bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to guidelines for management of acute kidney injury
Authors: Hauptmann Sarah , Matyukhin Igor , Patschan Susann , Ritter Oliver , Patschan Daniel 
Published: January 2024

Background and aim Acute kidney injury (AKI) affects a significant number of patients and the prognosis for this condition remains poor. The aim of this study was to assess adherence to KDIGO clinical practice guidelines and identify areas for improvement. Methods For this retrospective study, data were extracted from the medical database of the University Hospital Brandenburg, for patients who had been diagnosed with AKI from January to March 2021. Implementation rates of eight KDIGO AKI therapeutic measures were analyzed in relation to several AKI severity/risk categories. Results Data from 200 patients were included in the study. Three specific measures were commonly implemented: hyperglycemia control (100%), volume therapy (82%), and fluid balance management (65%). Nephrotoxic medications were discontinued in 51% patients, while iodinated contrast media was used in 35% patients. Patients with an increased risk of complications, such as those requiring ICU therapy or with sepsis, received these measures more frequently. Conclusions While some 2012 KDIGO recommended measures were implemented for a substantial number of affected individuals, others were not. Our study highlights the need for improvement in the quality of care for patients with AKI.
Efficiency of continuous positive airway pressure and high-flow nasal oxygen therapy in critically ill patients with COVID-19
Authors: Manole Corina , Dediu-Anghel Mihaela , Baroiu Liliana , Ștefanopol Ioana Anca , Nechifor Alexandru , Niculet Elena , Mihailov Raul , Moroianu Lavinia Alexandra , Voinescu Doina Carina , Firescu Dorel 
Published: January 2024

Objective Critically ill patients with COVID-19 develop acute respiratory distress syndrome characterized by relatively well-preserved pulmonary compliance but severe hypoxemia. The challenge in managing such patients lies in optimizing oxygenation, which can be achieved through either high oxygen flow or noninvasive mechanical ventilation. This study was performed to compare the efficiency of two methods of noninvasive oxygen therapy: continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO). Methods This retrospective cohort study involved 668 patients hospitalized in the intensive care unit (ICU) of the “Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania from 1 April 2020 to 31 March 2021 (CPAP, n = 108; HFNO, n = 108). Results Mortality was significantly lower in the CPAP and HFNO groups than in the group of patients who underwent intubation and mechanical ventilation after ICU admission. Mortality in the ICU was not significantly different between the CPAP and HFNO groups. Conclusions HFNO and CPAP represent efficient alternative therapies for patients with severe COVID-19 whose respiratory treatment has failed. Studies involving larger groups of patients are necessary to establish a personalized, more complex management modality for critically ill patients with COVID-19.
ABO and Rh (D) blood group phenotype distribution pattern among blood donors at the Nekemte Blood Bank, Oromia, West Ethiopia: a retrospective cross-sectional study
Authors: Tekle Esayas , Adisu Yonas , Rikitu Dufera , Teferi Sisay , Fikadu Ashetu , Kifle Edosa 
Published: January 2024

Objective To determine the distribution of ABO and Rh (D) blood group phenotypes among blood donors. Methods This retrospective cross-sectional study enrolled blood donors whose socio-demographic and blood group phenotype data were collected from blood bank donor records. Descriptive statistics were used to summarise the number and percentage distribution of categorical variables. To determine if the distributions of the ABO and Rh phenotypes differed, a chi-square test was employed. Results Of 14,887 blood donors with a median age of 20 years (interquartile range = 18–30 years), 72.8% were males, and young donors (age range = 18–24 years) accounted for 61.7%. Group O (45.6%) was the most prevalent ABO blood phenotype, followed by A (29.5%), B (20.2%), and AB (4.7%). The dominant blood group was O positive (42.4%), followed by A positive (27.4%), B positive (18.9%), AB positive (4.3%), O negative (3.2%), A negative (2.1%), B negative (1.3%), and AB negative (0.4%). The overall Rh (D)-negative distribution rate was 7.0%. Conclusion This study showed that blood group O was the most common ABO phenotype, followed by A, B, and AB. Overall, 93.0% of the donors were Rh (D)-positive. These findings may help guide blood transfusion programmes.
Treatment patterns and characteristics of headache in patients in Japan: A retrospective cross-sectional and longitudinal analysis of health insurance claims data
Authors: Katsuki Masahito , Matsumori Yasuhiko , Ichihara Taisuke , Yamada Yuya , Kawamura Shin , Kashiwagi Kenta , Koh Akihito , Goto Tetsuya , Kaneko Kazuma , Wada Naomichi , Yamagishi Fuminori 
Published: January 2024

Background The present study aimed to investigate prescription patterns for patients aged over 17 years with headaches in the REZULT database. Methods We conducted a cross-sectional study (Study 1) of the proportion of over-prescription of acute medications (≥30 tablets/90 days for triptans, combination non-steroidal anti-inflammatory drugs (NSAIDs) and multiple types; ≥45 tablets/90 days for single NSAIDs) among patients with headache diagnosed in 2020. We longitudinally studied (Study 2) patients for >2 years from initial headache diagnosis (July 2010 to April 2022). The number of prescribed tablets was counted every 90 days. Results In Study 1, headache was diagnosed in 200,055 of 3,638,125 (5.5%) patients: 13,651/200,055 (6.8%) received acute medication. Single NSAIDs were prescribed to 12,297/13,651 (90.1%) patients and triptans to 1710/13,651 (12.5%). Over-prescription was found in 2262/13,651 (16.6%) patients and 1200/13,651 (8.8%) patients received prophylactic medication. In Study 2, 408,183/6,840,618 (6.0%) patients were first diagnosed with headaches, which persisted for ≥2 years. Over time, the proportion of patients over-prescribed acute medications increased. Over 2 years, 37,617/408,183 (9.2%) patients were over-prescribed acute medications and 29,313/408,183 (7.2%) patients were prescribed prophylaxis at least once. Conclusions According to real-world data, prophylaxis remains poorly prescribed, and both acute and prophylactic treatment rates for headaches have increased over time.
Risk factors of stone residual after retrograde intrarenal surgery: A prospective cohort study
Authors: Zaza Mohamed Mahmoud Abdelfatah , Tawfeek Ahmed Mohamed , Salem Tarek Abd El-Mageed , Soliman Muhammad Ibrahim Salim , Hassan Ali Mohammed 
Published: January 2024

Background: Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection. Methods: This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications. Results: A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m2. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; p = 0.002), multiple stones (OR = 13.62, p = 0.002), stone size of 21–30 mm (OR = 4.91, p = 0.038), lower calyx site (OR = 4.85, p = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, p = 0.020), Conclusions: This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.
Systemic lupus erythematosus is associated with increased risk of mortality and acute kidney injury in patients with COVID-19 hospitalization: Insights from a National Inpatient Sample analysis
Authors: Akhlaq Anum , Aamer Sameen , Hasan Khawaja Muthammir , Muzammil Taimur Sohail , Sohail Amir Humza , Quazi Mohammed A , Khan Muhammad Salman , Sheikh Abu Baker 
Published: January 2024

Introduction The COVID-19 pandemic has significantly impacted global health, especially for patients with chronic diseases that may compromise the immune system. This study investigates the association between systemic lupus erythematosus (SLE) and COVID-19 outcomes. Methods Data from the National Inpatient Sample (NIS) were analyzed to create a retrospective cohort of COVID-19 hospitalizations, comparing patients with and without SLE. Propensity-score matched analysis was conducted to assess the association between SLE and clinical outcomes in COVID-19 hospitalizations. Results The study included over a million COVID-19 hospitalizations, with approximately 0.5% having a secondary diagnosis of SLE. The SLE-COVID hospitalizations were predominantly female and younger, with a median age of 57.2, while the non-SLE-COVID group had a median age of 64.8 years. Comorbidities such as chronic obstructive pulmonary disease, renal failure, liver disease, and others were more prevalent in the SLE-COVID group. Patients with SLE and COVID-19 had a significantly higher incidence of acute kidney injury requiring dialysis than those without SLE. In-hospital mortality was higher in the SLE group, particularly in the 18–44 year age group (6.15% vs 2.47%, p = .022). Conclusion COVID-19 patients with SLE are at an increased mortality risk, especially in the younger age group, and a higher incidence of acute kidney injury requiring dialysis. The elevated risk of adverse outcomes underscores the vulnerability of SLE patients to COVID-19. These findings emphasize the importance of special precautions and patient education for individuals with SLE to mitigate the risks associated with COVID-19.
A novel 3-DOF active vibration isolation method for TBM’s laser target
Authors: Hu Jinlong , Xie Zhe , Liu Yang , Zhu Guoli 
Published: January 2024

In the process of full-face tunnel boring machine (TBM) tunneling, pitch angle measurement accuracy of the laser target is greatly reduced by low frequency vibrations with large amplitude and multiple degrees of freedom. In order to improve pitch angle measurement accuracy of laser target under vibration, a three-degree-of-freedom (3-DOF) active vibration isolation system is designed in this paper. A plate-type voice coil motor with large air gap and large thrust is designed based on genetic algorithm. In order to increase damping of the vibration isolation system, an eddy current damper is designed by combining copper plate and permanent magnet of the voice coil motor. An active vibration isolation device for laser target was built by using the designed plate-type voice coil motor and eddy current damper, and the dynamic model of the system was established. Aiming at control and stability problems caused by the nonlinear factors, a High-Frequency sliding mode controller which can ensure system asymptotically stable is designed in this paper. A 1–30 Hz sinusoidal sweep excitation experiment was performed on a shaking table. The experimental results show that the active vibration isolation system has a good damping effect. The root mean square (RMS) of acceleration in Y direction can be attenuated by 90.5%, in Z direction can be attenuated by 95.8%. The active isolation system effectively attenuates the vibration transmitted to the laser target, and pitch angular fluctuation of the laser target is reduced by 75.8%. The designed active vibration isolation system improves the pitch angle measurement accuracy of the laser target.
Incidence of immune-related adverse events in U.S. veterans treated with immune checkpoint inhibitors
Authors: Krall Courtney , Tague Marshall , Lund Brian C 
Published: January 2024

Background Immune checkpoint inhibitors (ICIs) are associated with potentially severe immune-related adverse events (irAEs). Emerging clinical practice reports have suggested higher incidence of irAEs in real-world settings than initially observed in phase III clinical trials. Objectives were to determine the incidence of irAEs associated with ICIs in a clinical population, the Veterans Health Administration, characterize their time to onset, and explore potential risk factors. Methods This retrospective observational study included patients from eight Midwest VA medical centers who initiated an ICI between January 1, 2014, and June 30, 2022. Courses of incident prednisone therapy lasting at least seven days at a dose ≥ 20 mg/day were used to identify irAEs, within two years following ICI initiation. A multivariate Cox proportional hazards regression model was used to explore potential irAE risk factors. Results Of 1314 patients, the incidence of irAEs was 19.8%, with most (86.5%) occurring within one year of ICI initiation. Monthly incidence rates peaked three months following ICI initiation at 3.0% and decreased thereafter. Female gender (hazard ratio [HR] = 2.01, 95% confidence interval [CI]: 1.01–4.00) and combination therapy with ipilimumab and nivolumab (HR = 2.46, 95% CI: 1.44–4.21) were significantly associated with irAE incidence. Conclusions These findings are consistent with recent studies in clinical populations that demonstrate higher irAE incidence rates than originally reported in clinical trials. Our findings may enhance prompt recognition and treatment of irAEs for VA patients.
Navigating the COVID-19 pandemic: Experiences and self-management approaches adopted by people with interstitial lung disease
Authors: Tikellis Gabriella , Corte Tamera , Glaspole Ian N , Goh Nicole S L , Khor Yet H , Wrobel Jeremy , Symons Karen , Fuhrmeister Lisa , Glenn Laura , Chirayath Shiji , Troy Lauren K , King Bill , Holland Anne E 
Published: January 2024

Background People with interstitial lung disease (ILD) were deemed more vulnerable to the SARS-CoV-2 virus and isolated as a means of reducing risk of infection. This study examined the impact of the pandemic on daily life, psychological wellbeing and access to healthcare and identified approaches undertaken to remain safe. Methods Four specialist clinics in tertiary centres in Australia (Victoria: two sites; New South Wales: one site; Western Australia: one site) recruited patients with ILD during an 8-week period from March 2021. Semi-structured telephone interviews were conducted with transcripts analysed using principles of grounded theory. Results Ninety participants were interviewed between April and December 2021. Participants were predominantly female, former smokers with an average age of 66 years. IPF and connective tissue-ILD being the most common subtypes. Five main themes were identified: vulnerability reduced social interaction and isolation, access to healthcare services and support, staying active, emotional and psychological impact. Self-management strategies included staying active both physically and mentally. Discussion Self-management was key to managing the impact of the pandemic. In combination with advances in technology, implementation of strategies for monitoring wellbeing and support for self-management provides an opportunity to leverage the lessons learnt to ensure a more individualised model of care for people with ILD.
Impact of a Less Than 50% Residual Stenosis Following Vessel Preparation in Femoropopliteal Drug-Coated Balloon Angioplasty
Authors: Tomoi Yusuke , Soga Yoshimitsu , Imada Kazuaki , Sakai Nobuaki , Katsuki Tomonori , Ando Kenji 
Published: January 2024

Purpose: Drug-coated balloon (DCB) has been established as first-line therapy in femoropopliteal (FP) intervention, and successful vessel preparation (VP) is considered a key element. However, the clinical impact of successful VP remains unknown. This retrospective study examined the clinical impact of successful VP in DCB FP intervention. Methods: In total, 268 patients (308 limbs) who underwent successful FP intervention using DCB without atherectomy devices for symptomatic lower extremity artery disease between March 2018 and December 2019 were included in this study (high-dose DCB: 69.8%; low-dose DCB: 30.2%). Successful VP was defined as <50% residual stenosis and <dissection grade D before DCB (the successful VP group). The primary outcome measure was primary patency, and its associated factors were evaluated. Results: The median follow-up period was 2.1 (interquartile range=1.1-2.7) years. Successful VP was achieved in 163 patients (60.8%). Primary patency and freedom from clinically-driven target lesion revascularization (CD-TLR) were significantly higher in the successful VP group than in the nonsuccessful VP group (54.2% vs 33.0%, p<0.001; 69.9% vs 57.7%, p=0.047). In the successful VP group, high-dose DCB and low-dose DCB were comparable in primary patency and freedom from CD-TLR (53.2% vs 53.6%, p=0.48; 68.7% vs 70.9%, p=0.69). In nonsuccessful VP group, high-dose DCB demonstrated numerically higher primary patency but not statistically significant than low-dose DCB (44.5% vs 16.0%, p=0.06), whereas no significant difference in freedom from CD-TLR was observed (56.0% vs 58.9%, p=0.29). On multivariate analysis, successful VP and preballoon size to reference vessel diameter ratio were significantly associated with primary patency. Conclusions: Achieving successful VP before DCB was independently associated with primary patency in DCB FP intervention. Clinical Impact This study revealed that the successful vessel preparation (VP) before DCB and preballoonsize to reference vessel diameter ratio were independently associated with primary patency in DCB femoropopliteal intervention. When successful VP was achieved only before DCB treatment, the clinical outcomes were comparable between high-dose DCB and low-dose DCB at midterm follow-up.To maximized DCB efficacy, successful VP is very important in daily clinical practice.
Risk Factors for the Development of Persistent Scaphoid Non-Union After Surgery for an Established Non-Union
Authors: Patterson Ethan D. , Elliott Chloe , Dhaliwal Gurpreet , Sayre Eric C. , White Neil J. 
Published: January 2024

Background: Between 2014 and 2020, candidates for scaphoid non-union (SNU) surgery were enrolled in a prospective randomized trial (Scaphoid Nonunion and Low Intensity Pulsed Ultrasound [SNAPU] trial) evaluating the effect of low-intensity pulsed ultrasound on postoperative scaphoid healing. At trial completion, 114/134 (85%) of these patients went on to union, and 20/134 (15%) went on to persistent SNU (PSNU). The purpose of this study was to use this prospectively gathered data to identify patient-, fracture-, and surgery-specific risk factors that may be predictive of PSNU in patients who undergo surgery for SNU. Methods: Data were extracted from the SNAPU trial database. The inclusion and exclusion criteria of this study were the same as that of the SNAPU trial. Nineteen patient-, fracture-, and surgery-specific risk factors were determined a priori. A stepwise multivariable logistic regression model was used to identify independent risk factors for PSNU. Results: Three risk factors were found to be independently significant predictors of PSNU: age at the time of surgery, dominant hand injury, and previous surgery on the affected scaphoid. With every decade of a patient’s life, dominant hand injury, and previous scaphoid surgery, the odds of union are reduced by 1.72 times, 7.35 times, and 4.24 times, respectively. Conclusion: We identified three independent risk factors for PSNU: age at SNU surgery, dominant hand injury, and previous surgery on the affected scaphoid. The findings of this study are significant and may contribute to shared decision-making and prognostication between the patient, surgeon, and affiliated members of their care team.
Intra-arterial microguidewire electrocoagulation to treat intracranial vascular diseases
Authors: Wu Tao , Wu Yao , Li Zhao-liang , Yang De-hong , Chen Ai-lin , Dai Chun-gang , Zhu Qing 
Published: January 2024

Objective To investigate the therapeutic effect of intra-arterial microguidewire electrocoagulation on intracranial vascular diseases. Methods Data from 10 patients with cerebral aneurysms between May 2018 and September 2022 were analysed. Patients were treated with endovascular coil embolisation and microguidewire electrocoagulation. XperCT scans were conducted to identify new intracranial haemorrhage, infarction and hydrocephalus. Follow-up examinations were conducted 1, 3, 6 and 12 months after discharge. Results After the patients received electrocoagulation for different durations, Raymond Grade 1 embolisation was achieved in all 10 patients. No complications, such as haemorrhage, infarction or hydrocephalus, were found during or after surgery. Ten patients were followed up for 6–12 months, and none had any symptoms or new neurological dysfunction 1 month after their operation. Among them, nine were followed up for 12 months, and digital subtraction angiography showed no recurrence of aneurysms or occlusion of parent arteries. Conclusion Intra-arterial microguidewire electrocoagulation can be used as a supplementary treatment for cerebral aneurysms. In cases of incomplete lesion embolisation and cases where tamponade treatment cannot continue, immediate thrombosis may occur. Thus, intra-arterial microguidewire electrocoagulation can help achieve patients’ treatment goals.
Safety and efficacy of dual antiplatelet drugs for stent-assisted embolization on risk of stroke and prognosis in patients with ruptured intracranial aneurysms: One center results of CIAP-5 clinical trial
Authors: Wang Simin , Zhang Tongyu , Du Lei , Hu Peng , Ye Ming , Sun Liyong , Hong Tao , Li Guilin , Zhang Peng , Zhang Hongqi , He Chuan 
Published: January 2024

Background Although stent-assisted coiling embolization (SAC) has been associated with a higher risk of ischemic and hemorrhagic complications, the use of SAC continues to rise for treating ruptured intracranial aneurysms (RIAs). This study aims to assess the safety and effectiveness of dual antiplatelet therapy (DAPT) in the context of RIAs. Methods We conducted a retrospective analysis at a single center, involving patients with aneurysmal subarachnoid hemorrhage (aSAH) between May 1, 2017 and December 31, 2021. Patients were categorized into two groups: the SAC group and the non-SAC (NSC) group. Patients in the SAC group received DAPT. We compared modified Rankin Scale (mRS) score, along with hemorrhagic and ischemic complications, between the two groups to evaluate the safety and efficacy of DAPT for SAC. Results The study included a total of 541 patients, of whom 38 (7.0%) experienced hemorrhagic complications and 48 (8.9%) developed ischemic complications. Additionally, 99 (18.3%) and 84 (15.5%) had poor clinical outcomes at discharge and 6 months, respectively. However, no statistically significant differences were observed between the two groups. Our analysis revealed that aneurysm location in the posterior circulation was a significant risk factor for an unfavorable prognosis when antiplatelet drugs were used following SAC ( p = 0.025). Conclusions Administering antiplatelet drugs after SAC for RIAs has demonstrated both safety and effectiveness. However, caution should be exercised when considering this treatment strategy for RIAs located in the posterior circulation due to the potentially elevated risk.