bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of relative dose intensity on pathologic complete response in human epidermal growth factor receptor 2 positive breast cancer patients receiving neoadjuvant TCHP
Authors: Collette Kaylyn , Perkey Cassandra L. , Adams Val , Shelton Brent J. , Corum Lauren S. , Butts Allison 
Published: November 2023

Purpose The standard of care for locally advanced, human epidermal growth factor receptor 2 positive (HER2+) breast cancer includes neoadjuvant chemotherapy with docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP). Many patients do not receive the full course of therapy due to various complications, possibly affecting the potential to achieve a pathologic complete response (pCR). The amount of therapy received is typically measured by relative dose intensity (RDI). This study aimed to evaluate pCR rates in patients receiving optimal and suboptimal RDI TCHP. Methods This study was a retrospective chart review of patients treated between 2014 and 2021 at UK HealthCare. Patients included were 18 years of age or older with HER2+ breast cancer and received at least one cycle of neoadjuvant TCHP. The primary objective compared pCR rates in patients receiving ≥ 85% RDI or <85% RDI. Secondary objectives included pCR rates based on clinical stage, age, body mass index, or hormone receptor status; factors leading to discontinuation or delay in treatment; and impact of dose reductions and delays on pCR. Results A total of 101 patients were included and divided into two cohorts: 54 patients received ≥ 85% RDI and 47 patients received <85% RDI. Patients who received ≥ 85% total RDI had an approximate increase of 17% in pCR rates (59.3% vs 42.6%, p = 0.11). Additionally, 82% of patients experienced a dose delay or adjustment. Conclusions Patients who received ≥ 85% RDI had increased pCR rates compared to patients receiving <85% RDI. A larger patient population is needed to formulate definitive conclusions on the impact of RDI and pCR rates.
Use of antithymocyte globulin (rabbit) in a patient with known alpha-gal syndrome undergoing allogenic stem cell transplantation
Authors: Peterson Hannah , Wells Drew A , Marjoncu Dennis , Holman Kori 
Published: November 2023

Introduction Alpha-gal syndrome (AGS) is a hypersensitivity disorder in which tick bites—most commonly from the lone star tick ( Ambylomma americanum)—trigger immunoglobulin E-mediated hypersensitivity reaction upon exposure to oligosaccharide galactosse-alpha-1,3-galactose (α-gal). α-gal is most notorious for being found in “red meat” products but is present in mammalian meats such as beef, pork, lamb, rabbit, and others. Manifestations of AGS hypersensitivity are variable. There is currently no in vivo data describing allergic reactions against rabbit products in patients with AGS. Case Report Here, we describe a case of a 44-year-old male with myelodysplastic syndrome and a known history of AGS undergoing allogeneic hematopoietic cell transplantation (allo-HSCT) with the use of rabbit antithymocyte globulin (rATG) for graft-versus-host disease (GVHD) prophylaxis. Management and Outcome The risk of cross-reactivity against rATG in our patient with AGS could not be ruled out and, therefore, a test dose was administered. The patient tolerated the test dose with no signs of anaphylaxis. After demonstrating tolerance to the test dose, rATG was utilized for GVHD prophylaxis. Discussion Due to the heterogeneity of AGS manifestations in patients, the use of rATG in patients with known AGS should be considered on a case-by-case basis. The administration of a test dose may help predict the occurrence of severe hypersensitivity reactions. The limited data surrounding the risk of AGS with rabbit-containing products and the various indications for the use of rATG warrants more in-depth study of the reactivity of this medication in this population.
Impact of preexisting coronary artery and peripheral artery disease on outcomes in diabetic patients after kidney transplant
Authors: Jiwani Sania , Chan Wan-Chi , Majmundar Monil , Patel Kunal N , Mehta Harsh , Sharma Aditya , Parmar Gaurav , Wiley Mark , Tadros Peter , Hockstad Eric , Yarlagadda Sri G , Gupta Aditi , Gupta Kamal 
Published: November 2023

Background: Atherosclerotic cardiovascular disease is highly prevalent in patients with end-stage kidney disease (ESKD). Kidney transplant (KT) improves patient survival and cardiovascular outcomes. The impact of preexisting coronary artery disease (CAD) and peripheral artery disease (PAD) on posttransplant outcomes remains unclear. Methods: This is a retrospective study utilizing the United States Renal Data System. Adult diabetic dialysis patients who underwent first KT between 2006 and 2017 were included. The study population was divided into four cohorts based on presence of CAD/PAD: (1) polyvascular disease (CAD + PAD); (2) CAD without PAD; (3) PAD without CAD; (4) no CAD or PAD (reference cohort). The primary outcome was 3-year all-cause mortality. Secondary outcomes were incidence of posttransplant myocardial infarction (MI), cerebrovascular accidents (CVA), and graft failure. Results: The study population included 19,329 patients with 64.4% men, mean age 55.4 years, and median dialysis duration of 2.8 years. Atherosclerotic cardiovascular disease was present in 28% of patients. The median follow up was 3 years. All-cause mortality and incidence of posttransplant MI were higher with CAD and highest in patients with polyvascular disease. The cohort with polyvascular disease had twofold higher all-cause mortality (16.7%, adjusted hazard ratio (aHR) 1.5, p < 0.0001) and a fourfold higher incidence of MI (12.7%, aHR 3.3, p < 0.0001) compared to the reference cohort (8.0% and 3.1%, respectively). There was a higher incidence of posttransplant CVA in the cohort with PAD (3.4%, aHR 1.5, p = 0.01) compared to the reference cohort (2.0%). The cohorts had no difference in graft failure rates. Conclusions: Preexisting CAD and/or PAD result in worse posttransplant survival and cardiovascular outcomes in patients with diabetes mellitus and ESKD without a reduction in graft survival.
Coming out autistic at work: A review of the literature
Authors: Sreckovic Melissa A , Schultz Tia R , Kucharczyk Suzanne , Welsh-Young Nancy 
Published: November 2023

Research consistently documents the negative postsecondary outcomes of autistic individuals. Identifying facilitators and barriers to obtaining and maintaining employment is imperative to improve postsecondary outcomes. Autism diagnosis disclosure at work may serve as a facilitator or barrier to obtaining and maintaining employment, but little is known about the lived experiences of individuals on the spectrum regarding diagnosis disclosure at work. To ascertain why autistic individuals choose to pursue disclosure or choose not to disclose at work, how they disclose, and the consequences of that disclosure, a state-of-the-art literature review was conducted. Ten studies met the final inclusion criteria and were synthesized to provide guidance to autistic individuals, families, and professionals who support autistic individuals’ transition to employment. Lay abstract Research consistently documents the poor postsecondary outcomes of autistic individuals. It is important to identify supports that help autistic individuals get and keep jobs to improve postsecondary outcomes. Autism diagnosis disclosure at work may serve as a support (e.g., receiving accommodations) or as a barrier (e.g., discrimination) to getting and keeping employment, but little is known about the lived experiences of autistic individuals on diagnosis disclosure at work. To better understand why individuals on the spectrum choose to pursue disclosure or choose not to disclose at work, how they disclose, and the consequences of that disclosure, a state-of-the-art literature review was conducted. Ten studies met the final inclusion criteria and were synthesized to provide guidance to autistic individuals, families, and professionals who support their transition to employment. Findings from the review indicate that diagnosis disclosure is a highly complex decision. Across reviewed studies, participants chose to pursue disclosure for specific reasons, including access to accommodations or support, increase understanding, and advocate for self or others. Autistic individuals participating across reviewed studies shared they chose not to disclose primarily due to fears of discrimination and experience of stigma. Both the hopes (access to accommodations and supports) and fears (bullying and discrimination) were validated in the experienced consequences of disclosure. More research is needed on the contextual experiences of how individuals on the spectrum disclose their diagnosis at work.
Unfavorable clinical outcomes in patients with good collateral scores following endovascular treatment for acute ischemic stroke of the anterior circulation: The UNCLOSE study
Authors: Consoli Arturo , Pileggi Marco , Hasan ATM Hasibul , Rahman Mohammad H , Venier Alice , Sgreccia Alessandro , Pizzuto Silvia , Coskun Oguzhan , Di Maria Federico , Scarcia Luca , Lapergue Bertrand , Rodesch Georges , Bracard Serge , Chen Bailiang 
Published: November 2023

Background Patients with acute ischemic stroke secondary to large vessel occlusions and good collaterals are frequently associated with favorable outcomes after mechanical thrombectomy, although poor outcomes are observed also in this subgroup. We aimed to investigate the factors associated with unfavorable outcomes (modified Rankin Scale3–6) in this specific subgroup of patients. Methods In total, 219 patients (117 females) with anterior circulation stroke and good collaterals (American Society for Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology grades 3–4), treated by mechanical thrombectomy between 2016 and 2021 at our institution were included in this study. Clinical files and neuroimaging were retrospectively reviewed. Univariate and multivariate analyses were performed to identify the predictors of unfavorable outcomes in the overall population (primary endpoint). Secondary endpoints focused on the analysis of the predictors of unfavorable outcomes in the subgroup of successfully recanalized patients, mortality, and symptomatic intracerebral hemorrhages in the overall population. Results Poor outcome was observed in 47% of the patients despite the presence of good collaterals. Older age ( p < 0.001), higher baseline National Institute of Health stroke scale ( p < 0.001), no intravenous thrombolysis administration ( p = 0.004), > 3 passes ( p = 0.01), and secondary transfers ( p < 0.001) were associated with the primary endpoint. The multivariate analysis showed a predictive effect of modified treatment in cerebral infarction 2b-3 and of first pass effect on symptomatic intracerebral hemorrhage. Conclusions Despite good collaterals, defined through the American Society for Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology scale, poor outcomes occurred in almost half of the patients. Patients with good collaterals not receiving intravenous thrombolysis were significantly associated with unfavorable outcomes, whereas first pass effect was not significantly correlated with clinical outcome in this specific cohort of patients. Different methods to assess collaterals should also be investigated.
Transradial versus transfemoral approach in cerebral angiography: A meta-analysis
Authors: Batista Sávio , Oliveira Leonardo de Barros , Diniz Jordana Borges Camargo , Pinheiro Agostinho Camara , Maia Henrique , Duarte Matheus , Andreão Filipi Fim , Palavani Lucca Biolcati , Bertani Raphael , Almeida Filho José Alberto , Besborodco Raphael Muszkat , Hanel Ricardo 
Published: November 2023

Background Cerebral angiography has two common access sites: Transradial approach and transfemoral approach. However, there's no definitive answer to which one is superior. Objective Compare transradial approach and transfemoral approach for a cerebral angiography procedure. Methods A systematic review of the literature of studies reporting both transradial approach and transfemoral approach results was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Cochrane Library, and Embase were queried. Results The meta-analysis examined 18 studies comprising 9388 patients undergoing cerebral angiography. Among the patients, 4598 underwent transradial approach (48.9%) and 4790 underwent transfemoral approach (51.1%). Our results revealed no statistical differences between the approaches regarding procedure success, crossover to transfemoral approach, procedure and fluoroscopy time between both approaches in cerebral angiography. Total, major, and minor complications comparisons were more favorable to transradial approach for this procedure. Conclusion These findings suggest, despite the ultimate decision regarding the choice of access method might be influenced by the physician's experience and personal preference, the data distinctly lean toward transradial approach as the preferable option for cerebral angiography. The advantages of transradial approach, highlighted by its lower complication rates, especially major complications, suggest that its adoption could contribute to enhanced patient safety and procedural outcomes.
Clinical factors linked to the type of respiratory medication in COPD: results from the COSYCONET cohort
Authors: Alter Peter , Kahnert Kathrin , Trudzinski Franziska C. , Bals Robert , Watz Henrik , Speicher Tim , Söhler Sandra , Welte Tobias , Rabe Klaus F. , Wouters Emiel F. M. , Vogelmeier Claus F. , Jörres Rudolf A. 
Published: November 2023

Background: The use of maintenance medication in patients with chronic obstructive pulmonary disease (COPD) in real life is known to deviate from recommendations in guidelines, which are largely based on randomized controlled trials and selected populations. Objectives: We used the COSYCONET (COPD and Systemic Consequences – Comorbidities Network) cohort to analyze factors linked to the use of COPD drugs under non-interventional circumstances. Design: COSYCONET is an ongoing, multi-center, non-interventional cohort of patients with COPD. Methods: Patients with COPD of Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 0–4 participating in visits 1–5 were included. Data covered the period from 2010 to 2018. Generalized linear models were used to examine the relation of COPD characteristics to different types of respiratory medication. Results: A total of 1043 patients were included. The duration of observation was 4.5 years. Use of respiratory medication depended on GOLD grades 0–4 and groups A-D. Long-acting muscarinic antagonist therapy increased over time, and was associated with low carbon monoxide (CO) diffusing capacity, while inhaled corticosteroid (ICS) use decreased. Active smoking was associated with less maintenance therapy in general, and female sex with less ICS use. From the eight items of the COPD Assessment Test, only hill and stair climbing were consistently linked to treatment. Conclusion: Using data from a large, close to real-life observational cohort, we identified factors linked to the use of various types of respiratory COPD medication. Overall, use was consistent with GOLD recommendations. Beyond this, we identified other correlates of medication use that may help us to understand and improve therapy decisions in clinical practice. Trial registration: ClinicalTrials.gov NCT01245933.
Identifying the white matter pathways involved in multiple sclerosis-related tremor using diffusion tensor imaging
Authors: Bayoumi Ahmed , Hasan Khader M. , Patino Jorge , Keser Zafer , Thomas Joseph A. , Gabr Refaat E. , Pedroza Claudia , Kamali Arash , Schiess Mya C. , Wolinsky Jerry S. , Lincoln John A. 
Published: November 2023

Background Tremor affects up to 45% of patients with Multiple Sclerosis (PwMS). Current understanding is based on insights from other neurological disorders, thus, not fully addressing the distinctive aspects of MS pathology. Objective To characterize the brain white matter (WM) correlates of MS-related tremor using diffusion tensor imaging (DTI). Methods In a prospective case-control study, PwMS with tremor were assessed for tremor severity and underwent MRI scans including DTI. PwMS without tremor served as matched controls. After tract selection and segmentation, the resulting diffusivity measures were used to calculate group differences and correlations with tremor severity. Results This study included 72 PwMS. The tremor group (n = 36) exhibited significant changes in several pathways, notably in the right inferior longitudinal fasciculus (Cohen's d = 1.53, q < 0.001) and left corticospinal tract ( d = 1.32, q < 0.001), compared to controls (n = 36). Furthermore, specific tracts showed a significant correlation with tremor severity, notably in the left medial lemniscus (Spearman's coefficient [ rsp] = −0.56, p < 0.001), and forceps minor of corpus callosum ( rsp = -0.45, p < 0.01). Conclusion MS-related tremor is associated with widespread diffusivity changes in WM pathways and its severity correlates with commissural and sensory projection pathways, which suggests a role for proprioception or involvement of the dentato-rubro-olivary circuit.
The association between serum anion gap and acute kidney injury after coronary artery bypass grafting in patients with acute coronary syndrome
Authors: Pan Qinyuan , Mu Zhifang , Li Yong , Gu Caihong , Liu Tao , Wang Bing , Kang Xiuwen 
Published: November 2023

Abstract
Background
The purpose of this study was to explore the association between serum anion gap (SAG) and acute kidney injury (AKI) after coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS) in the Intensive Care Unit (ICU).

Methods
We retrospectively analyzed the clinical data of 2,428 ACS patients who underwent CABG in the Medical Information Mart for Intensive Care IV (Mimic-IV) database. The endpoint of this study was AKI after CABG. The baseline data of the two groups (non-AKI group vs. AKI group) was compared, and the restricted cubic spline (RCS) plot, multivariable logistic regression model, and subgroup analysis were used to explore the relationship between SAG and the risk of AKI after CABG.

Results
In the adjusted multivariate logistic regression model, SAG was an independent predictor of AKI after CABG (OR = 1.12, 95% CI: 1.02–1.23, P = 0.015). The RCS revealed that the relationship between SAG levels and risk of AKI was J-shaped. When the SAG was ≥ 11.58 mmol/L, the risk of AKI increased by 26% for each unit increase in SAG. Additionally, we further divided the SAG into quartiles. In the fully adjusted model, compared with the first quartile of SAG, the odds ratios (ORs) and 95% confidence intervals (CIs) for AKI risk across the SAG quartiles were 0.729 (0.311, 1.600), 1.308 (0.688–2.478), and 2.221 (1.072, 4.576).

Conclusions
The SAG level was associated with the risk of AKI after CABG in a J-shaped curve in the ICU. However, the underlying causes of the problem need to be investigated.
Prognostic impact of severe neutropenia in colorectal cancer patients treated with TAS-102 and bevacizumab, addressing immortal-time bias
Authors: Watanabe Daichi , Fujii Hironori , Ohata Koichi , Iihara Hirotoshi , Makiyama Akitaka , Kobayashi Ryo , Hirose Chiemi , Hishida Shiori , Matsuoka Serika , Tajima Jesse Yu , Kiyama Shigeru , Takahashi Takao , Suzuki Akio , Matsuhashi Nobuhisa 
Published: November 2023

Abstract
Background
Several studies have reported an association between severe neutropenia and long-term survival in patients treated with trifluridine-tipiracil (TAS-102). Because some of these studies failed to address immortality time bias, however, their findings should be interpreted with caution. Additionally, the association between severe neutropenia and survival in patients receiving TAS-102 in combination with bevacizumab (Bmab) remains unclear.

Patients and methods
We conducted a single-center retrospective cohort study in patients with colorectal cancer who received Bmab + TAS-102. We compared overall survival (OS) between patients who developed grade ≥ 3 neutropenia during the treatment period and those who did not. To account for immortal time bias, we used two approaches, time-varying Cox regression and landmark analysis.

Results
Median OS was 15.3 months [95% CI: 14.1–NA] in patients with grade ≥ 3 neutropenia and 10.0 months [95% CI: 8.1–NA] in those without. In time-varying Cox regression, onset grade ≥ 3 neutropenia was significantly related to longer survival after adjustment for age and modified Glasgow Prognostic Score. Additionally, 30-, 60-, 90-, and 120-day landmark analysis showed that grade ≥ 3 neutropenia was associated with longer survival after adjustment for age and modified Glasgow Prognostic Score, with respective HRs of 0.30 [0.10–0.90], 0.65 [0.30–1.42], 0.39 [0.17–0.90], and 0.41 [0.18–0.95].

Conclusion
We identified an association between long-term survival and the development of severe neutropenia during the early cycle of Bmab + TAS-102 using an approach that addressed immortality time bias.
Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults
Authors: Yang Yung-Ning , Su Jian-An , Pimsen Apiradee , Chen Jung-Sheng , Potenza Marc N. , Pakpour Amir H. , Chen Ji-Kang , Poon Wai Chuen , Nurmala Ira , Ruckwongpatr Kamolthip , Lin Chung-Ying 
Published: November 2023

AbstractBackgroundThe Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.MethodsA total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach’s α and McDonald’s ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale—Short Form (IGDS9-SF) scores.ResultsThe CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.ConclusionsData indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.