bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of chronic diarrhea and its association with obesity in a Chinese community-based population
Authors: Han Ke , Wang Xiangyao , Wang Yan , Niu Xiaotong , Xiang Jingyuan , Ru Nan , Jia Chunxu , Sun Hongyi , He Zhengting , Feng Yujie , Linghu Enqiang 
Published: June 2024

Abstract

Background:
Epidemiological data on chronic diarrhea in the Chinese population are lacking, and the association between obesity and chronic diarrhea in East Asian populations remains inconclusive. This study aimed to investigate the prevalence of chronic diarrhea and its association with obesity in a representative community-dwelling Chinese population.

Methods:
This cross-sectional study was based on a multistage, randomized cluster sampling involving 3503 residents aged 20–69 years from representative urban and rural communities in Beijing. Chronic diarrhea was assessed using the Bristol Stool Form Scale (BSFS), and obesity was determined based on body mass index (BMI). Logistic regression analysis and restricted cubic splines were used to evaluate the relationship between obesity and chronic diarrhea.

Results:
The standardized prevalence of chronic diarrhea in the study population was 12.88%. The average BMI was 24.67 kg/m2. Of all the participants, 35.17% (1232/3503) of participants were classified as overweight and 16.13% (565/3503) as obese. After adjustment for potential confounders, individuals with obesity had an increased risk of chronic diarrhea as compared to normal weight individuals (odds ratio = 1.58, 95% confidence interval: 1.20–2.06). A nonlinear association between BMI and the risk of chronic diarrhea was observed in community residents of males and the overall participant group (P = 0.026 and 0.017, respectively).

Conclusions:
This study presents initial findings on the prevalence of chronic diarrhea among residents of Chinese communities while offering substantiated evidence regarding the significant association between obesity and chronic diarrhea. These findings offer a novel perspective on gastrointestinal health management.
PRAME and Historical Immunohistochemical Antibodies Ki-67, P16, and HMB-45 in Ambiguous Melanocytic Tumors
Authors: Mert Merve , Bozdogan Onder , Bozdogan Nazan , Gamsızkan Mehmet , Safali Mukerrem 
Published: June 2024

Abstract:
Ambiguous melanocytic lesions/tumors (AMLs) can be simply described as melanocytic neoplasms that cannot be differentiated as either a melanoma or a nevus. Preferentially expressed antigen in melanoma (PRAME) is a novel antibody that can help differentiate between nevi and melanomas. However, its usefulness remains controversial in AMLs. The aim of this study was to demonstrate the importance of PRAME and diagnostic auxiliary antibodies (Ki-67, p16, HMB-45) in the diagnosis of melanocytic lesions, especially in AMLs. This study included 52 ambiguous melanocytic lesions, 40 nevi, and 40 melanomas. All immunohistochemical studies were performed automatically using the Universal Alkaline Phosphatase Red Detection Kit. Different analytic approaches were used for each antibody based on the literature. Statistically, the multinomial forward stepwise elimination logistic regression analysis was used to create a statistical model to predict the diagnosis of melanocytic lesions based on clinical, morphological, and immunohistochemical data. PRAME positivity was very strong and diffuse in the melanoma group and statistically significantly higher than that of the AML and nevus groups. There was no statistically significant difference between the nevus and AML groups. The Ki-67 proliferation index and HMB-45 staining pattern provided valuable indications for distinguishing between these 3 groups. The P16 antibody was limited in supporting the differential diagnosis. Our statistical model showed that a high mitosis count, central pagetoid spread, and PRAME positivity increased the probability of melanoma against an AML diagnosis. This study showed the advantages of evaluating the PRAME antibody together with morphological features and other immunohistochemical markers (Ki-67 and HMB-45) in the differential diagnosis of melanocytic lesions.
Neuromuscular blocking agent drug challenge: a literature review and protocol proposal with biological evaluation
Authors: Gouel-Chéron Aurélie , Neukirch Catherine , Chollet-Martin Sylvie , Valent Arnaud , Plaud Benoit , Longrois Dan , Nicaise-Roland Pascale , Montravers Philippe , de Chaisemartin Luc 
Published: June 2024

BACKGROUND
Drug challenge is the gold standard for identifying causative agents of drug allergies. Although clinical guidelines have recently been published, they do not recommend neuromuscular blocking agent (NMBA) drug challenges. NMBA challenges are rendered difficult by the lack of homogeneity of routine allergy work-ups and the necessity of a specialised setting. Several scenarios support NMBA challenges, such as an ambiguous allergy work-up, a high suspicion of a false-positive skin test or identification of a well tolerated alternative NMBA strategy. Furthermore, routine allergy work-ups may not recognise non-IgE mechanisms, such as IgG or MRGPRX2, whereas drug challenges may reveal them. Finally, if the culprit NMBA is not identified, subsequent anaesthesia regimens will be challenging to implement, resulting in increased risk.

OBJECTIVE(S)
This literature review discusses the indications, strategies, doses, monitoring methods, limitations, and unresolved issues related to drug challenges for NMBAs.

DESIGN
The literature review included randomised controlled trials, observational studies, reviews, case reports, series, and comments on humans.

DATA SOURCES
Studies were retrieved from databases (PubMed) and electronic libraries (OVID, EMBASE, Scopus, etc.).

ELIGIBILITY CRITERIA
All studies that referred to the NMBA challenge were included without publication date limitations.

RESULTS
NMBA challenge may be considered in NMBA anaphylaxis patients with inconclusive or ambivalent IgE diagnostic work-up under controlled conditions (presence of anaesthetists and allergists with continuous monitoring in a secured environment). To illustrate its utility, a case report of a double NMBA challenge in a patient with NMBA cross-reactivity is presented, along with biological explorations to detect subclinical cellular activation, a novel aspect of this procedure.

CONCLUSION
Drug challenges could be implemented during the NMBA allergy work-up under strict safety conditions at specialised centres with close collaboration between anaesthetists and allergists. This could decrease uncertainty and contribute to defining a safer strategy for subsequent anaesthetic drug regimens.
Arterial stiffness assessment by pulse wave velocity in postmenopausal women: comparison between noninvasive devices
Authors: Bohn Lucimere , Rial-Vázquez Jessica , Nine Iván , Rúa-Alonso María , Fariñas Juan , Giráldez-García Manuel Avelino , Mota Jorge , Iglesias-Soler Eliseo 
Published: June 2024

Abstract

Objective
This study aimed to ascertain the accuracy of measure arterial stiffness using the HUAWEI GT 3 Pro smartwatch and pOpmètre device against the SphygmoCor (algorithms: intersect tangent and maximum of the second derivate).

Methods
Twenty-three physically active postmenopausal women (age: 58.9 ± 3.2 years; body mass index: 26.3 ± 4.8 kg/m2) were recruited. Carotid-femoral pulse wave velocity, finger-toe pulse wave velocity, and wrist-finger pulse wave velocity were obtained using SphygmoCor, pOpmètre and HUAWEI GT 3 Pro devices in a randomized order. Additionally, the pulse mean carotid-femoral and finger-toe pulse transit time was registered for SphygmoCor and pOpmètre, respectively.

Results
Lower values of pulse wave velocity were recorded by HUAWEI in comparison with SphygmoCor with both algorithms, whereas no significant differences were detected between SphygmoCor and pOpmètre results. Pulse wave velocity values from SphygmoCor were positively correlated with pOpmètre results (r = 0.464 and r = 0.451 using intersect tangent and second derivative algorithms), whereas this was not the case with those obtained from HUAWEI. Coefficients of bias of Lin's concordance coefficients close to 1 (0.832 and 0.831 for intersect tangent and second derivative algorithm, respectively) and mean bias close to 0 from Bland-Altman analysis suggested an acceptable agreement between pulse wave velocity obtained from SphygmoCor and pOpmètre.

Conclusions
Our results suggest an acceptable concordance of pulse wave velocity values recoded by SphygmoCor and pOpmètre, whereas this was not the case for data obtained from HUAWEI GT 3 Pro smartwatch. Therefore, the pOpmètre may be a viable alternative for assessing arterial stiffness, but measurement via the smartwatch device cannot be recommended.
Sleep disturbance associated with the menopause
Authors: Maki Pauline M. , Panay Nick , Simon James A. 
Published: June 2024

Abstract

Importance and objectives
Sleep disturbance is one of the most common and debilitating symptoms experienced by women during the menopause transition. However, there are currently no therapies specifically approved for sleep disturbance associated with the menopause. Here, we consider how to characterize sleep disturbance associated with the menopause and discuss its etiology, including the latest advances in our understanding of the neuronal circuits that regulate reproduction, body temperature, sleep, and mood; and reflect on its impact on women's health and well-being. We also examine the current treatment landscape and look to the future of treatment for this condition.

Methods
We conducted a review of the literature and combined this with discussion with experts in the fields of sleep and menopause as well as experiences from our own clinical practices.

Discussion and conclusions
Sleep disturbance associated with the menopause is characterized by frequent night-time awakenings and increased awake time after sleep onset. Its impacts are wide-ranging, negatively affecting health as well as personal and social relationships, productivity, and work performance. There is currently an unmet need for effective, safe, and well-tolerated treatments to address this important symptom, and wider recognition of the association between sleep disturbances and the menopause is needed. Sleep disturbances associated with the menopause can result from hormone changes as well as vasomotor and mood symptoms. Growing research has contributed to our knowledge of the role of hypothalamic estrogen-sensitive kisspeptin/neurokinin B/dynorphin neurons. These neurons are thought to integrate the gonadotropin-releasing hormone pathway and the pathways responsible for the homeostatic control of body temperature and the circadian regulation of sleep-wake cycles. Understanding these neurons offers the potential to create treatments that target a key cause of sleep disturbance associated with the menopause. Further research to understand their etiology and characterize the neuronal circuits responsible could benefit the development of these targeted treatment approaches.
Suture Packaging as a Marker for Intraoperative Image Alignment in Augmented Reality on Mobile Devices
Authors: Necker Fabian N. , Cholok David J. , Shaheen Mohammed S. , Fischer Marc J. , Gifford Kyle , Le Castillo Chris , Scholz Michael , Leuze Christoph W. , Daniel Bruce L. , Momeni Arash 
Published: June 2024

Summary:
Preoperative vascular imaging has become standard practice in the planning of microsurgical breast reconstruction. Currently, translating perforator locations from radiological findings to a patient’s abdomen is often not easy or intuitive. Techniques using three-dimensional printing or patient-specific guides have been introduced to superimpose anatomy onto the abdomen for reference. Augmented and mixed reality is currently actively investigated for perforator mapping by superimposing virtual models directly onto the patient. Most techniques have found only limited adoption due to complexity and price. Additionally, a critical step is aligning virtual models to patients. We propose repurposing suture packaging as an image tracking marker. Tracking markers allow quick and easy alignment of virtual models to the individual patient’s anatomy. Current techniques are often complicated or expensive and limit intraoperative use of augmented reality models. Suture packs are sterile, readily available, and can be used to align abdominal models on the patients. Using an iPad, the augmented reality models automatically align in the correct position by using a suture pack as a tracking marker. Given the ubiquity of iPads, the combination of these devices with readily available suture packs will predictably lower the barrier to entry and utilization of this technology. Here, our workflow is presented along with its intraoperative utilization. Additionally, we investigated the accuracy of this technology.
Feasibility of BrainSTORM, a Traumatic Brain Injury Transitional Care Intervention
Authors: Loflin Callan , Cheever C. Ray , You HyunBin , Oyesanya Tolu O. 
Published: June 2024

Objective: To investigate the feasibility, acceptability, and clinical outcome measures of a transitional care intervention for patients with traumatic brain injury (TBI) and their family caregivers. Setting: Inpatient and outpatient rehabilitation at a level I trauma center in the Southeastern United States. Participants: Patients (ages 18-75) diagnosed with moderate to severe TBI, receiving rehabilitation, and their family caregivers. Design: Quasi-experimental, single-arm, single-center feasibility study with pre- and post-test design. Participants completed a 4-month transitional care program involving monthly education and social support. Main measures: Feasibility of enrollment, data collection, intervention completion rates, and intervention acceptability. Clinical outcome measures included patient quality of life (QOL) (12-Item Short Form Health Survey (SF-12), primary outcome) and patient and caregiver self-efficacy (Self-Efficacy for Management of Chronic Conditions Scale). Results: Eleven dyads and 1 monad enrolled (N = 23, 12 patients, 11 caregivers). All completed baseline data; 91.3% (n = 21, 11 patients, 10 caregivers) completed 2-month (intervention midpoint) data; and 86% (n = 20, 11 patients, 9 caregivers) completed 4-month (intervention endpoint) data. The intervention completion rate was 91.67%. Participants engaged in a mean of 2.17 (SD = 1.34) monthly educational webinars and 2.42 (SD = 1.51) social support groups during the intervention period. Approximately 70% of participants (n = 16, 9 patients, 7 caregivers) completed acceptability data, indicating positive intervention experiences (patients: mean 9.44/10 [SD = 1.01]; caregivers: mean 9.57/10 [SD = 0.79]). Patient QOL scores did not statistically improve over time; however, patient self-efficacy scores did statistically significantly improve from baseline (mean = 7.03, SD = 1.53; P = .0197) to intervention end point (4 months) (mean = 8.35, SD = 1.71). Conclusion: Brain Injury Support To Optimize Recovering Minds (BrainSTORM) is a promising new TBI transitional care intervention that has potential to enhance care standards for patients with TBI and their family caregivers. Further research is needed to determine its efficacy.
Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury
Authors: Pradhan Sujata , Esterov Dmitry , Driver Simon , Whyte John , Bell Kathleen R. , Barber Jason , Temkin Nancy , Bombardier Charles H. 
Published: June 2024

Objectives:
To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post–moderate-severe traumatic brain injury (TBI).

Setting:
Four inpatient rehabilitation centers.

Participants:
Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person.

Design:
Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days.

Main Analyses:
We used multivariate regression to predict minutes per week of MVPA at 12 months after TBI. Three classes of predictors were entered hierarchically—demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1 week after discharge from inpatient rehabilitation.

Results:
180 participants (ages 17.7–90.3 years) were enrolled, and 102 provided at least 5 days of valid accelerometer data at 12 months. At 12 months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA (r = −0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61.

Conclusions:
Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.
Descemet Membrane Endothelial Keratoplasty for Endothelial Failure in Primary Angle Closure Suspects
Authors: Roy-Chowdhury Eva , Angerer Maximilian P. M. , Schlötzer-Schrehardt Ursula , Tourtas Theofilos , Kruse Friedrich E. , Weller Julia M. 
Published: June 2024

Purpose:
To analyze the feasibility and outcome of Descemet membrane endothelial keratoplasty (DMEK) for treatment of endothelial failure in primary angle closure suspect (PACS) eyes.

Methods:
Retrospective, single-center case series of eyes treated by DMEK for endothelial failure caused by PACS. Main study parameters were success rate of DMEK, best-corrected visual acuity, anterior chamber depth, central corneal thickness, and endothelial cell density. Mean follow-up time was 16 ± 13 months.

Results:
Ten eyes of 9 patients receiving DMEK for the treatment of corneal endothelial failure because of PACS were included. Except for 2 eyes that had undergone cataract surgery, none of the eyes had previous ocular surgery. DMEK combined with cataract surgery was performed in 5 eyes, DMEK alone with second-step cataract surgery in 2 eyes. The eyes with corneal edema after cataract surgery received DMEK only. DMEK surgery was successful in nine out of 10 eyes, 1 patient required repeat DMEK because of primary graft failure. In the group of phakic eyes, mean preoperative internal anterior chamber depth was 1.74 ± 0.18 mm. In eyes with corneal edema, central corneal thickness was 849 ± 205 μm before DMEK surgery, and 517 ± 24 μm at the final postoperative visit (P = 0.002).

Conclusions:
DMEK is a feasible option in eyes with endothelial failure because of primary angle closure. In case of advanced corneal edema, a second-step procedure (first DMEK, second cataract surgery) is a possible approach if visibility of the lens is too poor for simultaneous cataract surgery.
Comparison of Hepatitis B Surface Antibody Levels After Vaccination With Combined One Dose of Hexavalent Vaccine and Two Doses of Pentavalent Vaccine Versus Three Doses of Pentavalent Vaccine
Authors: Soonthornarrak Kantron , Limrungsikul Anchalee , Apiwattanakul Nopporn 
Published: June 2024

Background:
Vaccination can effectively prevent hepatitis B virus (HBV) infection. Vaccination with 3 doses of hexavalent HBV-containing vaccines led to a higher Hepatitis B surface antibody (anti-HBs) antibody level than vaccination with 3 doses of pentavalent HBV-containing vaccines. Whether the substitution of one dose of hexavalent HBV-containing vaccine in the pentavalent regimen could lead to a higher anti-HBs antibody level remains unknown.

Methods:
A randomized, open-label controlled trial was conducted. Infants 30–120 days of age were randomly assigned to either a combined hexavalent/pentavalent regimen (hexavalent HBV-containing vaccine at 2 months of age and pentavalent HBV-containing vaccine at 4 and 6 months of age) or a 3-dose pentavalent regimen (pentavalent HBV-containing vaccine at 2, 4, and 6 months of age). Anti-HBs antibody levels were measured 3–6 months after the last vaccination.

Results:
Seventy-six infants were enrolled, 38 in each group. The geometric mean of anti-HBs antibody levels in the combined hexavalent/pentavalent group was significantly higher than that of the 3-dose pentavalent group [316.2 mIU/mL (95% CI: 173.8–575.4 mIU/mL) versus 81.3 mIU/mL (95% CI: 38.9–169.8 mIU/mL), P = 0.006]. By multivariate analysis, the combined hexavalent/pentavalent regimen (coefficient 0.57; P = 0.003) was associated with higher anti-HBs antibody levels, while body weight <10th percentile (coefficient −0.85; P = 0.006) and receiving concomitant pneumococcal conjugated vaccines (coefficient −0.65; P = 0.001) were associated with lower anti-HBs antibody levels.

Conclusion:
Substituting the first dose with a hexavalent HBV-containing vaccine in the pentavalent regimen for HBV vaccination led to higher anti-HBs antibody levels in infants. Concomitant pneumococcal conjugated vaccine administration may have an adverse impact on anti-HBs antibody level.
Treatment Outcomes and Associated Factors of Intravenous Colistin for Nosocomial Infections in Pediatric Patients: A Retrospective Study in a University Hospital in Thailand
Authors: Khamlek Sunisa , Lucksiri Aroonrut , Sunkonkit Kanokkarn , Oberdorfer Peninnah , Sukwuttichai Pattarapan 
Published: June 2024

Background:
This study aimed to investigate the efficacy and safety of intravenous colistin in pediatric patients with nosocomial Gram-negative bacteria infections and to determine factors associated with treatment outcomes.

Methods:
This retrospective study recruited patients <18 years of age receiving intravenous colistin between January 2014 and December 2018. Clinical data and treatment outcomes were reviewed, and factors associated with treatment outcomes were assessed.

Results:
This study included 178 patients with a median age of 3.4 years (range, 0.1–17.8). The mean ± SD dose of colistin prescribed to patients without renal impairment was 5.1 ± 0.6 mg/kg/day. The clinical response rate was 70.8% in patients receiving colistin for specific treatment. Infection-related mortality and crude mortality were 17.5% and 19.7%, respectively. The nephrotoxicity rate was 29.8%; approximately 70% of the episodes occurred between the 3rd and 7th day of treatment. The presence of at least 2 organ dysfunctions [adjusted hazard ratio (aHR): 7.17; 95% CI: 1.64–31.40], septic shock (aHR: 2.69; 95% CI: 1.36–5.32) and receiving chemotherapy/immunosuppressants (aHR: 2.68; 95% CI: 1.36–5.25) were observed to be associated with clinical failure. The factors observed to be associated with nephrotoxicity included hypoalbuminemia (aHR: 2.93; 95% CI: 1.26–6.78), receiving amphotericin B (aHR: 2.29; 95% CI: 1.16–4.52), vancomycin (aHR: 3.36; 95% CI: 1.50–7.56) and vasopressors (aHR: 2.57; 95% CI: 1.27–5.21).

Conclusion:
Colistin is generally effective in the treatment of nosocomial Gram-negative bacteria infections in pediatric patients. Close monitoring of renal function should be considered, especially in high-risk patients. Optimal dosage regimens for pediatric populations to promote more favorable clinical outcomes and minimize nephrotoxicity require further investigation.