bluuebunny/crossref_metadata_2025_split huggingface dataset:
71274 - Earnings and work loss after colon and rectal cancer: A Swedish nationwide matched cohort study
Authors: Nilsson Per J , Boman Sol Erika , Hed-Myrberg Ida , Bruze Gustaf , Martling Anna , Nordenvall Caroline 
Published: August 2024

Abstract

Introduction
Colorectal cancer is common and prognosis improving. Thus, survivorship including financial consequences after treatment is important. The aim of this study was to assess financial toxicity in working-age patients with colon and rectal cancer relative to matched comparators.

Method
The study utilised data from the Swedish national research database CRCBaSe that is generated from the Swedish ColoRectal Cancer Register and links several national registers. A retrospective population-based nation-wide cohort study on financial toxicity (i.e., earnings, disposable income, work loss) in survivors of stage I-III colorectal cancer treatment was undertaken. Median regression analyses were used to compare incomes and logistic regression for probability of work loss.

Result
A cohort of 8 863 colorectal cancer survivors (all diagnosed prior to 2017) with 52 138 matched comparators could be analysed. Although a clear reduction in earnings was observed the year of diagnosis, disposable income was unaltered. Earnings never fully recovered during the 5-year follow-up. The probability of work loss increased the year of diagnosis and never fully recovered. Probability of work loss appeared similar between colon and rectal cancer survivors, but the risk was most pronounced among patients with rectal cancer who had received neoadjuvant therapy.

Discussion
This study shows that despite a developed well-fare system providing maintained disposable income for colorectal cancer survivors, financial toxicity, particularly risk of work loss, occurs among survivors of colorectal cancer.
71795 - Income is associated with survival after diagnosis of metastatic colorectal cancer
Authors: Ljunggren Malin , Dietrich Caroline E , Merk Cecilia , Palmer Gabriella , Martling Anna , Nordenvall Caroline 
Published: August 2024

Abstract

Introduction
Treatment for metastatic colorectal cancer (mCRC) has evolved rapidly over the last few decades. We hypothesised that this had led to increasing differences in survival based on patient income. The aim was to investigate whether income was associated with survival after mCRC and whether a potential association persisted over the years.

Method
All Swedish adult patients diagnosed with colorectal cancer in 2009-2021 and metastases including 2022 were included. The CRCBaSe linkage was used to identify patients and retrieve data. The association between income quartile at metastasis diagnosis and overall survival was investigated using Cox regression. Diagnosis year was investigated as an effect modifier. Models were adjusted for sex, age, education level, marital status, and birth country.

Result
There were 33,800 patients with mCRC included. Median survival was 13 months for patients in the lowest income quartile and 19 months for patients in the highest income quartile. Median survival improved during the study period from 14 months in 2007-2011 to 19 months in 2017-2022. The adjusted model showed that patients in the highest income quartile had a superior survival (HR Q4 vs Q1: 0.86, 95% confidence interval: 0.83-0.90). Diagnosis year only marginally modified the effect income had on survival.

Discussion
Income is an important factor affecting survival after mCRC. Survival improved significantly during the time period. However, diagnosis year neither strengthened nor weakened the association between income and survival.
72315 - Point Of Care Ultrasound (POCUS) in screening for Abdominal Aortic Aneurysm: a comparative, cohort study
Authors: Starck Joachim , Brunkwall Silke , Mosonyi Andrea , Holst Jan 
Published: August 2024

Abstract

Introduction
Screening for abdominal aortic aneurysm (AAA) performed with ultrasound (US) in men reduces AAA-related mortality. Ambulatory screening and surveillance procedures could improve adherence to screening programs. Point Of Care Ultrasound (POCUS) could facilitate ambulatory screening for AAA. The aim of this study was to assess whether the infrarenal aortic diameter (IAD) in a screening setting could be measured interchangeably with POCUS compared to standard ultrasound equipment.

Method
A comparative cohort study was conducted of men screened for AAA at the age of 65 with IAD measured to ≥25-29 mm. The cohort was invited to re-examination 5-12 years after screening. Three measurements of IAD each were conducted with a standard US (LOGIQTM, GE) device and POCUS (LumifyTM, Philips) device. Limits of agreement between the devices and repeatability for each device were calculated.

Result
At screening, 500 men had IAD of ≥25–29 mm. With 102 men deceased at follow-up (FU), 230 men attended the examination. Median FU was 9.9 years (interquartile range [IQR]: 8.0-11.0). Median IAD was 27.1 mm, (IQR: 23.7-32.8). POCUS underestimated IAD by 0.23 mm compared to the standard ultrasound machine, 95% limits of agreement were -3.1 mm to 2.6 mm between the devices. The repeatability was ± 2.5 mm for standard equipment and ± 3.2 mm for handheld device.

Discussion
The handheld device showed no systematic bias of clinical importance in measuring IAD in a screening setting although with a slightly wider repeatability interval compared to standard US equipment implying the possibility to consider POCUS devices for AAA-screening purposes.
71312 - Ambulatory True-Close Thoracic Vent, an outpatient management of Pneumothorax – results of 24 years' experience
Authors: Leo Jonas , Shahrivar Mehrnoosh 
Published: August 2024

Abstract

Introduction
Traditional guidelines for the primary treatment of pneumothorax differ and include simple aspiration, small-bore catheter or chest tube drainage. Treatment via conventional chest tube drainage connected to a suction system is usually associated with hospitalization for approximately 6 days, immobilization, and discomfort. However, reliable patients who do not want to be hospitalized can safely be treated as outpatients with a small-bore catheter attached to a Heimlich valve, True-Close Thoracic Vent (TV).
We started using TV at Capio S:t Görans hospital (CStG) in 1999 in cooperation with dr Leif Dernevik, Department of Thoracic Surgery, Sahlgrenska University Hospital.

Method
TV is a minimally invasive, immediate salvage device for the treatment of pneumothorax. Indications are primary & secondary spontaneous and iatrogenic pneumothorax.
The exclusion criteria: hydro/hemopneumothorax, patient refusal, dementia or psychologically unstable, and underlying pulmonary disease requiring supplemental oxygen.
Patients are identified and operated on in the ward or postop area.
Operation technique: 2nd intercostal-space (IC2) in the midclavicular line (MCL), local anesthetics together with light iv sedation, mini thoracotomy (no-bore safe ATLS-technique), aspiration of air and fixation of TV.
Post drain x-ray is conducted and most of the patients are sent home the next day with a 5+2-day ambulatory treatment plan.

Result
2016-2023:
Cases n 445
Male/female 75/25%
Success rate 93%
AVLOS 2,3 days
Mortality 0%
Morbidity grade 3b, one patient (erroneous placement in IC1 MCL).

Discussion
TV is a safe, cost-effective ambulatory method for treatment of pneumothorax. By using this technique, CStG has saved approximately 2800 beds since 1999 compared to non-ambulatory pneumothorax care.
71533 - Epidemiology of the Trauma Population and Trauma-related Mortality at the Karolinska University Hospital over a 5-year period (2018-2022)
Authors: Kashash Sara , Akram Shahzad 
Published: August 2024

Abstract

Introduction
Trauma is the leading cause of mortality in adults under 45 years old. Trauma demographics change over time therefore requiring constant re-evaluation of the presenting trauma population to decrease morbidity and mortality. The study aimed to describe the trauma population at the Karolinska University Hospital, causes of death and examine the proportion of potentially preventable and preventable deaths.

Method
Using the trauma registry SweTrau, variables for all trauma patients &gt;15 years (6483 patients) were extracted during the period 2018 to 2022 with regards to age, gender, type of injury, injury mechanism, injury intention etc. Descriptive statistics were used to describe the general trauma population and compare survivors and non-survivors. Logistic regression was used to evaluate factors associated with 30-day mortality.

Result
Stockholm’s trauma demographics consist of predominantly male patients. Blunt, unintentional, injuries were the most common presenting trauma. The most common injury mechanism was falls. Most patients presented with mild to moderate injuries and were healthy prior to presentation. The main cause of death was traumatic brain injury. The percentage of potentially preventable and preventable deaths was 7% and 0.5%. The most common trauma care error was delay in time to surgery/treatment.

Discussion
The study shows a change in trauma mortality, with increasing mortality in the elderly population. There is a decrease in the number of preventable deaths which suggests that trauma care is improving. Future studies on specific subgroups of the trauma population, such as fall injuries in females and gunshot wound patients in males, can lead to further improvements.
72122 - Mesh removal due to foreign body reaction and mesh infection in Groin hernia surgery: A long-term nationwide population-based register study
Authors: Melkemichel Maria , Nordenson Mårten , De la Croix Hanna , Nordin Pär 
Published: August 2024

Abstract

Introduction
Groin hernia repairs (GHRs) with mesh is today gold standard procedure in western countries. Yet, foreign body reaction and mesh infection are feared complications. This study aimed to investigate the incidence and risk factors for mesh removal due to foreign body reaction and mesh infection following GHR.

Method
This is an observational nationwide populations-based register-study with the use of prospectively collected data from the Swedish Hernia Register (SHR). All patients ≥ 15 years old with a GHR registered in SHR between 1992 and 2022 were eligible. Primary outcome was the prevalence of re-surgery with mesh removal. Secondary outcome was risk factors for re-surgery with mesh removal.

Result
Out of 363 664 GHRs during this 30-years long study-period, 211 (0.058%) had a re-surgery with mesh removal. The share of female GHRs was higher in the mesh removal group (15.2 %) compared to the non-mesh removal group (7.9 %). Adjusted multivariate Cox regression analysis for the risk of re-surgery with mesh removal, demonstrated significantly increased hazard ratios for women (2.80, CI 1.70-4.63), emergency GHR (3.43, CI 1.94-6.03), open anterior GHR (2.76, CI 1.61-4.72), combined anterior/posterior GHR (3.98, CI 1.84-8.57) and for patients below the total median of 63 years old (2.61, CI 1.78-3.81). Combined anterior/posterior GHR consisted domintely of mesh plug repairs.

Discussion
The groin tissue tolerance for implanted mesh following GHR is considered high where re-surgery for mesh removal due to foreign body reaction and mesh infection is rare. Women, younger patients, emergency repairs and surgical method of repair were associated risk factors for such re-surgery.
71523 - 25 years with the Swedish national quality register for cleft lip and palate: -Where are we now?
Authors: Becker Magnus 
Published: August 2024

Abstract

Introduction
Initiated in 1999 by Sweden's six Cleft Lip and Palate (CLP) centers, the national CLP registry aimed to standardize treatment and improve care through outcome comparisons. Achieving a 100% participation rate, it was designated a national quality registry in 2009, including all Swedish children and adolescents with CLP born in 2009 onwards. In 2023, the registry attained the highest certification level, leveraging registered data for care development and research.

Method
As of March 20, 2023, the registry documented 4,695 individuals born between 1999 and 2022, with 2,671 cases post-2009. The predominant diagnosis was a cleft of the hard and soft palate, among other variations.
Data Quality: The registry boasts a 100% participation and a 94.6% coverage rate, with surgical and dental assessment reporting rates impressively over 90% for various age milestones. Early speech documentation presented challenges but showed improvement in recent cohorts.

Result
For isolated cleft palate cases, findings include a notable range in surgical interventions, secondary surgeries, and speech and dental outcomes at ages 5 and 10. Parent-reported intelligibility scores reflect high satisfaction, despite significant center-to-center variations in treatment specifics.

Discussion
CLP treatment in Sweden, marked by long-term engagement and diverse outcomes influenced by cleft severity and other factors, shows consistent success rates in dental occlusion and speech. The treatment for bilateral CLP and children with additional challenges continues to evolve, aiming for personalized care improvements.
71660 - Visualization of patient flow in standardized cancer patient pathways, and performance of detecting cancer
Authors: Borg Sixten , Hörstedt Ann-Sofi , Carlsson Tobias , Nilbert Mef , Larsson Anna-Maria , Ohlsson Björn 
Published: August 2024

Abstract

Introduction
Standardized cancer patient pathways (CPPs) were implemented to improve investigation and diagnostics for patients with symptoms comprising well-founded suspicion of cancer.
Our primary aim was to visualize the patient population going through CPPs, in terms of investigation time and various outcomes including cancer diagnoses. A second aim was to examine the performance of cancer detection in CPPs.

Method
We used data on patients starting in any of 28 CPPs (n=19,204) and patients diagnosed with cancer (n=7,895), in 2018 in Region Skåne in Sweden. The data, deterministically linked on the individual level, covered dates, events, and outcomes of CPPs and diagnoses recorded in the Swedish Cancer Register.
A state-transition model was developed to map patients' pathways through the CPPs. The patient flow through the model was visualized. Diagnoses were used to study rates of detected and undetected cancer.

Result
The visualization shows time of investigation, time to start of treatment, and rates of detected and undetected cancer. In patients whose suspicion of cancer was rejected, 0.8% were later diagnosed with the primarily suspected cancer, 1.0% with other cancer. Among patients not meeting criteria for well-founded suspicion, less than 3% were later diagnosed with cancer, none of which with the primarily suspected cancer.

Discussion
The visualization provides a useful overview of the patient flow through CPPs and illustrates investigation time, events, and outcomes. The use of CPPs detects cancer efficiently.
72012 - Nurses experience of caring for patients in need of surgical care cared for in non-surgical beds
Authors: Palafox Lucia Ocaranza , Persson Emma 
Published: August 2024

Abstract

Introduction
As the number of open care places in inpatient care has decreased over time, the number of outpatients has increased. Outlying of patients involve an increased patient safety risk and affect the nurse's nursing work. Patients with a surgical need of care may have a complex need for nursing and specialist nurses are an important part of the patient's care context. The aim is to describe nurses' experiences of caring for patients with a need of surgical care and who are out located in a non-specialized surgical ward.

Method
A qualitative interview study was conducted and a total of 8 nurses were interviewed. A qualitative content analysis was used in accordance with Graneheim and Lundman.

Result
Three main categories were crystallized: Patient safety risk, Impact on the work environment and Learning and development in the role of the nurse. The nurses stated that patients in need of surgical care are an interesting group of patients and that caring for these patients provided a positive variation in their work as well as development opportunities. The nurses also stated obstacles regarding providing patients with good and safe care as well as shortcomings in the nurses' work environment.

Discussion
Increased competence and better collaboration between different specialties can lead to improved patient safety and working environment for nurses who care for patients with surgical need of care and who are being treated at non-surgical wards. To increase the patient safety, the specialist nurse could have a more central role in the care of these patients.
Snow alga Sanguina aurantia as revealed through de novo genome assembly and annotation
Authors: Raymond Breanna B , Guenzi-Tiberi Pierre , Maréchal Eric , Quarmby Lynne M 
Published: August 2024

Abstract
To thrive on melting alpine and polar snow, some Chlorophytes produce an abundance of astaxanthin, causing red blooms, often dominated by genus Sanguina. The red cells have not been cultured, but we recently grew a green biciliate conspecific with Sanguina aurantia from a sample of watermelon snow. This culture provided source material for Oxford Nanopore Technology and Illumina sequencing. Our assembly pipeline exemplifies the value of a hybrid long- and short-read approach for the complexities of working with a culture grown from a field sample. Using bioinformatic tools we separated assembled contigs into two genomic pools based on a difference in GC content (57.5% and 55.1%). We present the data as two assemblies of S. aurantia variants but explore other possibilities. High-throughput chromatin conformation capture analysis (Hi-C sequencing) was used to scaffold the assemblies into a 96 MB genome designated ‘A’ and a 102 MB genome designated ‘B’. Both assemblies are highly contiguous: genome A consists of 38 scaffolds with an N50 of 5.4 Mb while genome B has 50 scaffolds with an N50 of 6.4 Mb. RNA-sequencing was used to improve gene annotation.
The Impact of Multimorbidity on Labor Force Participation Among the Middle-Aged and Older Working Population in the United States
Authors: Zhang Zhang , Gong Qing , Gilleskie Donna , Moulton Jeremy G , Sylvia Sean Y 
Published: August 2024

Abstract

Objectives
Multimorbidity, known as multiple chronic conditions (MCC), is the coexistence of two or more chronic health conditions (CHC). The near-retirement-age population with MCC is more likely to experience discontinued labor force participation (LFP). Our objective was to evaluate the impact of MCC on LFP among adults aged 50–64 and to explore heterogeneous effects between self-employed and non-self-employed workers.

Methods
We constructed our sample using the Health and Retirement Study (HRS) from 1996 to 2018. We adopted an individual fixed-effect (F.E.) model and propensity score matching (PSM) to measure the impact of MCC on the probability of being employed and changes in annual work hours.

Results
50.5% of respondents have MCC. Individuals with MCC exhibit a predicted probability of being employed that is 9.3 percentage points (p &lt; .01, 95% confidence interval [95% CI]: −0.109, −0.078) lower than those without MCC. Compared with non-CHC, MCC significantly reduced annual working hours by 6.1% (p &lt; .01, 95% CI: −0.091, −0.036) in the F.E. model and by 4.9% (p &lt; .01, 95% CI: −0.064, −0.033) in PSM estimation. The effect is more pronounced for the self-employed with MCC, who have 13.0% (p &lt; .05, 95% CI: −0.233, −0.026) fewer annual work hours than non-CHC based on the FE model and 13.4% (p &lt; .01, 95% CI: −0.197, −0.070) in PSM estimation.

Discussion
MCC significantly reduces LFP compared with non-MCC. MCC has a heterogeneous impact across occupational types. It is important to support the near-retirement-age working population with multimorbidity through effective clinical interventions and workplace wellness policies to help manage health conditions and remain active in the labor market.
Co-creating Humanistic AI AgeTech to Support Dynamic Care Ecosystems: A Preliminary Guiding Model
Authors: Hwang Amy S , Tannou Thomas , Nanthakumar Jarshini , Cao Wendy , Chu Charlene H , Zeytinoglu Atici Ceren , Scane Kerseri , Yu Amanda , Tsang Winnie , Chan Jennifer , Lea Paul , Harris Zelda , Wang Rosalie H 
Published: August 2024

Abstract
As society rapidly digitizes, successful aging necessitates using technology for health and social care and social engagement. Technologies aimed to support older adults (e.g., smart homes, assistive robots, wheelchairs) are increasingly applying artificial intelligence (AI), and thereby creating ethical challenges to technology development and use. The international debate on AI ethics focuses on implications to society (e.g., bias, equity) and to individuals (e.g., privacy, consent). The relational nature of care, however, warrants a humanistic lens to examine how “AI AgeTech” will shape, and be shaped by, social networks or care ecosystems in terms of their care actors (i.e., older adults, care partners, service providers); inter-actor relations (e.g., care decision making) and relationships (e.g., social, professional); and evolving care arrangements. For instance, if an older adult’s reduced functioning leads actors to renegotiate their risk tolerances and care routines, smart homes or robots become more than tools that actors configure; they become semiautonomous actors, in themselves, with the potential to influence functioning and interpersonal relationships. As an experientially diverse, transdisciplinary working group of older adults, care partners, researchers, clinicians, and entrepreneurs, we co-constructed intersectional care experiences, to guide technology research, development, and use. Our synthesis contributes a preliminary guiding model for AI AgeTech innovation that delineates humanistic attributes, values, and design orientations, and captures the ethical, sociological, and technological nuances of dynamic care ecosystems. Our visual probes and recommended tools and techniques offer researchers, developers/innovators, and care actors concrete ways of using this model to promote successful aging in AI-enabled futures.