bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kidney Outcomes and Trajectories of Tubular Injury and Function in Critically Ill Patients With and Without COVID-19
Authors: Granda Michael L. , Tian Frances , Zelnick Leila R. , Bhatraju Pavan K. , Hallowell Julia , Wurfel Mark M. , Hoofnagle Andrew , Morrell Eric , Kestenbaum Bryan 
Published: June 2024

IMPORTANCE:
COVID-19 may injure the kidney tubules via activation of inflammatory host responses and/or direct viral infiltration. Most studies of kidney injury in COVID-19 lacked contemporaneous controls or measured kidney biomarkers at a single time point.

OBJECTIVES:
To better understand mechanisms of acute kidney injury in COVID-19, we compared kidney outcomes and trajectories of tubular injury, viability, and function in prospectively enrolled critically ill adults with and without COVID-19.

DESIGN, SETTING, AND PARTICIPANTS:
The COVID-19 Host Response and Outcomes study prospectively enrolled patients admitted to ICUs in Washington State with symptoms of lower respiratory tract infection, determining COVID-19 status by nucleic acid amplification on arrival.

MAIN OUTCOMES AND MEASURES:
We evaluated major adverse kidney events (MAKE) defined as a doubling of serum creatinine, kidney replacement therapy, or death, in 330 patients after inverse probability weighting. In the 181 patients with available biosamples, we determined trajectories of urine kidney injury molecule-1 (KIM-1) and epithelial growth factor (EGF), and urine:plasma ratios of endogenous markers of tubular secretory clearance.

RESULTS:
At ICU admission, the mean age was 55 ± 16 years; 45% required mechanical ventilation; and the mean serum creatinine concentration was 1.1 mg/dL. COVID-19 was associated with a 70% greater occurrence of MAKE (relative risk 1.70; 95% CI, 1.05–2.74) and a 741% greater occurrence of KRT (relative risk 7.41; 95% CI, 1.69–32.41). The biomarker cohort had a median of three follow-up measurements. Urine EGF, secretory clearance ratios, and estimated glomerular filtration rate (eGFR) increased over time in the COVID-19 negative group but remained unchanged in the COVID-19 positive group. In contrast, urine KIM-1 concentrations did not significantly change over the course of the study in either group.

CONCLUSIONS:
Among critically ill adults, COVID-19 is associated with a more protracted course of proximal tubular dysfunction and reduced eGFR despite similar degrees of kidney injury.
Child Opportunity Index and Pediatric Extracorporeal Membrane Oxygenation Outcomes; the Role of Diagnostic Category
Authors: Alizadeh Faraz , Gauvreau Kimberlee , Barreto Jessica A. , Hall Matt , Bucholz Emily , Nathan Meena , Newburger Jane W. , Vitali Sally , Thiagarajan Ravi R. , Chan Titus , Moynihan Katie M. 
Published: June 2024

OBJECTIVES:
To study the impact of social determinants of health (SDoH) on pediatric extracorporeal membrane oxygenation (ECMO) outcomes.

DESIGN, SETTING, AND PATIENTS:
Retrospective study of children (< 18 yr) supported on ECMO (October 1, 2015 to March 1, 2021) using Pediatric Health Information System (44 U.S. children’s hospitals). Patients were divided into five diagnostic categories: neonatal cardiac, pediatric cardiac, neonatal respiratory, pediatric respiratory, and sepsis. SDoH included the Child Opportunity Index (COI; higher indicates social advantage), race, ethnicity, payer, and U.S. region. Children without COI were excluded. Diagnostic category-specific clinical variables related to baseline health and illness severity were collected.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Children supported on ECMO experienced a 33% in-hospital mortality (2863/8710). Overall, children with lower COI, “other” race, Hispanic ethnicity, public insurance and from South or West regions had greater mortality. Associations between SDoH and ECMO outcomes differed between diagnostic cohorts. Bivariate analyses found that only pediatric cardiac patients had an association between COI or race and mortality. Multivariable logistic regression analyses examined relationships between SDoH, clinical variables and mortality within diagnostic categories. Pediatric cardiac patients had 5% increased odds of death (95% CI, 1.01–1.09) for every 10-point decrement in COI, while Hispanic ethnicity was associated with higher survival (adjusted odds ratio [aOR] 0.72 [0.57–0.89]). Children with heart disease from the highest COI quintile had less cardiac-surgical complexity and earlier cannulation. Independent associations with mortality were observed in sepsis for Black race (aOR 1.62 [1.06–2.47]) and other payer in pediatric respiratory patients (aOR 1.94 [1.23–3.06]).

CONCLUSIONS:
SDoH are statistically associated with pediatric ECMO outcomes; however, associations differ between diagnostic categories. Influence of COI was observed only in cardiac patients while payer, race, and ethnicity results varied. Further research should investigate differences between diagnostic cohorts and age groups to understand drivers of inequitable outcomes.
Trends in diffuse type of gastric cancer: focus on younger women
Authors: Corso Giovanni , Santucci Claudia , Toffolutti Federica , Pisa Eleonora , La Vecchia Carlo , Serraino Diego 
Published: June 2024

Background
Gastric cancer (GC) incidence has been decreasing over the last decades; however, there are uncertainties in trends and proportional distribution of the diffuse type.

Methods
GC incidence data were extracted from the population-based Friuli Venezia Giulia Cancer Registry. GC types (diffuse vs. others) were compared in relation to age at diagnosis, calendar years, and sexes.

Results
Between 1995 and 2021, diffuse GC accounted for 10.2% of all GCs. The proportion was greater among individuals aged <45 years, 34.0% in women and 25.7% in men. An increasing proportion over time was observed, in particular in women (from 9.9% in 1995–2000 to 14.10% during 2011–2021). In the last decade (2011–2021), a decreased incidence of all GC was observed, reaching an age-standardized rate (world standard) of 1.4/100,000 for men and 1.2/100,000 for women. Rates of diffuse GC were 0.3/100,000 in younger population.

Conclusion
Although the overall GC incidence is decreasing, the percentage of diffuse GC is increasing in the younger population, particularly in women. Reasons for the increased proportion of diffuse-type GC within younger women remain uncertain, possibly related to the decreased exposure to risk factors for other GC histotypes.
Onychomatricomas: Assessing Surgical Outcomes
Authors: van de Borne Laura , Costantini Mathilde , Dehavay Florence , Richert Bertrand 
Published: June 2024

BACKGROUND
Onychomatricoma (OM) is a rare benign tumor of the nail matrix. Treatment is surgical, but data are currently limited.

OBJECTIVE
To review all cases of OM operated in their department and to assess the link between the location on the nail plate, the thickness and width of the lesion, and the postoperative outcomes.

MATERIALS AND METHODS
Records of 62 patients were retrieved from their department's database over a 25-year period (1998–2023).

RESULTS
Of the 62 patients, 41 were eligible. In total, 58% of OM occupied a width of a quarter of the nail plate, 51% had a plate thinner than 3 mm, and 51% were laterally located. Of the 41 patients included, 29 had a tangential excision and 12 underwent lateral longitudinal excision. Among the tangential excision group, 71% had normal nail regrowth. Onychomatricoma thicker than 3 mm and involving the total nail plate width had a sequelae in 60% of cases.

CONCLUSION
Tangential excision of onychomatricomas allows a normal nail regrowth in 71% of cases. The risk of sequelae increases for tumors thicker than 3 mm and involving the total nail plate width. Medial or lateral location seems to have no influence.
Documenting Compliance and Symptom Reactivity for Ambulatory Assessment Methodology Following Concussion in Adolescents and Young Adults: Feasibility of the Mobile Neurocognitive Health (MNCH) Project
Authors: Elbin R. J. , Durfee Kori J. , Womble Melissa N. , Jennings Sabrina , Fedor Sheri , Dollar Christina M. , Felt John M. , Elbich Daniel B. , Hakun Jonathan G. 
Published: June 2024

Objective:
Evaluate compliance, symptom reactivity, and acceptability/experience ratings for an ecological momentary assessment (EMA) protocol involving ultra-brief ambulatory cognitive assessments in adolescent and young adult patients with concussion.

Setting:
Outpatient concussion clinic.

Participants:
116 patients aged 13 to 25 years with concussion.

Design:
Prospective research design was used to examine compliance, symptom reactivity, and acceptability/experience for the Mobile Neurocognitive Health Project (MNCH); an EMA study of environmental exposures, symptoms, objective cognitive functioning, and symptom reactivity involving 4, daily EMA surveys (7:30 am, 10:30 am, 3:00 pm, 8:00 pm) for a period of 7 days following concussion. Overall compliance rates, symptom reactivity scores, and participant acceptability/experience ratings were described. A series of non-parametric Friedman Tests with post-hoc Wilcoxon signed-rank tests were used to examine differences in compliance and reactivity related to time of day and over the course of the protocol (first 3 days [Early Week] vs last 4 days [Late Week]).

Main Measures:
Compliance rates, symptom reactivity scores, participant experience/acceptability.

Results:
Overall median compliance was 71%, and there were significantly fewer 7:30 am surveys completed compared to the 10:30 am (Z = −4.88,P ≤ .001), 3:00 pm (Z = −4.13,P ≤ .001), and 8:00 pm (Z = −4.68, P ≤ .001) surveys. Compliance for Early Week surveys were significantly higher than Late Week (Z = −2.16,P = .009). The median symptom reactivity score was 34.39 out of 100 and was significantly higher for Early Week compared to Late Week (Z = −4.59,P ≤ .001). Ninety-nine percent (89/90) of the sample agreed that the app was easy to use, and 18% (16/90) indicated that the app interfered with their daily life.

Conclusion:
Adolescents and young adults with concussion were compliant with the MNCH EMA protocol. Symptom reactivity to the protocol was low and the majority of participants reported that the app and protocol were acceptable. These findings support further investigation into applications of EMA for use in concussion studies.
Possible involvement of satellite glial cell–derived lipocalin-2 in dermatitis not itch-related behavior of atopic dermatitis model mice
Authors: Takahashi Nobuaki , Tominaga Mitsutoshi , Kamata Yayoi , Takamori Kenji 
Published: June 2024

Introduction:
Atopic dermatitis (AD) is a chronic inflammatory skin disease with intractable itch. Dorsal root ganglion (DRG) plays an important role in signal transduction of itch. It has been reported that satellite glial cells (SGC) present around DRG neurons are involved in pain and itch through interactions with DRG neurons. However, it is unclear what factors in SGC are involved in inducing dermatitis and itch in DRG. In this study, we found that the expression of lipocalin-2 (LCN2) was increased in SGC of AD model NC/Nga mouse. Therefore, we also examined whether SGC-derived lipocalin-2 is involved in the induction of dermatitis and itch-related behavior in this model mice.

Materials and methods:
AD-like dermatitis was induced by the application of Dermatophagoides farinae body ointment to NC/Nga mice (AD-NC/Nga mice). Protein and gene expression in the DRG and spinal cord of AD-NC/Nga mice were examined. The effect of the LCN2 antibody on dermatitis pathology in AD-NC/Nga mice was confirmed.

Results:
LCN2 expression in DRG of AD-NC/Nga mice was higher than that of control NC/Nga mice. Immunohistochemical analysis revealed that LCN2 was expressed on SGC in DRG. Gene expression level of LCN2 in the DRG was significantly increased faster than in the spinal cord during the process of induction of AD-like dermatitis. LCN2 increased gene expression of MMP-9 in mouse DRG. Intrathecally administrated anti-LCN2 antibody twice a week for 3 weeks at the same time as induction of AD-like dermatitis reduced dermatitis score without inhibiting scratching behavior.

Discussion:
In conclusion, our data suggest that SGC-derived LCN2 is involved in the pathogenesis of dermatitis rather than itch-related behavior in AD-NC/Nga mice.
Prediction of sepsis among patients with major trauma using artificial intelligence: a multicenter validated cohort study
Authors: Sun Baisheng , Lei Mingxing , Wang Li , Wang Xiaoli , Li Xiaoming , Mao Zhi , Kang Hongjun , Liu Hui , Sun Shiying , Zhou Feihu 
Published: June 2024

Background:
Sepsis remains a significant challenge in patients with major trauma in the ICU. Early detection and treatment are crucial for improving outcomes and reducing mortality rates. Nonetheless, clinical tools for predicting sepsis among patients with major trauma are limited. This study aimed to develop and validate an artificial intelligence (AI) platform for predicting the risk of sepsis among patients with major trauma.

Patients and methods:
This study involved 961 patients, with a prospective analysis of data from 244 patients with major trauma at our hospital and a retrospective analysis of data from 717 patients extracted from a database in the United States. The patients from our hospital constituted the model development cohort, and the patients from the database constituted the external validation cohort. The patients in the model development cohort were randomly divided into a training cohort and an internal validation cohort at a ratio of 8:2. The machine-learning algorithms used to train models included logistic regression, decision tree, extreme gradient boosting machine (eXGBM), neural network (NN), random forest, and light gradient boosting machine (LightGBM).

Results:
The incidence of sepsis for the model development cohort was 43.44%. Twelve predictors, including gender, abdominal trauma, open trauma, red blood cell count, heart rate, respiratory rate, injury severity score, sequential organ failure assessment score, Glasgow coma scale, smoking, total protein concentrations, and hematocrit, were used as features in the final model. Internal validation showed that the NN model had the highest area under the curve (AUC) of 0.932 (95% CI: 0.917–0.948), followed by the LightGBM and eXGBM models with AUCs of 0.913 (95% CI: 0.883–0.930) and 0.912 (95% CI: 0.880–0.935), respectively. In the external validation cohort, the eXGBM model (AUC: 0.891, 95% CI: 0.866–0.914) had the highest AUC value, followed by the LightGBM model (AUC: 0.886, 95% CI: 0.860–0.906), and the AUC value of the NN model was only 0.787 (95% CI: 0.751–0.829). Considering the predictive performance for both the internal and external validation cohorts, the LightGBM model had the highest score of 82, followed by the eXGBM (81) and NN (76) models. Thus, the LightGBM has emerged as the optimal model, and it was deployed online as an AI application.

Conclusions:
This study develops and validates an AI application to effectively assess the susceptibility of patients with major trauma to sepsis. The AI application equips healthcare professionals with a valuable tool to promptly identify individuals at high risk of developing sepsis. This will facilitate clinical decision-making and enable early intervention.
Comparison of long-term survival of neoadjuvant therapy plus surgery versus upfront surgery and the role of adjuvant therapy for T1b-2N0-1 esophageal cancer: a population study of the SEER database and Chinese cohort
Authors: Xia Lingling , Shi Wei , Cai Yuxin , Liao Zhengkai , Huang Zhen , Qiu Hu , Wang Jing , Chen Yongshun 
Published: June 2024

Background:
For stage T1b-2N0-1 esophageal cancer, the impact of neoadjuvant therapy plus surgery (NS), surgery alone (SA), and surgery plus adjuvant therapy (ST) on cancer-specific survival (CSS) and overall survival (OS) is uncertain.

Methods:
Stage T1b-2N0-1 esophageal cancer patients from the SEER database and two Chinese cancer centers were included in this study. The Kaplan–Meier method was used to plot survival curves, which were compared using the log-rank test. Propensity score matching was used to equalize differences between the groups. Cox proportional hazards regression models were used to analyze prognostic factors. A nomogram for OS was developed after screening the variables using the Cox proportional hazards regression model and the least absolute shrinkage and selection operator. The performance of the nomogram was assessed by the Harrell concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic curve, calibration plots, and decision curve analysis.

Results:
After propensity score matching analysis, the 3-year CSS and OS rates in the NS group compared to the SA group were 80.3% versus 62.1% (P=0.016) and 75.8% versus 55.5% (P=0.006), the 3-year CSS and OS rates in the NS group compared to the ST group were 71.3% versus 68.3% (P=0.560) and 69.8% versus 62.9% (P=0.330), the 3-year CSS and OS rates in the SA group compared to the ST group were 54.6% versus 66.7% (P=0.220) and 50.2% versus 57.9% (P=0.290), respectively. The predictive nomogram for OS in T1b-2N0-1 patients ultimately incorporated five clinicopathological variables: T stage, N stage, age, examined lymph nodes, and therapy modality. The nomogram C-index for predicting OS was 0.648, 0.663, and 0.666 in the training group, external validation group-1, and external validation group-2, respectively. The 1-year, 3-year, and 5-year predicted AUC values of the OS prediction model were 0.659, 0.639, and 0.612 for the training group, and 0.786, 0.758, and 0.692 for validation group-1, and 0.805, 0.760, and 0.693 for validation group-2, respectively.

Conclusion:
For patients with stage T1b-2N0-1 esophageal cancer, neoadjuvant therapy significantly improves prognosis compared to surgery alone, those presenting with positive lymph nodes after upfront surgery can achieve survival benefits from adjuvant therapy.
Simulator Verification Is Potentially Beneficial for the Fitting of Softband Bone Conduction Hearing Devices in Young Children
Authors: Sun Le , Ping Lu , Fan Xinmiao , Wang Jian , Chen Xiaowei 
Published: June 2024

Hypothesis
The current study employed a skull-simulator verification method to assess whether the output of softband bone conduction hearing devices (BCHDs) at the manufacturer's default settings deviated widely from the target determined by the fitting formula.

Background
Real ear analysis is utilized for the verification of the fitting of air conduction hearing devices (ACHDs) in a variety of institutions. This procedure, however, has not been used in the fitting of BCHDs, largely due to the difficulty of testing the output of these devices to temporal bones. Despite the availability of skull simulators, they have not been utilized clinically to measure BCHD output.

Materials and Methods
This prospective, single-center study enrolled 42 subjects, aged 3 months to 10 years, with microtia-atresia–associated mild-to-severe bilateral conductive hearing loss. Hearing sensitivity was evaluated behaviorally by pure tone audiometry (PTA) in 22 subjects 4 years or older (the PTA group), and by auditory brainstem response (ABR) in 20 subjects younger than 4 years (the ABR group). Following 6 months of subjects wearing the prescribed softband BCHDs, their dial level (DL) thresholds were reassessed while using their own BCHDs, configured with zero gain across all frequencies, functioning solely as a bone vibrator. These DL thresholds were inputted into the fitting formula, desired sensation level–bone conduction devices (DSL-BCD) for children, to obtain the target values of BCHD output. The simulator output of the BCHD programmed at the manufacturer's default setting was measured in response to speech presented at 55, 65, and 80 dB SPL, followed by gain adjustment based on the differences between the simulator output and the target. Aided speech intelligibility index (SII) was measured before and after the gain adjustment.

Results
The softband BCHDs at the manufacturer's settings generally had lower output than the prescribed target values. This difference was larger at low frequencies and low levels. Across the 12 points tested (four frequencies from 500 to 4000 Hz multiplied by three levels), 22 (52.3%) and 42 (100%) BCHDs had deviations of +7 and +5 dB, respectively, at one point or more. The gain adjustments reduced the deviation and improved the SII values at the two lower levels of speech presented.

Conclusion
The simulator output of softband bone conduction hearing devices (BCHDs) with the manufacturer's settings may exhibit significant deviations from the formula. Objective output verification should be considered a beneficial step in BCHD fitting and is recommended when applicable.
The Role of Asymmetry Values, Gain, and Pathological Saccades of the Video Head Impulse Test (vHIT) in Sudden Sensorineural Hearing Loss
Authors: Qian Yi , Kang Houyong , Zhong Shixun , Tao Chen , Zuo Wenqi , Lei Yan , Jiang Lizhu 
Published: June 2024

Objective
The purpose of this study was to evaluate the value of asymmetry values, gain, and pathological saccades of the video head impulse test (vHIT) in sudden sensorineural hearing loss (SSNHL).

Study Design
Retrospective study.

Setting
Tertiary referral center.

Patients
A total of 226 individuals diagnosed with unilateral definite SSNHL were hospitalized. The assessment included a comprehensive evaluation of medical history, pure-tone test, acoustic impedance, positional test, video nystagmography (VNG), vHIT, vestibular evoked myogenic potentials (VEMPs) and magnetic resonance.

Interventions
vHIT, VNG, cVEMP, oVEMP. Statistical analysis was performed with SPSS version 22.0 for Windows.

Main Outcome Measures
The asymmetry values, gain, and pathological saccades of the vHIT.

Results
The abnormal gain of vHIT in anterior, horizontal, and posterior canal in SSNHL patients with vertigo were revealed in 20 of 112 (17.9%), 24 of 112 (21.4%), and 60 of 112 (53.6%), respectively. The vHIT pathological saccades (overt + covert) of anterior, horizontal, and posterior canal in SSNHL patients with vertigo were observed in 5 of 112 (4.6%), 52 of 112 (46.4%), and 58 of 112 (51.8%), respectively. Multivariate analysis indicated that the prognosis of patients with vertigo was correlated with vHIT gain of posterior canal, pathological saccade in horizontal canal, asymmetric ratio of horizontal canal gain, asymmetric ratio of posterior canal gain, Canal paresis (%) on caloric test and spontaneous nystagmus.

Conclusion
In the vHIT of patients with SSNHL with vertigo, the posterior canal is most easily affected. Reduced gain of posterior canal, pathological saccade of horizontal canal, and larger asymmetric gain of posterior canal and horizontal canal may be negative prognostic factors.