bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxalate Nephropathy After Kidney Transplantation: Risk Factors and Outcomes of Two Phenotypes
Authors: Garg Neetika , Nguyen Thanh Thanh , Astor Brad C. , Zhong Weixiong , Parajuli Sandesh , Aziz Fahad , Mohamed Maha , Djamali Arjang , Norby Suzanne M. , Mandelbrot Didier A. 
Published: June 2024

ABSTRACTDescribing risk factors and outcomes in kidney transplant recipients with oxalate nephropathy (ON) may help elucidate the pathogenesis and guide treatment strategies. We used a large single‐center database to identify patients with ON and categorized them into delayed graft function with ON (DGF‐ON) and late ON. Incidence density sampling was used to select controls. A total of 37 ON cases were diagnosed between 1/2011 and 1/2021. DGF‐ON (n = 13) was diagnosed in 1.05% of the DGF population. Pancreatic atrophy on imaging (36.4% vs. 2.9%, p = 0.002) and gastric bypass history (7.7% vs. 0%; p = 0.06) were more common in DGF‐ON than with controls with DGF requiring biopsy but without evidence of ON. DGF‐ON was not associated with worse graft survival (p = 0.98) or death‐censored graft survival (p = 0.48). Late ON (n = 24) was diagnosed after a mean of 78.2 months. Late ON patients were older (mean age 55.1 vs. 48.4 years; p = 0.02), more likely to be women (61.7% vs. 37.5%; p = 0.03), have gastric bypass history (8.3% vs. 0.8%; p = 0.02) and pancreatic atrophy on imaging (38.9% vs. 13.3%; p = 0.02). Late ON was associated with an increased risk of graft failure (HR 2.0; p = 0.07) and death‐censored graft loss (HR 2.5; p = 0.10). We describe two phenotypes of ON after kidney transplantation: DGF‐ON and late ON. Our study is the first to our knowledge to evaluate DGF‐ON with DGF controls without ON. Although limited by small sample size, DGF‐ON was not associated with adverse outcomes when compared with controls. Late ON predicted worse allograft outcomes.
Incidence and Risk Factors for Stroke After Combined Heart‐Kidney and Heart‐Liver Transplantation
Authors: Akbar Armaan F. , Rokui Sorush , Zhou Alice L. , Kilic Ahmet , King Elizabeth , Cho Sung‐Min 
Published: June 2024

ABSTRACTObjectiveWhile stroke is a well‐recognized complication of isolated heart transplantation, stroke in patients undergoing simultaneous heart‐liver (HLT) and heart‐kidney transplantation (HKT) has not been explored. This study assessed postoperative stroke incidence, risk factors, and outcomes in HLT and HKT compared with isolated heart transplant.MethodsThe United Network for Organ Sharing database was queried for adult patients undergoing HLT, HKT, and isolated heart transplants between 1994 and 2022. Patients were stratified by presence of in‐hospital stroke after transplant. Post‐transplant survival at 1‐year was assessed using Kaplan‐Meier analysis and log‐rank tests. Separate multivariable logistic regression models were constructed to identify risk factors for stroke after HKT and HLT.ResultsOf 2326 HKT recipients, 85 experienced stroke, and of 442 HLT recipients, 19 experienced stroke. Stroke was more common after HKT and HLT than after an isolated heart transplant (3.7% vs. 4.3% vs. 2.9%, p = 0.01). One‐year post‐transplant survival was lower in those with stroke among both HKT recipients (64.5% vs. 88.7%, p(log‐rank) < 0.001) and HLT recipients (43.8% vs. 87.4%, p(log‐rank) < 0.001. Pre‐transplant pVAD, prior stroke, postoperative dialysis, diabetes, prior cardiac surgery, and heart cold ischemic time were independent risk factors for stroke after HKT, after adjusting for age, sex, and need for blood transfusion on the waitlist. For HLT, postoperative dialysis was a significant risk factor.ConclusionsStroke is more common after HKT and HLT than after isolated heart transplant, and results in poor survival. Independent risk factors for stroke include pre‐transplant percutaneous VAD (HKT) and postoperative dialysis (HKT and HLT).
Diagnosis of Cutaneous Acute Graft‑Versus‑Host Disease Through Circulating Plasma miR‐638, miR‐6511b‐5p, miR‐3613‐5p, miR‐455‐3p, miR‐5787, and miR‐548a‐3p as Prospective Noninvasive Biomarkers Following Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Izadifard Marzieh , Ahmadvand Mohammad , Pashaiefar Hossein , Alimoghadam Kamran , Kasaeian Amir , Barkhordar Maryam , Seghatoleslami Ghazal , Vaezi Mohammad , Ghavamzadeh Ardeshir , Yaghmaie Marjan 
Published: June 2024

ABSTRACTBackgroundThere are currently no laboratory tests that can accurately predict the likelihood of developing acute graft‐versus‐host disease (aGVHD), a patient's response to treatment, or their survival chance. This research aimed to establish circulating miRNAs as diagnostic, prognostic, or predictive biomarkers of aGVHD.MethodsIn a prospective cohort, we studied the incidence of cutaneous aGVHD in AML patients undergoing allo‐HSCT at Shariati Hospital in Tehran, Iran during 2020–2023. Patients with cutaneous aGVHD were labeled as the case group, while patients without cutaneous aGVHD were selected as the control group. Accordingly, the expression levels of six significant miRNAs (miR‐638, miR‐6511b‐5p, miR‐3613‐5p, miR‐455‐3p, miR‐5787, miR‐548a‐3p) were evaluated by quantitative reverse transcription–polymerase chain reaction (RTqPCR) in three different time‐points: before transplantation, on day 14 and day 21 after transplantation.ResultsThe levels of plasma miR‐455‐3p, miR‐5787, miR‐638, and miR‐3613‐5p were significantly downregulated, while miR‐548a‐3p, and miR‐6511b‐5p were significantly upregulated in individuals with cutaneous aGVHD in comparison to patients without GVHD. Additionally, the possibility for great diagnostic accuracy for cutaneous aGVHD was revealed by ROC curve analysis of differentially expressed miRNAs (DEMs).ConclusionThe study findings encourage us to hypothesize that the aforementioned miRNAs may contribute to the predominance of aGVHD, particularly low‐grade cutaneous aGVHD.
Clinical and Economic Impact of CMV Infection in Allogeneic Hematopoietic Stem Cell Transplantation: Perspectives from a Middle‐Income Nation
Authors: Gan Gin Gin , Iyadorai Thevambiga , Sulaiman Noor Yuhyi , Hussein Najihah , Ariffin Hany 
Published: June 2024

ABSTRACTBackgroundCytomegalovirus infection (CMV) is a common complication after allogeneic hematopoietic stem cell transplantation (AHSCT). CMV infection increases transplantation costs; however, the extent of the financial burden may vary in different countries. This study aims to determine the clinical and economic impact of CMV infection in patients undergoing AHSCT in a middle‐income country.MethodsA total of 150 adult and pediatric patients post‐AHSCT were included for analysis. In addition to incidence of CMV infections, data on graft versus host disease (GVHD) were also collected. Standard hospital charges for AHSCT and any additional transplantation‐related expenditure within 12 months were also retrieved in 104 patients.ResultsCMV infection, acute GVHD and chronic GVHD occurred in 38.7%, 60.7%, and 22.0% of patients, respectively. Patients with CMV infections had higher readmission rates compared to those who did not (67.2% vs. 47.8%; p = 0.020). Additional expenditure was seen in HLA‐haploidentical AHSCT and CMV infection (MYR11 712.25/USD2 504.49; p < 0.0001 and MYR5 807.24/USD1 241.79; p = 0.036), respectively.ConclusionThis single‐center study demonstrated that patients who underwent HLA‐haploidentical AHSCT and subsequently developed CMV infection had higher transplantation expenditures compared to those who had matched‐related transplantation. Further studies should be conducted to evaluate if primary prophylaxis against CMV is cost‐effective, especially in patients who undergo HLA‐haploidentical AHSCT.
Early Tapering of Cyclosporine Is Feasible in Haploidentical Stem Cell Transplantation: A Single Center Experience
Authors: Yaman Samet , Başci Semih , Bozan Ersin , Seçilmiş Sema , Candir Burcu Aslan , Yiğenoğlu Tuğçe Nur , Çakar Merih Kızıl , Dal Mehmet Sinan , Altuntaş Fevzi 
Published: June 2024

ABSTRACTIntroductionCyclosporine‐A (CsA) and post transplantation cyclophosphamide (PTCy) are common agents used for graft versus host disease (GVHD) prophylaxis in Haploidentical hematopoietic cell transplantation (haplo‐HCT). However, the impact of CsA cessation timing in the posttransplant setting on clinical outcomes is uncertain. We aimed to investigate the impact of a novel approach that integrated early CsA cessation with PTCy utilization.Patients and MethodsThis study was a single arm retrospective study carried out at a tertiary referral hospital hematology and bone marrow transplantation center between 2009 and 2022. The patients who received haplo‐HCT with ATG, PTCy and CsA as GVHD prophylaxis were included. CsA was planned for cessation starting at day 45 to day 60. Acute and chronic GVHD were evaluated and graded. CsA blood concentrations and its impact on acute and chronic GVHD was evaluated.ResultsThirty‐one patients composed of 19 (61.3%) male and 12 (38.7%) female patients with a median age of 31 years (20–58). Busulfan and TBI based conditioning regimens were the most utilized regimens. The majority of donors were first degree relatives. Stem cell origin was peripheral blood for all patients. GVHD prophylaxis consisted of ATG, CsA and PTCy. Acute GVHD was observed in 9 (29%) cases, whereas chronic GVHD was seen in 3 (9.7%) cases, with 2 of them having overlapping GVHD. Age, gender, number of chemotherapy lines, transplant characteristics, infused CD34 cell count, and engraftment durations were similar among patients with and without GVHD. Patients with GVHD had similar 1st, 2nd, 3rd and 4th week CsA concentrations compared to patients without GVHD (p > 0.05). The presence of GVHD was not associated with worse progression free survival and overall survival (p = 0.6, p = 0.5, respectively). CMV reactivation was more common in the GVHD group.ConclusionIn the current study, we did not find an impact of CsA concentration on GVHD and post‐transplant outcomes in Haplo‐HCT setting. Therefore, together with the use of PTCy, early CsA cessation can be an option; further studies are needed to understand all aspects of this approach.
Comparative clinical feasibility of antireflux mucosectomy and antireflux mucosal ablation in the management of gastroesophageal reflux disease: Retrospective cohort study
Authors: Lee Ah Young , Kim Seong Hwan , Cho Joo Young 
Published: June 2024

ObjectivesNo definitive treatment has been established for refractory gastroesophageal reflux disease (GERD). Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) using argon plasma coagulation are promising methods. However, no study has compared these two. This study compared the efficacy and safety of the two procedures.MethodsThis multicenter, retrospective, observational study included 274 patients; 96 and 178 patients underwent ARMA and ARMS, respectively. The primary outcome was subjective symptom improvement based on GERD questionnaire (GERDQ) scores. The secondary outcomes included changes in the presence of Barrett's esophagus, Los Angeles grade for reflux esophagitis, flap valve grade, and proton pump inhibitor withdrawal rates.ResultsThe ARMS group had higher baseline GERDQ scores (10.0 vs. 8.0, P < 0.001) and a greater median postprocedure improvement than the ARMA group (4.0 vs. 2.0, P = 0.002), and even after propensity score matching adjustment, these findings remained. ARMS significantly improved reflux esophagitis compared with ARMA, with notable changes in Los Angeles grade (P < 0.001) and flap valve grade scores (P < 0.001). Improvement in Barrett's esophagus was comparable between the groups (P = 0.337), with resolution rates of 94.7% and 77.8% in the ARMS and ARMA groups, respectively. Compared with the ARMA group, the ARMS group experienced higher bleeding rates (P = 0.034), comparable stricture rates (P = 0.957), and more proton pump inhibitor withdrawals (P = 0.008).ConclusionsBoth ARMS and ARMA showed improvements in GERDQ scores, endoscopic esophagitis, flap valve grade, and the presence of Barrett's esophagus after the procedures. However, ARMS demonstrated better outcomes than ARMA in terms of both subjective and objective indicators.
Longitudinal links from attachment with mothers and fathers to adolescent substance use: Internalizing and externalizing pathways
Authors: Clinchard Claudia , Deater‐Deckard Kirby , Casas Brooks , Kim‐Spoon Jungmeen 
Published: June 2024

AbstractThe present study examined whether internalizing and externalizing symptoms may mediate the association between adolescent–mother and adolescent–father attachment and substance use. The sample included 167 adolescents (47% girls) who were assessed at five time points with approximately 1 year between each assessment, beginning in middle adolescence (Mage = 14.07) and ending in the transition to young adulthood (Mage = 18.39). The adolescents reported their perceived attachment with both their mother and father during middle adolescence (Times 1 and 2), their internalizing and externalizing symptoms during late adolescence (Times 3 and 4), and their alcohol use during the transition to young adulthood (Time 5). The results showed that less secure adolescent–father attachment, but not adolescent–mother attachment, was predictive of heightened externalizing and internalizing symptoms. In turn, heightened externalizing symptoms were predictive of heightened alcohol use. Despite the nonsignificant direct association between adolescent–father attachment and alcohol use, less secure adolescent–father attachment was indirectly predictive of greater alcohol use, mediated through heightened externalizing symptoms. The findings highlight the importance of close and trusting father–adolescent relationships in the development of psychopathology and substance use behaviors. The developmental cascade from a less secure adolescent–father attachment to greater externalizing symptoms and heightened substance use, as well as implications for prevention and intervention of young adult substance use, are discussed.Research Highlights
The differential pathways from adolescent–mother and adolescent–father attachment to substance use during the transition to young adulthood are not well known.
Longitudinal data were used to test whether internalizing and externalizing symptoms may mediate the association between adolescent–mother and adolescent–father attachment and substance use.
Less secure adolescent–father attachment predicted heightened internalizing and externalizing symptoms, and less secure adolescent–father attachment predicted greater alcohol use, mediated through heightened externalizing symptoms.
The findings suggest that addressing insecure attachment with fathers during adolescence may reduce unhealthy substance use during the transition to young adulthood.
Validation and clinical application of implantable loop recorders for diagnosis of atrial fibrillation in horses
Authors: Kjeldsen Sofie Troest , Nissen Sarah D. , Christensen Nina C. , Haugaard Simon L. , Schneider Mélodie J. , Vinther Zenta , Sattler Stefan M. , Carstensen Helena , Jøns Christian , Hopster‐Iversen Charlotte , Buhl Rikke 
Published: June 2024

AbstractBackgroundParoxysmal atrial fibrillation (pAF) occurs sporadically and can impair athletic performance. Gold standard for diagnosis is surface electrocardiography (ECG), however, this requires AF to be sustained. Implantable loop recorders (ILRs) are routinely used for AF detection in human medicine. While ILR placement has been studied in horses, its AF detection performance is unknown.Objectives(I) Validation of ILRs for AF detection in horses. (II) Determining pAF incidence using ILRs and estimate the positive predictive value (PPV).Study design(I) Experimental study; (II) Longitudinal observational study.Methods(I) Implantation of ILRs in 15 horses with AF and 13 horses in sinus rhythm. Holter ECGs were recorded at: 1, 4, 8, 12 and 16 weeks of AF. The ILR ECGs were compared with surface ECGs to assess diagnostic sensitivity and specificity. (II) Eighty horses (43 Warmbloods, 37 Standardbreds) with ILRs were monitored for 367 days [IQR 208–621].Results(I) ILRs detected AF on all recording days, in horses with AF, with a sensitivity of 66.1% (95% CI: 65.8–66.5) and a specificity of 99.99% (95% CI: 99.97–99.99). The sensitivity remained consistent across all time points. (II) The incidence of pAF was 6.3% (5/80). In horses with pAF, the PPV ranged from 8% to 87%. Increased body condition score (BCS > 6/9) was associated with an increased number of false positive episodes (p = 0.005).Main limitations(I) Horses were stabled during the ECG recordings, and AF was induced, rather than naturally occurring pAF. (II) Integrated algorithm in this ILR is optimised for AF detection in humans using remote monitors. Additionally, sensing is affected by motion artefacts.ConclusionThe ILR reliably detected AF in resting horses, particularly in horses with normal BCS (6/9). The ILR proved useful to detect pAF and is recommended alongside Holter monitoring for diagnostic workup of horses with suspected pAF.
Endodontic sequelae associated with repetitive impacts to the dentofacial region during boxing activities
Authors: McCarthy Sally , Gulabivala Kishor , St. George Geoffrey , Harvey Simon , Ng Yuan‐Ling 
Published: June 2024

AbstractAimTo explore self‐reported dentofacial trauma and their potential endodontic sequelae in boxers using a questionnaire, followed by clinical and radiographic assessment to (1) compare the nature and number of self‐reported dentofacial injuries with physical evidence of injury sequelae; and (2) investigate potential risk factors influencing dentofacial trauma and their endodontic sequelae.MethodologyA focus group validated questionnaire was completed by 176 boxers recruited from 16 London boxing clubs; 61 boxers from this cohort then attended a London dental hospital, for a clinical and radiographic assessment. Data from the questionnaire and clinical assessments were then collated and analysed using Chi‐squared or t‐tests.ResultsQuestionnaire data revealed 87.5% of boxers reported a history of dentofacial trauma during boxing activity. The clinical and radiographic assessment detected evidence of dentofacial trauma in 91.8% of boxers and dental injury or endodontic‐related injury sequelae in 68.9% of boxers. There was a significant association between dentofacial trauma and boxers who did not participate in weekly neck weight sessions (p < .001), and there was a significant association between trauma‐related endodontic sequelae and: boxer age (p = .01); competitions per month (p = .002); and defensive skill (p = .007).ConclusionsA majority of the cohort had suffered dentofacial injuries and endodontic sequelae. The questionnaire data under‐reported musculoskeletal injuries and endodontic sequelae, suggesting that some hard‐tissue injuries following repetitive dentofacial trauma may have a subclinical presentation. Injury risk may be related to increased boxer age, defensive skills, frequency of participation in competitions, and frequency of neck weight sessions per week.
Variables that predict nurses' job stress and intention to leave during the COVID‐19 pandemic in Turkey
Authors: Bingöl Ümran , Bilgin Nurcan , Çetinkaya Aynur , Kutlu Adalet 
Published: June 2024

AbstractAimTo investigate the variables predicting job stress and intention to leave the job among nurses during the COVID‐19 pandemic in Turkey.DesignThis research was designed as an analytical cross‐sectional study.MethodsThe population of the study consisted of 450 nurses working in a training and research hospital (N = 450). The study sample consisted of 178 nurses who worked in that hospital between February and July 2021. The Nurse Information Form, Job Stress Scale, and Intention to Leave Scale were used as data collection tools. The independent‐sample t‐test, one‐way analysis of variance, and Pearson correlation analysis were applied for univariate analysis while multiple regression analysis was used for multivariate analysis.ResultsIt was determined that the main factors predicting nurses’ job stress levels were their Intention to Leave Scale scores, level of organizational satisfaction. The main factors predicting intention to leave were their Job Stress Scale scores, working conditions, and job satisfaction. A positive moderate correlation was found between job stress and intention to leave.ConclusionThis study demostares that among nurses during the COVID‐19 pandemic, the predictors of job stress were intention to leave and organizational satisfaction, while the predictors of turnover intention included job stress, working conditions, and job satisfaction. Hospital managers, especially nursing services managers, should develop strategies for extraordinary situations such as pandemics and evaluate the professional satisfaction of nurses while providing a healthy working environment.Patient or Public ContributionNo patient or public contributions.
Psychological distress symptoms in nurses and their intention to leave: A cross‐sectional secondary data analysis
Authors: Edwin Hephzibah Sophie , Trinkoff Alison M. , Mills Mary Etta , Zhu Shijun 
Published: June 2024

AbstractAimThis study aimed to examine the psychological symptoms of distress among nurses in relation to their intention to leave.DesignThis study was a secondary data analysis of a cross‐sectional survey collected between November 2020 and March 2021.MethodsChi‐square was used to examine the associations between the demographic characteristics and intention to leave and psychological distress symptoms—feeling depressed, anxious and worried. Multiple linear regression analyses were performed to examine if work settings, position (staff, charge, administrators, educators/researchers and advanced practice registered nurses) and years of experience were associated with psychological distress and intention to leave. A mediation analysis examined if psychological distress mediated the relationship between years of experience and intention to leave.ResultsOverall, psychological distress was significantly positively associated with intention to leave and negatively associated with years of experience. Nurses with less than 2 years of experience had increased psychological distress, while nurses with >25 years of experience had decreased psychological distress. Both groups of nurses had increased intention to leave compared to those with 16–25 years of experience. Psychological distress partially mediated intention to leave in nurses with less than 2 years of experience and more so among nurses with >25 years of experience.ConclusionsThis study suggests that nurses encounter psychological distress symptoms, such as feeling anxious, depressed and worried, that contribute to an increased intention to leave. Among the workplace locations, nurses practicing in nursing homes had the highest intention to leave.ImpactThe study emphasizes that organizations need to focus on mitigating distress across all levels of nurses to promote retention efforts and intention to stay.Reporting MethodThe authors adhered to the STROBE guidelines.Patient or Public ContributionNo patient contribution. Completion of the survey in the original study (NWWS) implied consent from the participating nurses.