bluuebunny/crossref_metadata_2025_split huggingface dataset:
Needs of female outpatients with alcohol use disorder: data from an Italian study
Authors: Vignoli Teo , Staccioli Maria Caterina , Salaris Maristella , Sanchini Samantha , Martino Elisa , Rigoli Lorena , Salis Francesco , Caputo Fabio , Fattore Liana , Agabio Roberta 
Published: August 2024

Abstract

Aims
Alcohol use disorder (AUD) is a common mental disorder characterized by sex-gender differences (SGDs). The present study was aimed at evaluating attitudes displayed by Italian AUD treatment services towards investigating the presence of SGDs in their patients and implementing gender-specific treatments for female AUD patients.

Methods
Potential SGDs were initially investigated in a sample of AUD outpatients, subsequently followed by a national survey on the adoption of specific interventions for female AUD outpatients.

Results
The presence of SGDs was confirmed in a sample of 525 (332 men; 193 women) AUD outpatients, including a higher prevalence of anxiety and mood disorders, and episodes of violence and trauma among female AUD outpatients compared to males. Despite the presence of these SGDs, only &lt;20% of a total of 217 Italian AUD treatment services reported the implementation of specific strategies for female AUD outpatients. The majority of services (94%) reported investigating episodes of violence and/or trauma, largely resorting to specific procedures only when these issues were detected.

Conclusions
Our findings confirm the presence of SGDs among AUD outpatients, including a higher prevalence of anxiety and mood disorders and episodes of violence and trauma among females compared with males. However, only a small number of services have adopted a gender medicine approach in AUD treatment. These results underline the urgency of investigating the specific needs of female, male, and non-binary AUD patients in order to personalize and enhance the effectiveness and appeal of AUD treatment.
The protection motivation theory as an explanatory model for intention to use alcohol protective behavioral strategies related to the manner of drinking among young adults
Authors: González-Ponce Bella M , Carmona-Márquez José , Pilatti Angelina , Díaz-Batanero Carmen , Fernández-Calderón Fermín 
Published: August 2024

AbstractAimsThis study aimed to prospectively examine the explanatory value of the protection motivation theory (PMT) for the intention to use manner of drinking protective behavioral strategies (MD PBS) and to explore its invariance across genders.MethodA targeted sampling procedure was used to recruit 339 young adults in the community (Mage = 21.1; SD = 2.21; female = 50.7%) who completed baseline and 2-month follow-up measures of the PMT constructs and intentions to use each of the five MD PBS.ResultsRegression analyses revealed that the coping appraisal components (response efficacy and self-efficacy) had greater explanatory power for the intention to use MD PBS than the threat appraisal components (perceived vulnerability and perceived severity). Perceived vulnerability to alcohol consequences was not prospectively associated with any specific behavioral intention or with the total MD PBS score. In contrast, perceived severity was prospectively associated with the intention to use three out of five PBS and the total MD score. Regression coefficients revealed gender invariance for all six models.ConclusionsOur findings suggest that interventions aimed at encouraging young adults to use alcohol MD PBS would be most effective if they included components that enhance self-efficacy in using these strategies and emphasize their perceived usefulness in reducing alcohol-related consequences.
Cyclin-dependent kinase 4/6 inhibitors combined with stereotactic ablative radiotherapy in oligometastatic HR-positive/HER2-negative breast cancer patients
Authors: Kubeczko Marcin , Gabryś Dorota , Krzywon Aleksandra , Jarząb Michał 
Published: August 2024

Abstract

Objectives
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have significantly improved the survival of patients with hormone receptor-positive HER2-negative advanced breast cancer (ABC). Although stereotactic ablative radiotherapy (SABR) is used more often in routine clinical practice, data on the safety and efficacy of combining SABR with CDK4/6i are lacking. Herein, we present the results of SABR combined with CDK4/6i in ABC.

Methods
Patients with ABC who received CDK4/6i and SABR between 2018 and 2023 were analysed.

Results
Among 384 patients treated with CDK4/6i, 34 patients received 44 courses of SABR. Two-year progression-free survival (PFS) was 63.6% (95% CI, 45.8-88.3), and the median PFS was 32 months. Three-year overall survival (OS) was 88.9% (95% CI, 77.7-100). Two-year local control (LC) was 92.7% (95% CI, 83.4-100). Median OS and LC were not reached. The subgroup analysis showed the difference in survival between oligometastatic patients (OMD) and non-OMD subgroup. Two-year PFS was 69.2% (95% CI, 44.5-100) in OMD compared with 57.4% (95% CI, 36-91.7) in the non-OMD (P = .042). Three-year OS was 90% (95% CI, 73.2-100) in OMD compared with 86.2% (95% CI, 70-100) in the non-OMD (P = .67). Median PFS and OS in the non-OMD were 26 and 56 months, respectively, and were not reached in OMD. Fifteen patients required CDK4/6i dose reduction, and 2 discontinued treatment due to toxicity. No difference in high-grade toxicity was observed between the sequential and concurrent SABR.

Conclusion
The addition of SABR to CDK4/6i seems to be safe and effective, especially in patients with oligometastatic disease.

Advances in knowledge
In advanced breast cancer patients treated with CDK4/6i, SABR provides a high local control and may provide additional benefit in an oligometastatic setting.
Comparison of percutaneous antegrade double-J ureteral stent placement: first-hand vs. nephrostomy route approaches
Authors: Arslan Muhammet , Aslan Halil S , Alver Kadir H , Demirci Mahmut 
Published: August 2024

Abstract

Objective
This study aimed to conduct a comparative analysis of procedural efficacy, safety, and patient outcomes between 2 distinct approaches for percutaneous antegrade double-J ureteral stent (DJS) insertion: the first-hand approach and via a nephrostomy route.

Methods
Electronic records of patients undergoing percutaneous antegrade ureteral DJS placement from January 2016 to 2023 were reviewed. Patients were categorized into 2 groups based on stent placement technique: the first-hand group, involving a single-stage approach without prior percutaneous nephrostomy catheter insertion, and the nephrostomy group, where stent placement occurred through a percutaneous nephrostomy tube. Clinical data, including patient demographics, primary diagnoses, procedural details, complication rates, stent placement success, and post-procedural outcomes, were collected and analysed.

Results
Both approaches demonstrated high technical success rates (93.1%). However, the nephrostomy route group exhibited a comparatively higher fluoroscopy exposure rate (8.2 min) than the first-hand group (6.8 min). Moreover, the complication risk increased by 3.08 times in patients treated with the nephrostomy method (P = .047). Notably, in cases of urinary malignancies, the preference was for placing DJS via nephrostomy.

Conclusion
The first-hand approach should be prioritized as the initial choice in suitable cases owing to its reduced fluoroscopy time, lower complication rate, and the single-stage nature of the procedure.

Advances in knowledge
With the exception of cases necessitating urgent drainage, such as post-renal acute renal failure and urosepsis, the first-hand method is the primary approach for inserting DJS. This is primarily due to the significantly shorter radiation time and the single-stage nature of the procedure.
Approaches to Supporting Young People in Out-of-Home Care Who ‘Self-Place’ in Unapproved Locations: Perspectives of Statutory Child Protection Practitioners
Authors: Venables Jemma , Warrell Chloe , Cullin Joel , Ellem Kathy , Healy Karen 
Published: August 2024

Abstract
The responsibilities of statutory child protection practitioners (SCPPs) include supporting the care and protection needs of young people in out-of-home care. SCPPs face challenges in responding to young people’s preferences and rights to self-determination within child protection systems that are often risk averse. This article considers SCPPs’ approaches to working with young people who leave approved placements to stay in other, unapproved locations. This phenomenon is referred to as ‘self-placing’ in Queensland (Australia), where this study was conducted. These young people are often disconnected from support, at increased risk of homelessness and exploitation, have increased contact with the justice system, disengage from education, face barriers to mental and physical health care and experience ongoing trauma and crisis. We draw on data from seven focus groups conducted with twenty-six practitioners from Queensland’s child protection authority to explore how they work with this cohort. Our findings highlight the discomfort that SCPPs experience, due to concerns about risk and a lack of formal practice guidelines. Despite sharing concerns for the safety of young people, SCPPs adopt different approaches to manage the complexities of this work. Understanding these practices can assist in developing more responsive policies and practices for supporting this cohort.
Anion recognition by phosphoric triamide-based receptors
Authors: Kondo Shin-ichi , Yuki Yuto , Kumagai Honoka , Yoshida Yuka , Li Chenyi 
Published: August 2024

Abstract
A series of phosphoric triamides were employed as a new class of anion receptor. The binding abilities for anions were evaluated by means of ultraviolet-visible and nuclear magnetic resonance spectral titrations. Receptor 1a ((PhNH)3P=O), which has 3 aryl N–H groups, showed remarkable binding ability for anions comparable to the corresponding N,N’-diphenylurea 2. The orders of the association constants of receptors 1a, 1b ((BuNH)(PhNH)2P=O), and 1c ((BuNH)2(PhNH)P=O) for anions are basically dependent on the charge, Hofmeister series, and size of anions. The order of the binding ability of receptors for anions is 1a &gt; 1b &gt; 1c, indicating that the hydrogen bond ability of aryl substituted phosphoryl amide N–H is stronger than that of alkyl substituted phosphoryl amide. The properties were confirmed by using density functional theory calculations.
Implications of Age for the Diagnostic and Prognostic Value of Cardiac Troponin T and I
Authors: Hasselbalch Rasmus Bo , Schytz Philip Andreas , Schultz Martin , Sindet-Pedersen Caroline , Kristensen Jonas Henrik , Strandkjær Nina , Knudsen Sophie Sander , Pries-Heje Mia , Pareek Manan , Kragholm Kristian H , Carlson Nicholas , Schou Morten , Andersen Mikkel Porsborg , Bundgaard Henning , Torp-Pedersen Christian , Iversen Kasper Karmark 
Published: August 2024

Abstract

Background
The influence of age on cardiac troponin is unclear and may vary between cardiac troponin T (cTnT) and I (cTnI). We aimed to compare the impact of age on the diagnostic and prognostic utility of cTnT and cTnI.

Methods
This Danish nationwide, register-based cohort study included patients with at least one cardiac troponin (cTn) measurement from 2009 through June 2022, stratified into decades of age. We used peak cTn concentration during admission, dichotomized as positive/negative and normalized to the 99th percentile. Receiver operating characteristics for myocardial infarction (MI) and logistic regression were used to estimate the odds ratio (OR) for mortality at 1 year.

Results
We included 541 817 patients; median age 66 years (interquartile range [IQR] 51–77) and 256 545 (47%) female. A total of 40 359 (7.4%) had an MI, and 59 800 (14.1%) patients died within 1 year of admission. The predictive ability of both cTns for MI were highest for patients 30 to 50 years. This was most pronounced for cTnT, the specificity of which fell from 83% among patients 40 to 49 years to 4% for patients ≥90 years. The prognostic ability of both cTns for 1-year mortality declined with age. cTnT had stronger prognostic ability for all age-groups; OR for a positive cTnT 28.4 (95% CI, 20.1–41.0) compared with 9.4 (95% CI, 5.0–16.7) for cTnI among patients &lt;30 years.

Conclusions
The predictive and prognostic ability of cTnT and cTnI declined with age. cTnT had a low specificity for MI in elderly patients. However, cTnT was the strongest prognostic marker among all age groups.
Multidisciplinary team meetings improve survival in patients with esophageal cancer
Authors: Lindblad Mats , Jestin Christine , Johansson Jan , Edholm David , Linder Gustav 
Published: August 2024

Summary
Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs’ effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan–Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80–90 years; odds ratio [OR] 0.25, 0.16–0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43–0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02–1.67), being married (OR 1.20, 1.01–1.43), squamous histology (OR 1.50, 1.22–1.84) and later year of diagnosis (OR 1.33, 1.29–1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66–0.78) and median survival increased from 4.5 to 10.7 months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.
ST-segment elevation myocardial infarction without culprit lesion—a case report picturing the challenging interplay of epicardial atherosclerosis and coronary artery spasm
Authors: Wachter Kristina , Akyol Elif , Bekeredjian Raffi , Ong Peter 
Published: August 2024

Abstract

Background
Approximately 5–15% of patients with acute coronary syndrome have myocardial infarction with unobstructed coronary arteries (MINOCA). Guidelines recommend invasive assessments to identify underlying causes for MINOCA such as coronary artery spasm (CAS), spontaneous coronary dissection, or microvascular disease as well as non-invasive assessments in search of myocarditis, takotsubo syndrome, or cardiomyopathies.

Case summary
A 54-year-old male patient presented with ST-segment elevation myocardial infarction (STEMI). Upon arrival, ST-segment elevation and symptoms had ceased. Emergency coronary angiography showed diffuse epicardial atherosclerosis with stenoses in the distal left anterior descending coronary artery (LAD) and second diagonal branch (D2); however, no epicardial occlusion was seen. Left ventriculography showed no clear wall motion abnormalities. Based on these findings, intracoronary acetylcholine (ACh) testing in search of CAS was performed. At 200 µg ACh intracoronary ST-segment elevation and chest pain recurred. Angiography showed occlusive epicardial spasm in the LAD and D2. Based on studies where the tendency of epicardial CAS was linked with the presence of epicardial atherosclerosis, the decision was made to perform PCI in the LAD and D2. ACh re-challenge after intracoronary nitroglycerine revealed only very mild symptoms, no demonstrable epicardial CAS, and no ST-segment elevation anymore. Cardiac enzymes reached their peak on day one [creatine kinase max 262 U/L (norm &lt; 190 U/L), maximum of high-sensitivity troponin T 269 pg/mL (n &lt; 14 pg/mL)].

Discussion
There is a broad spectrum of patients with STEMI without culprit lesion regarding the extent of epicardial disease. In cases with an unclear culprit lesion, other causes for the acute presentation such as CAS should be investigated in an ad hoc fashion. The interplay of epicardial atherosclerosis and CAS should receive more attention in future trials.
Profiling heart failure with preserved or mildly reduced ejection fraction by cluster analysis
Authors: Vicent Lourdes , Rosillo Nicolás , Vélez Jorge , Moreno Guillermo , Pérez Pablo , Bernal José Luis , Seara Germán , Salguero-Bodes Rafael , Arribas Fernando , Bueno Héctor 
Published: August 2024

Abstract

Background
Significant knowledge gaps remain regarding the heterogeneity of heart failure (HF) phenotypes, particularly among patients with preserved or mildly reduced left ventricular ejection fraction (HFp/mrEF). Our aim was to identify HF subtypes within the HFp/mrEF population.

Methods
K-prototypes clustering algorithm was used to identify different HF phenotypes in a cohort of 2570 patients diagnosed with heart failure with mildly reduced ejection fraction or heart failure with preserved left ventricular ejection fraction. This algorithm employs the k-means algorithm for quantitative variables and k-modes for qualitative variables.

Results
We identified three distinct phenotypic clusters: Cluster A (n = 850, 33.1%), characterized by a predominance of women with low comorbidity burden; Cluster B (n = 830, 32.3%), mainly women with diabetes mellitus and high comorbidity; and Cluster C (n = 890, 34.5%), primarily men with a history of active smoking and respiratory comorbidities. Significant differences were observed in baseline characteristics and 1-year mortality rates across the clusters: 18% for Cluster A, 33% for Cluster B, and 26.4% for Cluster C (P &lt; 0.001). Cluster B had the shortest median time to death (90 days), followed by Clusters C (99 days) and A (144 days) (P &lt; 0.001). Stratified Cox regression analysis identified age, cancer, respiratory failure, and laboratory parameters as predictors of mortality.

Conclusion
Cluster analysis identified three distinct phenotypes within the HFp/mrEF population, highlighting significant heterogeneity in clinical profiles and prognostic implications. Women were classified into two distinct phenotypes: low-risk women and diabetic women with high mortality rates, while men had a more uniform profile with a higher prevalence of respiratory disease.
Protective effects of fructose-1,6-bisphosphate postconditioning on myocardial ischaemia-reperfusion injury in patients undergoing valve replacement: a randomized, double-blind, placebo-controlled clinical trial
Authors: Xu Hongchun , Wang Min , Zhao Ting , Yu Xiang , Wang Fangjun 
Published: August 2024

Abstract

OBJECTIVES
Pharmacological postconditioning can protect against myocardial ischaemia-reperfusion injury during cardiac surgery with extracorporeal circulation. The aim of this study was to observe the protective effects of fructose-1,6-bisphosphate (FDP) postconditioning on myocardial ischaemia-reperfusion injury in patients undergoing cardiac valve replacement with extracorporeal circulation.

METHODS
Patients undergoing elective mitral valve replacement and/or aortic valve replacement were divided into normal saline postconditioning group (NS group) and FDP postconditioning group (FDP group). The primary outcome was the plasma concentration of creatine kinase-MB (CK-MB). The secondary outcomes were the plasma concentrations of lactate dehydrogenase, CK, high-sensitivity C-reactive protein, alpha-hydroxybutyrate dehydrogenase and cardiac troponin I, the spontaneous cardiac rhythm recovery profile, the extracorporeal circulation time and duration of surgery, intensive care unit and postoperative hospitalization.

RESULTS
Forty patients were randomly assigned to receive intervention and included in the analysis. The serum concentrations of CK-MB, lactate dehydrogenase, CK, cardiac troponin I, alpha-hydroxybutyrate dehydrogenase and high-sensitivity C-reactive protein at T1∼4 were lower in the FDP group than in the NS group (P &lt; 0.001). Compared with the NS group, the dosage of dopamine administered 1–90 min after cardiac resuscitation, the spontaneous cardiac rhythm recovery time and the incidence of ventricular fibrillation were lower in the FDP group (P &lt; 0.001, P &lt; 0.001 and P = 0.040, respectively). The values of ST- changes were increased more significantly in the NS group than in the FDP group (median [standard deviation] 1.3 [0.3] mm vs 0.7 [0.2] mm; P &lt; 0.001). Compared with the NS group, the time of recovery of ST-segment deviations was shorter in the FDP group (50.3 [12.3] min vs 34.6 [6.9] min; P &lt; 0.001).

CONCLUSIONS
The FDP postconditioning could improve both myocardial ischaemia-reperfusion injury and the spontaneous cardiac rhythm recovery during cardiac valve surgery with extracorporeal circulation.
The Influence of Vision Impairment on the Measurement of Cognition in Older Adults in India: Findings From LASI-DAD
Authors: Ehrlich Joshua R , Nichols Emma , Chen Yizhou , Nagarajan Niranjani , Zeki Al Hazzouri Adina , Reed Nicholas S , Lee Jinkook , Gross Alden L 
Published: August 2024

Abstract

Background and Objectives
Prior investigations have not considered whether poor vision biases cognitive testing. However, such research is vital given increasing evidence that vision impairment (VI) may be an important modifiable risk factor for dementia, particularly in low- and middle-income settings where the prevalence of VI is high.

Research Design and Methods
This study employed data from 3 784 participants in Wave 1 of the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) who underwent both visual acuity and cognitive function testing. We used multiple indicators and multiple causes models to assess differential item functioning (DIF; eg, bias) in cognitive testing by objectively measured distance and near VI. Multivariable linear regression was used to model the association between VI and cognitive factor scores before and after DIF adjustment. Analyses were performed for general cognition and separate cognitive domains, corresponding to memory, language/fluency, executive functioning, and visuospatial performance. Models were adjusted for demographic, health, and socioeconomic covariates.

Results
Participants in our sample were 60 and older. Most participants with VI were 60–69 years old (59.6%) and 50.8% were female. Individuals experiencing both distance and near VI tended to be older, have lower educational attainment, be married, reside in rural settings, and belong to lower consumption and BMI categories. Both distance and near VI were associated with poorer cognition before and after DIF-adjustment. Differences between DIF-unadjusted and -adjusted scores were small compared to the standard error of measurement, indicating no evidence of meaningful measurement differences by VI.

Discussion and Implications
In well-conducted large-scale surveys, bias in cognitive testing due to VI is likely minimal. Findings strengthen previous evidence on the association between VI and dementia by showing that such associations are unlikely to be attributable to vision-related measurement error in the assessment of cognitive functioning.