bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting transfer to haemodialysis using the peritoneal dialysis surprise question
Authors: Anwaar Ayesha , Liu Sai , Montez-Rath Maria , Neilsen Hatsumi , Sun Sumi , Abra Graham , Schiller Brigitte , Hussein Wael F 
Published: November 2023

Background: People on peritoneal dialysis (PD) at risk of transfer to haemodialysis (HD) need support to remain on PD or ensure a safe transition to HD. Simple point-of-care risk stratification tools are needed to direct limited dialysis centre resources. In this study, we evaluated the utility of collecting clinicians’ identification of patients at high risk of transfer to HD using a single point of care question. Methods: In this prospective observational study, we included 1275 patients undergoing PD in 35 home dialysis programmes. We modified the palliative care ‘surprise question’ (SQ) by asking the registered nurse and treating nephrologist: ‘Would you be surprised if this patient transferred to HD in the next six months?’ A ‘yes’ or ‘no’ answer indicated low and high risk, respectively. We subsequently followed patient outcomes for 6 months. Cox regression model estimated the hazard ratio (HR) of transfer to HD. Results: Patients’ mean age was 59 ± 16 years, 41% were female and the median PD vintage was 20 months (interquartile range: 9–40). Responses were received from nurses for 1123 patients, indicating 169 (15%) as high risk and 954 (85%) as low risk. Over the next 6 months, transfer to HD occurred in 18 (11%) versus 29 (3%) of the high and low-risk groups, respectively (HR: 3.92, 95% confidence interval (CI): 2.17–7.05). Nephrologist responses were obtained for 692 patients, with 118 (17%) and 574 (83%) identified as high and low risk, respectively. Transfer to HD was observed in 14 (12%) of the high-risk group and 14 (2%) of the low-risk group (HR: 5.56, 95% CI: 2.65–11.67). Patients in the high-risk group experienced higher rates of death and hospitalisation than low-risk patients, with peritonitis events being similar between the two groups. Conclusions: The PDSQ is a simple point of care tool that can help identify patients at high risk of transfer to HD and other poor clinical outcomes.
Lymphoid interstitial pneumonia in a patient with systemic lupus erythematosus: Case report and literature review
Authors: Dans Vilán Laura , Ríos Fernández Raquel , Fernández Ontiveros Sergio , Suárez Robles Miguel , Caba Molina Mercedes , García Morales Marta , De la Hera Francisco Javier , Ortego Centeno Norberto , Callejas Rubio Jose Luis 
Published: November 2023

Lymphoid interstitial pneumonia (LIP) is a rare form of interstitial pulmonary disease, which has been described in association with a wide range of autoimmune disorders. Although the association of this entity with Sjogren’s syndrome is well known, only a few cases are reported in relation to systemic lupus erythematosus (SLE). The aim of this paper is to review the cases reported in literature to date, as well as to describe the characteristics of these patients including the new case presented herein. We will be focusing on the case of a 36-year-old female patient diagnosed with SLE on hydroxychloroquine treatment who develops pleuritic chest pain and progressive dyspnea after 3 years of follow-up. The chest CT scan showed pleural thickening and both multiple and bilateral micronodules. A lung biopsy was also performed, revealing an infiltration of lymphocytes, plasma cells, and histiocytes in the alveolar septa suggestive of LIP. After conducting a review of the literature, we identified seven other cases describing SLE in association with LIP. The majority of them were young women, and LIP tends to appear early in the course of the disease, even as a form of initial presentation in some cases. Symptoms included cough, dyspnea, and pleuritic pain, with the exception of one case which was asymptomatic. It is noteworthy that half of the patients were positive for anti-SSA/anti-SSB autoantibodies, and some of them also met criteria for Sjogren’s syndrome. Treatment with steroids and other immunosuppressive agents improved symptoms in all of them.
Living With Toxic Wounds: The Voices and Visual Self-Representations of Gulf War Veterans
Authors: Dieterich-Hartwell Rebekka , Malhotra Bani , Arslanbek Aslı , DeBeer Bryann , Alverio Tabitha , Kaimal Girija 
Published: November 2023

Operations Desert Shield and Storm occurred over 30 years ago, yet many of those who were deployed continue to experience chronic and debilitating symptoms, now recognized as Gulf War Illness (GWI). While efforts have been made to explore clinical treatments for GWI, misperceptions and skepticism about its complex nature and a lack of consensus on its etiology impede progress in this area. A critical necessity remains to better understand the experiences, needs, and concerns of veterans with GWI. In this qualitative research study, 40 Gulf War veterans were interviewed about their perceptions regarding symptoms of physical health, cognitive functioning, quality of life, and the quality of care received. In addition, they depicted their experiences through an artistic elicitation collage. Through a grounded theory method, key findings indicated that there are remaining hurdles, such as challenging symptoms, persisting unknowns about the illness, and variations in treatment quality. Veterans have mostly managed and coped with GWI, but they voice the need for acknowledgment and support. The main implication from this study is the significance of both clinical and institutional validation and recognition of the GWI experience as well as the need for specific support systems.
A review and metanalysis of metronomic oral single-agent cyclophosphamide for treating advanced ovarian carcinoma in the era of precision medicine
Authors: Martorana Federica , Scandurra Giuseppina , Valerio Maria Rosaria , Cufari Salvatore , Vigneri Paolo , Sanò Maria Vita , Scibilia Giuseppe , Scollo Paolo , Gebbia Vittorio 
Published: November 2023

Objective Oral metronomic cyclophosphamide has been used as a single agent or in combination with other drugs for several solid tumors with interesting results in disease palliation and mild to moderate toxicity, notably in patients with recurrent epithelial ovarian cancer (EOC) progressing after systemic chemotherapy. In this paper, we report a review and a metanalysis of heterogeneous data published up to date. Data sources The literature search was restricted to single-agent MOC. The analysis was conducted through March 2023 by consulting PubMed, Embase, Google Scholar, and The Cochrane Library databases. Research string and Medical Subject Headings included “ovarian tumor,” “ovarian carcinoma,” or “ovarian cancer,” “fallopian tube cancer,” “primary peritoneal cancer,” “oral chemotherapy,” and “metronomic cyclophosphamide.” All articles were assessed for quality by at least two investigators independently, and a < 18 patients sample size cutoff was chosen as a lower limit with a Cohen's kappa statistical coefficient for accuracy and reliability. Metanalysis of selected papers was carried out according to a fixed model. Data summary The percentage of agreement between investigators on literature study selection was very high, reaching 96.9% with a Cohen's k of 0.929. MOC pooled objective response rate (ORR) and disease control rate for recurrent or platinum-refractory ovarian cancer were 18.8% (range 4–44%) and 36.2% (range 16–58.8%), respectively. The mean progressive-free survival and overall survival were 3.16 months (range 1.9 to 5.0 months) and 8.7 months (range 8 to 13 months), respectively. The fixed model metanalysis of selected studies showed a 16% median ORR (12–20% CI, p < 0.001). Conclusions Single-agent oral cyclophosphamide in EOC holds promise as a treatment option, even in the era of precision medicine. Genetic factors, such as DNA repair gene polymorphisms, may influence treatment response. Combining cyclophosphamide with biological agents such as PARP inhibitors or immunotherapy agents is an area of active investigation.
A Scoping Review of Varying Mobile Electrocardiographic Devices
Authors: Dzikowicz Dillon J 
Published: November 2023

The electrocardiogram (ECG) can now be measured using mobile devices. Mobile ECG devices, which are defined as devices capable of recording and transmitting non-standard ECGs, offer numerous advantages such as cost-effectiveness and being user-friendly. Mobile ECG can also extend recording lengths (e.g., 2 days, 14 days), which is necessary to capture important intermittent events (e.g., cardiac arrhythmias) and evaluate prognostic risk markers (e.g., prolonged corrected QT (QTc) interval). Some mobile ECG devices can even connect to broadband networks allowing patients to remotely transmit their ECG to a clinician. This article systematically examines different mobile ECG devices used in prior studies and provides a detailed assessment of five diverse yet commonly used mobile ECG devices: AliveCor KardiaMobile; AliveCor KardiaMobile 6L; iRhythm ZioPatch; Apple Smartwatch ECG; and CardioSecur System. These mobile ECG devices are diverse in the number of leads measured and the duration of monitoring. Similar to their diversity, there has been a wide range of clinical applications of mobile ECG devices. Despite significant progress, questions regarding data quality, and clinican and patient acceptance and compliance persist.
Can the length of a catheter change the time to bubble at the tip performing the “Bubble Test”? A bench study
Authors: Giustivi Davide , Elli Stefano , Airoldi Chiara , Lo Izzo Federica , Rossini Michela , Gidaro Antonio , Lucchini Alberto , Privitera Daniele 
Published: November 2023

Introduction: Intraprocedural tip control techniques are critical during central venous catheter placement. According to international guidelines (INS 2021), intracavitary electrocardiography is the first method of choice to verify it; when this technique is not feasible, it is considered acceptable to use a contrast-enhanced ultrasound-based tip location method, commonly known as “bubble-test” as an effective alternative. Objective: To assess whether the length of the vascular catheter can alter the time between the injection of the contrast media and its appearance at the catheter tip and the injection duration. Differences between operators stratified according to experience were evaluated as secondary endpoints. Methods: A bench study was conducted using an extracorporeal circuit. For each catheter length (60, 40, and 20 cm), three injections were obtained by each of the five operators with different levels of experience for a total of 45 measurements. Differences among operators were evaluated using ANOVA, and the impact of catheter length and operator expertise on times was assessed using repeated measurement models. Results: Hub-to-tip times of 247.33 ms (SD 168.82), 166 ms (SD 95.46), 138 ms (SD 54.48), and injection duration of 1620 ms (SD 748.58), 1614 ms (SD 570.95), 1566 ms (SD 302.83) were observed for 60, 40, 20 cm catheter length, respectively. A significant time variability between operators was observed. Moreover, moving from 60 to 20 cm, hub-to-tip time was significantly longer for 60 cm devices ( p = 0.0124), while little differences were observed for injection duration. Conclusions: Catheter length can change both the time between the injection of the contrast media and its appearance at the catheter tip and the injection duration. Hub-to-tip times obtained with 20 and 40 cm and overall injection duration did not differ significantly; skilled personnel could substantially reduce both values analyzed in this study.
Longitudinal evaluation of serum MOG-IgG titers in MOGAD after initiation of maintenance immunoglobulin: A case series
Authors: Roy Shuvro , Vasileiou Eleni , Barreras Paula , Ahmadi Gelareh , Chen Haiwen , Suslovic William , Kornbluh Alexandra , Kahn Ilana , Sotirchos Elias S 
Published: November 2023

Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct demyelinating disease of the central nervous system. Immunoglobulin (Ig) has been used as a maintenance therapy to prevent relapses in MOGAD, but the impact of Ig on serum MOG-IgG titers is unclear. Objective: To characterize the variation in serum MOG-IgG titers after initiation of Ig treatment in people with MOGAD. Methods: We conducted a retrospective study of 10 patients with a diagnosis of MOGAD and available serum MOG-IgG titers before and after initiation of maintenance Ig treatment. Results: We found that most of the patients remained MOG-IgG seropositive while on Ig treatment with a reduced or unchanged titer, despite a lack of disease activity. Conclusions: This case series suggests that the mechanism of action of Ig therapy in MOGAD is not exclusively dependent on MOG-IgG titer reduction.
Pre-injury sarcopenia and the association with discharge destination in critical care trauma patients
Authors: Badminton Rebecca , Christie Robert , Brohi Karim , Cole Elaine 
Published: November 2023

Background Sarcopenia is a key physical component in the aetiology of frailty, representing progressive and CT-quantifiable muscle mass loss. In older trauma patients admitted to critical care, sarcopenic defined-frailty is associated with adverse outcomes, including poor function at discharge. This may complicate discharge to the usual place of residence, an important outcome for patients. This study aimed to identify pre-injury sarcopenia in all trauma patients admitted to critical care and investigate factors associated with discharge destination. Methods We performed a retrospective analysis of adult trauma patients admitted to a Major Trauma Centre (Level 1 equivalent) over 18 months. Psoas muscle density (PMD) was measured at the level of L4 vertebra from admission computerised tomography (CT) abdomen/pelvis. Sarcopenia was defined as the PMD calculated using Hounsfield unit average calculation within the lowest quartile for sex. Discharge destination was dichotomised into independent and dependent discharge. Multivariable logistic regression was used to determine factors associated with discharge destination. Results Overall, 197 patients were included. Patients were predominantly male (73%) with a median age of 52 (32–72) and the majority were severely injured (72%). Sarcopenia was identified in a quarter of the cohort on admission to critical care ( n = 49). Only a third of sarcopenic patients were discharged to home, compared to a half of non-sarcopenic patients ( p = 0.03). Sarcopenia (OR 0.30; 95% CI 0.17–0.81, p = 0.01), blunt injury (OR 0.22; 95% CI 0.06–0.87, p = 0.03), age (OR 0.97; 95% CI 0.95–0.99, p = 0.01) and Multiple Organ Dysfunction Syndrome (OR 0.24; 95% CI 0.12–0.57, p = 0.01) were associated with a decreased rate of independent discharge. Conclusion For trauma critical care patients, sarcopenia on admission CT was associated with dependent discharge destination and therefore is unfavourable. Defining sarcopenia early in an trauma patients critical care admission may help to identify those at risk of poor outcomes.
Lipoprotein (a) as a predictor of diabetic retinopathy in patients with type 2 diabetes: A systematic review
Authors: Gholami Chahkand Mohammad Sadra , Esmaeilpour Moallem Fatemeh , Qezelgachi Abolfazl , Seifouri Kiana , Pesaran Afsharian Armin , sheikhzadeh Farzad , poursalehi Atefe , Fani Sadrabadi Fateme Sadat , Saghab Torbati Mehrnush , Ramezanzade Mohaddese , Alishiri Goharsharieh , Ansari Arina , Zare Dehabadi Emad , Karimi Matloub Saeed , Sheikh Zahra , Deravi Niloofar , Mehrtabar Saba , Chichagi Fatemeh , Faal Hamedanchi Neda , Arzaghi Mohammadreza , Asadi Mahla , Alsadat Dadkhah Parisa , Ansari Akram 
Published: November 2023

Background Lipoprotein a (LP(a)), an LDL-like lipoprotein, known as a risk factor for cardiovascular diseases, has a controversial association with diabetic retinopathy in patients with type 2 diabetes—the current systematic review aimed to critically assess the association between LP(a) and diabetic retinopathy. Methods A systematic review of relevant studies was conducted after a thorough search in PubMed, Scopus, and Google Scholar electronic databases. We used English observational, case-control, and prospective cohort studies published up to August 2022, including type 2 diabetic patients as the population, diabetic retinopathy as the outcome, and LP(a) as the intervention. Result 17 relevant studies, including 4688 patients with diabetes, were included in this systematic review. While in 13 studies, Lipoprotein(a) was recognized as a risk factor for diabetic retinopathy, only three studies reported no evidence of a relationship between the two. Also, another study showed a mixed outcome of the relationship between LP(a) and diabetic retinopathy. Conclusion High serum lipoprotein(a) in patients with type 2 diabetes is considered a risk factor for diabetic retinopathy. However, further large-scaled cohort studies are still required to validate this finding.
Prognostic Significance of Advanced Age in Patients with T1a Renal Cell Carcinoma Treated by Microwave Ablation: A 16-Year Experience
Authors: Hou Qidi , Wang Yaxi , Zhang Dongyun , Luo Yanchun , Dong Linan , Mu Mengjuan , Yu Jie , Liang Ping 
Published: November 2023

Background Previous studies have failed to investigate the specific effects of advanced age on survival outcomes by considering the Charlson Comorbidity Index (CCI) and age permutation in patients with T1a renal cell carcinoma (T1a RCC) treated by microwave ablation (MWA). Notably, RCC guidelines recommended radiofrequency ablation (RFA) and active surveillance (AS) are both treatment options for elderly T1a RCC, but whether MWA is superior to AS in light of higher heating efficiency and larger ablation zone compared with RFA is not clear. This study aimed to investigate the specific effects of advanced age on survival outcomes of T1a RCC patients stratified by CCI score and indicate better intervention for elderly T1a RCC between MWA and AS. Methods This was a retrospective study. We retrospectively reviewed 237 patients with T1a RCC who had undergone MWA over the last 16 years. Data were analyzed by Cox regression and Landmark analysis. Interaction tests and propensity score matching were used to account for potential biases. We compared the overall survival (OS) and cancer-specific survival (CSS) rates of patients ≥75 years in our study with corresponding figures from 4251 counterparts undergoing AS in published articles. Results Using patients ＜75 years with a CCI ≤2 as a reference, the hazard ratio (HR) and 95% confidence interval (CI) of OS for patients＜75 years with a CCI ≥3, patients ≥75 years with a CCI ≤2, and patients ≥75 years with CCI ≥3, were 2.954 (1.139-7.663), 3.48 (1.487-8.146), and 3.357 (1.162-9.698), respectively. The adverse effect of an age ≥75 years on OS was attenuated in patients with a CCI ≥3. The attenuation lasted for 62.5 months of follow-up ( P = .017). Notably, advanced age exerted a protective effect on progression-free survival (PFS) in patients with a CCI ≥3, increasing the 8-year PFS from 67.8% to 100% ( P = .049). Relative to 1-, 3-, 5-, and 8-year survival data for patients aged ≥75 undergoing AS, the OS rates for 5-year follow-up were always better in MWA. However, beyond 5 years, the OS rates dropped to levels that were similar to AS. Conclusions Advanced age exerts adverse effects and significantly protective effects on OS and PFS, respectively, in T1a RCC patients with a CCI ≥ 3. According to our study, elderly patients with T1a RCC underwent radical MWA may yield a better medium-term OS relative to AS.
Association of obesity and different metabolic status with prognosis in patients with bladder cancer: a retrospective cohort study
Authors: Dong Yingchun , Cheng Yiping , Guo Honglin , Sun Jiaxing , Han Junming , Zhong Fang , Li Qihang , Wang Dawei , Chen Wenbin , Fan Xiude , Zhao Jiajun 
Published: November 2023

Background and objectives: Patients with bladder cancer (BC) are at high risk for recurrence rates and readmission costs. However, the evidence about obesity and metabolic abnormalities on the BC prognosis was inconsistent. Our primary aim was to determine the impact of obesity and different metabolic status on the readmission risk in patients with BC. Design and methods: We identified 16,649 patients with BC using the 2018 Nationwide Readmissions Database who were hospitalized from January to June 2018 and followed for 180 days. The primary outcome was 180-day readmission. The multivariate Cox regression analysis and ordered logistic regression were performed to analyze data. Results: Obesity and metabolic abnormalities were associated with an increased readmission risk in patients with BC [obesity: adjusted hazard ratio (aHR) = 1.08, 95% confidence interval (CI): 1.01–1.16; hyperglycemia: aHR = 1.11, 95% CI: 1.05–1.17; hypertension: aHR = 1.09, 95% CI: 1.03–1.15]. Compared with non-obese and no metabolic abnormalities, the risk of readmission was significantly increased in patients with metabolic abnormalities, irrespective of obesity (non-obese and metabolic abnormalities: aHR = 1.07, 95% CI: 1.02–1.13; obese and metabolic abnormalities: aHR = 1.20, 95% CI: 1.10–1.31), but not in obese and no metabolic abnormalities. These associations were consistent in patients aged 60 years or older and the surgery group. Moreover, hyperglycemia, hypertension, and a graded increment of metabolic risk were associated with an increased readmission risk. We also found increased length of stay for readmission in patients with obesity and metabolic abnormalities (aOR = 1.17, 95% CI: 1.00–1.36). Conclusion: Obesity with metabolic abnormalities and metabolic abnormalities alone were associated with higher readmission risks in patients with BC. It is suggested that prevention should focus not only on obesity but also on metabolic abnormalities to decrease the risk of readmission.
Safe Insertion Angle of the Suture Button to Avoid Saphenous Structure in Syndesmosis Injury
Authors: Kawabata Shingo , Nakasa Tomoyuki , Ikuta Yasunari , Sumii Junichi , Nekomoto Akinori , Sakurai Satoru , Moriwaki Dan , Adachi Nobuo 
Published: November 2023

In placing the medial suture button for syndesmosis injury, the risk of great saphenous vein and saphenous nerve injury has been reported. This study aimed to determine the safe insertion angle of the guide pin to avoid saphenous structure injury during suture button fixation. The incidence of saphenous structure injury was investigated using 8 legs of cadavers. The greater saphenous vein was depicted on the skin using near-infrared light (VeinViewer® Flex) and the distance between the greater saphenous vein and the posterior edge of the tibia at levels of 10, 20, and 30 mm from the joint line of the tibiotalar joint was measured in the 60 legs of healthy participants. On computed tomography (CT) images, the angles between the greater saphenous vein and transmalleolar axis at levels of 10, 20, and 30 mm from the joint line of the tibiotalar joint were measured. The cadaveric study revealed that the percentages of contact with the saphenous nerve were 8.3% to 16.7%. Using near-infrared light, the vein and tibia distance was 32.9 ± 6.8 mm of 10 mm, 26.6 ± 6.4 mm of 20 mm, and 20.4 ± 6.4 mm of 30 mm. The angle between the vein and transmalleolar axis was 1.0° to 9.4°, and more proximal, the angle was smaller. The veins depicted by near-infrared light can be a landmark to identify great saphenous vein, and injury of the saphenous structure can be prevented using VeinViewer Flex or considering the insertion angle defined in this study when placing the suture button for syndesmosis injuries. Level of Evidence: Level IV