bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Cohort Protocol for the Remnant Investigation in Sepsis Study
Authors: Seymour Christopher W. , Urbanek Kelly Lynn , Nakayama Anna , Kennedy Jason N. , Powell Rachel , Robinson Renã A.S. , Kapp Kathryn L. , Billiar Timothy R. , Vodovotz Yoram , Gelhaus Stacy L. , Cooper Vaughn S. , Tang Lu , Mayr Flo , Reitz Katherine M. , Horvat Christopher , Meyer Nuala J. , Dickson Robert P. , Angus Derek , Palmer Octavia Peck 
Published: October 2023

BACKGROUND:
Sepsis is a common and deadly syndrome, accounting for more than 11 million deaths annually. To mature a deeper understanding of the host and pathogen mechanisms contributing to poor outcomes in sepsis, and thereby possibly inform new therapeutic targets, sophisticated, and expensive biorepositories are typically required. We propose that remnant biospecimens are an alternative for mechanistic sepsis research, although the viability and scientific value of such remnants are unknown.

METHODS AND RESULTS:
The Remnant Biospecimen Investigation in Sepsis study is a prospective cohort study of 225 adults (age ≥ 18 yr) presenting to the emergency department with community sepsis, defined as sepsis-3 criteria within 6 hours of arrival. The primary objective was to determine the scientific value of a remnant biospecimen repository in sepsis linked to clinical phenotyping in the electronic health record. We will study candidate multiomic readouts of sepsis biology, governed by a conceptual model, and determine the precision, accuracy, integrity, and comparability of proteins, small molecules, lipids, and pathogen sequencing in remnant biospecimens compared with paired biospecimens obtained according to research protocols. Paired biospecimens will include plasma from sodium–heparin, EDTA, sodium fluoride, and citrate tubes.

CONCLUSIONS:
The study has received approval from the University of Pittsburgh Human Research Protection Office (Study 21120013). Recruitment began on October 25, 2022, with planned release of primary results anticipated in 2024. Results will be made available to the public, the funders, critical care societies, laboratory medicine scientists, and other researchers.
Cefepime Daily Exposure and the Associated Impact on the Change in Sequential Organ Failure Assessment Scores and Vasopressors Requirement in Critically Ill Patients Using Repeated-Measures Mixed-Effect Modeling
Authors: Alshaer Mohammad H. , Williams Roy , Mousa Mays J. , Alexander Kaitlin M. , Maguigan Kelly L. , Manigaba Kayihura , Maranchick Nicole , Shoulders Bethany R. , Felton Timothy W. , Mathew Sumith K. , Peloquin Charles A. 
Published: October 2023

IMPORTANCE:
Sepsis and septic shock are major healthcare problems that need early and appropriate management.

OBJECTIVES:
To evaluate the association of daily cefepime pharmacokinetic/pharmacodynamic (PK/PD) parameters with change in Sequential Organ Failure Assessment (SOFA) score and vasopressors requirement.

DESIGN, SETTING, AND PARTICIPANTS:
This is a retrospective study. Adult ICU patients who received cefepime for Gram-negative pneumonia or bloodstream infection (BSI) and had cefepime concentrations measured were included. Daily cefepime exposure was generated and PK/PD parameters calculated for patients. Repeated-measures mixed-effect modeling was used to evaluate the impact of PK/PD on the outcomes.

MAIN OUTCOMES AND MEASURES:
Change in daily SOFA score and vasopressors requirement.

RESULTS:
A total of 394 and 207 patients were included in the SOFA and vasopressors analyses, respectively. The mean (±sd) age was 55 years (19) and weight 81 kg (29). For the change in SOFA score, daily SOFA score, mechanical ventilation, renal replacement therapy, and number of vasopressors were included. In the vasopressors analysis, daily SOFA score, day of therapy, and hydrocortisone dose were significant covariates in the final model. Achieving cefepime concentrations above the minimum inhibitory concentration (MIC) (T>MIC) for 100% of the dosing interval was associated with 0.006 µg/kg/min decrease in norepinephrine-equivalent dose. Cefepime PK/PD did not have an impact on the daily change in SOFA score.

CONCLUSIONS AND RELEVANCE:
Achieving 100% T>MIC was associated with negligible decrease in vasopressors requirement in ICU patients with Gram-negative pneumonia and BSI. There was no impact on the change in SOFA score.
Validation of the “Indication for Use” (INDO) Variable in the Danish National Prescription Registry
Authors: Harbi Hanin , Pottegård Anton 
Published: October 2023

Background:
Despite its potential value in register-based pharmacoepidemiologic research, recorded information on “indication for use” (INDO) in the Danish National Prescription Registry has rarely been used, likely because of questions about the variable’s validity, which to our knowledge no study has systematically assessed.

Methods:
We extracted data on 80,814 prescriptions from the software systems (PharmaNet and C2) of five Danish community pharmacies filled between 4 and 16 February 2019 and 2020. Using the indication information recorded in the pharmacy software systems as the gold standard, we evaluated the extent and quality of the corresponding information from the Prescription Registry.

Results:
Of all prescriptions identified, we captured >99% in the Prescription Registry. The proportion of prescriptions with recorded indication codes in the Prescription Registry was 82% (n = 66,164) but was lower for C2 than PharmaNet. Correcting for the overrepresentation of C2 data in our sample, the estimated proportion of registration was ≈88%. Almost 100% (66,158 of 66,164) of the prescriptions with recorded indication codes in the Prescription Registry had correctly recorded indication codes. Nonspecific indication codes were present in 5.6%–36% of selected drugs and drug classes.

Conclusions:
Prescriptions filled at Danish community pharmacies are accurately captured by the Danish National Prescription Registry, and the recorded information on indication is generally valid and usable in research. However, minor concerns remain about missingness, nonspecific recorded indication codes, and lower validity, and a higher proportion of missingness of recorded indication codes is expected before 2017.
A supplementary digital video by the article’s co-author, Hanin Harbi, is available at http://links.lww.com/EDE/C89
Using three-dimensional versus two-dimensional laparoscopy in sleeve gastrectomy: A case matched comparison
Authors: Kang Lung-Yun , Lee Wei-Jei , Chen Sheng-Shih 
Published: October 2023

Abstract

Background
Laparoscopic sleeve gastrectomy using two-dimensional (2-D) systems has been proven to be a safe and effective treatment for obesity. Three-dimensional (3-D) systems have recently been introduced in the general field. We hypothesized that using a 3-D system offers more benefits than using 2-D laparoscopy in sleeve gastrectomy.

Materials and Methods
Patients who underwent laparoscopic sleeve gastrectomy (LSG) without any other surgeries between January 1, 2017, and February 28, 2019, were included. Characteristic factors and outcomes were reviewed and compared between the groups using the 2-D system and the 3-D system, including sex, age, length of stay, body mass index, operative time, blood loss, morbidity, total body weight loss, and excess weight loss.

Results
Seventy-five patients underwent LSG and were included in the study. Among them, 42 patients used the 3-D system, while 33 patients used the 2-D system. There were no significant differences between the two groups in terms of basic characteristics, including age, sex, and body mass index. The morbidity rate did not differ, but the 3-D group experienced less blood loss (25.12 vs 47.27 mL; P = 0.001) and shorter operative times (105.93 ± 30.645 minutes vs. 128.94 ± 28.566 minutes; P = 0.001) compared with the 2-D group (25.12 vs 47.27 mL; P = 0.001). Weight loss at 6 months was similar between the two groups.

Conclusions
Three-dimensional LSG shows promise in reducing both blood loss and operative time. Nevertheless, further prospective trials are essential to definitively establish its efficacy.
The impact of impaired insulin regulation on severity of SARS-CoV-2 infection: a 2-year retrospective single-center analysis
Authors: Phan Alexander T. , Ucar Ari , Malkoc Aldin , Nagori Essam , Qadir Aftab , Khosravi Chayanne , Tseng Alan , Nguyễ˜ên Julie P. T. , Modi Arnav P. , Deshpande Ojas , Lay Johnson , Ku Andrew , Dong Fanglong , Ogunyemi Dotun , Arabian Sarkis 
Published: October 2023

Background:
The COVID-19 pandemic has caused an international healthcare crisis and produced a large healthcare burden. Diabetes mellitus (DM) is a common disease that can be controlled via pharmacologic agents; however, many patients have poor glycemic control, leading to disease-related complications. DM has been reported in the literature to be associated with increasing morbidity and mortality in COVID-19 patients. The authors aim to assess the associations between glucose homoeostasis and COVID-19 disease severity and mortality.

Methods:
A retrospective chart review of patients ages 18–100 years of age admitted with COVID-19 between January 2020 and December 2021 was performed. The primary outcome was COVID-19 mortality with respect to haemoglobin A1C levels of less than 5.7%, 5.7–6.4%, and 6.5% and greater. Disease severity was determined by degree of supplemental oxygen requirements (ambient air, low-flow nasal cannula, high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation). COVID-19 mortality and severity were also compared to blood glucose levels on admission as grouped by less than 200 mg/dl and greater than or equal to 200 mg/dl.

Results:
A total of 1156 patients were included in the final analysis. There was a statistically significant association between diabetic status and mortality (P=0.0002). Statistical significance was also noted between admission blood glucose ≥200 mg/dl and mortality (P=0.0058) and respiratory disease severity (P=0.0381). A multivariate logistic regression for predicting mortality showed increasing haemoglobin A1C was associated with increased mortality (odds ratio 1.72 with 95% CI of 1.122–2.635).

Conclusions:
In our 2-year retrospective analysis, there was an association between a diagnosis of DM and COVID-19-related mortality. Hyperglycaemia on admission was found to be statistically significant with mortality in patients diagnosed with COVID-19. Glucose homoeostasis and insulin dysregulation likely play a contributing factor to COVID-19 disease severity and mortality.
The prevalence and pattern of complementary and alternative medicine use among cancer patients in a tertiary oncology center: a cross-sectional study
Authors: Almouaalamy Nabil Abdullah , Banjar Lama A. , Alshaikh Haifa M. , Altowairqi Jood M. , Alharbi Nuha M. , Alghamdi Waad A. 
Published: October 2023

Background:
Complementary and alternative medicine (CAM) is widely used nationally and internationally for multiple medical conditions, including different stages of cancer. It is used by the patients for multiple purposes, including to cure diseases or resolve symptoms, as patients have the misconception that natural remedies are safer than radiotherapy and chemotherapy.

Objectives:
The aim of this research is to investigate the prevalence, pattern, and purpose of CAM use by cancer patients at Princess Noorah Oncology Center (PNOC), King Abdulaziz Medical City, in Jeddah (KAMC-JD).

Methods:
This was a cross-sectional study that examined 293 patients (selected through random computerized sampling) who were seen at PNOC during the study period. To be eligible for the study, participants had to be cancer patients over the age of 18 who were seen at PNOC. The authors excluded patients who had privacy requests or did not fit our inclusion criteria.

Results:
Of the sample, 52.9% [95% confidence interval (CI), 47.0–58.7] used CAM. Only 5.8% of patients delayed their medical treatment to use CAM. A significantly higher proportion of females used CAM than males (61.8% vs. 40.0%, P<0.001). The most common types of CAM were Zamzam water (67.7%), Quran recitation (42.6%), water read upon Quran (41.3%), and black seed (Nigella sativa) (41.3%). The most frequently reported reasons for CAM use were to treat cancer (53.5%), increase immunity (34.2%), and religious beliefs (23.9%). Generally, 57.4% of CAM users felt improvement with CAM modalities.

Conclusion:
In conclusion, more than 50% of our sample used CAM; 5.8% of patients delayed the medical treatment to use CAM. The most common type of CAM was Zamzam water, and the most frequently reported reason for CAM use was to treat cancer. Of CAM users, 57.4% felt improvement with CAM modalities. Further studies that involve qualitative designs and include a more diverse sample are recommended in the Kingdom of Saudi Arabia to understand CAM utilization patterns.
ALS in Africa: current knowledge and exciting opportunities for future study – short communication
Authors: Kassahun Bekele Bezawit , Kwizera Lambert , Abdul Razzak Rawane , Alfadul Esraa S.A. , Anand Ayush , Wojtara Magda , Nazir Abubakar , Uwishema Olivier 
Published: October 2023

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that can present with motor and extra-motor manifestations. Its global prevalence is 4.42 per 1 000 000, and it has a high mortality rate. In sub-Saharan Africa alone, 15 per 100 000 develop ALS mainly between their 40s and 60s and only one-fourth of them have access to treatment. ALS was found to be not only affected by genetic variation but also by the patient’s mood and lifestyle. In Africa, males and younger people tend to be affected with ALS and rarely present with bulbar onset. ALS diagnosis is very challenging due to the lack of ALS-specific biomarkers and the sharing of some clinical features with other syndromes. ALS treatment is mainly riluzole and supportive treatment via nasogastric tube and ventilatory support. The access to treatment in Africa is very limited, thus a very bad prognosis with a median survival time of 14 months post-diagnosis. Further research is needed to assess the real situation in Africa and to try to closely monitor patients suffering from ALS.
Association between Covid-19 infection and platypnea–orthodeoxia syndrome
Authors: Saeed Sahrai , Hoxha Besnik , Rajani Ronak , Mohamed Ali Abukar , Lehmann Sverre 
Published: October 2023

Introduction and importance:
Platypnea–orthodeoxia syndrome is defined as dyspnoea and deoxygenation when changing from a recumbent to an upright position. Post-Covid-19 sequelae can induce or exacerbate pulmonary hypertension and thereby render a previously mild and asymptomatic platypnea–orthodeoxia syndrome to manifest with new or worsening symptoms.

Case presentation:
The authors present the case of an 80-year-old man who following an episode of moderate-severe Covid-19 infection developed type I respiratory failure that required hospital discharge with long-term oxygen therapy. He had a background history of postural paroxysmal hypoxaemia which had previously raised the suspicion of a right-to-left shunt through either a patent foramen ovale, atrial septal defect or an intrapulmonary arteriovenous malformation. However, given the low burden of symptoms this was not explored further. Following recovery from Covid-19 infection, the patient experienced marked dyspnoea and oxygen desaturation in an upright position that was relieved by a return to a supine position.

Discussion and conclusion:
Persistent dyspnoea and hypoxia are common symptoms in patients who experience post‐Covid‐19 syndrome. However, when patients with prior moderate-to-severe Covid-19 illness present with new onset breathlessness and/or desaturation that is worsened in an upright position, platypnea–orthodeoxia syndrome should be considered.
Infant feeding: emerging concepts to prevent HIV transmission
Authors: Bamford Alasdair , Foster Caroline , Lyall Hermione 
Published: October 2023

Purpose of review
HIV screening in pregnancy, universal suppressive antiretroviral therapy (ART) and breastfeeding avoidance can almost completely prevent vertical transmission of HIV. Breastfeeding is associated with an additional risk of transmission, although this risk is extremely low with suppressive maternal ART. This minimal risk must be balanced with the benefits of breastfeeding for women living with HIV (WLHIV) and their infants. Guidance in high-income countries has evolved, moving towards supported breast feeding for women on suppressive ART.

Recent findings
Breastmilk transmission accounts for an increasing proportion of new infant infections globally. The majority of transmission data comes from studies including women not on suppressive ART. Breastmilk transmissions in the context of undetectable viral load have rarely occurred, although risk factors remain unclear. Outcome data on supported breastfeeding are accumulating, providing evidence for guidelines and informing infant feeding decisions. Long-acting ART for maternal preexposure prophylaxis or treatment, and infant postnatal prophylaxis are promising future options.

Summary
Breastfeeding on suppressive ART has a very low risk of vertical transmission and can have multiple benefits for WLHIV and their infants. However, caution is advised with relaxation of breastfeeding guidance so as not to jeopardise the global goal of elimination of vertical transmission by 2030.
Tags for Tears: The Obstetric Anal Sphincter Injury Hashtag Ontology Project
Authors: Maliakal Cima , Dieter Alexis , Iglesia Cheryl , Davenport Abigail 
Published: October 2023

Importance
Social media is a powerful outlet for the dissemination of health care information. Adoption of a hashtag ontology—a standardized list of terms—may help better organize information and improve access to educational materials for health care providers (HCPs) and patients.

Objectives
The primary objective was to create a hashtag ontology specific to obstetric anal sphincter injuries (OASIS) based on Twitter usage. Secondary objectives included (1) performing a thematic analysis of OASIS-related tweet content and (2) reporting the type of users posting about OASIS.

Study Design
This study was an analysis of tweets related to OASIS posted between June 1, 2019, and June 1, 2022. Symplur Signals (a Twitter analytics software) (Symplur LLC, Los Angeles, CA) was used to identify relevant tweets based on predetermined search terms. Hashtags were reviewed by social media influencers to create a finalized ontology list. The top 100 tweets underwent thematic analysis and were grouped based on emergent themes. Types of users posting about OASIS were also analyzed.

Results
Symplur identified 660 tweets related to OASIS. The final ontology included the following 8 hashtags: #OASIS, #perinealtrauma, #birthtrauma, #3rddegreetear, #4thdegreetear, #episiotomy, #operativedelivery, and #postpartumbody. Major tweet content themes included education, self-promotion, patient experience, medical-legal, research, and opinions. Educational tweets surrounded prevention, risk factors, complications, and educational events related to OASIS and perineal trauma. Of the educational tweets, only 30% were posted by HCPs.

Conclusion
This study created a standardized hashtag ontology related to OASIS. Less than one third of educational tweets were posted by HCPs.
Perspectives From Black and White Participants and Care Partners on Return of Amyloid and Tau PET Imaging and Other Research Results
Authors: Rahman-Filipiak Annalise , Lesniak Mary , Sadaghiyani Shima , Roberts Scott , Lichtenberg Peter , Hampstead Benjamin M. 
Published: October 2023

Purpose:
Alzheimer disease (AD) biomarker testing is now common in research and approaching clinical translation. Disclosure protocols must be informed by diverse participants’ perspectives on if/how the information would be useful.

Methods:
This study utilized semistructured interviews assessing interest in receiving positron emission tomography (PET) amyloid and tau results, as well as perceived risks and benefits of hypothetical PET disclosure as a function of race and participant diagnosis.

Participants:
Participants [39% Black; 61% White; M
age=74.28 (5.98)] included 57 adults diagnosed as either cognitively healthy (58%) or with mild cognitive impairment (42%) and their respective care partners [33% Black; 67% White; M
age=66.93 (10.92)].

Results:
Most dyads endorsed strong interest in PET results (82.5% of both participants and partners) regardless of race or diagnosis. Black care partners were less interested in receiving the participant’s results than White care partners (χ
2
(4)=8.31, P=0.047). Reasons for disclosure were diverse and highly personalized, including access to treatments or clinical trials (23.2% participants; 29.8% partners), advance planning (14.3% participants; 17.5% partners), and improved health knowledge (12.5% participants; 15.8% partners). In contrast, over 80% of respondents denied any risks of disclosure.

Discussion:
Results suggest that predisclosure education, decisional capacity assessment, and a flexible disclosure approach are needed.
The gems of the Middle-East: Unveiling the biodiversity of Monogonont rotifers in temporary waterbodies of Israel
Authors: Hirshberg Ofir , Paraskevopoulou Sofia , Kiemel Katrin , Ben-Ami Frida 
Published: October 2023

AbstractTemporary ponds represent ecologically important habitats that support high species diversity and provide essential ecosystem services, particularly in certain countries surrounding the Mediterranean Sea, where natural lakes are scarce. Israel is located along the southeastern Mediterranean coast and features Mediterranean and arid climatic zones that vary in a variety of meteorological parameters. Temporary ponds are prevalent throughout Israel, including the Mediterranean coast, Mediterranean mountain (i.e., Galilee region), and arid climatic zones. These temporal ponds harbor diverse invertebrate communities that exhibit significant spatial and temporal variations. Among these communities, Monogonont rotifers are notably one of the most diverse and abundant groups. Despite their significant role in aquatic food webs, rotifers are often overlooked in environmental studies, likely due to their small size and difficulties associated with their taxonomy. Resilient resting eggs produced by Monogonont rotifers during periods of unsuitable environmental conditions serve as significant source of propagules that drive the recolonization of temporary ponds upon rehydration, thereby influencing the dynamics of the pond community and metacommunity organization. Here, we examined the diversity of Monogonont rotifers by rehydrating sediment from 30 temporary ponds across Israel. Our analysis identified 39 species, with 25 (64%) of them being reported for the first time in Israel. We found the highest diversity of Monogonont rotifers in the Mediterranean coast region, which is characterized by low altitude, long hydroperiod, and relatively low mean summer daily maximum temperature, while the lowest diversity was found in the Arid region which is characterized by high altitude, short hydroperiod, and high mean summer daily maximum temperature. Our findings suggest that altitude, hydroperiod and mean summer daily maximum temperature are important parameters associated with the observed biodiversity patterns. Our metacommunity analysis further revealed a small contribution of geographic distance (2%) and environmental factors (1%) in shaping rotifer metacommunities. We also found a significant positive correlation among community composition, environmental distance (i.e., Gower’s distance) and geographic distance, possibly due to a linearity in the sampling set-up. Overall, our study highlights the importance of temporary ponds as significant habitats for diverse rotifer communities and emphasizes the need to further study “micro” invertebrate diversity in these unique ecosystems.