bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unrecognized opportunities: The landscape of pediatric kidney‐paired donation in the United States
Authors: Verbesey Jennifer , Thomas Alvin G. , Waterman Amy D. , Karhadkar Sunil , Cassell Victoria R. , Segev Dorry L. , Hogan Julien , Cooper Matt 
Published: January 2024

AbstractBackgroundPediatric (age < 18 years) kidney transplant (KT) candidates face increasingly complex choices. The 2014 kidney allocation system nearly doubled wait times for pediatric recipients. Given longer wait times and new ways to optimize compatibility, more pediatric candidates may consider kidney‐paired donation (KPD). Motivated by this shift and the potential impact of innovations in KPD practice, we studied pediatric KPD procedures in the US from 2008 to 2021.MethodsWe describe the characteristics and outcomes of pediatric KPD recipients with comparison to pediatric non‐KPD living donor kidney transplants (LDKT), pediatric LDKT recipients, and pediatric deceased donor (DDKT) recipients.ResultsOur study cohort includes 4987 pediatric DDKTs, 3447 pediatric non‐KPD LDKTs, and 258 pediatric KPD transplants. Fewer centers conducted at least one pediatric KPD procedure compared to those that conducted at least one pediatric LDKT or DDKT procedure (67, 136, and 155 centers, respectively). Five centers performed 31% of the pediatric KPD transplants. After adjustment, there were no differences in graft failure or mortality comparing KPD recipients to non‐KPD LDKT, LDKT, or DDKT recipients.DiscussionWe did not observe differences in transplant outcomes comparing pediatric KPD recipients to controls. Considering these results, KPD may be underutilized for pediatric recipients. Pediatric KT centers should consider including KPD in KT candidate education. Further research will be necessary to develop tools that could aid clinicians and families considering the time horizon for future KT procedures, candidate disease and histocompatibility characteristics, and other factors including logistics and donor protections.
The impact of phototherapy on itch intensity and itch‐related quality of life amongst different skin diseases, skin phototypes and genders – A prospective study with 102 patients
Authors: Merkel Tamara , Navarini Alexander , Mueller Simon 
Published: January 2024

AbstractBackgroundPhototherapy is a mainstay to treat itchy conditions. However, only little is known about differences in the antipruritic effect of phototherapy amongst different skin conditions, phototypes and genders.MethodsIn this prospective, single‐center study, we analyzed the effect of phototherapy on itch intensity and itch‐related quality of life amongst these subgroups after a treatment duration of 4 weeks, while on‐demand treatment with topical corticosteroids, topical calcineurin inhibitors and/or antihistamines was allowed.ResultsOf 102 patients (age 53.0 ± 18.7, 56 females [54.9%]), 72 (78.3%) reported a significant reduction of itch intensity by Δ −2.76 on a 0–10 Numerical Rating Scale (NRS), p = <.001, 95% CI [2.2; 3.3] paralleled by a significant improvement of itch‐related quality of life as measured by the German version of the ItchyQoL by Δ 7.3, p = <.001, 95% CI [4.4; 11.6]. The best improvement of itch intensity and itch‐related QoL was reported by patients with pruritus on non‐diseased skin (ΔNRS −3.5; Δ 9.7 Ger‐ItchyQoL points), followed by patients with atopic dermatitis and psoriasis. We found no statistical differences in the response to phototherapy amongst Fitzpatrick phototypes I–VI. Women had higher itch intensities at baseline but itch‐related quality of life impairment at baseline and phototherapy treatment response did not significantly differ between genders.ConclusionPhototherapy appears to induce a meaningful itch reduction in various itchy skin conditions, all phototypes and both genders within 4 weeks that directly translates into improvement of itch‐related quality of life.
Effects of a remotely supervised resistance training program on muscle strength and body composition in adults with cystic fibrosis: Randomized controlled trial
Authors: Sosa‐Pedreschi Alicia , Donadio Márcio Vinícius Fagundes , Iturriaga‐Ramírez Tamara , Yvert Thomas , Pérez‐Salazar Fernanda , Santiago‐Dorrego Catalina , Barceló‐Guido Olga , Sanz‐Santiago Verónica , Girón Rosa , Punter Rosa Mar Gómez , Rubio‐Alonso Margarita , Pérez‐Ruiz Margarita 
Published: January 2024

AbstractIntroductionAmong the limited studies on physical exercise interventions in adults with cystic fibrosis (CF), few have specifically addressed the improvement of peripheral muscle strength and body fat‐free mass. The aim of this study was to examine the impacts of a remotely supervised, individualized 8‐week resistance training program of moderate to high intensity on strength and body composition in these subjects.MethodsThis was a randomized controlled trial performed in adults with CF. The exercise group (EX) performed three 1‐h resistance training sessions per week over 8 weeks. The control group (CON) followed the physical activity recommendations of their physician. The main outcomes were muscle strength and body composition, with secondary measures including pulmonary function and quality of life. Two‐way repeated measures analysis was used.ResultsIn 23 participants (age 32.13 ± 7.72 years), the intervention showed a significant beneficial effect on leg press strength, with a large effect size, both in absolute (p = 0.011;  = 0.281) and relative (p = 0.007;  = 0.310) terms. Large intervention effects were observed on total fat mass (p < 0.001;  = 0.415), body adiposity index (p < 0.001;  = 0.436), and fat mass index (p < 0.001;  = 0.445), all showing reduction in the EX group. In addition, significant large size effects were detected on total fat‐free mass (p = 0.046;  = 0.177), trunk fat‐free mass (p = 0.039;  = 0.188), and fat‐free mass index (p = 0.048;  = 0.174), all favoring exercise. No significant effects were observed on pulmonary function and quality of life.ConclusionsAn 8‐week remotely supervised resistance training program, with moderate to high intensity, effectively improved lower limb muscle strength and body composition.
Are analytical performance specifications derived from reference intervals of any use in the veterinary clinical laboratory? A preliminary study on the empirical biological variation model
Authors: Manzocchi Simone , van Rooyen Liesl J. 
Published: January 2024

AbstractBackgroundAnalytical performance specifications (APS) are vital for method evaluation and quality control validation. However, the limited availability of biological variation (BV) data, regulatory guidelines, and expert opinion (EO) may present challenges in veterinary medicine. The empirical biological variation (EBV) approach, based on population reference intervals (pRI), has emerged as an alternative method to derive APS in human medicine.ObjectivesThis study aimed to assess the practicality and usefulness of the EBV approach in deriving performance limits for various measurands in dogs and cats.MethodsEight hematology and 13 biochemistry measurands were analyzed in dogs and cats. Estimates of combined biologic variation based on traditional biological (CVB) and EBV‐derived (CVE*) formulas were calculated and assessed for evidence of correlation. Performance limits for expanded uncertainty/total error and imprecision were compared among EO, BV, and EBV.ResultsStrong and significant correlations were found between CVB and CVE* for both dogs (r = .86, p < .00001) and cats (r = 0.95, p < .00001). The EBV‐derived APS were generally comparable to EO and BV, with a subjective criterion of 1.5% difference for imprecision and 3% for total error/expanded uncertainty.ConclusionThe EBV approach, using pRI, shows promise as a surrogate marker for biological variation and as a practical tool for determining performance limits in dogs and cats. Assuming accurate pRI generated on analyzers with stable analytical performance, this approach could offer benefits when expert recommendations or robust BV studies are lacking or yield conflicting results. Further research is needed to explore the applicability and advantages of the EBV in veterinary medicine.
Postural Balance in Boys With Intellectual Disabilities Who Participate in Soccer Training
Authors: Jouira Ghada , Rebai Haithem , Alexe Dan Iulian , Sahli Sonia 
Published: January 2024

Purpose: The aim of this study is to investigate the postural balance in children with intellectual disabilities who participate in soccer training compared with their sedentary peers. Method: Two groups of boys with intellectual disabilities aged 8–10 years participated in this study: a soccer group (n = 12) and a sedentary group (n = 12). Postural balance was assessed using a force platform under 4 different conditions: open eyes, and closed eyes, on firm and foam surfaces. The Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test were also conducted. Results: The soccer group had significantly lower (P < .05) center of pressure values compared with the sedentary group, on both firm and foam surfaces, but only under the open eyes condition. They were significantly faster (P < .05) in the Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test compared with their sedentary peers. However, there were no significant differences between the 2 groups on the sit-to-stand and turn-to-sit phases of the Timed Up and Go Test. Conclusion: Soccer participation may have a positive effect on postural balance in boys with intellectual disabilities. These findings may have implications for the development of exercise programs to improve postural balance and reduce the risk of falls in this population.
Lacrimal sac massage for congenital nasolacrimal duct obstruction: a multicentre randomised controlled trial
Authors: Asano Mizuki , Takeuchi Masaki , Ohno Tomoko , Nakamura Jutaro , Mizuki Nobuhisa , Matsumura Nozomi 
Published: January 2024

AimCongenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora and mucous discharge in the newborn. We conducted a multicentre randomised controlled trial to determine whether Crigler massage promotes the resolution of CNLDO in infants under 1 year of age.MethodsA total of 102 infants aged 3–11 months with unilateral CNLDO were enrolled in the study. Patients were randomly assigned to the massage and non-massage groups (n=51/group). As an allocation adjustment factor, the patients were divided into age groups of 3–5, 6–8 and 9–11 months. In the massage group, the guardian performed 10 strokes two times per day for each day until resolution or 1 month. The primary endpoint was a comparison of the 1-month resolution rate in the massage and non-massage groups.ResultsThis study included 49 male and 53 female patients with a mean age of 6.4±2.4 months. Overall, in this study, the resolution rate was not significantly different between the massage and non-massage groups (31.4% and 33.3%, respectively). However, the resolution rate was higher in the massage group in the 3–5 months age group among the protocol-compliant patients after excluding those with insufficient massage frequency (the massage group, 68.8% and the non-massage group, 28.6%, p=0.022).ConclusionsThere was no increase in the resolution rate after 1 month of lacrimal sac massage in patients 3–11 months old with unilateral CNLDO. However, in protocol-compliant younger age groups, Crigler massage may be effective.Trial registration numberUMIN Clinical Trial Registry (UMIN000032840;www.umin.ac.jp/).
Descriptive registry study on outcome and complications of external ventricular drainage treatment of intraventricular haemorrhage in a Danish cohort: a study protocol
Authors: Gu Chenghao , Haldrup Mette , Rasmussen Mads , Dyrskog Stig , Simonsen Claus Ziegler , Grønhøj Mads Hjortdal , Poulsen Frantz Rom , Busse Thor , Wismann Joakim , Debrabant Birgit , Korshoej Anders Rosendal 
Published: January 2024

IntroductionIntraventricular haemorrhage (IVH) is associated with high morbidity and mortality. External ventricular drainage (EVD) has been shown to decrease mortality. Although EVD is widely used, outcome and complication rates in EVD-treated patients with IVH are not fully elucidated. This study aims to describe EVD complication rates and outcomes in patients with primary and secondary IVH at two university hospitals in Denmark. The study will provide a historical reference of relevant endpoints for use in future clinical trials involving patients with IVH.Methods and analysisThis descriptive, multicentre registry study included adult patients (age 18+) with primary or secondary IVH and treated with at least one EVD between 2017 and 2021 at Aarhus University Hospital or Odense University Hospital. Patients are identified using the Danish National Patient Register. Data are collected and recorded from patient medical records. Relevant descriptive statistics and correlation analyses will be applied.Ethics and disseminationEthical approval and authorisation to access, store and analyse data have been obtained (Central Denmark Region Committee on Health Research Ethics). The research lead will present the results of the study. Data will be reported according to the Strengthening the Reporting of Observational Studies in Epidemiology and results submitted for publication in peer-reviewed journals.
Efficacy and safety of avatrombopag in combination with immunosuppressive therapy in treatment-naïve and relapsed/refractory severe aplastic anaemia: protocol for the DIAAMOND-Ava-FIRST and DIAAMOND-Ava-NEXT Bayesian Optimal Phase II trials
Authors: McQuilten Zoe , Heritier Stephane , Fox Lucy , Fox Vanessa , Young Lauren , Blombery Piers , Cunningham Ilona , Curnow Jennifer , Higgins Alisa , Hiwase Devendra K , Filshie Robin , Firkin Frank , Lacaze Paul , Mason Kylie , Mills Anthony K , Pepperell Dominic , Patil Sushrut , Stevenson William , Szer Jeff , Waters Neil , Wilson Kate , Ting Stephen , Wood Erica 
Published: January 2024

IntroductionImmunosuppressive therapy (IST) with antithymocyte globulin (ATG) and ciclosporin is standard of care for patients with severe aplastic anaemia (sAA) not eligible or suitable for allogeneic stem cell transplant. While patients respond to IST, few achieve complete responses and a significant proportion are refractory or relapse. The addition of eltrombopag, a thrombopoietin-receptor agonist (TPO-A), to IST has been shown to improve haematological responses in sAA. Avatrombopag is a second-generation TPO-A with potential advantages over eltrombopag. However, to date avatrombopag has not been studied in sAA.Methods and analysisInvestigator-initiated, single-arm registry-based Bayesian Optimal Phase II trial of avatrombopag conducted in two cohorts, patients with untreated sAA (FIRST cohort) and in patients with sAA that has relapsed or is refractory to IST (NEXT cohort). In the FIRST cohort, participants receive IST (equine ATG and ciclosporin) plus avatrombopag from day 1 until day 180 at 60 mg oral daily, with dose adjusted according to platelet count. Participants in the NEXT cohort receive avatrombopag at 60 mg oral daily from day 1 until day 180, with or without additional IST at the discretion of the treating clinician.For each cohort, two primary endpoints (haematological response and acquired clonal evolution) are jointly monitored and the trial reviewed at each interim analysis where a ‘go/no-go’ decision is made by evaluating the posterior probability of the events of interests.Ethics and disseminationThe trial has received ethics approval (Monash Health RES-18-0000707A). The trial conduct will comply with ICH-GCP and all applicable regulatory requirements. The results of the trial will be submitted to a peer-review journal for publication.Trial registration numberACTRN12619001042134, ACTRN12619001043123.
Do current maternal health staffing and bed occupancy benchmarks work in practice? Results from a simulation model
Authors: Baggaley Rebecca F , Gon Giorgia , Mohammed Ali Said , Abdi Mahmoud Salma , Jowhar Farhat , Vegvari Carolin 
Published: January 2024

IntroductionThe WHO has issued the global target of reducing maternal mortality rates by two-thirds of 2010 baseline levels by 2030. In low-income settings, high birth rates and a relative lack of medical resources mean that an efficient use of resources and skilled staff is important in ensuring quality of intrapartum and postpartum care.MethodsWe use a stochastic, individual-based model to explore whether WHO resourcing benchmarks are sufficient to ensure consistent quality of care. We simulate all deliveries occurring in a region over a year, with date and time of presentation of each woman delivering at a facility assigned at random. Each woman stays in the delivery room for an assigned duration before her delivery, then moves to the maternity ward, followed by discharge. We explore the potential impact of seasonality of births on our findings and then apply the model to a real-world setting using 2014 data from Emergency Obstetric Care (EmOC) facilities in Zanzibar, United Republic of Tanzania.ResultsWe find that small EmOCs are frequently empty, while larger EmOCs are at risk of temporarily falling below minimum recommended staff-to-patient ratios. Similarly for Zanzibar, capacity of EmOCs in terms of beds is rarely exceeded. Where over-capacity occurs, it is generally smaller, basic EmOCs (BEmOCs) that are affected. In contrast, capacity in terms of staffing (skilled birth attendants:women in labour ratio) is exceeded almost 50% of the time in larger Comprehensive EmOCs (CEmOCs).ConclusionsOur findings suggest that increasing staffing levels of CEmOCs while maintaining fewer small BEmOCs may improve quality of care (by increasing the staff-to-patient ratio for the most frequently used facilities), provided that timely access to EmOCs for all women can still be guaranteed. Alternatively, BEmOCs may need to be upgraded to ensure that women trust and choose these facilities for giving birth, thus relieving pressure on CEmOCs.
Development and validation of multicentre study on novel Artificial Intelligence-based Cardiovascular Risk Score (AICVD)
Authors: Jalepalli Shiv Kumar , Gupta Prashant , Dekker Andre L A J , Bermejo Inigo , Kar Sujoy 
Published: January 2024

ObjectiveCardiovascular diseases (CVD) are one of the most prevalent diseases in India amounting for nearly 30% of total deaths. A dearth of research on CVD risk scores in Indian population, limited performance of conventional risk scores and inability to reproduce the initial accuracies in randomised clinical trials has led to this study on large-scale patient data. The objective is to develop an Artificial Intelligence-based Risk Score (AICVD) to predict CVD event (eg, acute myocardial infarction/acute coronary syndrome) in the next 10 years and compare the model with the Framingham Heart Risk Score (FHRS) and QRisk3.MethodsOur study included 31 599 participants aged 18–91 years from 2009 to 2018 in six Apollo Hospitals in India. A multistep risk factors selection process using Spearman correlation coefficient and propensity score matching yielded 21 risk factors. A deep learning hazards model was built on risk factors to predict event occurrence (classification) and time to event (hazards model) using multilayered neural network. Further, the model was validated with independent retrospective cohorts of participants from India and the Netherlands and compared with FHRS and QRisk3.ResultsThe deep learning hazards model had a good performance (area under the curve (AUC) 0.853). Validation and comparative results showed AUCs between 0.84 and 0.92 with better positive likelihood ratio (AICVD −6.16 to FHRS −2.24 and QRisk3 −1.16) and accuracy (AICVD −80.15% to FHRS 59.71% and QRisk3 51.57%). In the Netherlands cohort, AICVD also outperformed the Framingham Heart Risk Model (AUC −0.737 vs 0.707).ConclusionsThis study concludes that the novel AI-based CVD Risk Score has a higher predictive performance for cardiac events than conventional risk scores in Indian population.Trial registration numberCTRI/2019/07/020471.
Clinicopathological features of kidney injury in patients receiving immune checkpoint inhibitors (ICPi) combined with anti-vascular endothelial growth factor (anti-VEGF) therapy
Authors: Jin Shi , Shen Ziyan , Li Jie , Liu Xueguang , Zhu Qifan , Li Fang , Shi Yiqin , Lin Pan , Xu Xialian , Chen Xiaohong , Geng Xuemei , Ding Xiaoqiang , Liu Hong 
Published: January 2024

BackgroundImmune checkpoint inhibitor (ICPi) combined with anti-vascular endothelial growth factor (VEGF) therapy has increasingly become a promising strategy in various malignancies. However, the combination might be associated with increased risk of nephrotoxicity.MethodsWe retrospectively recruited patients who suffered kidney injury and received renal biopsy after anti-VEGF/ICPi mono- or combination therapy and divided them into three groups: anti-VEGF monotherapy, ICPi monotherapy and combination therapy. Clinical and histopathological features of three groups were analysed. All patients were followed-up for 3 months after biopsy, with or without glucocorticoid treatment, and renal outcome were compared.ResultsA total of 46 patients were enrolled. Eighteen patients received anti-VEGF monotherapy, 12 received ICPi monotherapy and 16 received combined treatment of anti-VEGF and ICPi. Proteinuria level of anti-VEGF group, ICPi group and combination group were 4.07±3.17 g/day, 0.60±0.61 g/day and 2.05±2.50 g/day, respectively (p=0.002). The peak serum creatinine level of combination group (1.75±0.77 mg/dL) was also in between ICPi group (2.79±0.90 mg/dL) and anti-VEGF group (1.34±0.60 mg/dL) (p<0.001). Multiple histopathological patterns involving glomerulus, tubulointerstitium and vessel existed in the majority of cases in combination group (68.8%). Renal complete and partial recovery rate of combination therapy were also in between monotherapy (57.1% vs 40.0% in anti-VEGF group, 100.0% in ICPi group, respectively).ConclusionsKidney injury in patients treated with combination therapy of ICPi and anti-VEGF shows hybrid pathological patterns and intermediate clinical features compared with monotherapy. Cohorts with larger sample and better design, as well as basic research, are needed to elucidate the mechanism of ‘protection’ effect of combination anti-cancer therapy to renal function.