bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographical heterogeneity in the disease characteristics and management of patients with inflammatory bowel disease, the preliminary results of a Chinese database for IBD (CHASE-IBD)
Authors: Wan Jian , Shen Jun , Wu Xiaoping , Zhong Jie , Chen Yan , Zhu Lanxiang , Miao Yinglei , Hu Naizhong , Chen Jie , Liang Jie , Wu Kaichun 
Published: December 2023

Background: The incidence of inflammatory bowel disease (IBD) is rapidly increasing in China, a vast country with significant geographical differences. The socioeconomic status of Eastern China is significantly higher than that of Western China. Objectives: This study aimed to describe the geographical heterogeneity in the characteristics and management of patients with IBD in both Eastern and Western China. Design: This was a multicenter, cross-sectional study. Methods: Patients with IBD with ages ⩾18 years up to 18 January 2023 were included in the analysis from the Chinese database for IBD. Logistic regression was used to identify risk factors associated with surgeries among patients with IBD. Results: Among 8305 patients with IBD, the ratio of ulcerative colitis (UC) to Crohn’s disease (CD) was 4.13 and 0.33 in Western and Eastern China, respectively. The median age at diagnosis of UC and CD was 40.69 and 28.58 years, respectively. There was a male predominance among patients with UC (54.3%) and CD (68.0%). The two regions exhibited a similar distribution of disease locations in UC. However, Western China had a higher proportion of L2 involvement (30.0% versus 19.1%) and more advanced disease behavior (B2 and B3) (48.8% versus 39.8%) than Eastern China. Patients with IBD in Western China received more 5-aminosalicylic acid and corticosteroids and fewer immunomodulators and biologicals. In terms of surgical risk, Eastern China [ versus Western China, odds ratios (OR): 5.36, 95% confidence intervals (CI): 2.96–9.68] was associated with a higher risk of surgery in UC, while Western China ( versus Eastern China, OR: 3.39, 95% CI: 2.37–4.86) was associated with a higher risk of surgery in CD. Conclusion: Geographical heterogeneity exists in the disease characteristics and management of IBD in Eastern and Western China. These findings have the potential to guide the formulation of location-specific strategies aimed at enhancing the long-term outcomes of patients with IBD.
Research hotspots for pediatric fractures from 2017 to 2022: A bibliometric and visual analysis via Citespace
Authors: Wang Huan , Yang Ya-ting , Lu Qing-da , Liu Chen-xin , Bai Huan-an , Wang Jia-ju , Jie Qiang 
Published: December 2023

Objective: This review provides guidance and ideas for researchers through a comprehensive and comparative analysis of the present state, trends, and hotspots in the pediatric fracture literature over the past 6 years. Methods: We used Citespace 6.1.R6 software to explore the country/region distribution, institutions, journals, keyword analysis, and co-cited references of the literature from Web of Science core database. Results: There are 6472 pieces of pediatric fracture–related literature, including 2962 from 2017 to 2019 and 3510 from 2020 to 2022. The country with the most papers is the United States, and US institutions and journals also have a pivotal position in this field. Research hotspots for pediatric fractures in 2017–2019: The topic with the most attention is bone mineral density leading to related bone diseases. Treatment for pediatric fractures, including supracondylar humeral fractures, Monteggia fractures, forearm fractures, knee fractures, and ankle fractures in children, is another topic of greater interest. Brain injuries and dental injuries in children due to abuse and trauma are also concerning issues. Research hotspots for pediatric fractures in 2020–2022: comparison with 2017–2019 revealed a relative decrease regarding ankle-related epiphyseal injuries, but there is a higher focus on the epidemiology of fractures in children, risk factors, and reasons for childhood trauma. We have confirmed through literature co-citations that the literature of high interest is also in these aspects. Conclusion: Researchers and clinicians can quickly learn about topics of interest through authoritative journals and highly cited literature and rapidly master the current status and frontiers of the field through study, providing ideas for future work.
Early Definitive Fixation of Talus Fractures Is Safe: A Retrospective Review
Authors: DeGenova Daniel T. , Miller Klay B. , Paulini Alex S. , Melaragno Anthony J. , Davis Trent , Hoffman Brett , Taylor Benjamin C. 
Published: December 2023

Background Talus fractures are often result of high energy mechanisms and can lead to devastating complications. Treatment is often operative; however, the appropriate timing of this has been debated. The purpose of this study is to determine the efficacy and safety of the early treatment of talus fractures. Methods Patients aged 18 years or older who underwent definitive operative stabilization of their talus fracture at a single urban level 1 trauma center were retrospectively reviewed. Patients were split into 2 groups based on their time to definitive fixation: ≤ or >24 hours. Pertinent demographic, surgical, and follow-up data were collected and analyzed. Results A total of 108 fractures were treated with 65 in the ≤24 hours fixation group and 43 in the >24 hours fixation group. Fractures involving the talar neck were the most commonly treated fracture pattern followed by the body and the head. There was no difference between the 2 groups in length to full weight bearing, union, or time to union. Open fracture was found to be the only significant risk factor for nonunion in both groups. There was no significant difference in infection or arthrodesis rates between the 2 groups. Conclusion Definitive treatment of talus fractures within 24 hours from presentation is both safe and effective with equal outcomes and without increased complications when compared with those injuries that undergo delayed or staged definitive fixation. Level of Evidence: Level III
Therapy for patients with chronic phase-chronic myeloid leukemia previously treated with ⩾2 tyrosine kinase inhibitors: a systematic literature review
Authors: Atallah Ehab , Saini Lovneet , Maegawa Rodrigo , Rajput Tanvi , Corbin Regina , Viana Ricardo 
Published: December 2023

Background: ATP-competitive tyrosine kinase inhibitors (TKIs) are the current standard of care for patients with chronic phase-chronic myeloid leukemia (CP-CML) in the first-line and second-line (2 L) setting. Treatment after 2 L is not clearly established. Objective: The objective of this study was to summarize the available evidence to compare the efficacy and safety of interventions in the treatment of CP-CML patients who had received ⩾2 prior TKIs. Design: A systematic literature review was performed. Data source and methods: A systematic literature review (SLR) of studies published until May 2021, reporting clinical outcomes in adult patients with CP-CML who had received ⩾ 2 prior TKIs was performed. Studies were identified through the database searches via Ovid platform (Embase, MEDLINE Epub Ahead of Print, In-Process and Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), bibliographic search of relevant reviews, and proceedings from the previous 3 years of the key conferences in the field of oncology. Results: Our search identified 38 relevant studies. Among the identified studies of the current third-line treatments, the major molecular response (MMR) rate for ponatinib was 19.0–66.7%, 23.3–25.5% for asciminib, 19.2% for omacetaxine, and 13.2% for bosutinib at 6 months. The complete cytogenetic response (CCyR) rate was 21.4–64.8% for ponatinib, 38.7–40.8% for asciminib, 18–24.2% for bosutinib, and 16.1% for omacetaxine at 6 months. Conclusion: The findings from current SLR demonstrated the lack of data for patients with CML treated with ⩾2 TKIs. TKIs such as asciminib, ponatinib, and bosutinib are valid options for those patients. Further research is needed to identify the best treatment option for patients with CML receiving later lines of therapy.
Efficacy of complement inhibitors for patients with paroxysmal nocturnal hemoglobinuria: a systematic review and meta-analysis
Authors: Lee Jiyeon , Lee Haeseon , Kim Siin , Suh Hae Sun 
Published: December 2023

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematological disease. The development of complement inhibitors such as eculizumab, ravulizumab, and pegcetacoplan has revolutionized the management of PNH, leading to improvements in overall survival and quality of life for patients. Objectives: This systematic review aims to provide comprehensive evidence of the efficacy of complement inhibitors in relation to treatment duration. Design: This is a systematic review and meta-analysis. Data sources and methods: A thorough literature search was conducted in MEDLINE, EMBASE, and the Cochrane Library up to 3 May 2022. We included all prospective interventional studies including single-arm trials. The primary outcomes of interest were lactate dehydrogenase (LDH) levels, hemoglobin (Hb) concentrations, transfusion avoidance, and Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scores. Results: Our study included a total of 27 studies, comprising 5 randomized controlled trials and 11 single-arm trials, with a total of 912 patients with PNH. We stratified the studies according to treatment duration, based on the most frequently reported period of 26 weeks. Our analysis showed that treatment-naïve patients who received complement inhibitors had a pooled estimate of a decrease in LDH levels from baseline by −1462.0 U/L (95% CI: −1735.6 to −1188.5) for treatment ⩽26 weeks and −1696.5 U/L (95% CI: −2122.7 to −1270.2) for treatment >26 weeks. The mean Hb levels were increased by 1.4 g/dL (95% CI: 0.5–2.3) and 1.9 g/dL (95% CI: 0.7−3.1) in each group. Treatment with any complement inhibitor prevented the need for transfusion in at least 50% of patients with PNH in all treatment periods. Clinically meaningful improvements in FACIT-F were observed both before and after 26 weeks, with a pooled estimate of 6.8 (95% CI: 6.0−7.6) and 9.5 (95% CI: 7.0−12.0), respectively. Conclusion: Our findings suggest that complement inhibitors can result in positive treatment outcomes and sustained benefits for patients with PNH.
Estimating the Health Care Expenditure to Manage and Care for Type 2 Diabetes in Nepal: A Patient Perspective
Authors: Dahal Padam Kanta , Rawal Lal , Ademi Zanfina , Mahumud Rashidul Alam , Paudel Grish , Vandelanotte Corneel 
Published: December 2023

Background. This study aimed to estimate the health care expenditure for managing type 2 diabetes (T2D) in the community setting of Nepal. Methods. This is a baseline cross-sectional study of a heath behavior intervention that was conducted between September 2021 and February 2022 among patients with T2D ( N = 481) in the Kavrepalanchok and Nuwakot districts of Nepal. Bottom-up and micro-costing approaches were used to estimate the health care costs and were stratified according to residential status and the presence of comorbid conditions. A generalized linear model with a log-link and gamma distribution was applied for modeling the continuous right-skewed costs, and 95% confidence intervals were obtained from 10,000 bootstrapping resampling techniques. Results. Over 6 months the mean health care resource cost to manage T2D was US $22.87 per patient: 61% included the direct medical cost (US $14.01), 15% included the direct nonmedical cost (US $3.43), and 24% was associated with productivity losses (US $5.44). The mean health care resource cost per patient living in an urban community (US $24.65) was about US $4.95 higher than patients living in the rural community (US $19.69). The health care costs per patient with comorbid conditions was US $22.93 and was US $22.81 for those without comorbidities. Patients living in rural areas had 16% lower health care expenses compared with their urban counterparts. Conclusion. T2D imposes a substantial financial burden on both the health care system and individuals. There is a need to establish high-value care treatment strategies for the management of T2D to reduce the high health care expenses. Highlights More than 60% of health care expenses comprise the direct medical cost, 15% direct nonmedical cost, and 24% patient productivity losses. The costs of diagnosis, hospitalization, and recommended foods were the main drivers of health care costs for managing type 2 diabetes. Health care expenses among patients living in urban communities and patients with comorbid conditions was higher compared with those in rural communities and those with without comorbidities. The results of this study are expected to help integrate diabetes care within the existing primary health care systems, thereby reducing health care expenses and improving the quality of diabetes care in Nepal.
Qualitative Findings of a Nominal Group Process to Identify Critical Factors in New LIC Implementation
Authors: Eddings Stacy K. , Brown Laura L. , Godin Steven 
Published: December 2023

OBJECTIVES Medical schools considering longitudinal integrated clerkships (LICs) have access to literature that provides recommendations for planning, implementation, and sustainability. However, LIC development and implementation remain notoriously challenging. University of Utah’s LIC development process was informed by the documented experiences of long-established LIC programs. A literature gap was identified pertaining to more recently implemented LICs. The aim of this study was to explore the experiences of faculty in the early stages of LIC development. METHODS Thirteen representatives from eight LICs implemented after 2015 participated in 2 Zoom focus groups (5 participated in the first and the other 8 participated in the second). Participants were asked questions to assess key supports, barriers, and recommendations. Following the focus groups, participants were asked to rank the responses based on their level of importance. RESULTS Highest ranked supports included stakeholder and partner involvement; a dedicated coordinator or team; and strong, committed leadership. Highest ranked barriers included difficulty recruiting preceptors and clinical sites; underestimation of the amount of work required to coordinate the LIC; and challenges in providing the needed faculty development. Top recommendations for new LICs included investing in the needs of clinical partners; staffing or assigning a dedicated coordinator early in the development and implementation process; and frequent communication with all stakeholders. CONCLUSION Despite variation among the types of new LICs represented, there was consensus among participants on the importance of key supports, barriers, and recommendations. Knowledge of these factors can help new schools plan and allocate resources during their LIC development process. Participants found the focus group process and follow-up discussions useful and have formed an ongoing workgroup which meets quarterly.
Sonographers’ Perception of Administrative Support and Resources for Burnout Prevention
Authors: McCalla-Henry Rose , Mathieson Kathleen 
Published: December 2023

Objective: The purpose of this study was to explore the occupational burnout levels among a cohort of sonographers practicing in the United States and their perception of administrative support and resources for burnout prevention. Materials and Methods: This study used a quantitative descriptive design with a cross-sectional online survey administered to the Society of Diagnostic Medical Sonography members. The survey consisted of demographic information, administrative support questions, and burnout measurements using the validated Oldenburg Burnout Inventory. Results: A total of 1393 sonographers participated in the study. The results of this sonographer cohort indicated that 55.7% experienced moderate burnout. Although 30.9% reported feeling their employers cared for their well-being, 36.6% of respondents indicated no administrative support, and 30.7% said their administration did not provide resources to help them cope. Conclusion: Occupational burnout levels among this cohort of sonographers was moderate and could increase without adequate intervention. Addressing sonographer burnout and managing stressors will help organizations to retain staff, continue providing quality patient care, and maintain patient outcomes.
Asthma exacerbations and eosinophilia in the UK Biobank: a genome-wide association study
Authors: Edris Ahmed , Voorhies Kirsten , Lutz Sharon M. , Iribarren Carlos , Hall Ian , Wu Ann Chen , Tobin Martin , Fawcett Katherine , Lahousse Lies 
Published: December 2023

BackgroundAsthma exacerbations reflect disease severity, affect morbidity and mortality, and may lead to declining lung function. Inflammatory endotypes (e.g.T2-high (eosinophilic)) may play a key role in asthma exacerbations. We aimed to assess whether genetic susceptibility underlies asthma exacerbation risk and additionally tested for an interaction between genetic variants and eosinophilia on exacerbation risk.MethodsUK Biobank data were used to perform a genome-wide association study of individuals with asthma and at least one exacerbation compared to individuals with asthma and no history of exacerbations. Individuals with asthma were identified using self-reported data, hospitalisation data and general practitioner records. Exacerbations were identified as either asthma-related hospitalisation, general practitioner record of asthma exacerbation or an oral corticosteroid burst prescription. A logistic regression model adjusted for age, sex, smoking status and genetic ancestryviaprincipal components was used to assess the association between genetic variants and asthma exacerbations. We sought replication for suggestive associations (p<5×10−6) in the GERA cohort.ResultsIn the UK Biobank, we identified 11 604 cases and 37 890 controls. While no variants reached genome-wide significance (p<5×10−8) in the primary analysis, 116 signals were suggestively significant (p<5×10−6). In GERA, two single nucleotide polymorphisms (rs34643691 and rs149721630) replicated (p<0.05), representing signals near the NTRK3 and ABCA13 genes.ConclusionsOur study has identified reproducible associations with asthma exacerbations in the UK Biobank and GERA cohorts. Confirmation of these findings in different asthma subphenotypes in diverse ancestries and functional investigation will be required to understand their mechanisms of action and potentially inform therapeutic development.
Chronic cough associated with COPD exacerbation, pneumonia and death in the general population
Authors: Landt Eskild M. , Çolak Yunus , Nordestgaard Børge G. , Lange Peter , Dahl Morten 
Published: December 2023

BackgroundChronic cough affects up to 10% of the general population and was previously perceived as a comorbidity of underlying conditions, but is nowadays classified as a disease in its own entity that could confer increased risk of morbidity and mortality. We tested the hypothesis that chronic cough is associated with increased risk of COPD exacerbation, pneumonia and all-cause mortality in the general population.MethodsWe identified 2801 individuals with chronic cough, defined as cough lasting >8 weeks, among 44 756 randomly selected individuals from the Copenhagen General Population Study, and recorded COPD exacerbations, pneumonia and all-cause mortality during follow-up.ResultsDuring up to 5.9 years of follow-up (median 3.4 years), 173 individuals experienced COPD exacerbation, 767 experienced pneumonia and 894 individuals died. Individuals with chronic coughversusthose without had cumulative incidences at age 80 years of 12%versus3% for COPD exacerbation, 30%versus15% for pneumonia, and 25%versus13% for death from all causes. After adjustment for age, sex and smoking, individuals with chronic coughversusthose without had adjusted hazard ratios of 4.6 (95% CI 2.9–7.2) for COPD exacerbation, 2.2 (1.7–2.7) for pneumonia and 1.7 (1.4–2.0) for all-cause mortality. Among current smokers aged >60 years with airflow limitation, those withversuswithout chronic cough had an absolute 5-year risk of 10%versus4% for COPD exacerbation, 16%versus8% for pneumonia and 19%versus12% for all-cause mortality.ConclusionChronic cough is associated with higher risks of COPD exacerbation, pneumonia and death, independent of airflow limitation and smoking.
Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance
Authors: Kahn Peter A. , Joseph Phillip , Heerdt Paul M. , Singh Inderjit 
Published: December 2023

BackgroundPost-acute sequelae of COVID-19 (PASC) affect a significant proportion of patients who have previously contracted SARS-CoV-2, with exertional intolerance being a prominent symptom. This study aimed to characterise the invasive haemodynamic abnormalities of PASC-related exertional intolerance using invasive cardiopulmonary exercise testing (iCPET).Study design and intervention55 patients were recruited from the Yale Post-COVID-19 Recovery Program, with most experiencing mild acute illness. Supine right heart catheterisation and iCPET were performed on all participants.Main resultsThe majority (75%) of PASC patients exhibited impaired peak systemic oxygen extraction (pEO2) during iCPET in conjunction with supranormal cardiac output (CO) (i.e., PASC alone group). On average, the PASC alone group exhibited a “normal” peak exercise capacity,V′O2(89±18% predicted). ∼25% of patients had evidence of central cardiopulmonary pathology (i.e., 12 with resting and exercise heart failure with preserved ejection fraction (HFpEF) and two with exercise pulmonary hypertension (PH)). PASC patients with HFpEF (i.e., PASC HFpEF group) exhibited similarly impaired pEO2with well compensated PH (i.e., peakV′O2and CO >80% respectively) despite aberrant central cardiopulmonary exercise haemodynamics. PASC patients with HFpEF also exhibited increased body mass index of 39±7 kg·m−2. To examine the relative contribution of obesity to exertional impairment in PASC HFpEF, a control group comprising obese non-PASC group (n=61) derived from a historical iCPET cohort was used. The non-PASC obese patients with preserved peakV′O2(>80% predicted) exhibited a normal peak pulmonary artery wedge pressure (17±14versus25±6 mmHg; p=0.03) with similar maximal voluntary ventilation (90±12versus86±10% predicted; p=0.53) compared to PASC HFpEF patients. Impaired pEO2was not significantly different between PASC patients who underwent supervised rehabilitation and those who did not (p=0.19).ConclusionsThis study highlights the importance of considering impaired pEO2in PASC patients with persistent exertional intolerance unexplained by conventional investigative testing. Results of the current study also highlight the prevalence of a distinct high output HFpEF phenotype in PASC with a primary peripheral limitation to exercise.