bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the influence of the impending death discharge tradition on home death rate in Taiwan
Authors: Lin Ming-Hwai , Chou Yiing-Jenq 
Published: June 2024

Background:
As modern societies witness a shift from home deaths to hospital deaths, the compromise practice of impending death discharge (IDD) in response to Chinese traditions and changing times deserves further exploration.

Methods:
Using the Longitudinal Generation Tracking Database 2005, a validated cohort of two million randomly sampled National Health Insurance (NHI) beneficiaries, we conducted a retrospective analysis on the places of death for 123 832 individuals from 2008 to 2017.

Results:
Approximately 47.4% of the residents died in hospitals, 45.6% died in their own homes, and 2.4% died in long-term care facilities. Of those who died at home, 27 809 (49.2%) had undergone an IDD and were classified in the IDD group. Over the past decade, there has been a noticeable trend of decreasing home death rates. This trend is mainly due to the decline in the IDD group, which decreased from 29.6% in 2008 to 16.0% in 2017. The percentage of non-IDD group deaths that occurred at home ranged from 21.4% to 24.7%. The logistic regression analyses of all patients admitted to hospital before death revealed that individuals with IDD tend to be women, middle-aged individuals (aged between 50 and 79 years), married, and those residing outside of the six municipalities. Furthermore, the choice for IDD varied with the cause of death, with conditions like sepsis and malignancy recording higher rates as opposed to pneumonia. Patients who were discharged from hospice care were less likely to choose IDD. No association was found between choosing IDD and receiving hospice home care or emergency room visits in the year before death.

Conclusion:
This study investigates factors associated with IDD, informing healthcare professionals on end-of-life care in Chinese culture. Future qualitative or prospective research can offer deeper insights into family dynamics, patient preferences, and other unmeasured factors influencing IDD utilization.
Short-term outcomes of short- and long-course chemoradiotherapy before total mesorectal excision for locally advanced rectal tumors: A single-center study in Taiwan utilizing propensity score matching
Authors: Chang Chih-Hsien , Chang Shih-Ching , Jiang Jeng-Kai , Wang Huann-Sheng , Lan Yuan-Tzu , Lin Chun-Chi , Lin Hung-Hsin , Huang Sheng-Chieh , Cheng Hou-Hsuan , Yang Yi-Wen , Lin Yu-zu 
Published: June 2024

Background:
Locally advanced rectal tumors are typically treated with neoadjuvant chemoradiotherapy. Short-course chemoradiotherapy (SCRT, 2500 cGy in five fractions) is a convenient alternative to concurrent chemoradiotherapy with long-course radiotherapy (CCRT, 4500 cGy in 25 fractions) without sacrificing efficacy. We aimed to compare the short-term outcomes of SCRT and CCRT in patients with mid- and low- rectal tumors who underwent total mesorectal excision using real-world data.

Methods:
We retrospectively reviewed the data of patients with locally advanced rectal cancer who underwent radical resection after neoadjuvant chemoradiotherapy from 2011 to 2022. We analyzed the clinicopathological findings and prognostic factors for disease-free and overall survival in the SCRT and CCRT groups and compared the outcomes using propensity score matching.

Results:
Among the 66 patients in the two groups, no disparities were noted in the demographic features, pathological remission, or downstaging rates. Nonetheless, the SCRT group exhibited superior 3-year disease-free survival (81.8% vs 62.1%, p = 0.011), whereas the overall survival did not differ significantly between the two groups. The initial carcinoembryonic antigen (CEA) levels and neoadjuvant SCRT were associated with the recurrence rates [hazard ratio (HR) = 1.13-4.10; HR = 0.19-0.74], but the harvested lymph node count was not (HR = 0.51-1.97).

Conclusion:
Among patients with locally advanced rectal cancer, SCRT combined with four cycles of FOLFOX was shown to enhance short-term disease-free survival. Factors impacting recurrence include the initial CEA level and SCRT, but not the harvested lymph node count.
Pain, Return to Community Status, and 90-Day Mortality Among Hospitalized Patients With Heart Failure
Authors: Smith Asa B. , Jung Miyeon , O'Donnell Daniel , White Fletcher A. , Pressler Susan J. 
Published: June 2024

Background
Pain is common among patients with heart failure but has not been examined with short-term discharge outcomes. The purpose was to examine whether pain at discharge predicts return to community status and 90-day mortality among hospitalized patients with heart failure.

Methods
Data from medical records of 2169 patients hospitalized with heart failure were analyzed in this retrospective cohort study. The independent variable was a diagnosis of pain at discharge. Outcomes were return to community status (yes/no) and 90-day mortality. Logistic regression was used to address aims. Covariates included age, gender, race, vital signs, comorbid symptoms, comorbid conditions, cardiac devices, and length of stay.

Results
The sample had a mean age of 66.53 years, and was 57.4% women and 55.9% Black. Of 2169 patients, 1601 (73.8%) returned to community, and 117 (5.4%) died at or before 90 days. Patients with pain returned to community less frequently (69.6%) compared with patients without pain (75.2%), which was a statistically significant relationship (odds ratio, 0.74; 95% confidence interval, 0.57–0.97; P = .028). Other variables that predicted return to community status included age, comorbid conditions, dyspnea, fatigue, systolic blood pressure, and length of stay. Pain did not predict increased 90-day mortality. Variables that predicted mortality included age, liver disease, and systolic blood pressure.

Conclusion
Patients with pain were less likely to return to community but did not have higher 90-day mortality. Pain in combination with other symptoms and comorbid conditions may play a role in mortality if acute pain versus chronic pain can be stratified in a future study.
A Set of Acupuncture Needles in the Late Qing Dynasty Collected by George Soulié de Morant
Authors: WANG Han , PANG Yichao , ZENG Ruilin , WU Kai 
Published: June 2024

Abstract
In the early 20th century, French vice-consul George Soulié de Morant encountered acupuncture during his visit to China, and then brought it back to France. After more than 100 years, his collection was transported from Paris, France to Kunming, China, and later recognized as a Chinese national third-class precious cultural heritage. Currently housed in the Museum of Western Studies on Chinese Medicine at Yunnan University of Chinese Medicine, this set of instruments includes one needle holder converted from a fan-shaped holder, ten acupuncture needles, and eleven paper tags handwritten in English with names of diseases and body parts. This article attempts to present the basic information and historical appearance of this set of late Qing dynasty acupuncture instruments by reviewing the collection and related research on acupuncture instruments, consulting acupuncture professionals, measuring the detailed information of the set of instruments, and employing a method of translating and summarizing the content of the attached tags.
Determining the association between systematic lupus erythematosus and the occurrence of primary biliary cirrhosis: a systematic review and meta-analysis
Authors: Polpichai Natchaya , Saowapa Sakditad , Chan Shu-Yen , Wattanachayakul Phuuwadith , Danpanichkul Pojsakorn , Fangsaard Panisara , Trongtorsak Angkawipa 
Published: June 2024

Background
Autoimmune diseases often coexist; however, the concomitant occurrence of systemic lupus erythematosus (SLE) and primary biliary cirrhosis (PBC) is rare. Therefore, this study aims to provide a comprehensive summary of evidence regarding the co-occurrence of SLE and PBC.

Methods

PubMed, Web of Science, ScienceDirect, and Google Scholar databases were systematically and comprehensively searched for records published up to February 2024. Full-text articles that aligned with the study’s aim were included, while those published in languages other than English and those designed as case reports, reviews, conference abstracts, or editorials were excluded. Statistical analyses were performed using Comprehensive Meta-Analysis software, and methodological quality was assessed using the Newcastle–Ottawa Scale.

Results
Only 14 studies that met the inclusion criteria with 3944 PBC and 9414 SLE patients were included for review and analysis. Pooled data analysis revealed that approximately 1.1% of SLE patients have concomitant PBC (range: 0.02–7.5%), while around 2.7% of PBC patients concurrently have SLE (range: 1.3–7.5%). Furthermore, qualitative data analysis indicated that the prevalence of PBC in SLE patients presenting with hepatic dysfunction or abnormal liver enzymes ranges from 2 to 7.5%.

Conclusion
Although the concomitant occurrence of SLE and PBC is rare, the small proportion of patients where these diseases coexist warrants close monitoring by clinicians. This underscores the importance of surveillance to prevent their co-occurrence.
Effects of Cardiopulmonary Rehabilitation on Cardiorespiratory Fitness and Clinical Symptom Burden in Long COVID
Authors: Besnier Florent , Malo Jacques , Mohammadi Hânieh , Clavet Sarah , Klai Chiheb , Martin Nicolas , Bérubé Béatrice , Lecchino Catia , Iglesies-Grau Josep , Vincent Thomas , Gagnon Christine , Gaudreau-Majeau Flavie , Juneau Martin , Simard François , L’Allier Philippe , Nigam Anil , Gayda Mathieu , Bherer Louis 
Published: June 2024

Objective
The aim of the study is to investigate the effectiveness of an 8-wk cardiopulmonary rehabilitation program on cardiorespiratory fitness (VO2peak) and key cardiopulmonary exercise test measures, quality of life, and symptom burden in individuals with long COVID.

Design
Forty individuals with long COVID (mean age 53 ± 11 yrs), were randomized into two groups: (1) rehabilitation group: center-based individualized clinical rehabilitation program (8 wks, 3 sessions per week of aerobic and resistance exercises, and daily inspiratory muscle training) and (2) control group: individuals maintained their daily habits during an 8-wk period.

Results
There was a significant difference between groups in mean VO2peak improvement (P = 0.003). VO2peak improved significantly in the rehab group (+2.7 mL.kg.min; 95% CI = +1.6 to +3.8; P < 0.001) compared to the control group (+0.3 mL.kg.min; 95% CI = −0.8 to +1.3 P = 0.596), along with VE/VCO2 slope (P = 0.032) (−2.4; 95% CI = −4.8 to +0.01; P = 0.049 and +1.3; 95% CI = −1.0 to +3.6; P = 0.272, respectively) and VO2 at first ventilatory threshold (P = 0.045). Furthermore, all symptom impact scales improved significantly in the rehabilitation group compared to the control group (P < 0.05).

Conclusions
An individualized and supervised cardiopulmonary rehabilitation program was effective in improving cardiorespiratory fitness, ventilatory efficiency, and symptom burden in individuals with long COVID. Careful monitoring of symptoms is important to appropriately tailor and adjust rehabilitation sessions.
Impact of a Sensor-Based Platform on the Outcome of Medial Off-Loader Bracing in Individuals With Knee Osteoarthritis
Authors: Darcy Rose , Couri Juliana , Newkirk Keira , Neagu Remus , Darbhe Vikram , Jayabalan Prakash 
Published: June 2024

Objective
The aim of the study is to determine the effectiveness of a medial off-loader brace with sensor monitoring capabilities and associated phone application in improving outcomes for individuals with knee osteoarthritis.

Methods
This is a randomized clinical trial of participants with knee osteoarthritis, aged 40–75 with two groups: 1) brace-only and 2) brace+sensor (sensor providing walking time, knee range of motion, and 7-day activity streak). Both groups received a prefabricated custom-fitted medial off-loader brace and 12-wk self-guided exercise therapy program. Baseline and postintervention assessments included subjective and objective outcomes.

Results
Sixty participants were recruited (n = 30/group). The brace+sensor group demonstrated higher study retention (88.89%) compared with the brace-only group (73.33%). Significant improvement in Knee Injury and Osteoarthritis Outcome Survey knee pain and other Knee Injury and Osteoarthritis Outcome Survey subscores compared with baseline was observed for both groups. However, only the brace+sensor group improved beyond the established minimal clinically important difference for Knee Injury and Osteoarthritis Outcome Survey pain (11.31 ± 13.87). Knee Injury and Osteoarthritis Outcome Survey activities of daily living was also significantly improved in the brace+sensor group compared with brace-only group (P = 0.049). Both treatment groups had significant improvement in functional outcomes (10-m walk, 5× sit-to-stand, P < 0.05). Only the brace+sensor group had significant improvements in the 6-min walk test (P = 0.02) and reduction in participant weight (P = 0.01) at 12 wks.

Conclusions
Incorporating wearable technology in standard bracing for individuals with knee osteoarthritis has potential in improving clinical outcomes.
Ultrasound-Guided Supraorbital Nerve Block as a Diagnostic Tool in the Outpatient Physiatry Setting
Authors: Myers Keith , Stitik Todd , Liu Shiyu , Tollin Noah 
Published: June 2024

Abstract
Here, we describe a case in which an ultrasound-guided supraorbital nerve block was used for the purposes of confirming the diagnosis of trigeminal neuralgia associated with herpes zoster and determining which trigeminal nerve branch is the pain generator in a patient with clinically suggestive findings. We discuss how performing a nerve block at the site of where the affected nerve exits the skull may identify which nerve is mediating the patient’s symptoms and therefore guide possible further treatment options, which could potentially provide a more lasting duration of relief.
LYMPHOSCORE (Lymphoscintigraphy Scoring Reliability) Reliability of a New Qualitative and Semiquantitative Lymphoscintigraphy Scoring System for Primary Lymphedema
Authors: Guillemard Sophie , Moulis Lionel , Ilonca Diana , Mestre Sandrine , Deshayes Emmanuel , Quéré Isabelle , Adham Salma 
Published: June 2024

Purpose of the Report
Primary lymphedema (PLE) is a rare chronic disorder. Extremity lymphoscintigraphy offers access for dynamic and functional information on peripheral lymphatics and lymph nodes. We aimed to assess intraobserver and interobserver reliability of a new lymphoscintigraphy quantitative and qualitative scoring system in a homogeneous population of adult patients followed for PLE of the lower limb(s).

Patients and Methods
This is a monocentric retrospective study. Clinical files of patients who underwent a lymphoscintigraphy were reviewed for inclusion. Lymphoscintigraphies were interpreted twice by 2 observers with a washout period. To assess intraobserver and interobserver reliability for both lower limbs, Cohen κ and Gwet’s AC1 reliability coefficients were calculated with 95% confidence interval and P value of the zero-reliability comparison test. To interpret reliability coefficients, we used the orders of magnitude reported by Landis and Koch.

Results
One hundred forty-four patients (288 limbs) with PLE were included. For intraobserver reliability, agreement range was 0.87–1 with an almost perfect agreement in all staging items of the score for both limbs with the lower limit of the 95% confidence interval ≥80%. Interobserver reliability was overall strong or almost perfect, ranging from 0.67 to 0.97.

Conclusions
This new scoring system demonstrated excellent intraobserver reliability and a very good interobserver reliability. Lymphoscintigraphy, when performed in a referral center and interpreted by trained nuclear medicine physicians, is a reliable means of investigation in patients with PLE of the lower limbs. This reproducibility advocates for further use of lymphoscintigraphy in multicentric cohorts of PLE patients.
A Dwindling Matter
Authors: Saxton Anthony T. , Monreal Alberto J. , Stang Michael T. , Kazaure Hadiza S. , Scheri Randall P. 
Published: June 2024

Objective:
To evaluate Medicare reimbursement trends for endocrine surgeries from 2000-23.

Background:
As the population ages, demand for endocrine surgeries is expected to increase. Understanding reimbursement trends is essential to ensure the financial sustainability of endocrine surgery.

Methods:
Data were extracted from Medicare Inpatient and Outpatient Hospital datasets, National Summary, and Physician Fee Look-up Files for nine common thyroid, parathyroid and adrenal surgeries. Data were adjusted for inflation. Descriptive statistics, compound annual growth rate (CAGR), and linear regression models were built to evaluate practice and reimbursement trends.

Results:
From 2000-23, there was a 63.8% increase in endocrine surgery volume. However, inflation-adjusted average procedure reimbursements decreased by 43.2% from $1709 to $972 (CAGR -2.4%), which is the largest decrease for any surgical subspecialty reported in the published literature. At the current CAGR, the average estimated reimbursement is projected to decrease to $868 by 2030 (P<0.001). Average facility reimbursements for inpatient and outpatient hospitalizations increased. However, substantial practice pattern shifts in the study period led to decreased overall facility reimbursements, with a $17.9 million decrease in total inpatient reimbursements between 2016-21 that was only partially offset by a $3.2 million increase in outpatient hospital reimbursements.

Conclusion:
Medicare procedure reimbursements for endocrine surgeries have been outpaced by inflation, with large decreases since 2000. Concurrent changes in practice patterns have also resulted in markedly fewer inpatient stays leading to lower total facility reimbursements. Our data raise concern over the financial sustainability of the endocrine surgery field as the demand for endocrine surgery procedures increases.
Does Hyperventilation Increase the Diagnostic Yield of the Routine Electroencephalogram: A Retrospective Analysis of Adult and Pediatric Cohorts
Authors: Nadarajah Neerrajah , Fahey Michael , Seneviratne Udaya 
Published: June 2024

Purpose:
While hyperventilation (HV) increases the diagnostic yield of EEG in children, there is conflicting evidence to support its application in adults. For the first time in history, a large cohort of patients has undergone EEGs without HV during the COVID-19 pandemic. Utilizing this opportunity, we sought to investigate whether HV increases the diagnostic yield of EEG in children compared with adults.

Methods:
Patients aged six years and above who had routine EEGs at Monash Health between January 2019 and December 2020 were studied. The cohort was divided into two, pediatric (younger than 18 years) and adult (18 years or older). Epileptiform abnormalities (ictal and interictal) were the outcomes investigated. The effect of HV was examined with logistic regression to determine odds ratios with 95% confidence intervals.

Results:
In total, we studied 3,273 patients (pediatric = 830, adult = 2,443). In the pediatric cohort, HV significantly increased the diagnostic yield of absence seizures (p = 0.01, odds ratios 2.44, 95% confidence intervals 1.21–4.93). In adults, HV did not increase the yield of absence seizures (p = 0.34, odds ratios 0.36, 95% confidence intervals 0.05–2.88). Interictal epileptiform discharges during HV were significantly more frequent in children compared with adults (p < 0.001, odds ratios 3.81, 95% confidence intervals 2.51–5.77).

Conclusions:
Hyperventilation is useful to increase the yield of interictal epileptiform discharges and absence seizures in pediatric patients but not in adults. Hence, routine EEG may be recorded in adults without HV when it is unsafe to perform.
Candida glabratamaintains two Hap1 homologs, Zcf27 and Zcf4, for distinct roles in ergosterol gene regulation to mediate sterol homeostasis under azole and hypoxic conditions
Authors: Saha Debasmita , Gregor Justin B. , Hoda Smriti , Eastman Katharine E. , Navarrete Mindy , Wisecaver Jennifer H. , Briggs Scott D. 
Published: June 2024

ABSTRACTCandida glabrataexhibits innate resistance to azole antifungal drugs but also has the propensity to rapidly develop clinical drug resistance. Azole drugs, which target Erg11, is one of the three major classes of antifungals used to treatCandidainfections. Despite their widespread use, the mechanism controlling azole-inducedERGgene expression and drug resistance inC. glabratahas primarily revolved around Upc2 and/or Pdr1. In this study, we determined the function of two zinc cluster transcription factors, Zcf27 and Zcf4, as direct but distinct regulators ofERGgenes. Our phylogenetic analysis revealedC. glabrataZcf27 and Zcf4 as the closest homologs toSaccharomyces cerevisiaeHap1. Hap1 is a known zinc cluster transcription factor inS. cerevisiaein controllingERGgene expression under aerobic and hypoxic conditions. Interestingly, when we deletedHAP1orZCF27in eitherS. cerevisiaeorC. glabrata,respectively, both deletion strains showed altered susceptibility to azole drugs, whereas the strain deleted forZCF4did not exhibit azole susceptibility. We also determined that the increased azole susceptibility in azcf27Δstrain is attributed to decreased azole-induced expression ofERGgenes, resulting in decreased levels of total ergosterol. Surprisingly, Zcf4 protein expression is barely detected under aerobic conditions but is specifically induced under hypoxic conditions. However, under hypoxic conditions, Zcf4 but not Zcf27 was directly required for the repression ofERGgenes. This study provides the first demonstration that Zcf27 and Zcf4 have evolved to serve distinct roles allowingC. glabratato adapt to specific host and environmental conditions.IMPORTANCEInvasive and drug-resistant fungal infections pose a significant public health concern.Candida glabrata, a human fungal pathogen, is often difficult to treat due to its intrinsic resistance to azole antifungal drugs and its capacity to develop clinical drug resistance. Therefore, understanding the pathways that facilitate fungal growth and environmental adaptation may lead to novel drug targets and/or more efficacious antifungal therapies. While the mechanisms of azole resistance inCandidaspecies have been extensively studied, the roles of zinc cluster transcription factors, such as Zcf27 and Zcf4, inC. glabratahave remained largely unexplored until now. Our research shows that these factors play distinct yet crucial roles in regulating ergosterol homeostasis under azole drug treatment and oxygen-limiting growth conditions. These findings offer new insights into how this pathogen adapts to different environmental conditions and enhances our understanding of factors that alter drug susceptibility and/or resistance.