bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of intravascular lithotripsy and rotational atherectomy for the treatment of heavily calcified coronary lesions: the STIFF (Stenoses with calcificaTIon treated with angioplasty eFFected with dedicated interventional tools) study
Authors: Garzon Stefano , Bezerra Felipe , Mariani José , Bandeira Willterson , Prado Guy , Rueda Victor , Almeida Breno , Lemos Pedro 
Published: February 2024

Background
Percutaneous coronary interventions in heavily calcified coronary lesions are associated with technical difficulties and the worse prognosis. Lesion preparation is important to reduce complications and improve outcomes. The aim of this study is to compare the results of rotational atherectomy (RA) and intravascular lithotripsy (IVL) at achieving optimal stent implantation using intravascular ultrasound criteria.

Methods
Retrospective, single-center study comparing patients with heavily calcified coronary lesions that underwent percutaneous coronary interventions using RA or IVL.

Results In total
25 patients (13 in the RA group and 12 in the IVL group) were included. Reference vessel diameter was similar between the groups [2.59 (2.51–3.63) mm in the RA group vs. 2.79 (2.59–3.16) mm in the IVL group; P = 0.89], as were minimal lumen area [1.02 (0.80–1.23) mm vs. 1.40 (1.01–1.40) mm; P = 0.43] and diameter stenosis [60.4% (52.3–72.3) vs. 56.1% (47.8–61.3); P = 0.56). The final minimal lumen area was significantly larger in the IVL group [7.6 mm2 (5.8–8.6) vs. 5.4 mm2 (4.5–6.2); P = 0.01] as were lumen area gain [4.1 mm2 (2.6–5.9) vs. 2.3 mm2 (1.4–3.6); P = 0.01] and final stent volume [491.2 mm3 (372.2–729.8) vs. 326.2 mm3 (257.1–435.4); P = 0.03]. In the RA group, 69.2% of the patients achieved the preestablished intravascular ultrasound-based criteria for successful stent implantation, vs. 100% of the patients in the IVL group (P = 0.04).

Conclusion
Patients in the IVL group achieved the Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation trial criteria of successful stent implantation more frequently than those treated with RA.
Efficacy and safety of restrictive versus liberal blood transfusion strategies in acute myocardial infarction and anemia: a systematic review and meta-analysis of randomized controlled trials
Authors: Amin Ahmed Mazen , Ali Karim , Elbenawi Hossam , Saber Alhassan , Abuelazm Mohamed , Abdelazeem Basel 
Published: February 2024

Background
Blood transfusion strategies in patients with acute myocardial infarction (AMI) and anemia are yet to be conclusively identified. Thus, we aim to assess the efficacy and safety of restrictive versus liberal blood transfusion strategies for AMI and anemia.

Methods
A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, web of science, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials were performed through November 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). (PROSPERO): ID: CRD42023490692.

Results
We included four RCTs with 4.325 patients. There was no significant difference between both groups regarding MACE whether at 30 days (RR: 0.93 with 95% CI [0.57–1.51], P = 0.76) or ≥ six months (RR: 1.17 with 95% CI [0.95–1.45], P = 0.14), all-cause mortality at 30 days (RR: 1.16 with 95% CI [0.95–1.40], P = 0.14) or ≥ six months (RR: 1.16 with 95% CI [0.88–1.53], P = 0.28). However, the liberal strategy was significantly associated with increased hemoglobin level change (MD: −1.44 with 95% CI [−1.68 to −1.20], P < 0.00001). However, the restrictive strategy was significantly associated with a lower incidence of acute lung injury (RR: 0.11 with 95% CI [0.02–0.60], P = 0.01).

Conclusion
There was no significant difference between the restrictive blood transfusion strategy and the liberal blood transfusion strategy regarding the clinical outcomes. However, restrictive blood transfusion strategy was significantly associated with a lower incidence of acute lung injury than liberal blood transfusion strategy.
Biopsy-based transcriptomics in the diagnosis of kidney transplant rejection
Authors: de Nattes Tristan , Beadle Jack , Roufosse Candice 
Published: February 2024

Purpose of review
The last year has seen considerable progress in translational research exploring the clinical utility of biopsy-based transcriptomics of kidney transplant biopsies to enhance the diagnosis of rejection. This review will summarize recent findings with a focus on different platforms, potential clinical applications, and barriers to clinical adoption.

Recent findings
Recent literature has focussed on using biopsy-based transcriptomics to improve diagnosis of rejection, in particular antibody-mediated rejection. Different techniques of gene expression analysis (reverse transcriptase quantitative PCR, microarrays, probe-based techniques) have been used either on separate samples with ideally preserved RNA, or on left over tissue from routine biopsy processing. Despite remarkable consistency in overall patterns of gene expression, there is no consensus on acceptable indications, or whether biopsy-based transcriptomics adds significant value at reasonable cost to current diagnostic practice.

Summary
Access to biopsy-based transcriptomics will widen as regulatory approvals for platforms and gene expression models develop. Clinicians need more evidence and guidance to inform decisions on how to use precious biopsy samples for biopsy-based transcriptomics, and how to integrate results with standard histology-based diagnosis.
Cystatin C should be routinely available for estimating kidney function
Authors: Lees Jennifer S. , Fabian June , Shlipak Michael G. 
Published: February 2024

Purpose of review
In this report, we summarize why the availability of cystatin C is important across a variety of clinical scenarios, the recent literature on when, why and in whom cystatin C testing should be considered, and how nephrologists can take practical steps to incorporate cystatin C testing into their practice.

Recent findings
Large intra-individual discrepancies between estimated glomerular filtration rate by creatinine (eGFRcr) and estimated glomerular filtration rate by creatinine eGFRcys (known as eGFRdiff) are observed in at least 1 in 4 people. These differences are seen more commonly among more vulnerable individuals: older adults, females, non-White individuals and those living with multiple medical conditions. A large eGFRdiff, where eGFRcys is lower than eGFRcr, is associated with a plethora of adverse outcomes, including medication-associated adverse events, acute kidney injury, cardiovascular disease, kidney failure and all-cause mortality. Among studies that have measured GFR, eGFRcr-cys usually provides the most accurate estimation of kidney function compared to mGFR, including among participants with large discrepancies between eGFRcr and eGFRcys.

Summary
Cystatin C improves sensitivity and specificity of chronic kidney disease diagnosis, improves detection of harmful acute and chronic changes in kidney function, improves precision of treatment eligibility and safety, and may reduce healthcare inequalities. Better education, curiosity, and motivation among nephrologists could substantially improve the availability and utilization of cystatin C.
Precision care in the treatment of pediatric asthma
Authors: Mahmood Lina , Keskin Sevdenur , Jefferson Akilah A. 
Published: February 2024

Purpose of review
Precision medicine in pediatric asthma involves identification of asthma phenotypes, genetic markers, biomarkers, and biologics that target specific pathways. This review includes a discussion of the efficacy of currently approved biologics for pediatric asthma and most recent advances in biomarker/phenotype identification and genetic associations that affect asthma care.

Recent findings
Biologics targeting type-2 mediated pathways have shown success in the treatment of moderate to severe asthma in pediatric and adult patients. In comparative studies, dupilumab, an interleukin-4 (IL-4) alpha receptor inhibitor, and mepolizumab, an IL-5 inhibitor, have shown more improvement in asthma exacerbation rates and lung function compared to other biologics such as tezepelumab, omalizumab and benralizumab. Other methods used to categorize asthma treatment response have been investigated and include use of biomarkers such as fractional exhaled nitric oxide (FeNO). Genomic studies are also emerging in precision care for pediatric asthma.

Summary
An understanding of underlying immunologic and genetic mechanisms affecting the development of asthma in pediatric patients has resulted in the production of numerous targeted therapies that have led to improvement in lung function and reduced exacerbation burden.
Hypoglycemia Associated With PEG-asparaginase and 6-MP Therapy During Treatment of Acute Lymphoblastic Leukemia in Pediatric Patients: A Case Series
Authors: Jiang Mary R. , Ahmet Alexandra , Lawrence Sarah , Bassal Mylene , Speckert Matthew , Geraghty Michael T. , Somerville Scott 
Published: February 2024

Background:
Asparaginases are a mainstay treatment for pediatric acute lymphoblastic leukemia (ALL). Recent reports identified hypoglycemia associated with asparaginases. Other reports describe hypoglycemia associated with 6-mercaptopurine (6-MP), another fundamental ALL therapy. Little is known about the risk of hypoglycemia associated with ALL therapy, an adverse event that puts children at risk of decreased level of consciousness, seizures, and possibly negative neurocognitive sequelae.

Methods:
We performed a retrospective chart review of 6 children with hypoglycemia during ALL treatment in our institution from May 2016 to August 2019. Timing and duration of hypoglycemia relative to polyethylene glycol (PEG)–asparaginase, 6-MP, and corticosteroids were determined. Laboratory values of the critical sample were collected.

Results:
The median age was 2.75 (interquartile range: 1.88 to 3.63) years. Three patients had trisomy 21. The onset of hypoglycemia was 5 to 19 days after the most recent PEG-asparaginase administration or 6 to 7 months after initiating daily 6-MP. Sixteen hypoglycemic events were documented, and 9/16 had a critical sample drawn. Six events were hypoketotic, associated with PEG-asparaginase. Three were ketotic, associated with 6-MP. Two patients required treatment with diazoxide and cornstarch.

Conclusions:
Hypoglycemia associated with PEG-asparaginase occurred later and lasted longer than previous reports with l-asparaginase, with the likely mechanism being hyperinsulinism. 6-MP was associated with ketotic hypoglycemia.
A randomized controlled trial comparing pioglitazone and metformin prior to in vitro fertilization in polycystic ovary syndrome – associated infertile women: impact on pregnancy rates
Authors: Taheripanah Robabeh , Kazemi Seyyedeh N. , Taheripanah Anahita , Fereidoonjah Somayyeh 
Published: February 2024

Background:
Polycystic ovarian syndrome (PCOS) is one of the significant causes of infertility. Impaired glucose metabolism and insulin resistance add chiefly to the pathogenesis of PCOS. This study aimed to evaluate the efficacy of metformin and pioglitazone (insulin sensitizers) on the quality of the ovum and pregnancy rate in the IVF cycle.

Methods:
In this randomized clinical trial study, 172 infertile women with PCO were enrolled and randomly assigned to receive either 15 mg pioglitazone (case group) or 1000 mg metformin (control group) twice a day for 6 weeks before IVF, and the pregnancy rate was compared across the groups. The number of ovum and embryos were also accessed and compared between the two groups.

Results:
In the study, 172 patients participated. The mean age in the control and case groups was 32.09±3.9 years and 32.12±3.9 years, respectively, with no significant age difference. In both groups, the mean number of IVF eggs retrieved was 11.76±3.7 (control) and 11.86±3.7 (case), and the number of embryos formed was 7.43±2.8 (control) and 7.87±3.5 (case), with no significant disparities (P<0.05). Regarding positive pregnancies, 28 out of 86 (32.6%) occurred in the control group, while 42 out of 86 (48.8%) happened in the case group, demonstrating a significant difference (P=0.03).

Conclusions:
According to the results obtained in this study, it may be concluded that pioglitazone is superior to metformin in IVF cycles in PCOS-associated infertile women leading to a higher pregnancy rate.
Lutembacher syndrome presenting as heart failure in an old female from rural Nepal: a case report
Authors: Chaudhary Durgesh , Adhikari Pratik , Mehta Binod , Yadav Pramodman Singh , Koirala Sagar , Shah Sumit Kumar , Khadka Manita 
Published: February 2024

Introduction and significance:
Lutembacher syndrome (LS), combining atrial septal defect (ASD) and mitral stenosis (MS), is rare, particularly in rural areas. This case presents a 55-year-old Nepalese woman with LS symptoms; however, financial constraints hindered surgical treatment, highlighting LS challenges and the need for early intervention in resource-limited settings.

Case presentation:
A 55-year-old woman from rural Nepal presented with 30-day leg swelling and shortness of breath. Apart from autosomal dominant polycystic kidney disease (ADPKD) and smoking, she had no significant comorbidities. Clinical examination revealed severe mitral stenosis and an ASD, but financial limitations prevented surgery.

Clinical discussion:
LS is rarer in regions with low rheumatic heart disease (RHD) prevalence like Nepal. This case, despite rarity, delayed presentation, and financial barriers, emphasizes early intervention’s importance. While rheumatic fever wasn’t confirmed, clinical and echocardiographic findings suggest rheumatic mitral stenosis. The patient’s surgery reluctance due to finances highlights resource limitations’ impact.

Conclusion:
This Nepalese LS case highlights its complexity and management challenges, especially in resource-limited settings. It stresses early intervention’s importance and the impact of financial constraints on patient care. The study urges improved healthcare access and alternative funding in high RHD-prevalence regions.
Association of Systemic Immune-Inflammation Index With Stroke and Mortality Rates
Authors: Yang Lei , Wang Maode 
Published: February 2024

Objective:
This study aimed to examine the association of the systemic immune-inflammation index (SII) with stroke and mortality rates using data from the National Health and Nutrition Examination Survey (NHANES).

Methods:
A cross-sectional study was conducted using the aggregated data from 5 cycles (2009 to 2018) of NHANES. SII was the independent variable, and stroke was the dependent variable. Weighted logistic regression models were employed to analyze their relationship. The nonlinear association between SII and stroke was examined using the restricted cubic spline (RCS) method in subgroups stratified by smoking status, hypertension, and dietary inflammatory index. Weighted Kaplan-Meier curves and Cox regression analysis were used to investigate the association of SII with all-cause mortality and cardiovascular disease (CVD) mortality.

Results:
A total of 22,107 samples were included in this study. Weighted logistic regression analysis showed a significant correlation between SII and stroke (OR: 1.53, 95% CI: 1.22-1.92, P<0.001). The stratified analysis revealed that interactions of smoking status and hypertension with SII, respectively, had significant impacts on stroke risk. A remarkable positive link between SII and stroke risk (OR>1, P<0.05) was observed in the crude model (unadjusted for confounding factors), model I (adjusted for demographic characteristics), and model II (adjusted for all confounding factors). RCS analysis displayed a remarkable nonlinear positive correlation between SII and stroke risk only in the “now smoking” population (P-nonlinear<0.05) after adjusting for all confounding factors. In the overall sample population, Kaplan-Meier curves indicated that individuals in the highest quartile of SII had the highest risk of all-cause mortality and CVD mortality (log-rank test P<0.05). Samples with proinflammatory dietary habits had considerably higher risks of all-cause mortality and CVD mortality compared with those with anti-inflammatory dietary habits (log-rank test P<0.05). Multivariable-adjusted Cox regression models showed significantly increased all-cause mortality and CVD mortality rates in the highest quartile of SII compared with the lowest quartile.

Conclusions:
SII levels were considerably positively linked to stroke risk, particularly in the “now smoking” population. Moreover, elevated SII levels increased the risk of all-cause mortality and CVD mortality in the overall population. On the basis of these findings, we recommend incorporating smoking cessation measures into stroke risk reduction strategies.
Development of psycho-oncology telehealth guidelines: a modified Delphi consensus study
Authors: Cooper Claire , Gilchrist Jemma , Beatty Lisa , Kirsten Laura , Sharpe Louise , Zomerdijk Nienke , Grier Maree , Turner Jane , Hobbs Kim , Haydon Helen M. , Dhillon Haryana , Kelly Brian , Shaw Joanne 
Published: February 2024

Abstract

Objective:
In response to COVID-19, psycho-oncology clinicians moved to a model of telephone and videoconference treatment in Australia. The Psycho-oncology Co-operative Research Group (PoCoG) identified a paucity of evidence available to guide adaptation of therapy for remote delivery. This research aimed to develop consensus for evidence-based guidelines on ways to adapt psychological therapies in psycho-oncology for remote delivery.

Methods:
A national expert advisory group (N = 11) was convened consisting of psycho-oncology clinicians and clinical researchers. An iterative codesign methodology was used to draft psycho-oncology telehealth guidelines. Australian psycho-oncology clinicians participated in a Delphi consensus process to guide the content included in the guidelines. Content was presented under six domains: (i) screening and outcome measures, (ii) formulation, (iii) safety considerations, (iv) resource adaptation, (v) adaptations to therapy, and (vi) example case studies. Participants rated items based on importance, therapeutic appropriateness, and/or usefulness. Consensus was defined as >80% agreement.

Results:
Thirty-two psycho-oncology clinicians with telehealth experience participated in three Delphi rounds. Agreement was reached on (i) the importance of including screening and outcome measures (90%) and items (n = 5) related to how best to facilitate this; (ii) the importance of addressing provision of a formulation (100%), although only 2/6 strategies presented to facilitate formulation reached consensus; (iii) the appropriateness of proposed risk assessment and management strategies (84%); (iv) therapeutic appropriateness of simplifying resources (100%), including 3/5 visual optimization strategies; and (v) common behavioral components of therapy (n=5).

Conclusions:
Providing guidance to psycho-oncology clinicians for integrating telehealth into routine clinical practice must go beyond logistical considerations. These consensus-based guidelines provide support to clinicians for adaptation of psycho-oncology therapy to telehealth and will ensure evidence-based practice.
Femicide in the United States
Authors: Alexander Abigail L. , Gill James R. 
Published: February 2024

Abstract
We examined the records of the Connecticut Office of the Chief Medical Examiner for all female homicides from 2012 to 2021 to ascertain the rate of femicide. The investigative data were subcategorized as femicides and nonfemicides. The records included autopsy, toxicology, and investigators' reports. All underwent autopsy examination. The relationship of the perpetrator, cause of death, and special circumstances were examined in conjunction with the United Nations operational criteria. If the death investigation did not identify the suspected perpetrator, news media were searched for a reported homicide or manslaughter arrest. The total number of homicides was 271, and 259 (96%) could be further categorized, of which 181 (70%) were femicides. Differences between the 2 cohorts included causes of death (P's < 0.001), age at death (P < 0.001), and the involvement of murder-suicide (P < 0.001). No differences were observed for race, and the yearly rate of femicides did not increase during the COVID-19 pandemic.
American Association of Plastic Surgeons Consensus on Breast Implant–Associated Anaplastic Large-Cell Lymphoma
Authors: Clemens Mark W. , Myckatyn Terence M. , Di Napoli Arianna , Feldman Andrew L. , Jaffe Elaine S. , Haymaker Cara L. , Horwitz Steven M. , Hunt Kelly K. , Kadin Marshall E. , McCarthy Colleen M. , Miranda Roberto N. , Prince H. Miles , Santanelli di Pompeo Fabio , Holmes Sari D. , Phillips Linda G. 
Published: February 2024

Background:
In the absence of high-quality evidence, there is a need for guidelines and multidisciplinary consensus recommendations on breast implant–associated anaplastic large-cell lymphoma (BIA-ALCL). The purpose of this expert consensus conference was to evaluate the existing evidence regarding the diagnosis and management of BIA-ALCL caused by textured implants. This article aims to provide evidence-based recommendations regarding the management and prevention of BIA-ALCL.

Methods:
A comprehensive search was conducted in the MEDLINE, Cochrane Library, and Embase databases, and supplemented by manual searches of relevant English-language articles and “related articles” sections. Studies focusing on breast surgery and lymphoma associated with breast implants were included for analysis. Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons using a Delphi consensus method.

Results:
A total of 840 articles published between January of 2011 and January of 2023 were initially identified and screened. The full text of 188 articles was assessed. An additional 43 articles were excluded for focus, and 145 articles were included in the synthesis of results, with 105 of them being case reports or case series. The analysis encompassed a comprehensive examination of the selected articles to determine the incidence, risk factors, clinical presentation, diagnostic approaches, and treatment modalities related to BIA-ALCL.

Conclusions:
Plastic surgeons should be aware of the elevated risks by implant surface type, implement appropriate patient surveillance, and follow the recommendations outlined in this statement to ensure patient safety and optimize outcomes. Ongoing research on the pathogenesis, genetic drivers, and preventative and prophylactic measures for BIA-ALCL is crucial for improving patient care.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, V.