bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse Events in Patients Aged 90 Days or Younger Receiving Ketamine in the Emergency Department
Authors: Mills Lauren A. , Kuntz Heather M. 
Published: May 2024

Objectives
The aim of this study was to identify the incidence of adverse events of ketamine administration in the pediatric emergency department in patients aged 90 days or younger in order to demonstrate the safety and efficacy of administration in this patient population.

Methods
An 8-year retrospective chart review of patients aged 90 days or younger who received ketamine in the pediatric emergency department was conducted. All patients who met the age criteria were included in this study. Identified routes of ketamine administration included oral, intramuscular, and intravenous.

Results
Fourteen patients were identified who met the inclusion criteria and were included in the final analysis. The median age was 45 days old. Indications for ketamine administration included 7 cases for procedural sedation, 5 cases for RSI, and 2 cases for postintubation sedation. The average dose amount (mg/kg) of ketamine administered was 10, 4.43, and 1.59 for oral, intramuscular, and intravenous routes, respectively. Of the 14 patients, 1 patient was identified to have an adverse event to ketamine administration. A transient desaturation and bradycardic event due to laryngospasm was observed during laryngoscopy performed for RSI that was resolved with administration of anticholinergics and paralytics as well as successful intubation and ventilation.

Conclusions
In this study, 1 patient suffered an adverse event due to laryngospasm during intubation. In the pediatric population, the incidence of adverse events of ketamine administration has been found to be variable in the current literature, ranging from 0.71% to 7.26%. In our study, an adverse event occurred in 1 out of 14 administrations (7.1%). The incidence of adverse events associated with ketamine administration in our patients aged 90 days or less appeared to be similar to that reported in the general pediatric population.
Diffuse Intense 18F-PSMA-1007 Uptake of the Breasts in a Woman With TFE3-Rearranged Renal Cell Carcinoma
Authors: Zhao Qian , Dong Aisheng , Zuo Changjing 
Published: May 2024

Abstract
A 23-year-old woman presenting with gross hematuria was found to have a left renal mass suspicious for renal cell carcinoma on abdominal contrast-enhanced CT. An 18F-PSMA-1007 PET/CT scan was performed for evaluating the renal mass. 18F-PSMA-1007 PET/CT showed focal activity of the renal mass, which was a transcription factor E3-rearranged renal cell carcinoma proved after nephrectomy. Surprisingly, diffuse heterogeneous intense activity of the bilateral breasts and moderate activity of the right accessory breast was observed. There was no morphological abnormality of the bilateral breasts and right accessory breast on CT images, indicating physiological PSMA uptake.
Between Pathological Prostate Cancer Lymph Nodes and Sentinel Nodes
Authors: Morel Agnès , Rousseau Thierry , Ferrer Ludovic , Lacoste Jacques , Nevoux Pierre , Picot-Dilly Elise , Le Thiec Maelle , Rusu Daniela , Campion Loic , Rousseau Caroline 
Published: May 2024

Purpose
On the basis of the concept of sentinel lymph node biopsy (SLNB), SLNs should contain decisive information for clinical outcomes. In localized prostate cancer patients, this study assessed retrospectively clinical outcome after radical laparoscopic prostatectomy associated with SLNB and extensive pelvic lymph node dissection.

Methods
A total of 231 consecutive patients of intermediate to high risk were analyzed. Recurrence-free survival (RFS) was assessed with Kaplan-Meier curves. Various pathological parameters were analyzed using univariable and multivariable analyses through Cox regression analysis. The study was approved and registered under 2007-R41.

Results
The median follow-up was 7.1 years (95% confidence interval, 6.6–7.5). In total, 38/231 (16.5%) patients were pN1. Of these 38 patients, 27 had only SLN involvement (SLNI), 10 patients had both SLN and non-SLNI, and 1 patient had isolated non-SLNI, indicating a false-negative (FN). If the updated Briganti nomogram threshold set at >7% for recommending extensive pelvic lymph node dissection had been applied to these patients, we would have missed 44% (12/27) of patients with SLNI and 50% (5/10) of patients with SLNI and non-SLNI, as well as the FN patient. At the time of final follow-up, 84/231 (36.5%) patients had recurrence. In multivariable analysis, and regarding node status, the most significant prognostic factor was SLN with macrometastases and/or micrometastases, respectively, P = 10−3 and P < 10−3. No more information was obtained with non-SLN status. Probabilities of RFS between negative and positive SLN patients presented a major significant difference (P < 10−15) with a risk of event 8.75 times more frequent if SLN was involved than if it was metastasis-free.

Conclusions
SLNB seems to contain decisive information for the clinical outcome of patients with localized intermediate- and high-risk prostate cancer patients. The question raised is thus whether immediate additional postoperative treatment should be offered to patients with metastatic SLN.
Scapholunate Ligament Reconstruction With Internal Brace Augmentation Techniques for Chronic Scapholunate Dissociation
Authors: An Young Sun , Lee Sang Ki , Choy Won Sik 
Published: May 2024

Introduction
The scapholunate ligament is the most important stabilizer of the scapholunate articulation. The management of chronic irreversible injuries of this ligament in the absence of preexisting arthritis of the wrist joint remains controversial. Recently, surgeons introduced a novel surgical technique using an internal brace (IB). Several biomechanical studies on this technique have been conducted using cadavers; however, very few studies have discussed the results in detail in actual clinical practice. Therefore, herein, we investigated the radiological and functional results of patients who underwent IB augmentation as a treatment for chronic scapholunate dissociation.

Methods
This retrospective study was conducted from April 2018 to May 2022. Twenty-two patients with chronic scapholunate dissociation were treated using the IB augmentation technique, of whom 17 were followed-up for at least 1 year. Radiological results, including scapholunate distance, scapholunate angle, and radioscaphoid angle, were collected. Furthermore, clinical parameters, such as the visual analog scale (preoperative and at final follow-up), the Disabilities of the Arm, Shoulder, and Hand scores (preoperatively and at 3, 6, and 12 months postoperatively), and Mayo wrist scores (preoperative and at final follow-up), were measured.

Results
The scapholunate distance increased significantly in the affected wrist compared to the unaffected wrist, which improved after reconstruction in all wrist positions (P < 0.05). Compared to the unaffected wrist, the scapholunate angle increased significantly in all positions (P < 0.05) except for extension (P = 0.535) and improved after reconstruction in all wrist positions. The radioscaphoid angle significantly increased compared to the angle of the unaffected wrist in all positions (P < 0.05) except for extension (P = 0.602) and clenched fist (P = 0.556). This angle improved after reconstruction in all wrist positions except for extension (P = 0.900). The visual analog scale score (7–2, preoperatively and at final follow-up) and Mayo wrist score (53–82, preoperatively and at final follow-up) improved after surgery. The Disabilities of the Arm, Shoulder, and Hand scores also improved after surgery (68, 53, 30, 7, preoperatively and at 3, 6, and 12 months postoperatively).

Conclusions
This study revealed that scapholunate ligament reconstruction using an autologous tendon and suture tape is a good reconstruction technique that can improve clinical symptoms and radiographic parameters with a shorter operation time and fewer complications than other reconstruction methods.
Major Pancreatic Resection Increases Bone Mineral Density Loss, Osteoporosis, and Fractures
Authors: Khalilieh Saed , Iyer Amrita , Hammelef Emma , Zohar Nitzan , Gorgov Eliyahu , Yeo Theresa P. , Lavu Harish , Bowne Wilbur , Yeo Charles J. , Nevler Avinoam 
Published: May 2024

Objective:
To assess whether long-term survivors of pancreatic surgery show increased risk to develop impaired bone mineral density, osteoporosis, and vitamin D deficiency.

Background:
Pancreatic resection poses a risk for malabsorption of fat-soluble vitamins and other micronutrients essential for bone mineralization. Here, we evaluated the long-term effects of pancreatic resection on bone mineral density (BMD) and its clinical sequelae.

Methods:
This was a two-pronged analysis of post-pancreatectomy patients with a follow-up period greater than 3 years comprising (1) a large, propensity score-matched, cohort study based on a multinational federated research network (FRN) and (2) a retrospective single institution review of clinical and radiographic patient data. In the FRN analysis, an initial cohort of 8,423 post-pancreatectomy patients were identified and propensity score-matched with normal controls. The primary endpoint was the 10-year risk of developing osteoporotic pathological fractures and secondary endpoints included diagnosis of osteoporosis, vitamin-D deficiency, and related therapies. The single institution retrospective analysis identified 224 patients who underwent pancreatic resection between 2005 and 2019. BMD was quantified in CT images acquired before and after surgery. BMD trends and related factors were assessed in a time-series mixed effect linear regression model.

Results:
A total of 8,080 propensity score-matched pairs were included in the FRN analysis. The analysis revealed a 2.4-fold increase in pathological fractures (P<0.0001) and 1.4-1.5 fold increase in osteoporosis/osteomalacia (P<0.0001) and vitamin-D deficiency (P<0.0001) in post-pancreatectomy patients. Vitamin-D supplements were more common in the pancreatectomy group (OR 1.4, 95% CI 1.28-1.53, P<0.0001), as were specific osteoporosis/osteomalacia treatments such as calcitonin, denosumab, romosozumab, abaloparatide, and teriparatide (OR 2.24, 95%CI 1.69-2.95, P<0.0001). Retrospective analysis of CT imaging revealed that BMD declined more rapidly following pancreatic resection compared to normal historical controls (P=0.015). Older age, pancreatic cancer, and pancreaticoduodenectomy were associated with increased rates of BMD loss (P<0.05, each).

Conclusions:
After pancreatic resection, patients are at higher risk for BMD loss and subsequent fractures. As the cohort of pancreatic resection survivorship grows, attention will need to be paid to focused prevention efforts to reduce BMD loss, osteoporosis, and fractures in these vulnerable patients, with specific attention to the pancreatic cancer population.
The Potential Utilization of Machine Perfusion to Increase Transplantation of Macrosteatotic Livers
Authors: Cywes Claire , Banker Amay , Muñoz Nicolas , Levine Matthew , Abu-Gazala Samir , Bittermann Therese , Abt Peter 
Published: May 2024

Background.
The demand for liver transplantation has led to the utilization of marginal grafts including moderately macrosteatotic livers (macrosteatosis ≥30% [Mas30]), which are associated with an elevated risk of graft failure. Machine perfusion (MP) has emerged as a technique for organ preservation and viability testing; however, little is known about MP in Mas30 livers. This study evaluates the utilization and outcomes of Mas30 livers in the era of MP.

Methods.
The Organ Procurement and Transplantation Network database was queried to identify biopsy-proven Mas30 deceased donor liver grafts between June 1, 2016, and June 23, 2023. Univariable and multivariable models were constructed to study the association between MP and graft utilization and survival.

Results.
The final cohort with 3317 Mas30 livers was identified, of which 72 underwent MP and were compared with 3245 non-MP livers. Among Mas30 livers, 62 (MP) and 1832 (non-MP) were transplanted (utilization of 86.1% versus 56.4%, P < 0.001). Donor and recipient characteristics were comparable between MP and non-MP groups. In adjusted analyses, MP was associated with significantly increased Mas30 graft utilization (odds ratio, 7.89; 95% confidence interval [CI], 3.76-16.58; P < 0.001). In log-rank tests, MP was not associated with 1- and 3-y graft failure (hazard ratio, 0.49; 95% CI, 0.12-1.99; P = 0.319 and hazard ratio 0.43; 95% CI, 0.11-1.73; P = 0.235, respectively).

Conclusions.
The utilization rate of Mas30 grafts increases with MP without detriment to graft survival. This early experience may have implications for increasing the available donor pool of Mas30 livers.
Graft Survival of En Bloc Deceased Donor Kidneys Transplants Compared With Single Kidney Transplants
Authors: White Molly H. , Ross Lainie , Gallo Amy , Parker William F. 
Published: May 2024

Background.
The US Kidney Allocation System allocates en bloc deceased donor kidney grafts from donors <18 kg in sequence A along with single kidney transplants (SKTs) from kidney donor profile index (KDPI) top 20% donors. Although en bloc grafts outperform SKT grafts holding donor weight constant, it is unclear if en bloc grafts from the smallest pediatric donors perform the same as top 20% KDPI SKTs.

Methods.
Using the Scientific Registry of Transplant Recipients, we compared the donor characteristics and graft survival of en bloc grafts from the smallest donors (<8 kg) and from larger donors (≥8 kg) with SKTs by KDPI sequence for transplants performed in 2021.

Results.
Larger donor en blocs had similar 1-y survival to sequence A SKTs estimated by the Kaplan–Meier method (96% versus 96%, P = 0.9), but the smallest donor en blocs had significantly shorter 1-y survival than those SKTs (80% versus 96%, P < 0.01). Using transplants from 2010 to 2012, the smallest donor en blocs had similar 10-y survival to sequence A SKTs (69% versus 64%, P = 0.3).

Conclusions.
These findings suggest that future updates of the Kidney Allocation System should include a score specific to pediatric donors to account for these differences in en bloc graft survival.
Usefulness of aortic valve calcification in patients with low flow aortic stenosis
Authors: Mogensen Nils Sofus Borg , Sanchez Dahl Jordi , Ali Mulham , Annabi Mohamed-Salah , Haujir Amal , Powers Andréanne , Carter-Storch Rasmus , Grenier-Delaney Jasmine , Møller Jacob Eifer , Øvrehus Kristian Altern , Pibarot Philippe , Clavel Marie-Annick 
Published: May 2024

ABSTRACTBackgroundAortic valve calcification (AVC) has been shown to be a powerful assessment of aortic stenosis severity (AS) and predictor of adverse outcome. However, its accuracy in patients with low-flow AS has not yet been proven.ObjectivesTo assess the predictive value of AVC in patients classical (CLF, i.e. low left ventricular ejection fraction [LVEF]) or paradoxical (PLF, i.e. low flow preserved LVEF) AS patients.MethodsWe prospectively include 641 patients, 319 (49.8%) with CLF-AS and 322 (50.2%) with PLF-AS who underwent Doppler-echocardiography and multidetector computed tomography. AVCratio was calculated as AVC divided by the sex-specific AVC threshold for AS-severity; AVC score ≥2,000 AU in males, and ≥1,200 AU in females. The primary endpoint of the study was all-cause mortality regardless of treatment.ResultsDuring a median follow-up of 4.9 (4.3-5.9) years there were 265 deaths. After comprehensive adjustment, AVCratio was associated with all-cause mortality in CLF-AS (aHR=1.25 [1.01-1.56]; p<0.05) and PLF-AS (aHR=1.51[1.14-2.00]; p=0.004) patients. There was an interaction (p=0.001) between AVC and AS flow pattern (i.e. CLF vs. PLF) with regard to the prediction of mortality. The best AVCratio threshold to predict mortality was different in CLF-AS (AVCratio≥0.7) and PLF-AS (AVCratio≥1) patients. After comprehensive analysis, AVCratio as a dichotomic variable was associated with all-cause mortality in all groups (p≤0.001). The addition of AVCratio to the models improved all model’s predictive value (all net reclassification index >18%; all p≤0.05).ConclusionIn patients with CLF or PLF AS, AVC is a major predictor of mortality. Thus, AVC should be used in low flow patients to stratify risk. Importantly, in patients with reduced LVEF, a non-severe AS (i.e. AVC 70% of severe) could be associated with reduce survival.Clinical PerspectiveWhat is new?Aortic valve calcification is a powerful predictor of outcome in patients with low ejection fraction aortic stenosis and in patients with low-flow despite normal ejection fraction aortic stenosis.In patient with low ejection fraction aortic stenosis, a non-severe calcification (AVCratio=0.7) is associated with increased mortality. An AVCratio of 0.7 correspond to an AVC of 840AU in female patients and 1,400AU in male patients.What are the clinical implications?AVC should be used in low ejection fraction and low flow patients to assess aortic stenosis severity and stratify risk.A severe AVC, in patient with low-flow preserved ejection fraction, could help in clinical decision making.A moderate-to-severe AVC (i.e. AVCratio>0.7), in patients with low ejection fraction, is detrimental and may be used to refine clinical decision making.
Challenges in Synthesising the Effects of Synchronous Remote-based Interventions on Suicidal Behaviours: A Systematic Review and Meta-Analysis
Authors: Comendador Laura , Jiménez-Villamizar María P. , Losilla Josep-Maria , Sanabria-Mazo Juan P. , Mateo-Canedo Corel , Cebrià Ana Isabel , Palao Diego , Sanz Antoni 
Published: May 2024

ABSTRACTIntroductionSuicide is one of the leading causes of preventable death worldwide. Evidence reported in the literature seems to support the impact of providing active contact for people that have attempted suicide. The current systematic review and meta-analysis aim to investigate the effects of suicide prevention strategies implemented through remote and synchronous technology-based interventions.MethodsThe systematic review and meta-analysis followed the PRISMA 2020 guidelines. The searches were conducted in PubMed, PsycInfo, Scopus, and Web of Science. Screening, selection process, data extraction, and risk of bias (RoB) assessment have been performed independently by two reviewers. A systematic review and narrative synthesis of the data has been performed. Data on adherence to treatment and suicide-related factors to explain heterogeneity were extracted. A meta-analysis was conducted to determine effect sizes (Hedge’sg) for suicidal ideation, odds ratios (OR) and 95% confidence intervals (95% CI) for lethal and non-lethal suicide behaviours. Data were pooled using a random-effects model. Subgroup analyses were performed by classifying the studies according to the evaluation period.ResultsA total of 26 publications were finally included. Synchronous remote-based interventions were effective in preventing repeated suicide attempts (OR = 0.75; 95% CI 0.62 – 0.90) and suicide deaths (Peto OR = 0.37; 95% CI 0.18 – 0.77); however, considerable heterogeneity was reported. The effects on suicidal ideation were not confirmed (Hedge’sg= 0.23; 95% CI −1.54 – 1.07).ConclusionsThe observed heterogeneity suggests that the effects should be considered under caution. Methodological and procedural guidelines are proposed to improve the quality of future research studies.
West African pre-pandemic cross-reactive antibody and cellular responses against SARS-CoV-2
Authors: Herrera Bobby Brooke , Chaplin Beth , MBoup Souleymane , Abdullahi Adam , He Michelle , Fisher Sydney M. , Akanmu Sulaimon , Chang Charlotte A , Hamel Donald J , Gupta Ravindra K. , Kanki Phyllis J 
Published: May 2024

AbstractThe COVID-19 pandemic had a severe impact globally, yet African populations exhibited unexpectedly lower rates of severe disease and mortality. We investigated the potential role of pre-existing immunity in shaping the epidemiology of COVID-19 in Africa. Leveraging paired plasma and peripheral blood mononuclear cells collected from Senegalese female sex workers prior to the COVID-19 pandemic, we observed substantial levels of pre-existing cross-reactive immunity to SARS-CoV-2, stemming from prior exposure to seasonal human coronaviruses (hCoVs). Our antibody analysis revealed a 23.5% (47/200) seroprevalence rate against SARS-CoV-2 nucleocapsid (N). Of these SARS-CoV-2 N-reactives, 85.1% (40/47), 44.7% (21/47), and 95.7% (45/47) showed antibody reactivity against hCoV-229E or hCoV-OC43 spike (S) and/or N or hCoV-HKU1 S. Our analysis of cellular responses also demonstrated cross-reactivity to SARS-CoV-2 with 82.2% (37/45) and 84.4% (38/45) showing IFN-γ responses against S and N, respectively. These findings suggest that prior hCoV exposure may induce cross-reactive adaptive immunity, potentially contributing to protection against COVID-19. A unique pre-pandemic subject had cross-reactive SARS-CoV-2 S antibodies with detectable neutralization and cellular responses. Our study provides unique insights into the dynamics of hCoV and SARS-CoV-2 immunity in West African populations and underscores the importance of understanding the role of pre-existing immunity in shaping COVID-19 outcomes globally.
Causes and consequences of major depressive disorder: An encompassing Mendelian randomization study
Authors: Pasman Joëlle A. , Bergstedt Jacob , Harder Arvid , Gong Tong , Xiong Ying , Hägg Sara , Fang Fang , Treur Jorien L. , Choi Karmel W. , Sullivan Patrick F. , Lu Yi 
Published: May 2024

AbstractBackgroundMajor depressive disorder (MDD) is a prevalent and debilitating disorder that has been associated with a range of risk factors and outcomes. Causal pathways between MDD and other traits can be studied using genetic variants as instrumental variables.MethodsA literature review was conducted to identify 201 MDD-associated traits. For 115 traits, there were well-powered genome-wide association study (GWAS) results available that could be used to assess the genetic correlation with MDD. Of these, there were 89 meeting criteria for investigating causal associations in both directions using two-sample Mendelian randomization (TSMR). Of the traits that were not captured by GWAS, 43 could be included as outcomes of MDD using one-sample MR (OSMR). A range of methods and sensitivity tests was applied to gauge robustness of results, together with statistical power analyses to aid interpretation.OutcomesModerate to strong genetic overlap was found between MDD and most traits. Support for causal effects of MDD liability were found for circadian, cognitive, diet, medical disease, endocrine, functional, inflammatory, metabolic, mortality, physical activity, reproduction, risk behavior, social, socioeconomic, and suicide outcomes. Most associations were bidirectional, although there was less evidence for diet, disease, and endocrine traits causing MDD risk. Results were robust across sensitivity analyses.InterpretationThis study provides a systematic overview of traits putatively causally related to MDD, confirming previous findings as well as identifying new associations. Our results highlight the importance of MDD as a risk factor cross-cutting across medical, functional, and psychosocial domains and emphasize the need for concerted efforts at reducing this highly prevalent disorder.