bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profiling of expert bouldering routesetters
Authors: Henz Julian , Sanchez Xavier , Memmert Daniel , Medernach Jerry Prosper 
Published: May 2024

Introduction Bouldering is an Olympic discipline that takes place on low-height climbing structures known as boulders. Routesetters play a critical role in bouldering; they design and set boulders to be climbed, which must be original, safe to climb and adapted to climbers’ levels. Considering the critical role routesetters play to keep the present success and ensure the future development of bouldering, the purpose of this study was to profile expert routesetters by identifying relevant key skills they possess and examining specific strategies they use when designing boulders. Methods Seventy-eight expert routesetters completed an online survey structured in eight sections that assessed the following: perceptual–cognitive skills; soft skills; motor skills; climbing skills; welfare; safety and difficulty; climbing holds and wall features; and climbing movement diversity and boulder styles. Results Among fundamental skills experts identified, most relevant to routesetters were possessing a broad climbing movement repertoire, the ability to develop several climbing strategies for one boulder, forecasting of climbing movements, climbing-specific decision-making and creativity, self-reflection, teamwork, dealing with negative feedback, technical skills and general fitness. Furthermore, most relevant specific routesetter skills and strategies appeared to encompass the ability to design boulders that account for climbers’ skill levels and safety, to adapt to the constraints of climbing gyms, to make optimal use of climbing wall features and to design versatile climbing movements. Conclusion The expert routesetters’ profile comprises fundamental and specific skills and strategies that enable them to design target-oriented boulders with versatile climbing movements for different levels whilst accounting for climbers’ welfare.
Return to sports following arthroscopic Bankart repair in collision athletes: A systematic review
Authors: Pasqualini Ignacio , Turan Oguz A , Hurley Eoghan T , Frangiamore Salvatore J , Levin Jay M , Dickens Jonathan F , Klifto Christopher S , Rossi Luciano A 
Published: May 2024

Background The purpose of this study was to systematically review the rate and time frame to return to sports in collision athletes following arthroscopic Bankart repair. Methods A systematic literature search based on Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases was performed. Manuscripts were included if they studied collision or contact athletes, reported on return to play rates or percentages, underwent arthroscopic Bankart repair, published in a peer-reviewed journal, and published in English. The study characteristics and clinical outcomes were extracted. Results A total of 19 studies with 1077 patients were included. Among collision athletes undergoing arthroscopic Bankart repair, the overall rate of return to sports was 89.8% (range 72%–100%). The mean time to return to sports was 5 months (range 3–6). The overall rate of returning to the same level of play was 80.8% (range 71.1%–100%). There were high return to sports rates among all collision sports. Specific return-to-play criteria were reported in most of the studies (95%), with time to return to sport being the most reported item (89.4%). Conclusion Although overall return to sport among collision athletes following arthroscopic Bankart repair remains high, the proportion of athletes returning to their preoperative level of play was substantially lower.
The concomitant use of the renin–angiotensin system inhibitors and survival outcomes of patients with pancreatic adenocarcinoma: an analysis from a tertiary center
Authors: Tseng Kuan-Yu , Hsu Chiann-Yi , Shih Yu-Hsuan , Lin Hsin-Chen , Li You-Cheng , Jerry Teng Chieh-Lin , Chou Cheng-Wei 
Published: May 2024

Background: The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma (PDAC) necessitates the exploration of novel strategies to overcome treatment resistance. Objectives: This study aimed to investigate the impact of combining renin–angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC. Design: Patients with PDAC were enrolled in the retrospective study. Methods: We analyzed patients with PDAC ( n = 384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers. Results: Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p = 0.008) compared to the non-ACEI/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI/ARB was associated with better 12-month EFS (hazards ratio = 0.71, 95% confidence interval: 0.52–0.96; p = 0.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes. Conclusion: Concomitant use of ACEIs/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.
Changes in Chemical Constituents and Kidney-Yang Tonifying of Traditional Herbs After Processing: A Brief Review
Authors: Truong Minh-Nhut , Nguyen Thi Hong-Hieu , Tran Hoang-Huy , Le Thi Lan-Phuong 
Published: May 2024

Background Kidney-Yang deficiency is one of the common medical syndromes in traditional medicine, characterized by symptoms such as weakness, coldness in the lower back and knees, cold, fatigue, etc. In clinical practice, Yang tonifying medicines are often used to treat patients with Kidney-Yang deficiency. Moreover, the medicinal processing method according to the principles of traditional medicine can enhance the effects on the Kidney of these herbs. This brief overview aims to gather and assess the post-processing modifications to the chemical composition and the kidney-Yang tonifying effects of specific traditional herbal remedies. Methodology Firstly, all kidney-Yang tonifying herbs were collected. Next, the selection was made based on the herbs with processing procedures specified in Circular 30/2017/TT-BYT issued by the Vietnamese Ministry of Health. All studies on the chemical composition and/or effects of processed drugs were searched in the PubMed and Google Scholar databases using the search formula: processed + scientific name of herbal medicine. Finally, among the studies on the changes in effects after processing, only studies on the tonifying Yang effect were included in this review. Results The kidney Yang-nourishing effects of the five traditional herbal medicines prescribed in Circular 30/2017/TT-BYT by the Ministry of Health of Vietnam (Radix Morindae officinalis, Cortex Eucommiae, Herba Cistanches, Semen Cuscutae, and Radix Dipsaci) have been demonstrated through several studies and summarized. From the PubMed and Google Scholar databases, 25 studies were collected for the review. Additionally, the changes in composition and content of certain active compounds in these herbal medicines have also been searched and reported. Conclusion This report provides a brief overview of the differences between chemical constituents and kidney-Yang tonifying of some traditional herbs after processing to partially contribute scientific evidence for standardizing the preparation processes and serve as an important reference for clinical practitioners of traditional medicine.
Adverse event profiles of drug-induced liver injury caused by antidepressant drugs: a disproportionality analysis
Authors: Jiang Aidou , Wei Chunyan , Zhu Weiwei , Wu Fengbo , Wu Bin 
Published: May 2024

Background: Antidepressants are widely used to manage depression and other psychiatric diseases. A previous study revealed that hepatotoxicity was the main adverse event related to antidepressants. Therefore, drug-induced liver injury (DILI) caused by antidepressants deserves more attention. Objectives: To investigate DILI adverse events reported due to antidepressant use in the United States Food and Drug Administration Adverse Events Reporting System (FAERS) database. Research design: A disproportionality analysis of spontaneously reported adverse events was conducted to assess the association between antidepressant drugs and DILI. Methods: FAERS data from 1 January 2004 to 31 December 2021 were compiled and analyzed using the reporting odds ratio (ROR) and information component (IC). Results: As per the FAERS database, of the 324,588 cases that were administered antidepressants, 10,355 were identified as cases with DILI. Among the identified 42 antidepressants, nefazodone ( n = 47, ROR = 7.79, IC = 2.91), fluvoxamine ( n = 29, ROR = 4.69, IC = 2.20), and clomipramine ( n = 24, ROR = 3.97, IC = 1.96) had the highest ROR for cholestatic injury; mianserin ( n = 3, ROR = 21.46, IC = 3.99), nefazodone ( n = 264, ROR = 18.67, IC = 3.84), and maprotiline ( n = 15, ROR = 5.65, IC = 2.39) for hepatocellular injury; and nefazodone ( n = 187, ROR = 12.71, IC = 0.48), clomipramine ( n = 35, ROR = 2.07, IC = 0.26), and mirtazapine ( n = 483, ROR = 1.96, IC = 0.94) for severe drug-related hepatic disorders. Only nefazodone elicited hepatic failure signals ( n = 48, ROR = 18.64, IC = 4.16). There are limited reports on the adverse reactions of relatively new antidepressant drugs, such as milnacipran, viloxazine, esketamine, and tianeptine, and those not approved by the Food and Drugs Administration, such as reboxetine and agomelatine. Conclusion: A significant association was observed between DILI and nefazodone. Duloxetine and clomipramine were associated with three DILI categories, except hepatic failure. The disproportionality analysis cannot conclude on a definite causal link between antidepressants and DILI. Additional research is required to assess new-generation antidepressants for their propensity to cause DILI.
Clinical characteristics, outcome, and factors associated with mortality of pulmonary mucormycosis: a retrospective single-center study from Pakistan
Authors: Khalid Rameesha , Khanum Iffat , Habib Kiren , Ali Akbar Shoukat , Farooqi Joveria , Iqbal Nousheen , Ejaz Taymmia , Jabeen Kauser , Irfan Muhammad 
Published: May 2024

Introduction and objective: Pulmonary mucormycosis is a rare but rapidly progressive fatal disease. Limited data exist on the outcomes and factors associated with poor prognosis of pulmonary mucormycosis. The objective of this study was to evaluate clinical characteristics, factors associated with mortality, and outcomes of pulmonary mucormycosis at a tertiary care hospital in Pakistan. Methods: This was a retrospective observational study conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of hospitalized patients diagnosed with proven or probable pulmonary mucormycosis between January 2018 and December 2022 were reviewed. Univariate and regression analyses were performed to identify factors associated with mortality. Results: Fifty-three pulmonary mucormycosis patients (69.8% male) were included, with mean age of 51.19 ± 21.65 years. Diabetes mellitus was the most common comorbidity [ n = 26 (49.1%)]. Chronic lung diseases were present in [ n = 5 (9.4%)], and [ n = 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. The predominant isolated Mucorales were Rhizopus [ n = 32 (60.3%)] and Mucor species [ n = 9 (17%)]. Main radiological findings included consolidation [ n = 39 (73.6%)] and nodules [ n = 14 (26.4%)]. Amphotericin B deoxycholate was prescribed in [ n = 38 (71.7%)], and [ n = 14 (26.4%)] of patients received combined medical and surgical treatment. The median [interquartile range (IQR)] hospital stay was 15.0 (10.0–21.5) days. Intensive care unit (ICU) care was required in [ n = 30 (56.6%)] patients, with 26 (49.1%) needing mechanical ventilation. Overall mortality was seen in 29 (54.7%) patients. Significantly higher mortality was found among patients requiring mechanical ventilation 20/29 (69%, p = 0.002). Immunosuppression ( p = 0.042), thrombocytopenia ( p = 0.004), and mechanical ventilation ( p = 0.018) were identified as risk factors for mortality on multivariable analysis. Conclusion: This study provides essential insights into the clinical characteristics, outcomes, and mortality factors associated with pulmonary mucormycosis. The mortality rate was high (54.7%), particularly in patients with immunosuppression, thrombocytopenia, and those who required mechanical ventilation.
Cost-effectiveness of l-glutamine versus crizanlizumab for adults with sickle cell disease: model focused on reducing pain episode costs from Qatar’s healthcare perspective
Authors: Adel Ahmad M , Abushanab Dina , Al-Badriyeh Daoud , Hamad Anas , Alshurafa Awni , Yassin Mohamed A 
Published: May 2024

Objectives: Treatment options for preventing vaso-occlusive crises among sickle cell disease patients are on the rise, especially if hydroxyurea treatment has failed. This economic analysis is conducted to assess the comparative clinical effectiveness, safety, and acquisition cost of l-glutamine and crizanlizumab for older adolescents and adults (⩾16 years old) with sickle cell disease in Qatar, with an emphasis on treatment costs and acute pain crises. Methods: We conduct a decision-tree model, where we compare the clinical and economic outcomes of two novel Food and drug administration (FDA)-approved medications which are available in Qatar; l-glutamine and crizanlizumab over a time horizon of 1 year in a hypothetical cohort of adult sickle cell disease patients from a Qatar healthcare perspective. The main outcome is incremental cost per sickle cell disease-related acute pain crises averted. Model clinical parameters were derived from individual drug randomized trials, published literature, whereas cost parameters from Qatar healthcare payer system (2020–2021). A sensitivity analysis was carried out, and the study results were robust around model inputs. Costs were converted to 2020 US dollars. Results: Study results showed that both treatment modalities’ costs were the main driver of this analysis, with an average annual cost of the treatments per patient being $189,014 for crizanlizumab (5 mg/kg), $143,798 for crizanlizumab (2.5 mg/kg), and $74,323 for l-glutamine. The probability of no first-time sickle cell disease-related vaso-occlusive crises averted was 0.001/year for glutamine, 0.26/year for crizanlizumab (5 mg/kg), and 0.34/year for crizanlizumab (2.5 mg/kg). Lower dose crizanlizumab (2.5 mg/kg) dominated the higher one (5 mg/kg). The incremental cost-effectiveness ratio of crizanlizumab (2.5 mg/kg), when compared to l-glutamine was $81,265 per sickle cell disease-related vaso-occlusive crises averted. When comparing crizanlizumab (5 mg/kg) and l-glutamine, crizanlizumab (5 mg/kg) showed higher efficacy, yet the crizanlizumab incremental cost-effectiveness ratio was at $459,620 than l-glutamine. Conclusions: Crizanlizumab (2.5 mg/kg) may be a cost-effective intervention, yet it is not the approved dose for preventing vaso-occlusive crises in adolescents and adults with sickle cell disease. Crizanlizumab (5 mg/kg) was more cost-effective than the approved l-glutamine per sickle cell disease vaso-occlusive crisis prevented. Of note, we primarily focused on modeling acute vaso-occlusive pain, which limited our ability to consider other key outcomes in sickle cell disease.
Association of medical comorbidities in obese subjects diagnosed with heparin-induced thrombocytopenia
Authors: Darok Matthew , Daly Alexander , Walter Vonn , Krawiec Conrad 
Published: May 2024

Objectives: Heparin-induced thrombocytopenia can occur in obese subjects. The medical comorbidities associated with obesity may contribute to the pathogenesis of this disease. It is unknown, however, which specific medical comorbidities and if higher odds of thrombosis are present in obese heparin-induced thrombocytopenia patients. We sought to determine whether obese heparin-induced thrombocytopenia subjects had higher odds of both comorbidities and thrombosis, hypothesizing that this patient population would have higher odds of both these conditions. Methods: This was a multi-center retrospective study utilizing TriNetX©, an electronic health record database, in subjects aged 18–99 years diagnosed with heparin-induced thrombocytopenia. The cohort was divided into two groups (1) non-obese (body mass index < 30 kg/m2) and (2) obese (body mass index ⩾ 30 kg/m2). We evaluated patient characteristics, diagnostic, laboratory, medication, and procedure codes. Results: A total of 1583 subjects (696 (44.0%) non-obese and 887 (56.0%) obese) were included. Obese subjects had higher odds of diabetes with complications (OR = 1.73, 95% CI = 1.35–2.22, p < 0.001) and without complications (OR = 1.81, 95% CI = 1.47–2.22, p < 0.001). This association was still present after correcting for demographic and clinical factors. There were no increased odds of thrombosis observed in the obesity group. Conclusions: Our study found that obese heparin-induced thrombocytopenia subjects had higher odds of having a diabetes mellitus comorbidity, but did not have higher odds of thrombosis. Given obesity is considered a hypercoagulable state, further study may be needed to understand why obese subjects diagnosed with heparin-induced thrombocytopenia do not have higher rates of thrombosis.
Assessing the causal association between sleep apnea and the human gut microbiome composition: A two-sample Mendelian randomization study
Authors: Yu Min , Chen Xuehui , Huang Xin , Gao Xuemei 
Published: May 2024

Background: Studies have linked gut microbiota dysbiosis with sleep apnea; however, no causal relationship was found in human subjects. Finding new targets for the pathophysiology of sleep apnea might be made possible by systematically investigating the causal relationship between the human gut microbiota and sleep apnea. Methods: A two-sample Mendelian randomization analysis was conducted. The human gut microbiome composition data, spanning five taxonomic levels, were acquired from a genome-wide association study that included 18,340 participants from 24 cohorts. Genome-wide association study data for sleep apnea were obtained from the Sleep Disorder Knowledge Portal for primary analysis and the FinnGen consortium for meta-analysis. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. Results: Using inverse-variance weighted analysis, eight microbial taxa were initially found to be substantially linked with the apnea-hypopnea index. Only three microbial taxa remained significant associations with sleep apnea when combined with the FinnGen consortium (the class Bacilli: B = 8.21%, 95% CI = 0.93%–15.49%; p = 0.03; the order Lactobacillales: B = 7.55%, 95% CI = 0.25%–4.85%; p = 0.04; the genus RuminococcaceaeUCG009: B = −21.63%, 95% CI = −41.47% to −1.80%; p = 0.03). Conclusions: Sleep apnea may lead to gut dysbiosis as significant reductions in butyrate-producing bacteria and increases in lactate-producing bacteria. By integrating genomes and metabolism, the evidence that three microbiome species are causally linked to sleep apnea may offer a fresh perspective on the underlying mechanisms of the condition.
Strategies for Accessible Breast Screening for People With Intellectual Disability
Authors: Weise Janelle , Cvejic Rachael , Trollor Julian 
Published: May 2024

Introduction: People with intellectual disability are less likely to participate in breast screening than people without intellectual disability. They experience a range of barriers to accessing breast screening, however, there is no consensus on strategies to overcome these barriers. Our objective was to reach consensus on the strategies required for accessible breast screening for people with intellectual disability. Methods: Fourteen experts participated in a modified on-line Delphi that used Levesque’s model of health care access as the theoretical framework. At the end of each round descriptive and thematic analyses were completed. Data was then triangulated to determine if consensus was reached. Results: After 3 rounds, 9 strategies were modified, 24 strategies were added and consensus was reached for 52 strategies across the 5 dimensions of access. Key areas of action related to (i) decision making and consent, (ii) accessible information, (iii) engagement of peer mentors, (iv) service navigators, and (v) equipping key stakeholders. Conclusions: The resulting strategies are the first to articulate how to make breast screening accessible and can be used to inform health policy and quality improvement practices.
Patients Aged 80 or More With Distal Radius Fractures Have a Lower One-Year Mortality Rate Than Age- and Gender-Matched Controls: A Register-Based Study
Authors: Arvidsson Linnea , Landgren Marcus , Harding Anna Kajsa , Abramo Antonio , Tägil Magnus 
Published: May 2024

Introduction With a rapidly ageing population, the number of distal radius fractures (DRFs) in the elderly will increase dramatically. The aim of this retrospective register study was to examine the 1- and 5-year mortality in DRF patients aged 80 years or more and correlate the overall survival to factors not related to the fracture itself. Material and Methods Patients aged ≥80 diagnosed with DRFs in Lund University Hospital in Sweden in the period 2010-2012 were extracted from the prospective Lund Distal Radius Fracture register. One- and 5-year standardised mortality rates (SMRs) were calculated using the Swedish standard population as a reference. Medical records were searched for non-fracture-related factors including comorbidity, medications, cognitive impairment and type of living. Cox proportional hazard regression models were used to identify prognostic factors for all-cause mortality. Results The study cohort included 240 patients, with a mean age of 86. The overall 1-year mortality was 5% (n = 11/240) and the 5-year mortality was 44% (n = 105/240). The 1-year SMR was .44 (CI .18-.69, P < .01) when indirectly adjusted for age and gender and compared to the Swedish standard population. The 5-year SMR was .96 (CI .78-1.14). The patients’ ability to live independently in their own home had the highest impact on survival. Discussion The 1-year mortality rate among the super-elderly DRF patients was only 44% of that expected. Possibly, a DRF at this age could be a sign of a healthier and more active patient. Conclusions The DRF patients aged 80 or more had a substantially lower mortality rate 1 year after fracture compared to the age- and gender-matched standard population. Patients living independently in their own homes had the longest life expectancy. Treatment should not be limited solely because of old age, but individualised according to the patient’s ability and activity level.