bluuebunny/crossref_metadata_2025_split huggingface dataset:
Escalation of Oxygenation Modalities and Mortality in Critically Ill Immunocompromised Patient With Acute Hypoxemic Respiratory Failure: A Clustering Analysis of a Prospectively Multicenter, Multinational Dataset
Authors: Yvin Elise , Kouatchet Achille , Mokart Djamel , Martin-Loeches Ignacio , Taccone Fabio Silvio , Pène Frederic , Bauer Philippe R. , Séguin Amélie , van de Louw Andry , Mabrouki Asma , Bredin Swann , Metaxa Victoria , Klouche Kada , Montini Luca , Mehta Sangeeta , Bruneel Fabrice , Lisboa Tiago , Viana William , Pickkers Peter , Russell Lene , Rusinova Katherina , Rello Jordi , Barbier Francois , Clere-Jehl Raphael , Lafarge Antoine , Lemiale Virginie , Mercat Alain , Azoulay Elie , Darmon Michael 
Published: February 2025

Objectives:
Acute hypoxemic respiratory failure in immunocompromised patients remains the leading cause of admission to the ICU, with high case fatality. The response to the initial oxygenation strategy may be predictive of outcome. This study aims to assess the response to the evolutionary profiles of oxygenation strategy and the association with survival.

Design:
Post hoc analysis of EFRAIM study with a nonparametric longitudinal clustering technique (longitudinal K-mean).

Setting and Patients:
Multinational, observational prospective cohort study performed in critically ill immunocompromised patients admitted for an acute respiratory failure.

Interventions:
None.

Measurements and Main Results:
A total of 1547 patients who did not require invasive mechanical ventilation (iMV) at ICU admission were included. Change in ventilatory support was assessed and three clusters of change in oxygenation modality over time were identified. Cluster A: 12.3% iMV requirement and high survival rate, n = 717 patients (46.3%); cluster B: 32.9% need for iMV, 97% ICU mortality, n = 499 patients (32.3%); and cluster C: 37.5% need for iMV, 0.3% ICU mortality, n = 331 patients (21.4%). These clusters demonstrated a high discrimination. After adjustment for confounders, clusters B and C were independently associated with need for iMV (odds ratio [OR], 9.87; 95% CI, 7.26–13.50 and OR, 19.8; 95% CI, 13.7–29.1).

Conclusions:
This study identified three distinct highly performing clusters of response to initial oxygenation strategy, which reliably predicted the need for iMV requirement and hospital mortality.
Association of Hypocalcemia and Mean Arterial Pressure With Patient Outcome in ICU
Authors: Li Fang-yuan , Chen Yan , Zhou Xiang , Su Long-xiang , Long Yun , Weng Li , Du Bin ,   on behalf of China National Critical Care Quality Control Center Group and China Critical Care Clinical Trials Group (CCCCTG)
Published: February 2025

Objectives:
We aimed to verify the relationship between hypocalcemia in the first 24 hours of ICU admission and mortality, we also hypothesized that blood pressure and blood pressure reactivity are associated with ionized calcium (iCa) and might have mediation effects in the iCa-mortality association.

Design:
Retrospective, observational study.

Setting:
ICUs in a general hospital.

Patients:
Nonhypercalcemia adult patients were divided into two groups based on mean iCa within the first 24 hours after ICU admission using a cutoff of 1.1 mmol/L.

Interventions:
None.

Measurements and Main Results:
A total of 4947 patients from Peking Union Medical College Hospital between January 2013 and December 2022 were included in the study, with 2160 (43.7%) suffering from hypocalcemia. Overall, the median (interquartile range) age was 61 years (49–71 yr), with 2824 (57.1%) being female. Time-weighted average mean arterial pressure (TWA-MAP) above 0 and 65 mm Hg, respectively, during the first 24 hours were used to analyze the MAP of each patient and TWA-MAP/norepinephrine (TWA-MAP/NE) dose was calculated to examine blood pressure reactivity. Among 4091 patients eligible for multivariate analysis, iCa was independently associated with ICU mortality (odds ratio, 0.17; 95% CI, 0.04–0.79; p < 0.05). Both the blood pressure parameter (TWA-MAP above 0 mm Hg [TWA-MAP-0]) and pressure reactivity parameter (TWA-MAP-0/weight-adjusted dose of norepinephrine infusion in the first 24 hr after ICU admission [TWA-MAP-0/NE]) mediated the outcome of ICU mortality with a proportion of 4.55% (95% CI, 0.16–17%; p < 0.05) and 2.6% (95% CI, 0.02–11%; p < 0.05), respectively. TWA-MAP-0 correlated positively with iCa (Spearman rank test, ρ = 0.17; p < 0.01) while no significant association was found between iCa and TWA-MAP-0/NE (Spearman rank test, ρ = –0.07; p < 0.01).

Conclusions:
In this retrospective study on nonhypercalcemia patients, iCa of the first 24 hours after admission was independently associated with ICU mortality, which was potentially mediated by TWA-MAP and blood pressure reactivity (TWA-MAP/NE). iCa was also positively associated with TWA-MAP, while no general relationship was found between iCa and TWA-MAP/NE.
One-Year Mortality and Hospital Readmission in Survivors of COVID-19 Critical Illness—A Population-Based Cohort Study
Authors: Fernando Shannon M. , Qureshi Danial , Ante Zharmaine , Talarico Robert , McIsaac Daniel I. , Urner Martin , Munshi Laveena , Rochwerg Bram , Needham Dale M. , Hodgson Carol L. , Brodie Daniel , Fowler Robert A. , Slutsky Arthur S. , Scales Damon C. , Herridge Margaret S. , Tanuseputro Peter , Fan Eddy 
Published: February 2025

Objectives:
To evaluate 1-year outcomes (mortality, and recurrent hospital and ICU readmission) in adult survivors of COVID-19 critical illness compared with survivors of critical illness from non-COVID-19 pneumonia.

Design:
Population-based retrospective observational cohort study.

Setting:
Province of Ontario, Canada.

Patients:
Six thousand ninety-eight consecutive adult patients (≥ 18 yr old) from 102 centers, admitted to ICU with COVID-19 (from January 1, 2020, to March 31, 2022), and surviving to hospital discharge.

Interventions:
None.

Measurements and Main Results:
The primary outcome was 1-year mortality. We also evaluated the number of emergency department (ED) visits, hospital readmissions, and ICU readmissions over this same time period. We compared patients using overlap propensity score-weighted, cause-specific proportional hazard models. Mean age was 59.6 years and 38.5% were female. Of these patients, 1610 (26.4%) and 375 (6.1%) were readmitted to hospital and ICU, respectively, and 917 (15.0%) died within 1 year. Compared with survivors of critical illness from non-COVID-19 pneumonia (n = 2568), those who survived COVID-19 critical illness had a lower risk of ED visit (hazard ratio [HR], 0.65 [95% CI, 0.60–0.71]), hospital readmission (HR, 0.56 [95% CI, 0.51–0.62]), ICU readmission (HR, 0.44 [95% CI, 0.37–0.53]), and mortality (HR, 0.67 [95% CI, 0.58–0.78]) within 1 year.

Conclusions:
Risk of ED visit, hospital readmission, ICU readmission, and mortality within 1 year of discharge among survivors of COVID-19 critical illness was lower than survivors of critical illness from non-COVID-19 pneumonia.
The hypotension prediction index versus mean arterial pressure in predicting intraoperative hypotension
Authors: Rellum Santino R. , Noteboom Sijm H. , van der Ster Björn J.P. , Schuurmans Jaap , Kho Eline , Vlaar Alexander P.J. , Schenk Jimmy , Veelo Denise P. 
Published: February 2025

BACKGROUND
The hypotension prediction index (HPI) predicts hypotension, with randomised trials showing a significant reduction in hypotension-related metrics. However, the reliability of previous validation studies is debated, and it's unclear if mean arterial pressure (MAP) can be used interchangeably with HPI.

OBJECTIVES
This study compared the effectiveness of HPI versus MAP thresholds in predicting intraoperative hypotension, focusing on three clinically relevant metrics: time from alert to event, positive predictive value (PPV), and proportion of missed hypotensive events.

DESIGN
Prospective observational study conducted between 2018 and 2020.

SETTING
Single-centre, academic hospital in the Netherlands.

PARTICIPANTS
Adults scheduled for elective non-cardiac surgery lasting over two hours. Of the 105 eligible patients, 91 had sufficient data for analysis.

MAIN OUTCOME MEASURES
The primary outcome was the time-to-hypotensive event intervals predicted by HPI popup alerts (≥85 for ≥40 s) and MAP-alerts (70–75 mmHg). Secondary analyses examined differences between these predictors regarding the PPV and missed event rates, as well as the difference in these metrics between instant HPI-85 alerts and the six MAP-alerts.

RESULTS
The largest time-to-event difference was seen between HPI-85 popup and MAP-70 alerts, with a gain of 0.58 (95% confidence interval (CI), 0.57 to 0.58) min, favouring HPI. Higher MAP thresholds reduced this time difference, but worsened PPV values, with 20.5 (95% CI, 20.3 to 20.6)% at MAP-75 compared to 55.6 (95% CI, 55.4 to 55.8)% for HPI-85 popups. Missed event proportions were similar: between one to three percent. Instant HPI-85 and MAP-72 alerts showed comparable performance, but both had suboptimal PPV values around 30%. However, adding a 40-s time-dependence to MAP's alert definition levelled the differences across the three evaluated metrics, aligning more closely with HPI-85 popup alerts.

CONCLUSIONS
Using HPI-85 popup alerts does not provide additional prediction time over MAP-alerts in the 70 to 75 mmHg range, but they may be preferred due to higher PPV values. Instant HPI-85 and MAP-alerts perform similarly, with MAP-72 being closest, though these alerts more frequently occur regardless of subsequent hypotension with the potential to introduce unnecessary treatment. Adding a 40-s time-dependence to MAP-alerts to match the HPI popup characteristic eliminates distinctions between prediction time and missed events, while maintaining the higher PPV. However, whether 40sec-MAP-alerts are clinically equivalent remains to be determined in prospective clinical trials.

TRIAL REGISTRATION
Clinicaltrials.gov (NCT03795831) on 10 January 2019. https://clinicaltrials.gov/study/NCT03795831
Impact of self-expandable metal stent deployment site on stent dysfunction during EUS-guided hepaticogastrostomy
Authors: Ogura Takeshi , Ueno Saori , Okuda Atsushi , Nishioka Nobu , Sakamoto Jun , Yamada Masanori , Yamamura Masahiro , Uba Yuki , Tomita Mitsuki , Hattori Nobuhiro , Nakamura Junichi , Bessho Kimi , Nishikawa Hiroki 
Published: February 2025

ABSTRACT

Background and Objectives
Hyperplasia at the distal side of an EUS–guided hepaticogastrostomy (HGS) stent is one of the most frequent causes of stent dysfunction. However, risk factors for hyperplasia during EUS-HGS remain unclear. The aim of the present study was to determine the most appropriate stent site during EUS-HGS to obtain prolonged stent patency.

Method
This study included 100 consecutive patients who underwent successful EUS-HGS using a partially covered, self-expandable, metal stent (PCSEMS) between January 2017 and September 2022. The patients were divided into 2 groups according to the distal site of the PCSEMS at the intrahepatic bile duct, the peripheral side group and the central side group.

Results
There were 30 patients in the peripheral side group and 70 in the central side group. The diameter of the intrahepatic bile duct at the PCSEMS deployment site was significantly greater in the central side group (mean 7.90 mm) than in the peripheral side group (mean 4.25 mm; P < 0.05). Stent patency was significantly longer in the central side group than in the peripheral side group (median, 60 days vs. 144 days, P = 0.011), although overall survival was not significantly different. Hyperplasia was significantly more frequent in the peripheral side group. On multivariate analysis, the site of the PCSEMS (peripheral) was the only risk factor for stent dysfunction.

Conclusions
In conclusion, the distal site of the PCSEMS deployed at the hepatic hilar site from the confluence between B2 and B3 might play a role in obtaining longer stent patency.
Relationship between night eating syndrome, eating disorders, and menopausal symptoms in climacteric women: a pilot study
Authors: Ayar Pelin , Yılmaz Hacı Ömer 
Published: February 2025

Abstract

Objective
The aim of this study was to examine the relationship between night eating syndrome, eating disorders, and menopausal symptoms in climacteric women.

Methods
In this descriptive study, 90 climacteric women who met the inclusion criteria volunteered to participated. The data for the participants were collected via a face-to-face interview method using a sociodemographic and menopause questionnaire, the Eating Disorder Examination Questionnaire, the Night Eating Questionnaire, and the Menopause Rating Scale, and their anthropometric measurements were recorded.

Results
Among all participants, 51.1% had night eating syndrome. However, the night eating syndrome (P = 0.790) and eating disorders (P = 0.634) of the participants did not differ significantly according to the climacteric periods. Menopausal symptoms were found to be higher in perimenopausal and postmenopausal women than in premenopausal women (P = 0.001). There were significant positive correlations between eating disorders and both night eating (r = 0.253 and P < 0.05) and menopausal symptoms (r = 0.291 and P < 0.001). There was no relationship between menopausal symptoms and night eating habits (r = 0.141 and P > 0.05).

Conclusions
Eating disorders were found to be associated with night eating and menopausal symptom severity in climacteric women. There is a need for multidisciplinary studies to measure the risk of occurrence and recurrence of menopausal symptoms and the association with eating disorders experienced by women.
The Use of Stromal Vascular Fraction, Platelet-rich Plasma, and Stem Cells in the Treatment of Thumb Carpometacarpal Osteoarthritis
Authors: Pumberger Peter , Wechselberger Gottfried , Schwaiger Karl , Zimmermann Valentin 
Published: February 2025

Background:
Thumb function is integral to hand movement and overall hand function. Impairment, often caused by carpometacarpal (CMC) arthritis, reduces the quality of life. Here, we explored a novel approach using a mixture of the stromal vascular fraction, adipose-derived stem cells, and platelet-rich plasma to treat symptomatic trapeziometacarpal osteoarthritis.

Methods:
Retrospective data from 30 hands of 19 patients classified as Eaton and Littler stages 1–4 were analyzed. Platelet-rich plasma and fat were collected under sterile conditions, followed by centrifugation, stem cell extraction, and injection of the mixture into the thumb CMC joint under x-ray guidance. The measurement parameters included the visual analog scale pain score, grip strength, pinch strength, and Thumb Disability Examination (TDX) score. Statistical analysis was performed using paired t tests to evaluate the outcomes across the entire group, individual stages, and early/late stages.

Results:
We examined 30 hands of 19 patients with trapeziometacarpal osteoarthritis. Pain reduction was significant at 6 and 24 months for all stages, particularly stages 2 and 3. Substantial pain reduction was also observed at the early and late stages. The TDX score decreased significantly in all groups after 6 and 24 months. Hand function notably improved with significant gains in tip-to-tip pinch strength at 24 months and palmar pinch strength at 6 and 24 months. No complications were observed.

Conclusions:
The intra-articular injection of autologous conditioned plasma/stromal vascular fraction in patients with thumb CMC arthritis, in all stages, helps to improve pain symptoms and postpone potential resection arthroplasty with minimal surgical intervention and risks.
Effects of Cardiovascular Rehabilitation on Myocardial Perfusion and Functional Exercise Capacity in Patients With Stable Coronary Artery Disease and Myocardial Ischemia
Authors: Mazzucco Guillermo , Pilón Leonardo , Torres-Castro Rodrigo , Lista-Paz Ana , López Silvana , Chichizola Nicolás , Zapata Gerardo , López Jorge , Berenguel-Senén Alejandro , Arbillaga-Etxarri Ane 
Published: February 2025

Purpose:
Myocardial ischemia is prevalent in chronic heart diseases. Cardiac rehabilitation (CR) offers non-pharmacological benefits to reduce hospitalization and mortality, yet its impact on coronary vascular changes remains unclear. We assessed the effects of CR on myocardial perfusion and exercise capacity in patients with stable coronary artery disease and exercise-induced ischemia.

Methods:
We conducted a retrospective observational study in individuals with stable coronary artery disease and myocardial ischemia enrolled in a CR program. Inclusion criteria required a minimum of 3 months of supervised CR and cardiac single-photon emission computed tomography (SPECT) imaging before and after the program. Blinded analysis and interpretation of the SPECT studies was carried out by nuclear cardiologists. The primary outcome was a change in myocardial perfusion via SPECT analysis. Secondary outcomes included changes in exercise capacity, electrocardiographic changes during treadmill stress tests, and evaluation of adverse effects during training. Cinecoronariographies reports were collected for further cardiac status assessment.

Results:
Of 394 patients, 22 with myocardial ischemia were analyzed (96% males, 61.5 ± 9.5 yr). Number of CR sessions ranged from 42 to 73. Stress-induced ischemia significantly decreased (P = .019), with improvements in exercise capacity, including absolute peak oxygen uptake (mL/min, P = .027), relative oxygen uptake (mL/kg/min, P = .044), maximum metabolic equivalent of task (P = .019), and exercise duration (P < .001). No adverse events occurred.

Conclusion:
After a structured CR program of at least 3 months in patients with stable coronary artery disease and exercise-induced ischemia, there was a notable reduction in stress-induced ischemia and enhancements in exercise capacity, highlighting the safety and efficacy of CR in improving myocardial perfusion and exercise tolerance.
Impaired Endothelial Function in Individuals With Post-Acute Sequelae of COVID-19
Authors: Choi Tae Gu , Kim Jae Yeop , Seong Joon Youp , Min Ho Jeong , Jung Yong Joon , Kim Yun Wook , Cho Min Jeong , Kim Hyun Jeong , Kunutsor Setor K. , Heffernan Kevin S. , Jae Sae Young 
Published: February 2025

Purpose:
We investigated the presence of impaired endothelial function in individuals with post-acute sequelae of coronavirus disease-2019 (PASC) compared to healthy individuals and explored the efficacy of combined exercise training in restoring or improving endothelial function in those with PASC.

Methods:
Study I was a cross-sectional study which compared endothelial function between individuals with PASC (n = 29, mean age 22.9 ± 3.9 year) and healthy individuals (n = 42, mean age 21.7 ± 2.0 year). Study II, an intervention design, explored if combined exercise training (n = 14) could reverse the decline in endothelial function associated with PASC compared to controls (n = 14). The combined exercise program included aerobic, resistance, and inspiratory muscle training administered for 8 weeks. We measured endothelial function using flow-mediated dilation of the brachial artery and assessed peak oxygen uptake (VO2peak), dyspnea, and fatigue before and after the intervention.

Results:
Individuals with PASC exhibited significantly lower endothelial function compared to healthy controls (4.95 ± 2.0% vs 8.00 ± 2.4%, P < .001). The exercise group showed a significant increase in endothelial function (4.73 ± 1.5% to 7.98 ± 2.4%) as opposed to the control group (5.31 ± 2.5% to 6.30 ± 2.5%) (interaction effect: P = .008), reaching levels similar to those in healthy individuals. Additionally, the exercise group demonstrated improvement in VO2peak (38.3 ± 6.4 ml/min/kg to 42.8 ± 7.3 ml/min/kg, P < .001) and a reduction in dyspnea and fatigue compared to the control group (P < .001).

Conclusions:
Having PASC is associated with impaired endothelial function, but combined exercise training effectively restores it, making it a promising lifestyle intervention for vascular function in PASC.
Cardiovascular and Risk Factor Outcomes for Ethnic Minorities From Cardiac Rehabilitation
Authors: Duggan Sarah , Gallagher Robyn , Zhang Ling , de Melo Ghisi Gabriela Lima , Candelaria Dion 
Published: February 2025

Purpose:
To determine the benefits of cardiac rehabilitation (CR) among ethnic minorities for cardiovascular risk factors (systolic blood pressure [BP], exercise capacity, lipids, body fat), mortality, and morbidity, and compare outcomes to majority reference groups.

Review Methods:
We searched electronic databases (Medline, EMBASE, CINAHL, Scopus, Cochrane Library) from inception until September 2023 for studies reporting CR outcomes of ethnic minorities. Meta-analyses were conducted for data that could be pooled using random effects model. Data that were not suitable for meta-analysis were synthesized and reported narratively.

Summary:
Thirteen studies with a total of 132 109 participants (10 494 from ethnic minorities [8% of total participants]) were included. Patients from ethnic minority groups made improvements in several outcomes post-CR. These outcomes were equivalent to majority groups for systolic BP (Mean Difference [MD] = −0.69: 95% CI, −1.62 to 0.24 mmHg), maximal exercise capacity (MD = −0.10: 95% CI, −0.63 to 0.44 metabolic equivalents of task), total cholesterol (MD = 0.16: 95% CI, −0.01 to 0.33 mmol/L), and low-density lipoprotein cholesterol (MD = 0.25: 95% CI, −0.04 to 0.54 mmol/L). However, ethnic minorities achieved less improvements than the majority for body mass index (MD = −0.31: 95% CI, −0.47 to −0.14 kg/m2) and waist circumference (MD = −1.50: 95% CI, −2.33 to −0.68 cm). Narrative synthesis indicated equivalent outcomes for minorities for all-cause mortality and mean cholesterol, with worse risk of hospitalization at 1 year. Patients from ethnic minorities attending CR achieve equivalent benefits to majority counterparts for multiple risk factors and potentially mortality and morbidity, therefore CR should be strongly promoted. Individual tailoring may be needed to address adiposity and exercise capacity.
Infection prevention and control of epidemic-prone acute respiratory infections in healthcare setting
Authors: Simniceanu Alice , Satta Giovanni 
Published: February 2025

Purpose of review
The recent COVID-19 pandemic sparked discussions and highlighted significant gaps on the most appropriate infection prevention and control (IPC) measures when dealing with acute respiratory infections (ARIs). This narrative review aims to provide an overview of the existing international and national guidelines on the IPC measures to control epidemic and pandemic-prone ARIs in healthcare settings.

Recent findings
The WHO has recently produced a report proposing an updated terminology for respiratory pathogens. One of the key outcomes of this consultation was the adoption of the term ‘infectious respiratory particles’ (IRPs). According to the report, IRPs are defined as infectious particles that can be expired from an infected person through activities like breathing, talking, singing, coughing, sneezing, or even spitting. Most notably, there is no longer the clear and traditional distinction between droplet and aerosol based on the cut-off of particle size, but rather a continuum of particle sizes of IRPs.

Summary
Among other recommendations, all international guidelines place emphasis on the use of standard and transmission-based precautions when dealing with respiratory viruses. It is important to assess how the new proposed terminology for respiratory pathogens may affect the current existing IPC measures.