bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of Africa's first unified hypertension management guidelines
Authors: Doku Alfred , Asamoah Kofi Tekyi , Amaechi Maureen U. , Auala Tangeni , Isiguzo Godsent , Beheiry Hind , Mutagaywa Reuben , Akintunde Abiodun Adeseye , Mamven Manmak , Odili Augustine 
Published: September 2024

Hypertension is a leading cardiovascular risk factor, contributing significantly to morbidity and mortality in Africa. The continent is plagued with a high incidence, coupled with low treatment and control rates. The causes are multifactorial, and among the major causes is an absence of standardized African guidelines for the management of hypertension. Systems of care vary across the continent, with low-income countries having less care than middle-income countries. International guidelines include recommendations for Black populations, but do not account for the cultural and sociodemographic situation of the African. There is therefore the need for African guidelines based on local data to improve the quality of hypertension care.
These guidelines will cover the clinical approach to hypertension and its complications at facilities with physicians and nonphysician health workers (NPHW). It will also proffer suggestions for policies to improve the care for patients with hypertension on the continent.
Translational evaluation of metabolic risk factors impacting DBS efficacy for PD-related sleep and depressive disorders: preclinical, prospective and cohort studies
Authors: Yao Longping , Chen Rui , Zheng Zijian , Hatami Maryam , Koc Sumeyye , Wang Xu , Bai Yang , Yao Chen , Lu Guohui , Skutella Thomas 
Published: September 2024

Background:
Parkinson’s disease (PD) is linked with metabolic risk factors including body mass index (BMI), fasting blood glucose (FBG), cholesterol levels, and triglycerides (TG). The extent to which these factors affect motor symptoms, depression, and sleep problems in PD, as well as their role in determining the success of deep brain stimulation (DBS) therapy, is yet to be fully understood.

Methods:
This study delved into the effects of metabolic risk factors like BMI, FBG, cholesterol, and TG on the outcomes of DBS in treating PD-related depression and sleep disturbances across both mouse models and human subjects.

Results:
DBS showcased noticeable betterment in depression and sleep perturbations in both PD-afflicted mice and patients. High-sugar–high-fat diet aggravates MPTP-induced depression and sleep disorders in mice. PD-afflicted individuals presenting with depressive and sleep disorders demonstrated elevated metrics of BMI, FBG, blood cholesterol, and TG. Remarkably, these metrics bore considerable adverse influences on the efficiency of DBS in ameliorating depression and sleep issues yet spared motor symptoms. The favorable impacts of DBS persisted for ~6 years, after which a significant decline was noted. Importantly, our translational evidence from both murine controls and patient cohorts indicated that antihyperglycemic and antihyperlipidemic therapies bolstered the efficacy of DBS in mitigating PD-related depression and sleep disturbances, without impinging upon motor functions in patients.

Conclusion:
In summary, this research emphasizes that DBS is a powerful treatment option for depression and sleep issues in PD, with its success influenced by metabolic risk factors. It further suggests that incorporating treatments for high blood sugar and cholesterol can enhance the efficacy of DBS in treating depression and sleep disturbances in PD, without impacting motor symptoms, highlighting the importance of metabolic risk management in PD patients receiving DBS.
Effect of immunochemotherapy infusion timing, sequence, and interval on prognosis of advanced esophageal cancer: a retrospective cohort study
Authors: Huang Shujie , Li Zijie , Gao Zhen , Wang Sichao , Sun Jiating , Wu Hansheng , Liu Jixian , Tang Patrick Ming-Kuen , Chen Rixin , Qiao Guibin 
Published: September 2024

Objective:
The present study aims to explore the roles of infusion time, administration sequence, and interval of immunochemotherapy (IO) in predicting overall survival (OS) in patients with locally advanced ESCC.

Methods:
This multicenter retrospective study enrolled advanced ESCC who received IO between November 2019 and November 2021. Patients were divided into groups according to the three classifiers (IO infusion time, administration sequence, and infusion interval), and were further analyzed for the roles of these classifiers in predicting the prognosis of the ESCC patients.

Results:
A total of 183 eligible patients with locally advanced ESCC were included in this study. Patients who received ≥75% of immunotherapy drug infusions after 12:00 h had better OS compared to those who received <75% of immunotherapy drug infusions after 12:00 h in the 1:1 propensity score matching analysis (HRadjusted: 0.38, 95% CI: 0.17–0.82; P=0.013). Cox proportional hazards regression revealed that ESCC patients with shorter infusion intervals (<3.3 h) had better OS (HRadjusted: 0.34, 95% CI: 0.15–0.76; P=0.008).

Conclusion:
For patients with ESCC, the OS is significantly better when immunotherapy is administered after 12:00 h. A shorter infusion interval (<3.3 h) on the same-day immunochemotherapy could lead to a better prognosis.
Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy
Authors: Vazquez Gabriel E. , Calhoun John R. , Fuchsen Elizabeth A. , Capella Jeannette M. , Vaudt Cory C. , Sidwell Richard A. , Smith Hayden L. , Pelaez Carlos A. 
Published: September 2024

Background:
Needle thoracostomy is a potentially life-saving intervention for tension pneumothorax but may be overused, potentially leading to unnecessary morbidity.

Objective:
To review prehospital needle thoracostomy indications, effectiveness, and adverse outcomes.

Methods:
A retrospective cohort study was conducted based on registry data for a United States Midwestern Level I trauma center for a 7.5-year period (January 2015 to May 2022). Included were patients who received prehospital needle thoracostomy and trauma activation before hospital arrival. The primary outcomes were correct indications and improvement in vital signs. Secondary outcomes were the need for chest tubes, correct needle placement, complications, and survival.

Results:
A total of n = 67 patients were reviewed, of which n = 63 (94%) received a prehospital thoracostomy. Of the 63 prehospital thoracostomies, 54 (86%) survived to arrival. Of these 54, 44 (n = 81%) had documented reduced/absent breath sounds, 15 (28%) hypotension, and 19 (35%) with difficulty breathing/ventilating. Only four patients met all three prehospital trauma life support criteria: hypotension, difficulty ventilating, and absent breath sounds. There were no significant changes in prehospital vitals before and after receiving needle thoracostomy. In patients receiving imaging (n = 54), there was evidence of 15 (28%) lung lacerations, 6 (11%) of which had a pneumothorax and 3 (5%) near misses of important structures. Review of needle catheters visible on computer tomography imaging found 11 outside the chest and 1 in the abdominal cavity.

Conclusion:
The study presents evidence of potential needle thoracostomy overuse and morbidity. Adherence to specific guidelines for needle decompression is needed.
A novel computed tomography enterography radiomics combining intestinal and creeping fat features could predict surgery risk in patients with Crohn’s disease
Authors: Du Jinfang , Xu Fangyi , Qiu Xia , Hu Xi , Deng Liping , Hu Hongjie 
Published: September 2024

Objective
The objective of this study is to segment creeping fat and intestinal wall on computed tomography enterography (CTE) and develop a radiomic model to predict 1-year surgery risk in patients with Crohn’s disease.

Methods
This retrospective study included 135 Crohn’s disease patients who underwent CTE between January and December 2021 (training cohort) and 69 patients between January and June 2022 (test cohort). A total of 1874 radiomic features were extracted from the intestinal wall and creeping fat respectively on the venous phase CTE images, and radiomic models were constructed based on the selected features using the Boruta and extreme gradient boosting algorithms. The combined models were established by integrating clinical predictors and radiomic models. The receiver operating characteristic curve, calibration curve, and decision curve analyses were used to compare the predictive performance of models.

Results
In the training and test cohorts, the area under the curve (AUC) values of the creeping fat radiomic model for surgery risk stratification were 0.916 and 0.822, respectively, similar to the intestinal model with AUC values of 0.889 and 0.822. Moreover, the combined radiomic model was superior to the single models, showing good discrimination with the highest AUC values (training cohort: 0.963; test cohort: 0.882). Addition of clinical predictors to the radiomic models failed to significantly improve the diagnostic ability.

Conclusion
The CTE-based creeping fat radiomic model provided additional information to the intestinal radiomic model, and their combined radiomic model enables accurate surgery risk prediction of Crohn’s disease patients within 1 year of CTE.
Impact of Social Risk Screening on Discharge Care Processes and Postdischarge Outcomes
Authors: Wallace Andrea S. , Bristol Alycia A. , Johnson Erin Phinney , Elmore Catherine E. , Raaum Sonja E. , Presson Angela , Eppich Kaleb , Elliott Mackenzie , Park Sumin , Brooke Benjamin S. , Park Sumin , Weiss Marianne E. 
Published: September 2024

Background:
Social risk screening during inpatient care is required in new CMS regulations, yet its impact on inpatient care and patient outcomes is unknown.

Objectives:
To evaluate whether implementing a social risk screening protocol improves discharge processes, patient-reported outcomes, and 30-day service use.

Research Design:
Pragmatic mixed-methods clinical trial.

Subjects:
Overall, 4130 patient discharges (2383 preimplementation and 1747 postimplementation) from general medicine and surgical services at a 528-bed academic medical center in the Intermountain United States and 15 attending physicians.

Measures:
Documented family interaction, late discharge, patient-reported readiness for hospital discharge and postdischarge coping difficulties, readmission and emergency department visits within 30 days postdischarge, and coded interviews with inpatient physicians.

Results:
A multivariable segmented regression model indicated a 19% decrease per month in odds of family interaction following intervention implementation (OR=0.81, 95% CI=0.76–0.86, P<0.001), and an additional model found a 32% decrease in odds of being discharged after 2 pm (OR=0.68, 95% CI=0.53–0.87, P=0.003). There were no postimplementation changes in patient-reported discharge readiness, postdischarge coping difficulties, or 30-day hospital readmissions, or ED visits. Physicians expressed concerns about the appropriateness, acceptability, and feasibility of the structured social risk assessment.

Conclusions:
Conducted in the immediate post-COVID timeframe, reduction in family interaction, earlier discharge, and provider concerns with structured social risk assessments likely contributed to the lack of intervention impact on patient outcomes. To be effective, social risk screening will require patient/family and care team codesign its structure and processes, and allocation of resources to assist in addressing identified social risk needs.
Communication Disparities and Trusted Sources of COVID-19 Information in Massachusetts School Districts
Authors: Thompson Anna L. , Davis Bradley S. , Rohrbach Augusta , Davis Jonathan M. , Sebastiani Paola , Tang Alice M. 
Published: September 2024

Context:
The COVID-19 pandemic led to the closure of prekindergarten to grade 12 schools and an inequitable return to full-time in-person learning.

Objective:
To explore how ethnic and racial differences across school districts in Massachusetts correlate with parents’ attitudes, beliefs, and trusted sources of information about COVID-19 and mitigation strategies.

Design:
An electronic survey was distributed by school administrators to parents and guardians in November and December 2021 using existing school district contact lists and established methods of communication (email in 2 school districts; email and text message in 1 district).

Setting:
Three school districts in Massachusetts (Chelsea, Medford, and Somerville).

Participants:
Parents of prekindergarten to grade 12 school students attending public schools.

Main Outcome Measure(s):
Parental attitudes and beliefs regarding mitigation strategies for COVID-19 (surveillance testing, masking, and vaccination); trusted information sources about COVID-19; preferred methods of communication from schools.

Results:
A total of 1496 survey responses were analyzed. Chelsea respondents were predominantly Hispanic/LatinX (88%); Medford and Somerville were predominantly White/non-Hispanic (80% and 68%, respectively). Testing, masks, and vaccination were supported by >80% of parents/guardians across districts. However, there were statistically significant differences between school districts regarding participation in testing programs, implications of a child testing positive, vaccination of young children, communication preferences, and trusted sources of information.

Conclusions:
Although primarily focused on COVID-19, these results highlight opportunities for public health personnel and school administrators to work directly with parents and guardians in their school districts to improve communication strategies and be a trusted source of information for a variety of public health issues.
Focused Team Engagements to Enhance Interprofessional Collaboration and Safety Behaviors among Novice Nurses and Medical Residents
Authors: Manuel Rosalyn , Barber Aisha , Kern Jeremy , Myers Kristi , Neary Tara , Nicholson Laura , Walsh Heather , Zaveri Pavan , Dwivedi Pallavi , Maggiotto Claire , King Simmy 
Published: September 2024

Background:
Team communication remains a challenge in hospital settings. Hospital-based teams are diverse, team composition changes daily, and team members are frequently not co-located. Novice nurses and medical residents entering the workforce during the coronavirus 2019 pandemic experienced higher communication challenges than before and lacked adequate opportunities for interprofessional learning and communication.

Method:
We evaluated perceptions of safety and communication among novice nurses and medical residents after a 1-hour focused team engagement consisting of an interprofessional virtual simulation and debrief. We conducted a retrospective pre/post survey to measure perceptions of interprofessional collaboration using the Interprofessional Socialization and Valuing Scale.

Results:
Sixty-eight pediatric nurse residents and medical residents participated in the survey. Overall, the focused team engagements significantly improve participants’ perceptions of interprofessional collaboration, with participants showing statistically significant improvement in seven of nine retrospective pre/post survey questions. When analyzing by discipline, nurse residents show stronger gains than medical residents.

Conclusions:
The interprofessional structured debriefings encourage nurses and medical residents to collaborate and discuss important safety topics away from bedside stressors. After completing the virtual simulation, the outcomes show improved perceptions of interprofessional collaboration and enhanced knowledge of safety techniques.
Blunt dissection of the axillary flap through double mini-incisions on both sides of the axilla to prevent postoperative hematoma
Authors: Yao Zhihua , Zhu Jifeng , Peng Min , Lei Benxu , Li Min , Yang Jie , Tang Jinyu , Chang Dongfang 
Published: September 2024

Objectives
The purpose of this study was to investigate the clinical effect of treating axillary osmidrosis by trimming the apocrine glands under direct vision after blunt dissection of the axillary flap through double mini-incisions on both sides of the axilla to prevent postoperative hematoma.

Methods
The clinical data of 108 patients with axillary osmidrosis were retrospectively analyzed. Treatment involved blunt dissection of the axillary flap through double mini-incisions and trimming of the apocrine glands under direct vision. The surgical duration, hematoma incidence, flap necrosis rate, incision healing rate, incision VSS score, comfort level, axillary odor cure rate, and satisfaction rating were all statistically analyzed.

Results
The average surgical duration was 72.45±5.71 min. The cure rate of axillary osmidrosis was 100%. Postoperative complications, including delayed incision healing 12 days after surgery (1 patient), a small hematoma (2 patients), and local flap necrosis (1 patient), were minor. No infection, malodor, or recurrence was observed. The VAS score for patient comfort was 8.53±0.89, the VAS score for patient satisfaction was 8.87±0.98, and the VSS score for the incision was 0.84±0.99.

Conclusion
This retrospective study demonstrated that the trimming of apocrine glands after blunt dissection of the axillary flap through double mini-incisions on both sides of the axilla effectively controlled bleeding. This approach significantly reduces the complication rate of axillary osmidrosis surgery and ensures the complete trimming of apocrine glands, eradicating axillary odor and maintaining a good appearance.
Exposure to angiotensin-converting enzyme inhibitors that cross the blood–brain barrier and the risk of dementia among people with HIV
Authors: Cummings Tammy H. , Magagnoli Joseph , Sikirzhytskaya Aliaksandra , Tyagin Ilya , Safro Ilya , Wyatt Michael D. , Shtutman Michael S. , Sutton S. Scott 
Published: September 2024

Background:
The decreased mortality of people with HIV (PWH) has revealed non-HIV-associated comorbidities such as neurocognitive disorders (e.g., dementia). There is an urgency to discover therapeutics to prevent or delay neurocognitive decline among PWH.

Methods:
The artificial intelligence platform Automatic Graph-mining And Transformer based Hypothesis Generation Approach (AGATHA) was utilized to seek potential drugs to be repurposed for the management of non-HIV-associated dementia. AGATHA revealed angiotensin-converting enzyme inhibitors that cross the blood–brain barrier (BBB ACEi) as a target for decreasing dementia. Subsequently, we conducted a retrospective study evaluating incident dementia using the Veterans Affairs Informatics and Computing Infrastructure (VINCI) evaluating ACE inhibitors. Cox proportional hazards models were fit and hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) are presented.

Findings:
A total 9419 PWH exposed to an BBB ACE inhibitor (ACEi) and 8831 PWH unexposed demonstrated that PWH exposed to BBB ACEi had a 21.4% (univariate) and 15.2% (multivariate) lower hazard of dementia. The propensity score matched analysis demonstrated a 14.3% lower hazard of incident dementia compared to BBB ACEi unexposed (HR 0.857, 95% CI 0.747–0.984).

Interpretation:
An artificial intelligence-based literature mining system (AGATHA) was utilized to uncover a medication with potential to be repurposed. AGATHA demonstrated that BBB ACEi as a target for decreasing dementia among PWH. Additionally, we conducted a retrospective study demonstrating a decrease in incident dementia among PWH exposed to BBB ACEi. Future research is needed to explore further and understand the relationship of dementia among PWH exposed to ACEi.
The gut microbiome and the brain
Authors: Rykalo Nadiia , Riehl Lydia , Kress Michaela 
Published: September 2024

Purpose of review
The importance of the gut microbiome for human health and well-being is generally accepted, and elucidating the signaling pathways between the gut microbiome and the host offers novel mechanistic insight into the (patho)physiology and multifaceted aspects of healthy aging and human brain functions.

Recent findings
The gut microbiome is tightly linked with the nervous system, and gut microbiota are increasingly emerging as important regulators of emotional and cognitive performance. They send and receive signals for the bidirectional communication between gut and brain via immunological, neuroanatomical, and humoral pathways. The composition of the gut microbiota and the spectrum of metabolites and neurotransmitters that they release changes with increasing age, nutrition, hypoxia, and other pathological conditions. Changes in gut microbiota (dysbiosis) are associated with critical illnesses such as cancer, cardiovascular, and chronic kidney disease but also neurological, mental, and pain disorders, as well as chemotherapies and antibiotics affecting brain development and function.

Summary
Dysbiosis and a concomitant imbalance of mediators are increasingly emerging both as causes and consequences of diseases affecting the brain. Understanding the microbiota’s role in the pathogenesis of these disorders will have major clinical implications and offer new opportunities for therapeutic interventions.
The WHO guidelines: the new and the old
Authors: Thompson Jo 
Published: September 2024

Purpose of the review
The original World Health Organisation (WHO) cancer pain guidelines were published in 1986 and used globally. Updated guidance was released in 2018. This review compares the ‘old’ with the ‘new’ with a closer look at the relevance of the WHO analgesic ladder in the current climate.

Recent findings
The new guidelines provide a more evidence based, rigorously developed document including recommendations relating to radiotherapeutic management. There is a more detailed focus on safe opioid prescribing, opioid stewardship and the importance of integrating pain management expertise early on in the cancer journey. There remains a lack of evidence for certain therapies despite their widespread use particularly in relation to adjuvants. The pitfalls of the original renowned analgesic ladder are highlighted including a recognition that omitting ‘step 2’ is safe, feasible and cost effective.

Summary
The new guidelines offer more detailed recommendations relevant to clinical practice with a strong focus on safety of opioid prescribing making it relevant in the current climate. The original WHO analgesic ladder is no longer recommended as a strict protocol for cancer pain management.