bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metolazone Versus Chlorothiazide in Acute Heart Failure Patients With Diuretic Resistance and Renal Dysfunction: A Retrospective Cohort Study
Authors: Gibson Caitlin M. , Beard Meghan M. , Escano Alisa K. , Good Brittany L. , Potter Teresa G. , Truong Albert M. , Van Tassell Benjamin 
Published: August 2024

Abstract:
Guidelines recommend intravenous loop diuretics as first-line therapy for patients hospitalized with acute heart failure (AHF) and volume overload. Additional agents can be used for augmentation, but there is limited guidance on agent selection. The study objective was to determine if chlorothiazide or metolazone is associated with differences in diuretic efficacy or safety in loop diuretic-resistant patients with AHF and renal dysfunction (eGFR <45 mL/min/1.73 m²). We conducted a multicenter, retrospective cohort study of patients hospitalized with AHF and renal dysfunction who received metolazone or chlorothiazide in addition to intravenous loop diuretics. The primary end point was a comparison of 24-hour urine output (UOP) between the 24 hours before and after thiazide administration. Secondary and safety end points included weight change, requirement for vasopressors or inotropes, electrolyte abnormalities, and changes in renal function. A total of 221 patients were included. The mean daily diuretic doses were chlorothiazide 632 mg and metolazone 7 mg. The mean 24-hour UOP increased more among chlorothiazide-treated (from 1668 mL to 3826 mL) versus metolazone-treated patients (from 1672 mL to 2834 mL) (P < 0.001) after the addition of the second diuretic. Statistically significant reductions in serum creatinine were observed in the chlorothiazide group following 72 hours of treatment (P = 0.016). More hypomagnesemia was observed in the chlorothiazide group; no differences in other electrolytes or changes in weight were observed. Overall, chlorothiazide was associated with a greater increase in 24-hour UOP than metolazone without an excess of potassium or serum creatinine derangements. However, weight changes did not differ significantly between groups. Future prospective studies are needed to confirm potential differences in diuretic response and safety.
Adverse complications of cervical spinal fusion in patients with different types of diabetes mellitus: a retrospective nationwide inpatient sample database cross-sectional study
Authors: Liao Yuan-Jing , Xu Lan-Wei , Xie Hao , Yang Qin-Feng , Wang Jian , Fan Lei , Cao Sheng-Lu 
Published: August 2024

Background:
Diabetes mellitus (DM) is a prevalent chronic condition that influences spine surgery outcomes. The impact of type Ⅰ and type Ⅱ DM on adverse postoperative outcomes, mortality, prolonged length of stay (LOS), and increased in-hospital costs following cervical fusion surgery remains unclear in the past decade. This study aims to determine the specific effect of different classifications of DM on postoperative complications in patients experiencing cervical fusion surgery.

Method:
Data from the Nationwide Inpatient Sample database was acquired between 2010 and 2019. Patients experiencing cervical fusion were included and classified as having type I DM, type II DM, or neither. Patient demographics, hospital characteristics, operative variables, comorbidities, complications, and other postoperative outcomes were assessed. Propensity score matching analysis was used to balance baseline differences. Univariate and multivariate logistic regression were employed to determine the risk of postoperative outcomes in patients with different classifications of DM.

Result:
A total of 267 174 cervical spinal fusions were identified (224 255 were patients without DM, 670 patients had type I DM, and 42 249 patients had type II DM). After propensity score matching, the multivariate analysis of non-DM and type I DM patients shows a significant difference in pneumonia (P=0.020). However, type Ⅱ DM served as an independent predictor of an increased risk of acute cerebrovascular disease (P=0.001), acute myocardial infarction (P=0.014), pneumonia (P=0.045), continuous trauma ventilation (P=0.016), chest pain (P<0.001), urinary tract infection (P<0.001), transfusion (P=0.005) and dysphagia (P=0.013), prolonged LOS (P<0.001), and increased costs (P=0.008).

Conclusion:
Using non-DM patients as a reference, the type II DM group demonstrated a higher risk of postoperative complications than the type I DM group among patients receiving cervical fusion surgery. This vital distinction could enhance risk stratification and guidance for patients diagnosed with DM before cervical fusion surgery.
Predicting prognostic factors in kidney transplantation using a machine learning approach to enhance outcome predictions: a retrospective cohort study
Authors: Kim Jin-Myung , Jung HyoJe , Kwon Hye Eun , Ko Youngmin , Jung Joo Hee , Kwon Hyunwook , Kim Young Hoon , Jun Tae Joon , Hwang Sang-Hyun , Shin Sung 
Published: August 2024

Background:
Accurate forecasting of clinical outcomes after kidney transplantation is essential for improving patient care and increasing the success rates of transplants. The authors’ study employs advanced machine learning (ML) algorithms to identify crucial prognostic indicators for kidney transplantation. By analyzing complex datasets with ML models, the authors aim to enhance prediction accuracy and provide valuable insights to support clinical decision-making.

Materials and methods:
Analyzing data from 4077 KT patients (June 1990–May 2015) at a single center, this research included 27 features encompassing recipient/donor traits and peri-transplant data. The dataset was divided into training (80%) and testing (20%) sets. Four ML models—eXtreme Gradient Boosting (XGBoost), Feedforward Neural Network, Logistic Regression, And Support Vector Machine—were trained on carefully selected features to predict the success of graft survival. Performance was assessed by precision, sensitivity, F1 score, area under the receiver operating characteristic (AUROC), and area under the precision-recall curve.

Results:
XGBoost emerged as the best model, with an AUROC of 0.828, identifying key survival predictors like T-cell flow crossmatch positivity, creatinine levels two years post-transplant and human leukocyte antigen mismatch. The study also examined the prognostic importance of histological features identified by the Banff criteria for renal biopsy, emphasizing the significance of intimal arteritis, interstitial inflammation, and chronic glomerulopathy.

Conclusion:
The study developed ML models that pinpoint clinical factors crucial for KT graft survival, aiding clinicians in making informed post-transplant care decisions. Incorporating these findings with the Banff classification could improve renal pathology diagnosis and treatment, offering a data-driven approach to prioritizing pathology scores.
The role of artificial intelligence measured preoperative kidney volume in predicting kidney function loss in elderly kidney donors: a multicenter cohort study
Authors: Jo Eun-Ah , Lee Juhan , Moon Seonggong , Kim Jin Sung , Han Ahram , Ha Jongwon , Kim Yong Chul , Min Sangil 
Published: August 2024

Background:
The increasing use of kidneys from elderly donors raises concerns due to age-related nephron loss. Combined with nephrectomy, this loss of nephrons markedly increases the risk of developing chronic kidney disease (CKD). This study aimed to investigate the prognostic value of preoperative kidney cortex volume in predicting the loss of kidney function in elderly donors, by developing an artificial intelligence (AI)-based model for precise kidney volume measurement and applying it to living kidney donors.

Materials and methods:
A multicenter retrospective cohort study using data from living donors who underwent donor nephrectomy between January 2010 and December 2020 was conducted. An AI segmentation model was developed and validated to measure kidney cortex volume from pre-donation computer tomographic (CT) images. The association between measured preoperative kidney volumes and post-nephrectomy renal function was analyzed through a generalized additive model.

Results:
A total of 1074 living kidney donors were included in the study. Validation of the developed kidney cortex volume model showed a Dice similarity coefficient of 0.97 and a Hausdorff distance of 0.76 mm. The measured cortex volumes exhibited an age-related decrease, which correlated with declining kidney function. Elderly donors showed greater decreases in estimated glomerular filtration rates (eGFR) post-donation compared to young donors (P=0.041). Larger preoperative remnant kidney cortex volume was associated with significantly less decline of eGFR post-donation than those with smaller preoperative remnant kidney cortex volume (P<0.001).

Conclusion:
This study highlights the critical role of preoperative kidney cortex volume in the donor assessment process, particularly for elderly donors. The fully automated model for measuring kidney cortex volume provides a valuable tool for predicting post-donation renal function and holds promise for enhancing donor evaluation and safety.
Simple severity scale for perforated peptic ulcer with generalized peritonitis: a derivation and internal validation study
Authors: Yamamoto Ryo , Hirakawa Shinya , Tachimori Hisateru , Matsuoka Tadashi , Kikuchi Hirotoshi , Hasegawa Hiroshi , Shirabe Ken , Kakeji Yoshihiro , Kawakubo Hirofumi , Kitagawa Yuko , Sasaki Junichi 
Published: August 2024

Background:
Perforated peptic ulcer (PPU) causes peritonitis and requires surgery based on disease severity. This study aimed to develop and validate a severity scale for PPU with generalized peritonitis.

Materials and methods:
This retrospective cohort study used a nationwide multicenter surgical database (2013–2020). Patients aged >15 years who underwent surgery for PPU with generalized peritonitis were included and categorized into the derivation (2013–2018) and two validation (2019 and 2020) cohorts. Possible severity predictors were selected via a literature review, and Lasso models were developed to predict severe postoperative adverse events with 2000 bootstrapping. Final variables for the scoring system were determined based on inclusion frequency (≥90%) in the Lasso models. Discrimination and accuracy were evaluated using C-statistics and calibration plots. Cutoff values for minimal postoperative adverse events were examined using negative predictive values.

Results:
Among 12 513 patients included (1202 underwent laparoscopic surgery), 533 (5.9%), 138 (7.6%), and 117 (6.9%) in the derivation and two validation cohorts experienced postoperative adverse events. Age, dyspnea at rest, preoperative sepsis, III/IV/V of American Society of Anesthesiologists physical status, and albumin and creatinine were selected for the final model. A 0–11 scoring system was developed with C-statistics of 0.812–0.819. Cutoff value was determined as 5, which predicted <3% probability of postoperative adverse events regardless of type of surgery.

Conclusions:
A score of <5 predicts minimal risks for postoperative adverse events and, therefore, would be clinically useful to determine the type of surgery. Further studies are needed to validate the score.
Using Structural Competencies for Faculty and Students to Integrate Principles of Social Justice and Health Equity Into a Doctor of Physical Therapy Program
Authors: Naidoo Keshrie , Karim Rania , Rimmel Lauren , Watkins Liu Callie , Washington Kamaria , Privett Rachel , Godsey Keelin , Rucker-Bussie Valerie , Plummer Laura 
Published: August 2024

Background and Purpose:Integrating principles of social justice and health equity (SJHE) into Doctor of Physical Therapy (DPT) education may be one way to confront the root causes of health inequity. The purpose of this method/model presentation is to highlight structural competencies for faculty and students to integrate SJHE into a 3-year DPT program and a professional development program designed to provide core and clinical faculty with the tools to engage in critical discussions with students and support their development as agents of change.Method/Model Description and Evaluation:This presentation highlights how SJHE structural competencies can be integrated into existing course content (as opposed to presented as a standalone course). Researchers interviewed 10 DPT faculty and 10 DPT students about their experience learning about SJHE. Six clinical instructors (CIs) who supervised students during a full-time clinical education experience (CEE) discussed students’ ability to apply SJHE concepts during CEEs.Outcomes:Faculty expressed the need for practice in low-stakes settings such as through simulation. Students valued learning about SJHE over 3 years with the opportunity to integrate content during CEEs but felt that SJHE could be better integrated in classroom content. Some peers were perceived to be resistant to SJHE. Clinical instructors described that although students were prepared to apply foundational SJHE concepts, students were surprised by the complexity of patient need.Discussion and Conclusion:Exploratory analysis of faculty, CI, and students’ perceptions confirm that SJHE is needed in DPT education but takes time to integrate well with a steep learning curve and additional faculty development needs that must be met.
SFPO and ESOP recommendations for the practical stability of anticancer drugs: second update
Authors: D'Huart Elise , Astier Alain , Bardin Christophe , Vigneron Jean 
Published: August 2024

Abstract
A second update of the recommendations for the practical stability of anticancer drugs published in 2013 has been realized by the French Society of Hospital Pharmacists (SFPO); European Society of Oncology Pharmacists (ESOP); and members of the Stabilis® database (www.stabilis.org), a stability and compatibility database of drugs. Forty-six new molecules have been included. These new data make it possible to optimize anticancer drug preparations and achieve product savings. These new recommendations have to be taken into consideration only if the preparation is made according to the Good Manufacturing Practices in classified rooms.
Analyzing the Impact of CIT on the Largest Reported Cohort of Robotic Kidney Transplantation From the Deceased Donors
Authors: Petrochenkov Egor , Bencini Giulia , Martinino Alessandro , Lian Amy , Olazar Joanna , Akshelyan Stepan , Yoshikawa Kentaro , Di Cocco Pierpaolo , Almario-Alvarez Jorge , Spaggiari Mario , Benedetti Enrico , Tzvetanov Ivo 
Published: August 2024

Background.
Robotic-assisted kidney transplant (RAKT) has proven to be a successful approach for patients with morbid obesity and more centers are encouraged to apply robotic approach also for deceased donor kidney transplantation. Prolonged cold ischemia time (CIT) is accompanied by delayed graft function (DGF) and early graft loss after traditional open kidney transplant (OKT). This study examines the impact of CIT after robotic kidney transplantation on settings of deceased donation.

Methods.
We present a single-center retrospective analysis of 115 cases of RAKT and 128 cases of OKT from deceased donors performed from deceased donor from 2009 to July 2022. Cohort was divided in 3 groups based on CIT (“high” CIT > 15 h, n = 43; “medium” CIT 11–15 h, n = 38; “low” CIT< 11 h, n = 40). The subgroup analysis of DGF and CIT was performed.

Results.
The median CIT in the cohort was 13.46 (7) h, and overall rate of DGF was 30.6%. The correlation between CIT and DGF was statistically significant (P = 0.008), and DGF negatively correlated with 1-y graft survival (P = 0.04). The rate of DGF was significantly different between the groups (P = 0.05).

Conclusions.
Results from our study demonstrate that the effect of CIT on DGF in settings of RAKT follows a similar pattern as in traditional OKT.
Training the Next Generation of Transplant Surgeons With a 3-Dimensional Trainer: A Pilot Study
Authors: Sanchez-Garcia Jorge , Lopez-Verdugo Fidel , Shorti Rami , Krong Jake , Zendejas Ivan , Contreras Alan G. , Botha Jean , Rodriguez-Davalos Manuel I. 
Published: August 2024

Background.
In the United States, no published guidelines promote exposure to technical variants (ie, living donor or split liver) during transplant fellowship. Simulation with hands-on liver models may improve training in transplantation. This pilot study addressed 3 overall goals (material and model creation tools, recruitment rates and assessment of workload, and protocol adherence).

Methods.
A patient-specific hands-on liver model was constructed from clinical imaging, and it needed to be resilient and realistic. Multiple types of materials were tested between January 2020 and August 2022. Participants were recruited stepwise. A left lateral segmentectomy simulation was conducted between August 2022 and December 2022 to assess protocol adherence.

Results.
Digital anatomy 3-dimensional printing was considered the best option for the hands-on liver model. The recruitment rate was 100% and 47% for junior attendings and surgical residents, respectively. Ten participants were included and completed all the required surveys. Seven (70%) and 6 (60%) participants “agreed” that the overall quality of the model and the material were acceptable for surgical simulation. Five participants (50%) “agreed” that the training improved their surgical skills. Nine participants (90%) “strongly agreed” that similar sessions should be included in surgical training programs.

Conclusions.
Three-dimensional hands-on liver models have the advantage of tactile feedback and were rated favorably as a potential training tool. Study enrollment for further studies is possible with the support of leadership. Rigorous multicenter designs should be developed to measure the actual impact of 3-dimensional hands-on liver models on surgical training.
Knowledge, Attitudes, and Beliefs Toward Organ Donation Registration Among Asian Americans: Development and Pilot-testing of Educational Intervention Video
Authors: Li Miah T. , Hillyer Grace C. , King Kristen L. , Yu Miko , Husain S. Ali , Mohan Sumit 
Published: August 2024

Background.
Organ donation registration rates in the United States are lowest among Asian Americans. This study aimed to investigate the reasons for low organ donation registration rates among Asian Americans and develop educational material to help improve organ donation rates and awareness.

Methods.
We conducted a 2-phase study. In phase 1, a cross-sectional observational survey was distributed in-person on an iPad to members of the Asian community in Queens, New York, to investigate their knowledge, attitudes, and beliefs toward organ donation. Based on the results, an educational video was developed, and the efficacy of the video was assessed with an independent cohort of participants in phase 2 using a pre-/post-video comprehension assessment survey.

Results.
Among 514 Chinese or Korean Americans who participated in the phase 1 survey, 97 participants (19%) reported being registered organ donors. Registered donors were more likely to have previously discussed their organ donation wishes with their family (adjusted odds ratio [aOR], 4.77; 95% confidence interval [CI], 2.56-8.85; P < 0.01), knowledge of the different registration methods (aOR, 2.57; 95% CI, 1.24-5.31; P < 0.01), or know a registered organ donor (aOR, 2.62; 95% CI, 1.39-4.95; P < 0.01). For the educational video efficacy assessment given pre-/post-video, the majority (90%) of the respondents reported learning something new from the video. After watching the video, there was a significant improvement in the mean knowledge score regarding organ donation (63% versus 92%; P < 0.01) and an increase in intention to have discussion regarding organ donation with family.

Conclusions.
We found varies factors associated with low organ donation registration rates among Asian Americans and demonstrated the potential of our educational video to impart organ donation knowledge to viewers and instigate the intention to have family discussions regarding organ donation. Further research is needed to assess the impact of videos in motivating actual organ donation registration.
Exploring Musculoskeletal Injuries Among Informal and Formal Carers of People With Dementia
Authors: Dimakopoulou Eleni , Bampouras Theodoros M. , Katsardi Georgia , Tavoulareas Georgios , Karydaki Maria , Theodorelou Maria , Zoi Panagiota , Sakka Paraskevi 
Published: August 2024

Background:
Carers of people with dementia manually handle the care recipients (eg, repetitive lifting, transferring, and pulling) as part of the care service, increasing the musculoskeletal injury risk to themselves.

Objective:
We aimed to determine the prevalence of musculoskeletal injuries among informal and formal carers of people with dementia and the perceived associated risk factors.

Methods:
Primary carers of people with dementia (26 males and 141 females) from Dementia Care Centers and Home Care programs completed a questionnaire providing information about (a) the carers’ and their care recipients’ characteristics, (b) musculoskeletal symptoms (via the Nordic Musculoskeletal Questionnaire) and related aspects, and (c) the caregiving activities exposing the carers to risk of musculoskeletal injury.

Results:
Our results showed that 69.7% of informal and 86.7% of formal carers reported having more than 1 musculoskeletal injury, while 63.1% and 61.5%, respectively, reported having a musculoskeletal injury in the last year. Lower back had the highest injury prevalence (>10% for both groups). The 2 carer groups were not different in any of the variables.

Conclusions:
Our results reinforce calls for education and support of carers, regardless of their formal status, to enable injury-free and prolonged service provision.
Reclaiming behaviour settings: reviewing empirical applications of Barker’s behaviour settings theory
Authors: Avram Christa M. , Jones Anne E. , Lucas Miranda L. , Barrett Louise 
Published: August 2024

Behaviour settings theory is the product of Roger Barker and Herbert F. Wright’s decades-long Midwest Field Station research programme. The theory followed from the demonstration that the best predictor of a person’s behaviour was the setting (i.e. location, timing and activity) in which their behaviour took place, rather than any individual trait (e.g. personality). Now little known in psychology, behaviour settings theory is often further obscured by being presented as a theory only, neglecting the clear methodology Barker provided for investigating the question: ‘What do people do in everyday life?’ This literature review takes a comprehensive look at Barker’s contributions both within and outside of psychology. The corpus comprises both theoretical and empirical articles; however, our primary interest is in the empirical articles. We describe the who, when and where of behaviour settings research over the past half-century, and we identify branches and neighbours of behaviour settings research (e.g. manning theory, behaviour mapping and activity settings theory). Primarily, however, we attempt to answer the following questions: (i) Are any of Barker’s tools for studying people in everyday settings being used currently? (ii) How accurately has Barker’s theory been explained, or his methods applied? (iii) Does such work contribute to behaviour settings theory in a meaningful way?
This article is part of the theme issue ‘People, places, things and communities: expanding behaviour settings theory in the twenty-first century’.