bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations Between Systolic Pressure, Vascular Waveform, and Volume Flow with Debridement or Amputation Treatment Decisions in Diabetic Foot Ulcer Patients
Authors: Darwis Patrianef , Syaifudin Ahmad , Suhartono Raden , Muradi Akhmadu , Pratama Dedy , Dewi Dian Kusuma , Hamzah Alif 
Published: February 2024

Introduction Diabetic foot ulcer disease, affecting 6.3% of the global population, necessitates crucial decisions regarding debridement and amputation, with substantial cost, morbidity, and mortality implications. This study's primary goal is to determine effective vascular examination modalities, including systolic blood pressure, vascular waveforms, and blood volume flow to guide optimal treatments for diabetic foot patients. Method This cross-sectional study at Cipto Mangunkusumo General Hospital aimed to identify effective vascular examination modalities, such as systolic blood pressure, vascular waveforms, and blood volume flow, to guide treatment choices for diabetic foot patients. The study included 38 subjects, equally split between debridement and amputation groups. Results Notably, the presence of a biphasic pattern in popliteal artery vascular examinations was associated with the decision for amputation in diabetic foot patients (p < 0.05). The Chi-square test revealed that a biphasic ultrasound pattern served as a predictive factor for amputation among diabetic foot patients, with three times more biphasic patients choosing amputation over debridement. Conversely, assessments of popliteal artery systolic pressure, common femoral artery waveform, popliteal artery volume flow, and common femoral artery volume flow showed no significant correlations with the choice of debridement or amputation treatment for diabetic foot patients. Conclusion In summary, ultrasound assessment of vascular waveform in the popliteal artery emerges as a predictive factor for amputation or debridement in diabetic foot patients.
Onyx®, A New Tool for Intraoperative Localization of Liver Lesions
Authors: Rubio-García J. J. , Mantilla Pinilla A. J. , Gil Sánchez S. , Villodre Tudela C. , Alcázar López C. , Melgar Requena P. , Rodríguez Laiz G. , Irurzun López J. , Ramia-Ángel J. M. 
Published: February 2024

Background Precise preoperative localization of liver tumors facilitates successful surgical procedures, Intraoperative ultrasonography is a sensitive imaging modality. However, the presence of small non-palpable isoechoic intraparenchymal lesions may be challenging intraoperatively. Methodology and Material Description Onyx® is a non-adhesive liquid agent comprised of ethylene-vinyl alcohol usually used dissolved in dimethyl-sulfoxide and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy and ultrasonography and a macroscopic black shape. This embolization material has been increasingly used for the embolization of intracranial arteriovenous malformations. We present the novel application of Onyx® on liver surgery. Current Status We present the case of a female, 55 years-old, whose medical history revealed an elective sigmoidectomy (pT3N1a). After 17 months of follow up, by PET-CT scan, the patient was diagnosed of a small intraparenchymal hypo-attenuated 13 mm tumor located at segment V consistent with metachronous colorectal liver metastasis. Open metastasectomy was performed, ultrasonography-guided Onyx® infusion was delivered the day after, intraoperative ultrasonography showed a palpable hyperechoic material with a posterior acoustic shadowing artifact around the lesion. Onyx® is a promising new tool, without any previous application on liver surgery, feasible with advantages in small not palpable intraparenchymal liver lesions.
Characteristics of successful performance support team members at the Olympic games
Authors: Burns Lauren , Stanimirovic Rosanna , Donaldson Alex 
Published: February 2024

Objectives Athletes and coaches rely on their performance support team to optimise training and competition. The specific characteristics of performance support teams that contribute to success in competition from the perspective of athletes and coaches have not been examined. Olympic gold medal winning athletes and coaches were asked about the characteristics they valued in the performance support team members who were with them at the Olympic Games. The insights shared provide important context to the role of the performance support team member, beyond technical skills, in the high-stress environment of elite sporting competition. Methods Concept mapping was completed online to collect, analyse, and visually represent insights from 30 Olympic gold medal winning athletes and coaches. The concept mapping focus prompt used to generate insights from participants was ‘When I reflect on my gold medal winning performance, a characteristic that I really valued within my support team was….’. Athletes then brainstormed, sorted, and rated relevant statements. Results Multidimensional scaling and hierarchical cluster analysis produced an 8-cluster map – Way of Working, Communication Style, Emotional Management in Competition, Teamwork, Commitment to Athlete Preparation, Professionalism, Embracing the Experience, and Equality – as the best visual representation of the way participants sorted the 49 unique brainstormed statements. Conclusions Olympic gold medal winning athletes and coaches prioritised ways of working, communication style, emotional management, and teamwork as the characteristics they valued most in their performance support team. These constructs, when further examined by item, encourage performance support staff to develop emotional management skills to (a) strengthen interpersonal relationships within the team, (b) enhance the working alliance with athletes and coaches, and (c) contribute to team performance overall. Concept mapping provided a structured way of collecting lived experience insights that may compliment other qualitative approaches such as structured interviews.
Shoulder arthroplasty in the management of native shoulder joint infections has a high complication rate and poor functional outcome – a systematic review
Authors: Jordan Robert W , Ahmed Imran , D’Alessandro Peter , Woodmass Jarret M , MacDonald Peter B , Malik Shahbaz S 
Published: February 2024

Background Shoulder arthroplasty is a treatment option of the sequelae of native shoulder joint infections. However, the functional outcomes and re-infection rates are unknown. The aim of this review was to analyse the outcome of shoulder arthroplasty in patients with native shoulder infections. Methods A review of the online databases MEDLINE and Embase was conducted according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Studies reporting either primary or secondary infections of native shoulder joints treated with any form of arthroplasty were included and appraised using the methodological index for non-randomised studies (MINORS) tool. Results Fourteen studies were eligible for inclusion. Mean age ranged from 56 to 72 years and the mean follow-up from 20.5 months to 8.2 years. Primary shoulder infections were present in 50 patients and secondary infections in 86. 76 patients underwent a two stage: 46 patients a single-stage procedure whilst 14 refused second-stage surgery. Mean post-operative Constant score ranged from 38 to 56.2. The overall reported re-infection rate was 2.3% and complication rate was 26%. Conclusion Shoulder arthroplasty in the management of either primary or secondary native shoulder infections has a high complication rate and low functional outcome but low re-infection rates at short-term follow-up.
Prognosis of patients with residual pathological disease after neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy and surgery for esophageal squamous cell carcinoma: a retrospective cohort study
Authors: Okunaka Mashiro , Kotani Daisuke , Fujiwara Hisashi , Sato Kazuma , Fujiwara Naoto , Mishima Saori , Sakashita Shingo , Yoshino Takayuki , Fujita Takeo , Kojima Takashi 
Published: February 2024

Background: Docetaxel, cisplatin, and 5-fluorouracil (DCF) combination chemotherapy has been established as one of the standard neoadjuvant therapies for locally advanced esophageal squamous cell carcinoma (ESCC). However, little is known about prognostic factors in patients with residual pathological disease after neoadjuvant DCF followed by surgery for locally advanced ESCC who are candidates for adjuvant nivolumab. Objectives: This study aimed to investigate prognostic factors in patients with residual pathological disease after neoadjuvant DCF chemotherapy followed by surgery for locally advanced ESCC. Design: This was a retrospective cohort study. Methods: This retrospective cohort study included patients who received neoadjuvant DCF followed by surgery for locally advanced ESCC between June 2014 and January 2020 at the National Cancer Center Hospital East. Results: Among a total of 210 patients, 45 patients (21.4%) achieved a pathological complete response. The 3-year disease-free survival (DFS) rate was significantly lower in patients with residual pathological disease than in those with a pathological complete response [53.5% versus 74.5%; hazard ratio (HR): 2.09, 95% confidence interval (CI): 1.16–3.77, p = 0.01]. In patients with residual pathological disease ( n = 165), multivariate analysis revealed that pathological node positivity (HR: 3.59, 95% CI: 1.92–6.71, p < 0.01), supraclavicular lymph node metastasis (HR: 2.15, 95% CI: 1.19–3.90, p = 0.01), and lymphovascular invasion (HR: 1.90, 95% CI: 1.14–3.17, p = 0.02) were significantly associated with poor DFS. Conclusion: In this largest-to-date cohort study, patients with residual pathological disease after neoadjuvant DCF followed by surgery for locally advanced ESCC had a poor prognosis. In these patients, pathological node positivity, including supraclavicular lymph node metastasis, and lymphovascular invasion were considered significant prognostic factors.
Enophthalmos: Historical Perspective on Definitions, Measurement Devices, and Clinical Significance
Authors: Mayo John , Schubert Warren 
Published: February 2024

Assessing enophthalmos is critical in facial trauma patients, and there are many ways to do so. We have reviewed the various devices for measuring enophthalmos over the last 155 years. Knowing the benefits and drawbacks of each instrument is important in obtaining accurate results and interpreting them. We have reviewed the evolution of enophthalmos definitions and surgical indications. Although 2 mm of enophthalmos is commonly used as a cutoff for clinical significance, one should take into account individual patient factors, measurement techniques used, symptoms and/or the patient’s aesthetic concerns. The decision to operate must also be balanced with the risks of surgery, which may cause or worsen symptoms, such as diplopia, soft tissue deformities related to the surgical approach, and possibly blindness. We question whether enophthalmos greater than 2 mm should be considered the main criteria for corrective surgery.
Evaluation of the diagnostic utility of metagenomic next-generation sequencing testing for pathogen identification in infected hosts: a retrospective cohort study
Authors: Williams Austin , Webster William Zach , Cai Chao , Milgrom Alexander , Al-Hasan Majdi , Bookstaver P. Brandon 
Published: February 2024

Background: Metagenomic next-generation sequencing (mNGS) testing identifies thousands of potential pathogens in a single blood test, though data on its real-world diagnostic utility are lacking. Objectives: Determine the diagnostic utility of mNGS testing in practice and factors associated with high clinical utility. Design: Retrospective cohort study of mNGS tests ordered from June 2018 through May 2020 at a community teaching hospital. Methods: Tests were included if ordered for diagnostic purposes in patients with probable or high clinical suspicion of infection. Exclusions included patient expiration, hospice care, or transfer outside of the institution. Utility criteria were established a priori by the research team. Two investigators independently reviewed each test and categorized it to either high or low diagnostic utility. Reviewer discordance was referred to a third investigator. The stepwise multiple regression method was used to identify clinical factors associated with high diagnostic utility. Results: Among 96 individual tests from 82 unique patients, 80 tests met the inclusion criteria for analysis. At least one potential pathogen was identified in 58% of tests. Among 112 pathogens identified, there were 74 bacteria, 25 viruses, 12 fungi, and 1 protozoon. In all, 46 tests (57.5%) were determined to be of high diagnostic utility. Positive mNGS tests were identified in 36 (78.3%) and 11 (32.4%) of high and low diagnostic utility tests, respectively ( p < 0.001). Antimicrobials were changed after receiving test results in 31 (67.4%) of high utility tests and 4 (11.8%) of low utility tests ( p < 0.0001). In the multiple regression model, a positive test [odds ratio (OR) = 10.9; 95% confidence interval (CI), 3.2–44.4] and consultation with the company medical director (OR = 3.6; 95% CI, 1.1–13.7) remained significantly associated with high diagnostic utility. Conclusion: mNGS testing resulted in high clinical utility in most cases. Positive mNGS tests were associated with high diagnostic utility. Consultation with the Karius® medical director is recommended to maximize utility.
Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities
Authors: Myette Robert L. , Lamarche Caroline , Odutayo Ayodele , Verdin Nancy , Canney Mark 
Published: February 2024

Purpose of review: Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study. Sources of information: The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner. Methods: We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective. Key findings: Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective. Limitations: This is a narrative review and does not represent a comprehensive and systematic review of the literature.
AFEX-Net: Adaptive feature extraction convolutional neural network for classifying computerized tomography images
Authors: Zahedi Nasab Roxana , Mohseni Hadis , Montazeri Mahdieh , Ghasemian Fahimeh , Amin Sobhan 
Published: February 2024

PurposeDeep convolutional neural networks are favored methods that are widely used in medical image processing due to their demonstrated performance in this area. Recently, the emergence of new lung diseases, such as COVID-19, and the possibility of early detection of their symptoms from chest computerized tomography images has attracted many researchers to classify diseases by training deep convolutional neural networks on lung computerized tomography images. The trained networks are expected to distinguish between different lung indications in various diseases, especially at the early stages. The purpose of this study is to introduce and assess an efficient deep convolutional neural network, called AFEX-Net, that can classify different lung diseases from chest computerized tomography images.MethodsWe designed a lightweight convolutional neural network called AFEX-Net with adaptive feature extraction layers, adaptive pooling layers, and adaptive activation functions. We trained and tested AFEX-Net on a dataset of more than 10,000 chest computerized tomography slices from different lung diseases (CC dataset), using an effective pre-processing method to remove bias. We also applied AFEX-Net to the public COVID-CTset dataset to assess its generalizability. The study was mainly conducted based on data collected over approximately six months during the pandemic outbreak in Afzalipour Hospital, Iran, which is the largest hospital in Southeast Iran.ResultsAFEX-Net achieved high accuracy and fast training on both datasets, outperforming several state-of-the-art convolutional neural networks. It has an accuracy of [Formula: see text] and [Formula: see text] on the CC and COVID-CTset datasets, respectively, with a learning speed that is 3 times faster compared to similar methods due to its lightweight structure. AFEX-Net was able to extract distinguishing features and classify chest computerized tomography images, especially at the early stages of lung diseases.ConclusionThe AFEX-Net is a high-performing convolutional neural network for classifying lung diseases from chest CT images. It is efficient, adaptable, and compatible with input data, making it a reliable tool for early detection and diagnosis of lung diseases.
Music Therapy as a Topic in Medical Education: Course Concept and Student Evaluation of an Elective Course for Medical Students
Authors: Kobus Susann , Felderhoff-Mueser Ursula , Lainka Elke , Fandrey Joachim , Benson Sven 
Published: February 2024

OBJECTIVES Music therapy has been proven as a safe and well-established intervention in healthcare to relieve symptoms and improve quality of life. While music therapy is already established in several settings to supplement medical care, there is a lack of integration in the field of medical education. METHODS We report on the implementation and evaluation of a teaching concept for a five-day-intensive-course on music therapy. The course was offered as an elective course for medical students at the University Duisburg-Essen. At the end of the course, students filled out a free text questionnaire to assess the students’ perception of the course, and additionally answered standardized questions by the structured EVALuna online evaluation tool of the University of Duisburg-Essen. RESULTS All students (N = 35) who participated in the music therapy course between September 2019 and March 2023 completed the questionnaires and N = 21 students filled out the EVALuna. Most students (89%) chose the course because of their interest in alternative and supportive therapy options to improve patients’ well-being. About 46% had previous musical experience and passion and fun with music and 37% of the students were interested in the interdisciplinary academic subject that combined music and medicine. EVALuna online evaluation reflected high satisfaction with the course. CONCLUSION Due to the well-proven effectiveness and evidence of music therapy as well as the positive perception of medical students, music therapy should be further established in medical care and medical education.
Tyrosine kinase inhibitor response of ABL-class acute lymphoblastic leukemia: the role of kinase type and SH3 domain
Authors: van Outersterp Inge , Tasian Sarah K. , Reichert Caitlin E. J. , Boeree Aurélie , de Groot-Kruseman Hester A. , Escherich Gabriele , Boer Judith M. , den Boer Monique L. 
Published: February 2024

Abstract
Acute lymphoblastic leukemia (ALL) with fusions of ABL-class tyrosine kinase genes other than BCR::ABL1 occurs in ∼3% of children with ALL. The tyrosine kinase genes involved in this BCR::ABL1-like (Ph-like) subtype include ABL1, PDGFRB, ABL2, and CSF1R, each of which has up to 10 described partner genes. ABL-class ALL resembles BCR::ABL1-positive ALL with a similar gene expression profile, poor response to chemotherapy, and sensitivity to tyrosine kinase inhibitors (TKIs). There is a lack of comprehensive data regarding TKI sensitivity in the heterogeneous group of ABL-class ALL. We observed variability in TKI sensitivity within and among each ABL-class tyrosine kinase gene subgroup. We showed that ALL samples with fusions for any of the 4 tyrosine kinase genes were relatively sensitive to imatinib. In contrast, the PDGFRB-fused ALL samples were less sensitive to dasatinib and bosutinib. Variation in ex vivo TKI response within the subset of samples with the same ABL-class tyrosine kinase gene was not associated with the ALL immunophenotype, 5′ fusion partner, presence or absence of Src-homology-2/3 domains, or deletions of IKZF1, PAX5, or CDKN2A/B. In conclusion, the tyrosine kinase gene involved in ABL-class ALL is the main determinant of TKI sensitivity and relevant for specific TKI selection.