bluuebunny/crossref_metadata_2025_split huggingface dataset:
344 Effectiveness of Intra-operative Antibiotics in Reducing Post-Orchidectomy Infection Rates and Subsequent Delays in Chemotherapy
Authors: Rahman I , Raza K , Douglas-Moore J 
Published: August 2024

Abstract

Aim
Radical inguinal orchidectomy is the gold standard treatment for Testicular cancer. Further adjuvant chemotherapy reduces recurrence. Thus, it is imperative to prevent delays in post-operative chemotherapy. Concerns were raised by our Oncology department regarding post-operative infection rates causing such delays. This audit was undertaken to compare our infection rates with that of BAUS’s generally accepted rate of 2-10% post-orchidectomy and determine if our current local practice of using intra-operative antibiotics with no subsequent antibiotic prophylaxis is sufficient.

Method
Patients who underwent radical orchidectomy from January 2022 to January 2023 were retrospectively reviewed. Orchidectomies performed for suspected testicular malignancy were identified and their final histology was noted. Electronic notes were read to check for post-operative infection and delays in chemotherapy.

Results
In total, 29 radical orchidectomies were performed, 10 of which were for suspected testicular malignancy. 2 patients had benign histology. In the other 8 patients, histology confirmed testicular cancer. From these, 6 patients showed no post-operative infection and no delay. 1 patient developed infection, which was managed in primary care, also with no delay to subsequent chemotherapy. 1 patient lacked available notes, so couldn’t be followed up.

Conclusions
Our audit in a large tertiary centre suggests that our current local practice of using a single dose of intra-operative antibiotics is sufficient to prevent post-operative infection and there is no indication for the routine use of post-operative antibiotic prophylaxis. This was a small cohort of patients. Nonetheless, it contributes to the growing evidence demonstrating that routine post-operative antibiotics aren’t indicated in clean urological surgery.
1068 The Clinical and Financial Impact of Unplanned Nephrostomy Dislodgement in the Urology Department
Authors: Wijayasuriya D , McCauley N , Saunders H , Eylert M 
Published: August 2024

Abstract

Aim
Nephrostomies are inserted electively and in the emergency setting to relieve urinary tract obstruction. Local adherence to the national recommended target rate of 10% for nephrostomy reinsertion was measured to assess the quality of patient nephrostomy aftercare. The financial burden of unplanned nephrostomy reinsertion was also measured.

Method
Data was collected retrospectively using the computer software programme for fluoroscopic images to retrospectively identify all patients undergoing nephrostomy insertion in the health board during June-July 2023. The local online clinical portal was used to collect further data for analysis. Further information was collected to calculate the financial implications of nephrostomy re-insertion.

Results
The cost of a nephrostomy insertion was estimated at £1000-1500 per episode when including an overnight stay for observation. A total of 25 nephrostomy insertions were recorded. Of these, 5 required reinsertions during the audit period and 3 unplanned dislodgements occurred within 2 weeks of insertion. These results were presented at a multi-disciplinary education day on the topic of Nephrostomy management with external speakers in attendance. A second cycle of the audit was performed after which demonstrated no perceivable improvement.

Conclusions
Education of staff alonenwas not satisfactory in creating demonstrable improvement in the rate of unplanned nephrostomy dislodgement. The local rate of 16% is much higher than the national acceptable rates of dislodgement. A patient nephrostomy aftercare information leaflet is currently being trialled for the next PDSA cycle. A solution providing patient autonomy and ownership in nephrostomy aftercare may be the key to sustained demonstrable improvement in re-insertion rates.
Alpha transcranial alternating current stimulation as add-on to neglect training: a randomized trial
Authors: Middag-van Spanje Marij , Nijboer Tanja C W , Schepers Jan , van Heugten Caroline , Sack Alexander T , Schuhmann Teresa 
Published: August 2024

Abstract
Visuospatial neglect is a common and debilitating condition following unilateral stroke, significantly impacting cognitive functioning and daily life. There is an urgent need for effective treatments that can provide clinically relevant and sustained benefits. In addition to traditional stroke treatment, non-invasive brain stimulation, such as transcranial alternating current stimulation, shows promise as a complementary approach to enhance stroke recovery. In the current study, we aimed to evaluate the additive effects of multi-session transcranial alternating current stimulation at alpha frequency when combined with visual scanning training in chronic stroke patients with visuospatial neglect. In this double-blind randomized controlled trial, we compared the effects of active transcranial alternating current stimulation at alpha frequency to sham (placebo) transcranial alternating current stimulation, both combined with visual scanning training. Both groups received eighteen 40-minute training sessions over a 6-week period. A total of 22 chronic visuospatial neglect patients participated in the study (active group n = 12, sham group n = 10). The median age was 61.0 years, with a median time since stroke of 36.1 months. We assessed the patients at six time-points: at baseline, after the first, ninth and eighteenth training sessions, as well as 1 week and 3 months following the completion of the combined neuromodulation intervention. The primary outcome measure was the change in performance on a visual search task, specifically the star cancellation task. Secondary outcomes included performance on a visual detection task, two line bisection tasks and three tasks evaluating visuospatial neglect in daily living. We found significantly improved visual search (primary outcome) and visual detection performance in the neglected side in the active transcranial alternating current stimulation group, compared to the sham transcranial alternating current stimulation group. We did not observe stimulation effects on line bisection performance nor in daily living. Time effects were observed on all but one outcome measures. Multi-session transcranial alternating current stimulation combined with visual scanning training may be a more effective treatment for chronic visuospatial neglect than visual scanning training alone. These findings provide valuable insights into novel strategies for stroke recovery, even long after the injury, with the aim of enhancing cognitive rehabilitation outcomes and improving the overall quality of life for individuals affected by this condition.
Trial registration: ClinicalTrials.gov; registration number: NCT05466487; https://clinicaltrials.gov/ct2/show/NCT05466487
Efficacy and Safety of Long-Acting Subcutaneous Lenacapavir in Heavily Treatment-Experienced People with Multidrug-Resistant HIV-1: Week 104 Results of a Phase 2/3 Trial
Authors: Ogbuagu Onyema , Molina Jean-Michel , Chetchotisakd Ploenchan , Ramgopal Moti N , Sanchez William , Brunetta Jason , Castelli Francesco , Crofoot Gordon E , Hung Chien-Ching , Ronot-Bregigeon Sylvie , Margot Nicolas A , Wang Hui , Dvory-Sobol Hadas , Rhee Martin S , Segal-Maurer Sorana 
Published: August 2024

Abstract

Background
Lenacapavir is a long-acting human immunodeficiency virus type 1 (HIV-1) capsid inhibitor for treatment of HIV-1 infection. We evaluated the efficacy and safety of lenacapavir in combination with an investigator-selected optimized background regimen (OBR) after 104 weeks in adults with multidrug-resistant HIV-1.

Methods
This ongoing, international, Phase 2/3 trial at 42 sites included 72 adults living with multidrug-resistant HIV-1. Following a 2-week oral lenacapavir loading phase, participants received subcutaneous lenacapavir every 26 weeks with an OBR. HIV-1 RNA, CD4 cell counts, and adverse events were assessed over 104 weeks. One participant did not enter the extension phase.

Results
At Week 104, 44 of 71 participants (62%, 95% confidence interval [CI]: 50; 73) had HIV-1 RNA &lt;50 copies/mL via US Food and Drug Administration (FDA) snapshot algorithm. When missing data (including discontinuations) were excluded, 44 of 54 participants (82%) had HIV-1 RNA &lt;50 copies/mL at Week 104, mean CD4 cell count increased by 122 cells/µL (95% CI: 80; 165), and the proportion of participants with CD4 cell count &lt;200 cells/µL decreased from 64% (46 of 72) at Baseline to 29% (16 of 55). Fourteen participants had treatment-emergent lenacapavir resistance; 7 resuppressed (HIV-1 RNA &lt;50 copies/mL) while maintaining lenacapavir use. There were no Grade 4 or serious treatment-related adverse events. One participant discontinued study drug due to an injection site reaction.

Conclusions
Treatment with subcutaneous lenacapavir in combination with an OBR was well tolerated and resulted in a high rate of virological suppression over 104 weeks. Lenacapavir represents an important treatment option in people with multidrug-resistant HIV-1.
Estimating glomerular filtration in young people
Authors: Delanaye Pierre , Derain-Dubourg Laurence , Björk Jonas , Courbebaisse Marie , Couzi Lionel , Gaillard Francois , Garrouste Cyril , Grubb Anders , Jacquemont Lola , Hansson Magnus , Kamar Nassim , Legendre Christophe , Littmann Karin , Mariat Christophe , Rostaing Lionel , Rule Andrew D , Sundin Per-Ola , Bökenkamp Arend , Berg Ulla , Åsling-Monemi Kajsa , Åkesson Anna , Larsson Anders , Nyman Ulf , Pottel Hans 
Published: August 2024

ABSTRACT

Background
Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.

Methods
We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.

Results
In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), –2.50 (–3.85; –1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (–1.69; 3.06), –2.62 (–5.14; –1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.

Conclusions
We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.
Unravelling monocyte functions: from the guardians of health to the regulators of disease
Authors: Mildner Alexander , Kim Ki-Wook , Yona Simon 
Published: August 2024

Abstract
Monocytes are a key component of the innate immune system. They undergo intricate developmental processes within the bone marrow, leading to diverse monocyte subsets in the circulation. In a state of healthy homeostasis, monocytes are continuously released into the bloodstream, destined to repopulate specific tissue-resident macrophage pools where they fulfil tissue-specific functions. However, under pathological conditions monocytes adopt various phenotypes to resolve inflammation and return to a healthy physiological state. This review explores the nuanced developmental pathways and functional roles that monocytes perform, shedding light on their significance in both physiological and pathological contexts.
Long-term outcomes among out-of-hospital cardiac arrest survivors with reversible vs. non-reversible causes
Authors: Barcella Carlo Alberto , Grunau Brian E , Guan Meijiao , Hawkins Nathaniel M , Deyell Marc W , Andrade Jason G , Helmer Jennie S , Wong Graham C , Kragholm Kristian H , Humphries Karin H , Christenson Jim , Fordyce Christopher B 
Published: August 2024

Abstract

Aims
A reversible cause of out-of-hospital cardiac arrest (OHCA) is vaguely defined in international guidelines as an identifiable transient or potentially correctable condition. However, studies evaluating long-term outcomes of patients experiencing OHCA due to reversible and non-reversible causes are lacking. We aimed to determine differences in long-term outcomes in OHCA survivors according to different aetiology.

Methods and results
From the British Columbia Cardiac Arrest registry, adults with non-traumatic OHCA (2009–2016) surviving to hospital discharge were identified. Patients were categorized by OHCA aetiology combining reversibility and underlying ischaemic aetiology. The primary outcome was a composite of all-cause mortality, recurrent OHCA, or re-hospitalization for sudden cardiac arrest or ventricular arrhythmias. Using the Kaplan–Meier method and multivariable Cox regression models, we compared the risk of the composite outcome according to different OHCA aetiology. Of 1325 OHCA hospital-discharge survivors (median age 62.8 years, 77.9% male), 431 (32.5%) had reversible ischaemic, 415 (31.3%), non-reversible ischaemic, 99 (7.5%), reversible non-ischaemic, and 380 (28.7%), non-reversible non-ischaemic aetiologies. At 3 years post discharge, the Kaplan–Meier event-free rate was highest in patients with a reversible ischaemic aetiology [91%, 95% confidence interval (CI) 87–94%], and lowest in those with a reversible non-ischaemic aetiology (62%, 95% CI 51–72%). In multivariate analyses, compared with non-reversible non-ischaemic cause, reversible ischaemic cause was associated with a significantly lower hazard ratio (HR; 0.52, 95% CI 0.33–0.81), reversible non-ischaemic cause with a significantly higher HR (1.53, 95% CI 1.03–2.32), and non-reversible ischaemic cause with a non-significant HR (0.92, 95% CI 0.64–1.33) for the composite outcome.

Conclusion
Compared to other aetiologies, the presence of a reversible ischaemic cause is associated with improved long-term OHCA outcomes.
Prediction of major arrhythmic outcomes in ischaemic cardiomyopathy: value of hibernating myocardium in positron emission tomography/computed tomography
Authors: Kovacs Boldizsar , Gllareva Valon , Ruschitzka Frank , Duru Firat , Kaufmann Philipp A , Buechel Ronny R , Benz Dominik C , Saguner Ardan M 
Published: August 2024

Abstract

Aims
Known predictors of major arrhythmic events (MAEs) in patients with ischaemic cardiomyopathy (ICM) include previous MAE and left ventricular ejection fraction (LVEF) ≤ 35%. Myocardial scars detected by perfusion imaging in ICM have been linked to MAE, but the prognostic significance of hibernating myocardium (HM) is unclear. The objective was to predict MAEs from combined 13N-ammonia (NH3) and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in ICM.

Methods and results
Consecutive patients with ICM undergoing combined NH3- and FDG-PET/CT were included. HM was quantified in relation to total left ventricular myocardium (i.e. ≥7% is large). The primary outcome was MAEs [sudden cardiac death, implantable cardioverter defibrillator (ICD) therapy, and sustained ventricular tachycardia/fibrillation].
Among 254 patients, median baseline LVEF was 35% [interquartile range (IQR) 28–45] and 10% had an ICD. PET/CT identified ischaemia in 94 (37%), scar in 229 (90%), and HM in 195 (77%) patients. Over a median follow-up of 5.4 (IQR 2.2–9.5) years, MAE occurred in 34 patients (13%). Large HM was associated with a lower incidence of MAE (hazard ratio 0.31, 95% confidence interval 0.1–0.8, P = 0.001). After multivariate adjustment for history of MAE, LVEF ≤35%, and scar ≥10%, large HM remained significantly associated with a lower incidence of MAE (P = 0.016). LVEF improved over time among patients with large HM (P = 0.006) but did not change in those without (P = 0.610) or small HM (P = 0.240).

Conclusion
HM conveys a lower risk of MAE in patients with ICM. This may be explained by an increase in LVEF when a large extent of HM is present.
Earthquake migration characteristics and triggering mechanisms in the Baihetan Reservoir Area based on machine-learning microseismic detection
Authors: Duan Mengqiao , Zhou Lianqing , Duan Longfei , Li Ziyi , Zhao Cuiping , Zhang Xiaodong 
Published: August 2024

SUMMARY
The Baihetan Reservoir, the second largest in the world, is located at the intersection of multiple large active fault zones on the eastern boundary of the Sichuan-Yunnan rhombic block. After impoundment on 6 April 2021, many earthquakes occurred around the reservoir area submerged by water. The largest ML 4.7 earthquake in the reservoir area occurred after the water level reached its highest point. But the seismogenic structures and mechanisms of earthquakes in the reservoir area are still unclear. Based on dense array data from the reservoir area, this paper uses the experimental site submodel of USTC-Pickers, transfer learned with ‘DiTing’ data set of China to obtain a high-precision earthquake catalogue that is twice as large as that the manual catalogue. This study show that earthquakes in the reservoir region primarily occur on secondary faults of pre-existing ones, characterized by a prominent feature of high dip angles trending northwest to southeast. Combined with the spatiotemperal migration characteristics of earthquakes and the relationship between earthquakes and water levels, we infer that most earthquakes are rapid response type and may be induced by rapid increase in elastic stress. Only the spatiotemporal distribution image of the ML 3.2 earthquakes sequence in the dam site-Toudaogou section conforms to the law of pore pressure diffusion, and belongs to the fast response type, which may be induced by the poroelasiticity coupling mechanism. The ML 3.0 earthquake swarm with deep depths in the Heishui River section belongs to the delayed response type and may be induced by the poroelasiticity coupling mechanism.
Spurious Rayleigh-wave apparent anisotropy near major structural boundaries: a numerical and theoretical investigation
Authors: Zeng Qicheng , Lin Fan-Chi , Tsai Victor C 
Published: August 2024

SUMMARY
The recent developments in array-based surface-wave tomography have made it possible to directly measure apparent phase velocities through wave front tracking. While directionally dependent measurements have been used to infer intrinsic $2\psi $ azimuthal anisotropy (with a 180° periodicity), a few studies have also demonstrated strong but spurious $1\psi $ azimuthal anisotropy (360° periodicity) near major structure boundaries particularly for long period surface waves. In such observations, Rayleigh waves propagating in the direction perpendicular to the boundary from the slow to the fast side persistently show a higher apparent velocity compared to waves propagating in the opposite direction. In this study, we conduct numerical and theoretical investigations to explore the effect of scattering on the apparent Rayleigh-wave phase velocity measurement. Using 2-D spectral-element numerical wavefield simulations, we first reproduce the observation that waves propagating in opposite directions show different apparent phase velocities when passing through a major velocity contrast. Based on mode coupling theory and the locked mode approximation, we then investigate the effect of the scattered fundamental-mode Rayleigh wave and body waves interfering with the incident Rayleigh wave separately. We show that scattered fundamental-mode Rayleigh waves, while dominating the scattered wavefield, mostly cause short wavelength apparent phase velocity variations that could only be studied if the station spacing is less than about one tenth of the surface wave wavelength. Scattered body waves, on the other hand, cause longer wavelength velocity variations that correspond to the existing real data observations. Because of the sensitivity of the $1\psi $ apparent anisotropy to velocity contrasts, incorporating such measurements in surface wave tomography could improve the resolution and sharpen the structural boundaries of the inverted model.
Temporal and Spatial Variation of Fault Creep along the Xianshuihe Fault from InSAR Stacking
Authors: Tong Xiaopeng , Chen Shi 
Published: August 2024

Summary
The left-lateral Xianshuihe fault is a seismically active fault system located at the eastern boundary of the Tibetan Plateau. We analyzed the Sentinel InSAR data from 2014 to 2021 to study the temporal and spatial variation of fault creep along the Xianshuihe fault. We applied the InSAR stacking method and the coherence-based SBAS method to derive the Line-Of-Sight (LOS) velocity map and time-series from both the ascending and descending orbits. We studied both the secular component and the time-dependent component of surface deformation from InSAR. We compare the InSAR-derived velocity maps with the GPS-derived velocity field and found that these two independent measurements are consistent. A 200 km long creeping section is identified along the central segment of the Xianshuihe fault. The surface creep rate is measured to be ranging from 0 to 6 mm yr−1. We combined the elastic dislocation model and the InSAR velocity maps to invert for the geodetic fault slip rate and the aseismic slip distribution in the upper crust. The secular fault creep model shows that most of the Xianshuihe fault is creeping at depth. The time-dependent fault creep model indicates that the maximum aseismic slip rate from Bamei to Kangding accelerated from 30 mm yr−1 to 40 mm yr−1 and then decayed to 5 mm yr−1 from 2014 to 2021. The fully creeping segment of the Xianshuihe fault seems to become a partially locked segment in a short time period (a couple of years). We suspect that the acceleration of fault creep from 2017 to 2019 is linked to dynamic triggering by passing seismic waves or fluid migration. Finally, we compare the temporal variation of fault creep with previous studies and discuss the earthquake hazard implications.
Injuries to Pacific mackerel (Scomber japonicus) from underwater explosions
Authors: Bowman Victoria , Jenkins A Keith , Dahl Peter H , Kotecki Sarah E , Casper Brandon M , Boerger Christiana , Smith Michael E , Popper Arthur N 
Published: August 2024

Abstract
This study expands previous work examining the effects on fishes from exposure to a single 4.5 kg underwater explosive detonation. Experiments were done in the field, with fish in cages at different distances from the source. Although our earlier work reported high acoustic dosage levels (e.g. based on peak pressure) correlating with severe injuries, dosage levels that result in moderate, or mild injuries were not clearly established. Thus, in this study, caged Pacific mackerel (Scomber japonicus) were placed at targeted ranges of 150–800 m from the source. All procedures were the same as in the earlier study except that animals were left at depth for ∼3 hours post-exposure to determine immediate effects on survival. Fish were then retrieved and assessed for physical damage. The only statistically significant tissue injuries were swim bladder bruising and in a reduction in inner ear sensory hair cell density that lessened with distance from the source. Still, results must be taken with caution since they may vary with different source levels, water depths, location of the fish in the water column, and by species.