, particularly fentanyl dosage, plays a crucial role in minimizing complications. These findings support the adoption of TBLC as a standard diagnostic approach for ILD and highlight the importance of adequate training and optimized sedation protocols to ensure safety and efficacy in clinical practice.
Demographic and clinical features of extremity crush injuries resulting from entrapment under the rubble: An orthopedic perspective
Authors: Gümüşoğlu Ender , Asfuroğlu Zeynel Mert , Eskandari Metin Manouchehr 
Published: October 2024

Abstract

Background:
We aimed to contribute to the literature by reporting the demographic and clinical characteristics of patients who suffered extremity crush injuries as a result of being trapped under rubble following the earthquake that occurred in Turkey on February 6, 2023.
Methods:
In total, 65 patients, including 33 females and 32 males, were enrolled. The mean age of the patients was 32.2 ± 20.45 years. Patients were categorized into four treatment groups, including nonoperative (n = 13), fasciotomy/debridement (n = 20), fracture fixation (n = 5), and amputation (n = 27) groups. Demographic and clinical information were analyzed.
Results:
The lower extremities were the most frequently affected anatomical regions. Upon hospital admission, all patients exhibited significant elevations in serum potassium and creatinine kinase levels; however, these levels decreased significantly within 24 h of the initiation of operative or nonoperative treatment (p < 0.05). The rate of crush syndrome development was 54%, 60%, and 59% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. Similarly, the rate of hemodialysis was 15%, 35%, and 22% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. The reoperation rate was 75% and 30% in the fasciotomy/debridement and amputation groups, respectively. Furthermore, the incidence of infection was 40% in fracture fixation group, 40% in the fasciotomy/debridement group, and 33% in the amputation group. The mortality rate was 5% in the fasciotomy/debridement group and 7% in the amputation group. The mean duration of hospitalization for all treatment groups was 10.9 ± 10.41 days, with the fasciotomy/debridement group having the longest duration of hospitalization (14.5 ± 9.8 days).
Conclusion:
During the acute treatment phase, a significant increase in crush syndrome and wound infection rates, accompanied by a greater need for hemodialysis and prolonged hospitalization, were frequently observed. We hypothesize that the findings of studies on earthquake-related experience could provide a reference for future investigations.
Effect of Western-based and five-element music therapy on patients undergoing maintenance hemodialysis: study protocol for a randomized controlled trial
Authors: Zhang Jing-yi , Wu Wen-min , Zhang Li-ping , Zhou Su-jin , Ye Xuan-ying , Zeng Hui-ping , Gao Yun 
Published: October 2024

Abstract

Background
Music therapy has emerged as a significant complementary approach to psychotherapy. However, due to the intricate interplay between music and culture, the comparative effectiveness of five-element music therapy and Western music therapy for Chinese patients undergoing maintenance hemodialysis warrants further investigation.
Methods
In this prospective randomized controlled trial, 87 patients on maintenance hemodialysis will be recruited and randomly assigned in a 1:1:1 ratio to the five-element music group, Western music group, and control group. Participants in the Five-element music group and Western music group will receive eight weeks of five-element music therapy and Western music therapy, respectively, for 60 min per session, three times per week. All outcome indicators will be measured at baseline, week 4 of the intervention, week 8 of the intervention, and after a follow-up period of 4 weeks at the end of the intervention. The primary outcome indicator will be the Hospital Anxiety and Depression Scale (HADS). Secondary outcome indicators will include the Pittsburgh Sleep Quality Index (PSQI), the Dialysis Symptom Index (DSI) and the Positive and Negative Emotions Schedule (PANAS).
Discussion
The trial will evaluate the effects of Western music and traditional Chinese five-element music on emotion, sleep and symptoms of patients undergoing maintenance hemodialysis. This study is expected to provide a more personalized and effective music therapy program for patients on maintenance hemodialysis which can be added to the treatment of patients on maintenance hemodialysis as a non-invasive complementary and alternative therapy to help improve the quality of life of patients on maintenance hemodialysis.
Trial registration:
The trial was registered with the Chinese Clinical Trial Registry on 14 June 2024 under registration number ChiCTR2400085665.