bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterising the killing of girls and women in urban settings in Latin America, 2000–2019: an analysis of variability and time trends using mortality data from vital registration systems
Authors: Trejo Bricia Gonzalez , Michael Yvonne L , Diez Roux Ana V , Sánchez Brisa N , Sun Nina , Stöckl Heidi , Vidaña-Perez Dèsirée , Correa-Salazar Catalina , Ortigoza Ana , de Lima Friche Amélia Augusta , DiCecco Vanessa , Mazariegos Mónica , Bilal Usama 
Published: July 2024

IntroductionLatin America is burdened by high levels of violence. Although boys and men often experience more violence and fatalities, girls and women face a greater risk of being killed by family members or intimate partners due to their gender, a phenomenon known as femicide. Our study estimates femicide rates in Latin America across age groups, examining city-level variations and temporal trends.MethodsUtilising data from theSalud Urbana en America Latinaproject, we analysed mortality data from 343 cities in nine countries between 2000 and 2019. We calculate the variability between and within countries using data from 2015 to 2019. We then describe time trends using femicide counts by year and city and fitting a three-level negative binomial model with a random intercept for country, fixed effects for age categories, and city-level and country-level random slopes for time (scaled to decades). Finally, we assess longitudinal time trends by age by including an interaction term for age and time (scaled to decades).ResultsOur results highlight substantial heterogeneity in femicide rates within and between countries. Additionally, we find that women 15–29 and 30–44 years of age experience the highest femicide rates across all countries. While our findings suggest a slight decline in femicide rates per additional decade (RR 0.95, 95% CI: 0.74 to 1.24) between 2000 and 2019, the trends diverge in different countries, suggesting increasing rates in some countries like Mexico. Age-specific trends suggest the persistence of higher rates among women 15–29 and 30–44 years of age over time.ConclusionWe underscore the need to consider gender dynamics in understanding and preventing femicides, focusing on city-level interventions to address the multifaceted causes of violence against girls and women in the region.
Detection of early neurological deterioration using a quantitative electroencephalography system in patients with large vessel occlusion stroke after endovascular treatment
Authors: Yan Yujia , An Xingwei , Ma Yuxiang , Jiang Zeliang , Di Yang , Li Tingting , Wang Honglin , Ren Hecheng , Ma Lin , Luo Bin , Huang Ying 
Published: July 2024

BackgroundEarly neurological deterioration (END) is a serious complication in patients with large vessel occlusion (LVO) stroke. However, modalities to monitor neurological function after endovascular treatment (EVT) are lacking. This study aimed to evaluate the diagnostic accuracy of a quantitative electroencephalography (qEEG) system for detecting END.MethodsIn this prospective, nested case–control study, we included 47 patients with anterior circulation LVO stroke and 34 healthy adults from different clinical centers in Tianjin, China, from May 2023 to January 2024. Patients with stroke underwent EEG at admission and after EVT. The diagnostic accuracy of qEEG features for END was evaluated by receiver operating characteristic curve analysis, and the feasibility was evaluated by the percentage of artifact-free data and device-related adverse events.Results14 patients with stroke had END (29.8%, 95% CI 16.2% to 43.4%), with most developed within 12 hours of recanalization (n=11). qEEG features showed significant correlations with National Institutes of Health Stroke Scale score and infarct volume. After matching, 13 patients with END and 26 controls were included in the diagnostic analysis. Relative alpha power demonstrated the highest diagnostic accuracy for the affected and unaffected hemispheres. The optimal electrode positions were FC3/4 in the unaffected hemisphere, and F7/8 and C3/4 in the affected hemisphere. No device-related adverse events were reported.ConclusionThe qEEG system exhibits a high diagnostic accuracy for END and may be a promising tool for monitoring neurological function. The identification of optimal electrode positions may enhance device convenience.Clinical trial registrationChiCTR 2300070829.
Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis?
Authors: Stamm Lea , Garaiman Alexandru , Becker Mike Oliver , Bruni Cosimo , Dobrota Rucsandra , Elhai Muriel , Ismail Sherif , Jordan Suzana , Zampatti Norina , Tatu Aurora Maria , Distler Oliver , Mihai Carina 
Published: July 2024

ObjectivesWhile important progress was made regarding the treatment of systemic sclerosis (SSc), there is still no evidence-based disease-modifying treatment available for SSc-related gastrointestinal (GI) manifestations. We aimed to identify an association between immunosuppressive therapy and the the severity of GI symptoms, measured by the University of California at Los Angeles/Scleroderma Clinical Trial Consortium Gastro-Intestinal Tract instrument 2.0 (GIT).MethodsWe selected patients with SSc who had at least two visits (further referred to as ‘baseline’ and ‘follow-up’) with completed GITs, within an interval of 12±3 months. The study outcome was the GIT score at follow-up. We used multivariable linear regression with the following covariates: immunosuppressive therapy during observation, immunosuppressive therapy before baseline, baseline GIT and several baseline parameters selected by clinical judgement as potentially influencing GI symptoms.ResultsWe included 209 SSc patients (82.3% female, median age 59.0 years, median disease duration 6.0 years, 40 (19.1%) diffuse cutaneous SSc, median baseline GIT 0.19). Of these, 71 were exposed to immunosuppressive therapy during the observation period, and, compared with unexposed patients, had overall more severe SSc and a higher prevalence of treatment with proton pump inhibitors. In multivariable linear regression, immunosuppressive therapy during the period of observation and lower baseline GIT scores were significantly associated with lower (better) GIT scores at follow-up.ConclusionImmunosuppressive treatment was associated with lower GIT scores in our cohort, which suggests the potential effects of immunosuppressants on GI manifestations in patients with SSc, requiring confirmation in prospective randomised clinical trials.
Challenges and Advances in the Diagnosis and Management of Neurogenic Thoracic Outlet Syndrome: A Comprehensive Review
Authors: AHMED Syeda Hoorulain , SHEKOUHI Ramin , CHIM Harvey 
Published: July 2024

Neurogenic thoracic outlet syndrome (nTOS) is caused by brachial plexus compression in the thoracic outlet. It accounts for 85%–95% of thoracic outlet syndrome (TOS) cases, which may also be caused by compression of the subclavian artery and vein. Compression occurs in the interscalene triangle, costoclavicular space or subpectoralis minor space, with congenital anomalies and repetitive overhead activities as contributing factors. Diagnosis is challenging due to overlapping symptoms with other conditions. Patients commonly report pain, numbness, tingling and weakness in the neck, shoulder and arm, exacerbated by arm elevation. Symptoms related to nTOS may manifest in the distribution of the upper (C5–C6), middle (C7) and lower plexus (C8–T1). Although widely used, provocative tests have varying degrees of sensitivity and specificity and may have high false-positive rates, complicating the diagnosis. Patterns on electrodiagnostic studies provide key diagnostic clues, such as reduced sensory response in the medial antebrachial cutaneous nerve and low compound motor action potential in the median nerve. Imaging techniques like magnetic resonance imaging (MRI), alongside procedures like diagnostic and therapeutic anterior scalene blocks, assist in identifying anatomical abnormalities and predicting surgical outcomes. Management of nTOS involves lifestyle changes, physical therapy, medication and botulinum toxin injections for symptomatic relief. Surgical options may include supraclavicular, transaxillary and infraclavicular approaches, each offering specific benefits based on patient anatomy and surgeon expertise. Minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS) and robotic surgery, enhance exposure and dexterity, leading to better outcomes. Future research should focus on developing precise diagnostic tools, understanding nTOS pathophysiology, standardising diagnostic criteria and surgical approaches, comparing long-term treatment outcomes and exploring preventive measures to improve patient care and quality of life. Level of Evidence: Level V (Therapeutic)
Clusters of Regional Precipitation Seasonality Change in the Community Earth System Model, Version 2
Authors: Swenson Leif M. , Ullrich Paul A. 
Published: July 2024

Abstract
The likely changes to precipitation seasonality with warming are both impactful and not well understood. This work aims to describe areas that experience similar changes to seasonal precipitation irrespective of the original underlying precipitation seasonality. We train a self-organizing map on the difference between the seasonal cycle of precipitation in the past and in a high-warming future climate as represented by the Community Earth System Model, version 2, to create regions with similar changes in precipitation seasonality. This method is applied separately over land and ocean surfaces because of the differing processes leading to precipitation over each. This method indicates that future changes in seasonal precipitation are most varied in the tropics because of a southward shift in the intertropical convergence zone. The seasonal shifts found over midlatitude oceans indicate a poleward shift in atmospheric river activity. We find a correspondence between certain land-based precipitation changes and Köppen climate classification. The seasonality of large-scale and convective precipitation is examined for each region. The relationship between the seasonal changes to precipitation and associated atmospheric processes is discussed. These processes include atmospheric rivers, the intertropical convergence zone, tropical cyclones, and monsoons.
Comparison of bone mineral density between female amateur triathletes and nonathletes: A cross-sectional study
Authors: Cruz Correa Netto Soares Guilherme , Barbosa Junior José Geraldo Gomes , Seffrin Aldo , Vivan Lavínia , Rosa de Freitas João Victor , Costa Gustavo De Conti Teixeita , de Lira Claudio André Barbosa B , Vancini Rodrigo Luiz , Weiss Katja , Knechtle Beat , Andrade Marilia Santos 
Published: July 2024

Purpose: Physical inactivity is considered an important risk factor for osteoporosis, however, some athletes performing extremely high training volumes can also develop bone mass loss. Moreover, the effect of total body mass or body surface area on bone mineral density remains controversial. Therefore, the aim of this study was to compare the absolute bone mineral density and bone mineral density adjusted to body surface area between amateur triathletes and nonactive women. Methods: Forty-two healthy women (23 amateur triathletes and 19 nonactive individuals) were evaluated for body composition using a dual-energy X-ray absorptiometry system. Results: Compared to nonactive women, amateur triathletes exhibited lower body mass index ( p < 0.001), lower bone mineral density ( p < 0.001), and body surface area ( p < 0.001). However, bone mineral density adjusted by body surface area in the triathletes was higher than in the nonactive women ( p = 0.03). Conclusion: These findings showed that amateur triathles presented lower absolute bone mineral density, but higher bone mineral density adjusted to body surface area. Future studies are recommended to identify if the higher bone mineral density adjusted to body surface area are associated with a lower bone fragility.
Introduction of one-view tomosynthesis in population-based mammography screening: Impact on detection rate, interval cancer rate and false-positive rate
Authors: Vilmun Bolette Mikela , Napolitano George , Lillholm Martin , Winkel Rikke Rass , Lynge Elsebeth , Nielsen Mads , Nielsen Michael Bachmann , Carlsen Jonathan Frederik , von Euler-Chelpin My , Vejborg Ilse 
Published: July 2024

Objective To assess performance endpoints of a combination of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) compared with FFDM only in breast cancer screening. Materials and methods This was a prospective population-based screening study, including eligible (50–69 years) women attending the Capital Region Mammography Screening Program in Denmark. All attending women were offered FFDM. A subgroup was consecutively allocated to a screening room with DBT. All FFDM and DBT underwent independent double reading, and all women were followed up for 2 years after screening date or until next screening date, whichever came first. Results 6353 DBT + FFDM and 395 835 FFDM were included in the analysis and were undertaken in 196 267 women in the period from 1 November 2012 to 12 December 2018. Addition of DBT increased sensitivity: 89.9% (95% confidence interval (CI): 81.0–95.5) for DBT + FFDM and 70.1% (95% CI: 68.6–71.6) for FFDM only, p < 0.001. Specificity remained similar: 98.2% (95% CI: 97.9–98.5) for DBT + FFDM and 98.3% (95% CI: 98.2–98.3) for FFDM only, p = 0.9. Screen-detected cancer rate increased statistically significantly: 11.18/1000 for DBT + FFDM and 6.49/1000 for FFDM only, p < 0.001. False-positive rate was unchanged: 1.75% for DBT + FFDM and 1.73% for FFDM only, p = 0.9. Positive predictive value for recall was 39.0% (95% CI: 31.9–46.5) for DBT + FFDM and 27.3% (95% CI: 26.4–28.2), for FFDM only, p < 0.0005. The interval cancer rate decreased: 1.26/1000 for DBT + FFDM and 2.76/1000 for FFDM only, p = 0.02. Conclusion DBT + FFDM yielded a statistically significant increase in cancer detection and program sensitivity.
In vitro compatibility of admixture solutions of 5-fluorouracil and khapzory (disodium levofolinate) in a single infusion bag
Authors: Saeed Hayder 
Published: July 2024

Introduction First-line chemotherapy for metastatic colorectal cancer typically involves a fluoropyrimidine, like 5-fluorouracil (5-FU), along with a folate agent, levoleucovorin. However, calcium-based levoleucovorin with 5-FU necessitates sequential infusion due to incompatibility, leading to calcium carbonate precipitation and potential IV catheter occlusion. In contrast, sodium-based levoleucovorin (disodium levoleucovorin-Khapzory) exhibits higher solubility in the low pH environment of 5-FU, enabling combination within a single IV bag for simultaneous infusion. This study aims to assess the safety of combining different concentrations of disodium levoleucovorin with 5-FU to create a single IV admixture bag or single pump Y-site, without risk of precipitate formation and catheter occlusion. Methods Compatibility of admixture 5-FU and disodium levoleucovorin in a 0.9% sodium chloride IV bag was evaluated, focussing on clarity (suspension, precipitation, and haziness). Particulate matter analysis was conducted at 25°C/60% relative humidity, for 29 samples at five timepoints. Defined pass criteria included a minimum of 6000 particles ≥10 µm per container and 600 particles ≥25 µm. Results All prepared concentrations remained clear for up to 72 h with no observed suspension, precipitation or haziness at any concentration or time point. Conclusions Combining 5-FU and disodium levoleucovorin in admixture IV bags eliminates the risk of catheter occlusion associated with calcium-based levoleucovorin formulations. This approach offers a more favorable operational and safety profile, enhancing convenience for patients and cost-efficiency for institutions.
Concomitant use of calcitonin gene-related peptide (CGRP) antagonists with azole antifungals in patients with hematological malignancies
Authors: Mehta Purav , Ngo Dat , Tinajero Jose 
Published: July 2024

Objective Small molecule calcitonin gene-related peptide (CGRP) antagonists such as rimegepant, ubrogepant, and atogepant have been approved for migraine treatment and/or prevention. These molecules are metabolized by cytochrome P-450 3A4 (CYP3A4) enzymes in vivo, hence they are contraindicated or recommended to be avoided in combination with strong/moderate CYP3A4 inhibitors, namely posaconazole (strong) and isavuconazonium (moderate). However, no literature has been published on the impact this interaction has on patient safety and tolerability. In this case series, we report five cases in which CGRP antagonists and azole antifungal therapy were given concurrently, to provide real-world outcomes of this interaction. Data sources Electronic medical records at our hospital system were reviewed between January 2021 and December 2023 to find patients who met the criteria of hematological malignancy, taking CGRP-antagonist and azole antifungal therapy. Records were then further investigated to find cases where CGRP antagonists and azole antifungals were used concomitantly. Data summary Concurrent use of CGRP antagonists and azole antifungal therapy was feasible for patients with migraines and hematological malignancies. None of the patients experienced any grade 3 or higher non-hematological toxicity from the proposed over-exposure to CGRP antagonist. The combination was well tolerated without any need for therapy discontinuation or dose modifications. Conclusions It is recommended to follow the manufacturers' guidance on drug interactions, however, in the setting where there are no other options, concomitant use of CGRP antagonists with azole antifungals is possible with monitoring and observation for adverse effects.
The effect of examining somatic alterations with NGS in patients with solid tumors, on patient management: A single-center experience in Turkey
Authors: Arak Hacı , Sahinoğlu Bahtiyar , KUS Tulay 
Published: July 2024

Objective This study aimed to investigate the impact of analyzing somatic alterations using next-generation sequencing (NGS) on treatment management in patients with metastatic solid cancers and their ability to access NGS recommended treatments. Methods This retrospective study included eligible patients who underwent NGS on somatic tumor tissue. We examined the clinical and pathological characteristics of these patients and the alterations in their treatment following NGS results. Results A total of 101 patients who underwent NGS were included in the study. The most common cancers were non-small cell lung cancer (NSCLC), colorectal, and breast cancers, in that order. The median age was 58 (range 21–82) years, with 60 (59.4%) male participants. The median NGS turnaround time was 23 (range 17–29) days. NGS was performed on tissue from the primary lesion in 89(88%) patients. Predictive, prognostic, actionable, or variants of unknown significance were detected in 62(61.4%) patients. The most frequent variants identified were KRAS, EGFR, TP53, PIK3CA, and other rare mutations. Treatment was altered in 17(16.8%) patients based on NGS results. Of the 30 (29.7%) patients for whom NGS-informed treatment was recommended, only seven (6.9%) received the recommended therapy. There was no significant difference in overall survival (OS) between patients whose treatment was changed based on NGS results and those whose treatment remained unchanged (p = 0.897). There was no difference in OS between patients with and without variants (p = 0.384). Conclusions NGS analysis of somatic alterations in patients with metastatic cancer may reveal additional variants beyond those identified by baseline tests. However, based on the recommendations of the reimbursement institution in Turkey, only a limited number of patients are able to access treatments recommended by NGS results. Therefore, baseline tests established in Turkey need to be made available in more centers in an appropriate time.
Outcomes of Pedicled Groin Flaps for Upper Extremity Injuries
Authors: Devarasetty V. V. N. Manohar , Vickery Justin W. , Maslow Jed I. 
Published: July 2024

Background: Free flap reconstruction has become the more common treatment over pedicled groin flaps for reconstruction of upper extremity injuries in recent years. Groin flaps are still used for a variety of reasons, though limited literature is available to guide surgeons and patients regarding outcomes. This study aimed to investigate the epidemiology and outcomes of pedicled groin flaps for upper extremity pathology. Methods: The study was a single-institution retrospective case series at a level one trauma center including patients who underwent pedicled groin flaps for upper extremity soft tissue coverage between 1992 and 2022. The data collected included patient and injury characteristics, surgical management, and complication data. Ordinal logistic regression, univariate analysis, and bivariate analysis were performed to assess the relationship between the total number of groin flap surgeries and complications with patient and injury characteristics. Results: The analysis included 88 pedicled groin flaps performed for upper extremity injuries, with a median follow-up of 1.14 years after injury. Patients had a median age of 35 (interquartile range [IQR]: 22-49) years and underwent a median of 4 (IQR: 3-5.25) surgeries with stiffness (90.6%), partial flap loss (38%), and infection (32%) as the most common complications. High-energy injuries increased the risk of requiring more surgeries based on ordinal logistic regression. Univariate and bivariate analysis revealed no significant difference in wound complications based on patient or injury characteristics. Conclusions: Patients undergoing pedicled groin flaps for upper extremity injuries can expect to undergo an average of 4 surgeries, and high-energy injuries predict the need for more surgeries.