bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial
Authors: Kriege M. , Lang P. , Lang C. , Schmidtmann I. , Kunitz O. , Roth M. , Strate M. , Schmutz A. , Vits E. , Balogh O. , Jänig C. 
Published: February 2024

SummaryAspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy rapid sequence intubation in the operating theatre. We hypothesised that the use of a videolaryngoscope during rapid sequence intubation would be associated with a higher first pass tracheal intubation success rate than conventional direct laryngoscopy. In this multicentre randomised controlled trial, 1000 adult patients requiring tracheal intubation for elective, urgent or emergency surgery were allocated randomly to airway management using a McGrath™ MAC videolaryngoscope (Medtronic, Minneapolis, MN, USA) or direct laryngoscopy. Both techniques used a Macintosh blade. First‐pass tracheal intubation success was higher in patients allocated to the McGrath group (470/500, 94%) compared with those allocated to the direct laryngoscopy group (358/500, 71.6%), odds ratio (95%CI) 1.31 (1.23–1.39); p < 0.001. This advantage was observed in both trainees and consultants. Cormack and Lehane grade ≥ 3 view occurred less frequently in patients allocated to the McGrath group compared with those allocated to the direct laryngoscopy group (5/500, 1% vs. 94/500, 19%, respectively; p < 0.001). Tracheal intubation with a McGrath videolaryngoscope was associated with a lower rate of adverse events compared with direct laryngoscopy (13/500, 2.6% vs. 61/500, 12.2%, respectively; p < 0.001). These findings suggest that the McGrath videolaryngoscope is superior to a conventional direct laryngoscope for rapid sequence intubation in the operating theatre.
Management & surveillance of rectal neuroendocrine tumours: a single‐centre retrospective analysis
Authors: Barnard Paige , Stephensen Bree , Taylor Georgia , Huang Johnson , de Jager Elzerie , McMahon Matthew 
Published: February 2024

AbstractBackgroundRectal neuroendocrine tumours (rNETs) are rare but are increasing in incidence. Current management and surveillance recommendations are based on low‐grade evidence. Follow‐up practices are often inconsistent and costly. This retrospective study analyses a single‐centre's experience with rNETs to assess incidence, management practices, outcomes, and guideline adherence.MethodsThis is a single‐centre retrospective study from Queensland Australia, spanning from 2012 to 2023. Twenty‐eight rNET cases met inclusion criteria. Examined parameters included incidence, management, outcomes and adherence to European Neuroendocrine Tumour Society (ENETS) guidelines. R1 resection rate was analysed for associations with resection technique and lesion recognition and recurrence rate was assessed in all patients.ResultsThis study shows an increasing incidence of rNETs during the study period, reflecting a global trend. R1 resection rate at initial endoscopy was 75%. There was a general lack of advanced endoscopic techniques utilized and poor lesion recognition, however a statistically significant correlation was not established between these factors and an R1 result (P < 0.05). Most patients with an R1 result had subsequent re‐resection to render the result R0, however five patients (33%) underwent surveillance with no reports of recurrence on follow‐up. Overall, follow‐up practices in our cohort were inconsistent and did not adhere to guidelines.ConclusionrNETs are increasing in incidence, emphasizing the need for standardized management and surveillance. Further training is required for rNET recognition and advanced endoscopic resection techniques. Further research is required to assess long‐term outcomes in surveilled R1 cases, understand optimal endoscopic resection techniques and further develop local surveillance guidelines.
Diabetic retinopathy as an independent marker of cardiovascular disease in type 1 diabetes: Results from a nationwide longitudinal matched case–cohort study
Authors: Mabala Ditte Simmelkær , Stokholm Lonny , Andersen Nis , Andresen Jens , Bek Toke , Heegaard Steffen , Hajari Javad , Højlund Kurt , Kawasaki Ryo , Laugesen Caroline Schmidt , Möller Sören , Pedersen Frederik Nørregaard , Schielke Katja Christina , Thykjær Anne Suhr , Grauslund Jakob 
Published: February 2024

AbstractPurposeTo investigate diabetic retinopathy (DR) as a potential marker of cardiovascular disease (CVD) in adults with type 1 diabetes attending the Danish DR‐screening programme and non‐diabetes adults.MethodsIn this registry‐based matched case–cohort study, we identified 16 547 adults with type 1 diabetes, who were registered in the Danish Registry of Diabetic Retinopathy (DiaBase). Each case was age‐ and sex‐matched by five non‐diabetes individuals (n = 82 399), and odds ratios (ORs) and hazard ratios (HRs) were estimated for incident and upcoming CVD in multivariable models.ResultsAdults with type 1 diabetes (median age 44.5 years, 57.6% male) were more likely to have prevalent CVD (OR 1.29; 95% CI, 1.20–1.38) and to develop CVD within 5 years (HR 1.19; 95% CI, 1.08–1.30) as compared to non‐diabetes control. However, adults without DR were less likely to develop CVD (HR 0.84; 95% CI, 0.72–0.97) compared to the reference population. For adults with type 1 diabetes, there was an increasing risk for incident CVD for increasing levels of DR (HR 1.33, 1.95, 1.71 and 2.39 for DR‐levels 1–4, respectively). Patients with CVD at the time of the first screening had a higher risk to develop DR during follow‐up (HR 1.23; 95% CI, 1.02–1.49).ConclusionIn a nationwide matched case–cohort study adjusted for potential confounders, DR was identified as an independent marker of prevalent and incident CVD in type 1 diabetes with increasing risk demonstrated for higher levels of DR. Likewise, CVD also independently predicted the risk of incident DR.
Understanding barriers to reducing antimicrobials on Australian dairy farms: A qualitative analysis
Authors: Langhorne C , Wood BJ , Wood C , Henning J , McGowan M , Schull D , Ranjbar S , Gibson JS 
Published: February 2024

IntroductionReducing antibiotic use in production animal systems is one strategy which may help to limit the development of antimicrobial resistance. To reduce antimicrobial use in food‐producing animals, it is important to first understand how antibiotics are used on farm and what barriers exist to decreasing their use. In dairy production systems, mastitis is one of the most common reasons for administering antimicrobials. Therefore, it is important to understand the motivations and behaviours of dairy farmers in relation to the diagnosis, treatment and prevention of mastitis.Materials and methodsIn this study, we interviewed a sample of dairy farmers and dairy industry professionals from the major dairying regions of eastern Australia regarding their current practices used to diagnose, treat, and control subclinical and clinical mastitis. Inductive thematic analysis was used to code interview transcripts and identify the recurrent themes.ResultsFour overarching themes were identified: (1) the challenges associated with the detection and diagnosis of clinical mastitis, including with laboratory culture, (2) the motivations behind treatment decisions for different cases, (3) decisions around dry cow therapy and the role of herd recording, and (4) concerns regarding the development of antimicrobial resistance.DiscussionThis study identifies several challenges which may limit the ability of Australian dairy farmers to reduce antimicrobial use on farm, such as the need for rapid and reliable diagnostic tests capable of identifying the pathogenic causes of mastitis and the difficulties associated with conducting herd recording for the implementation of selective dry cow therapy. Industry professionals were concerned that farmers were not using individual cow records to aid in treatment decisions, which could result in unnecessary antimicrobial use. The results of this study can act as the basis for future research aimed at assessing these issues across the broader Australian dairy industry.
Economic evaluation of personalized vs. standard dosing of 5‐fluorouracil in first‐line chemotherapy for metastatic colorectal cancer in Australia
Authors: Erku Daniel , Martin Jennifer H. , Michael Michael , Galettis Peter , Scuffham Paul 
Published: February 2024

AimsUsing pharmacokinetics (PK)‐guided 5‐fluorouracil (5‐FU) for metastatic colorectal cancer (mCRC) improves overall survival (OS) and decreases toxicity, yet its value for money in the Australian setting is unknown. Our study assesses the cost‐effectiveness of PK vs. body surface area (BSA) dosing of 5‐FU for patients with mCRC.MethodsWe developed a semi‐Markov model with four health states to compare PK‐guided dosing within a FOLFOX regimen vs. BSA‐guided dosing for mCRC patients from an Australian healthcare system perspective. Transition probabilities were derived from fitted survival models, with utility values obtained directly from published studies. We calculated direct healthcare costs, quality‐adjusted life years (QALYs) and incremental cost‐effectiveness ratios (ICERs), and included both one‐way and probabilistic sensitivity analyses.ResultsBSA‐guided FOLFOX provided 1.291 QALYs at a cost of $36 379, compared with PK‐guided FOLFOX which delivered 1.751 QALYs at a cost of $32 564. Therefore, PK‐guided dosing emerges as the dominant strategy offering both better health outcomes and lower costs. The variables that had the greatest impact on the overall ICER were the adverse event rates in the BSA and PK groups, model time horizon, utility of progression‐free survival and PREDICT assay cost. Our univariate and multivariate sensitivity analysis confirmed that the ICER for PK FOLFOX consistently remained below $50 000 per QALY across all tested variables.ConclusionsPK dose management of 5‐FU‐based chemotherapy in mCRC patients appears to be a cost‐saving strategy in Australia. However, our model estimates are drawn from limited, low‐quality evidence. Further evidence from randomized controlled trials (RCTs), directly comparing PK‐based to BSA‐based dosing across a variety of current regimens, is needed to address our model's uncertainties.
Cardiac effects of deferasirox in transfusion‐dependent patients with myelodysplastic syndromes: TELESTO study
Authors: Sarocchi Matteo , Li Junmin , Li Xiao , Wu Depei , Montaño Figueroa Efreen , Rodriguez Maria Guadalupe , Hou Ming , Finelli Carlo , Shi Hong‐Xia , Xiao Zhijian , Oliva Esther Natalie , Gercheva Kyuchukova Liana , Drummond Mark , Symeonidis Argiris , Velazquez Eric J. , Rivoli Giulia , Izquierdo Miguel , Kolekar Yogita , Spallarossa Paolo , Angelucci Emanuele 
Published: February 2024

SummaryIron overload from repeated transfusions has a negative impact on cardiac function, and iron chelation therapy may help prevent cardiac dysfunction in transfusion‐dependent patients with myelodysplastic syndromes (MDS). TELESTO (NCT00940602) was a prospective, placebo‐controlled, randomised study to evaluate the iron chelator deferasirox in patients with low‐ or intermediate‐1–risk MDS and iron overload. Echocardiographic parameters were collected at screening and during treatment. Patients receiving deferasirox experienced a significant decrease in the composite risk of hospitalisation for congestive heart failure (CHF) or worsening of cardiac function (HR = 0.23; 95% CI: 0.05, 0.99; nominal p = 0.0322) versus placebo. No significant differences between the arms were found in left ventricular ejection fraction, ventricular diameter and mass or pulmonary artery pressure. The absolute number of events was low, but the enrolled patients were younger than average for patients with MDS, with no serious cardiac comorbidities and a modest cardiovascular risk profile. These results support the effectiveness of deferasirox in preventing cardiac damage caused by iron overload in this patient population. Identification of patients developing CHF is challenging due to the lack of distinctive echocardiographic features. The treatment of iron overload may be important to prevent cardiac dysfunction in these patients, even those with moderate CHF risk.
Fully Automated Versions of Clinically Validated Nephrometry Scores Demonstrate Superior Predictive Utility versus Human Scores
Authors: Wood Andrew M. , Abdallah Nour , Heller Nicholas , Benidir Tarik , Isensee Fabian , Tejpaul Resha , Suk‐ouichai Chalairat , Curry Caleb , You Alex , Remer Erick , Haywood Samuel , Campbell Steven , Papanikolopoulos Nikolaos , Weight Christopher 
Published: February 2024

ObjectiveTo automate the generation of three validated nephrometry scoring systems on preoperative computerised tomography (CT) scans by developing artificial intelligence (AI)‐based image processing methods. Subsequently, we aimed to evaluate the ability of these scores to predict meaningful pathological and perioperative outcomes.Patients and MethodsA total of 300 patients with preoperative CT with early arterial contrast phase were identified from a cohort of 544 consecutive patients undergoing surgical extirpation for suspected renal cancer. A deep neural network approach was used to automatically segment kidneys and tumours, and then geometric algorithms were used to measure the components of the concordance index (C‐Index), Preoperative Aspects and Dimensions Used for an Anatomical classification of renal tumours (PADUA), and tumour contact surface area (CSA) nephrometry scores. Human scores were independently calculated by medical personnel blinded to the AI scores. AI and human score agreement was assessed using linear regression and predictive abilities for meaningful outcomes were assessed using logistic regression and receiver operating characteristic curve analyses.ResultsThe median (interquartile range) age was 60 (51–68) years, and 40% were female. The median tumour size was 4.2 cm and 91.3% had malignant tumours. In all, 27% of the tumours were high stage, 37% high grade, and 63% of the patients underwent partial nephrectomy. There was significant agreement between human and AI scores on linear regression analyses (R ranged from 0.574 to 0.828, all P < 0.001). The AI‐generated scores were equivalent or superior to human‐generated scores for all examined outcomes including high‐grade histology, high‐stage tumour, indolent tumour, pathological tumour necrosis, and radical nephrectomy (vs partial nephrectomy) surgical approach.ConclusionsFully automated AI‐generated C‐Index, PADUA, and tumour CSA nephrometry scores are similar to human‐generated scores and predict a wide variety of meaningful outcomes. Once validated, our results suggest that AI‐generated nephrometry scores could be delivered automatically from a preoperative CT scan to a clinician and patient at the point of care to aid in decision making.
Community science enhances modelled bee distributions in a tropical Asian city
Authors: Lim Daniel Shan En , Pang Sean Eng Howe , Koay Tze Min , Soh Zestin Wen Wen , Ascher John S. , Tan Eunice Jingmei 
Published: February 2024

AbstractBees and the ecosystem services they provide are vital to urban ecosystems, but little is understood about their distributions, particularly in the Asian tropics. This is largely due to taxonomic impediments and limited inventorying, monitoring, and digitization of occurrence records. While expert collections (EC) are demonstrably insufficient by themselves as a data source to model and understand bee distributions, the boom of community science (CS) in urban areas provides an untapped opportunity to learn about bee distributions within our cities. We used CS observations in combination with EC observations to model the distribution of bees in Singapore, a small tropical city‐state in Southeast Asia. To address the restricted spatial context, we performed multiple bias corrections and show that species distribution models performed well when estimating the distribution of habitat specialists with distinct range limits detectable within Singapore. We successfully modelled 37 bee species, where model statistics improved for 23 species upon the incorporation of CS observations. Nine species had insufficient EC observations to obtain acceptable models, but could be modelled with the incorporation of CS observations. This is the first study to combine both EC and CS observations to map and model the occurrences of tropical Asian bee species for a highly urbanized region at such fine resolution. Our results suggest that urban landscapes with impervious surfaces and higher temperatures are less suitable for bee species, and such findings can be used to advise the management of urban landscapes to optimize the diversity of bee pollinators and other organisms.
Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria
Authors: Zubiaga‐Fernandez L. , Testera‐Montes A. , Rondon C. , Perez‐Sanchez N. , Gomez‐Perez F. , Vega‐Chicote J. M. , Bartra J. , Ferrer M. , Eguiluz‐Gracia I. , Torres M. J. 
Published: February 2024

AbstractBackgroundClinical trials showed the efficacy of 300 mg/4 weeks of omalizumab (OMA) during 6 months in patients with severe chronic spontaneous urticaria (CSU). Nevertheless, in real life, many patients require higher doses and/or longer treatment. This study assesses the real‐life performance of OMA in severe CSU and identifies factors associated with the response.MethodsCSU patients eligible for OMA were recruited prospectively. Clinical data and a blood test were collected before OMA initiation. Urticaria Activity Score 7 (UAS7) was calculated at baseline and every 3 months during OMA treatment. CSU control was defined as UAS7 <7 points. This work was partially sponsored by OMA manufacturer.ResultsEighty‐nine adults (19.1% males) with severe CSU were recruited. Median duration of CSU prior to OMA initiation was 2 years, and median severity by UAS7 at baseline was 24 points (range 10–42 points). OMA controlled 94.4% of patients, but 17.9% of responders required doses >300 mg/4 weeks. A blood basophil count >20 cells/μL (OR 13.33; 95% CI 3.32–52.63; p < .001) and the absence of hypothyroidism (OR 3.65; 95% CI 0.78–16.95; p = .099) were identified as predictive factors to achieve control with 300 mg/4 weeks. Twelve patients were able to stop OMA during the study (responders in remission, RR). RR had received OMA for a median of 29 months (12–53 months). Conversely, 32 patients had been on OMA for >29 months at the end of the study (active responders, AR). AR had received OMA for a median of 45 months (30–100 months). There were no significant differences in clinical or analytical factors between RR and AR patients.ConclusionsLow blood basophil count and the presence of hypothyroidism might serve as biomarkers for the controller dose of OMA in severe CSU patients.
The biofilm removal effect and osteogenic potential on the titanium surface by electrolytic cleaning: An in vitro comparison of electrolytic parameters and five techniques
Authors: Zhu Yun , Xu Yangbo , Ling Zhaoting , Zhao Congrui , Xu Antian , He Fuming 
Published: February 2024

AbstractObjectivesTo determine the optimal current and time of electrolytic cleaning (EC), compare its biofilm removal effect with generic treatments and evaluate the influence of EC to surface characteristics and osteogenic potential of SLA titanium (Ti) discs.Materials and MethodsThe six‐species biofilm‐covered Ti discs were placed as cathodes in physiologic saline and subjected to various current and time treatments. The residual biofilms were evaluated to determine the optimal parameters. The contaminated Ti discs were randomized and treated by rotating Ti brush; ultrasonic‐scaling with metal tips; ultrasonic‐scaling with PEEK tips; air‐polishing and EC. The residual biofilms were compared using a lipopolysaccharide kit (LPS), scanning electron microscope (SEM), confocal laser scanning microscopy and colony‐forming unit counting. Non‐contaminated Ti discs were treated and characterized. The bone marrow mesenchymal stem cells (BMSCs) were cultured on treated non‐contaminated Ti discs. The adhesion, proliferation, alkaline phosphatase (ALP) activity and osteocalcin level of BMSCs were assessed.ResultsThe parameters at 0.6A5min were considered optimal. For LPS and SEM, EC promoted a significantly greater biofilm removal than the other groups. There were no changes in the Ti discs' colour, topography, roughness and chemical elements after EC, and the electrolysis‐treated Ti discs obtained a super‐hydrophilic surface. EC positively impacted the proliferation and ALP activity of BMSCs, surpassing the efficacy of alternative treatments.ConclusionsEC achieves a near‐complete eradication of contaminants on the SLA surface, causes no surface damage with improved hydrophilicity, and promotes the early osteogenic response of BMSCs, which makes it a promising treatment for peri‐implantitis.
Distinct age‐adjusted D‐dimer threshold to rule out acute pulmonary embolism in outpatients and inpatients
Authors: Liu Peng , Yu Haixu , Liu Wei , Lin Lin , Ji Ying Qun 
Published: February 2024

AbstractIntroductionThe diagnosis of acute pulmonary embolism (PE) is combinations of clinical probability assessments, plasma D‐dimer (DD) test results, and/or computed tomographic pulmonary angiography (CTPA).ObjectiveThe aim of this study is to explore the appropriate DD cutoff using the immunoturbidimetric method in outpatients and inpatients.MethodsWe retrospectively enrolled 2689 patients with suspected PE between January 2014 and December 2019. All patients underwent clinical probability assessments, DD tests, and CTPA. We investigated the appropriate cutoff level for plasma DD tests in the correlation analysis and receiver operating characteristic (ROC) curves.ResultsAmong all patients, 1263 were confirmed acute PE. The age‐adjusted DD level was determined to be age × 10 μg/L (for patients aged >50 years) in outpatients. This cutoff value resulted in a sensitivity of 96.75% and a specificity of 87.02%, with the area under the curve (AUC) of 0.908 and the number needed to treat (NNT) of 1.18. For inpatients, the age‐adjusted cutoff values for the biomarker DD demonstrated poor specificity (13.34%) and NNT (9.88). However, when the DD cutoff was adjusted to 2 × the upper limit of normal (ULN), the sensitivity increased to 93.19%, while the specificity remained at 29.55%, with the AUC of 0.610 and the NNT of 4.76. The optimal DD cut‐off value was 3010 μg/L (about 5 × ULN), resulting in a sensitivity of 75.22% and specificity of 61.72%, with the AUC of 0.727 and the NNT of 2.7.ConclusionUsing the immunoturbidimetric method to measure DD, an age‐adjusted DD cutoff (age × 10 μg/L, if aged >50 years) should be considered for outpatients with suspected PE. For inpatients, increasing the DD cutoff value to at least 2 × ULN yields the best test performance.