bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observational cohort study protocol: neutrophil function and energetics in adults with pneumonia and sepsis – Pneumonia Metabolism in Ageing (PUMA)
Authors: Grudzinska Frances S , Faniyi Aduragbemi A , Scott Aaron , Sapey Elizabeth , Thickett David R 
Published: October 2023

IntroductionCommunity-acquired pneumonia has high mortality and is associated with significant healthcare costs. In older adults with community-acquired pneumonia neutrophil dysfunction has been identified and is associated with poor outcomes for patients. Immunometabolism is a rapidly developing field which links immune cell function to metabolism. This study aims to explore neutrophil metabolism in community-acquired pneumonia.Methods and analysisPneumonia Metabolism in Ageing study is a prospective observational study recruiting older adults hospitalised with community-acquired pneumonia to examine neutrophil function and metabolic status. Controls will be older adults with no acute illness. The primary endpoint is neutrophil chemotaxis.Ethics and disseminationThe study has ethical approval from the Research Ethics Committee Wales, reference 19/WA/0299. This study involves participants who may lack the capacity to consent to research involvement, in this situation, personal or professional assent will be sought. The results from this study will be submitted for publication in peer-reviewed journals and disseminated at local and international conferences.
Temporal course of cognitive and behavioural changes in motor neuron diseases
Authors: McHutchison Caroline A , Wuu Joanne , McMillan Corey T , Rademakers Rosa , Statland Jeffrey , Wu Gang , Rampersaud Evadnie , Myers Jason , Hernandez Jessica P , Abrahams Sharon , Benatar Michael 
Published: October 2023

BackgroundCognitive and behavioural dysfunction may occur in people with motor neuron disease (MND), with some studies suggesting an association with theC9ORF72repeat expansion. Their onset and progression, however, is poorly understood. We explored how cognition and behaviour change over time, and whether demographic, clinical and genetic factors impact these changes.MethodsParticipants with MND were recruited through the Phenotype-Genotype-Biomarker study. Every 3–6 months, the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was used to assess amyotrophic lateral sclerosis (ALS) specific (executive functioning, verbal fluency, language) and ALS non-specific (memory, visuospatial) functions. Informants reported on behaviour symptoms via semi-structured interview.ResultsParticipants with neuropsychological data at ≥3 visits were included (n=237, mean age=59, 60% male), of which 18 (8%) wereC9ORF72positive. Baseline cognitive impairment was apparent in 18 (8%), typically in ALS specific domains, and associated with lower education, but notC9ORF72status. Cognition, on average, remained stable over time, with two exceptions: (1)C9ORF72carriers declined in all ECAS domains, (2) 8%–9% of participants with baseline cognitive impairment further declined, primarily in the ALS non-specific domain, which was associated with less education. Behavioural symptoms were uncommon.ConclusionsIn this study, cognitive dysfunction was less common than previously reported and remained stable over time for most. However, cognition declines longitudinally in a small subset, which is not entirely related toC9ORF72status. Our findings raise questions about the timing of cognitive impairment in MND, and whether it arises during early clinically manifest disease or even prior to motor manifestations.
Development of a Broadband and High-Gain Circularly Polarized Array of Multilayer Slot Antennas for X-Band Wireless Communication Networks
Authors: Saghafi Hosein , Kazemi Robab , Hamlbar Gerami Hamed 
Published: October 2023

This paper presents a wideband cavity-backed slot antenna array designed for X-band wireless communication systems. The antenna element consists of a circular slot combined with a cross-slotted patch; both are fed by an L-shaped microstrip line through proximity coupling to extend the impedance bandwidth and gain. The reduction of beam squint in the radiation patterns, caused by the asymmetric feed line, is achieved through intelligent optimization of the dimensions and position of the cross slot on the patch. Additionally, a back cavity is included to provide unidirectional radiation and enhance gain. The antenna exhibits right-hand circularly polarized (RHCP) radiation patterns with high gain over a wideband frequency range. To further improve the axial ratio (AR) bandwidth and gain, the antenna is utilized in a

2
×
2

array configuration with a sequential rotation feed network. The overall dimensions of the proposed array are

1.42

λ

0

×
1.42

λ

0

×
0.45

λ

0

, where

λ

0

represents the wavelength at the center frequency of 10 GHz. The fabricated array is then tested, and the measurements show an impedance bandwidth of 60% (7 GHz-13 GHz) with

S

11

<
−
10

dB, a 3 dB AR bandwidth of 42% (7.45-11.65 GHz), and a peak gain of 11.14 dB. The simulated and measured results exhibit good agreement, validating the effectiveness of the design.
An Embarrassment of Riches: Three FDA-Approved Bispecific Antibodies for Relapsed Refractory Multiple Myeloma
Authors: Firestone Ross , Lesokhin Alexander M. , Usmani Saad Z. 
Published: October 2023

Summary:In the past year, three new bispecific antibodies have received accelerated FDA approval for the treatment of relapsed/refractory multiple myeloma. In this article, we review the available data for these three agents, teclistamab, elranatamab, and talquetamab, and discuss practical considerations for their use in clinical settings while the medical community awaits randomized phase III clinical trial datasets comparing them to standard-of-care regimens.
Trimelopter cordifolium (Hyacinthaceae subfam. Ornithogaloideae), a new species from South Africa
Authors: MARTÍNEZ-AZORÍN MARIO , PAONESSA GIACOMO , ZAALBERG BERT , CRESPO MANUEL B. , VARGAS MARÍA ÁNGELES ALONSO 
Published: October 2023

The study of wild and cultivated material of Trimelopter from the Northern Cape province of South Africa revealed an undescribed species that shows a unique syndrome of morphological characters. We here describe Trimelopter cordifolium based on plants approaching T. psammophorum but differing in its small, cordate, psammophorous leaf, shorter inflorescence and pedicels, smaller flowers and bracts, and more prominently sculptured ovary. We provide a complete morphological description as well as data on ecology and distribution. We also report new data and illustrations of T. psammophorum, which complement its scarce description in the protologue.
Ultrasound versus computed tomography-guided transthoracic biopsy for pleural and peripheral lung lesions: a systematic review and meta-analysis
Authors: Li Xuemei , Kong Lan 
Published: October 2023

Background An accurate diagnosis of peripheral lung and pleural lesions using image-guided transthoracic biopsy procedure becomes a good diagnostic performance protocol. Purpose To examine the difference between ultrasonography (USG)-guided versus computed tomography (CT)-guided transthoracic biopsy for pleural and peripheral lung lesions by pooling data from published studies. Material and Methods PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched for comparative studies up to 20 February 2023 irrespective of the language of publication. The outcomes were adequacy of the sample and complications (pneumothorax and hemothorax). Results Two randomized controlled trials (RCTs) and eight non-RCTs were eligible. The total sample size was 1618. Meta-analysis showed that there was no difference in the adequacy of the sample obtained by USG- or CT-guided biopsies; however, an analysis of only non-RCTs indicated better adequacy with USG. On pooled analysis of any pneumothorax, there was a lower risk associated with USG-guided biopsies, but the risk of pneumothorax requiring interventional treatment was not different in the two groups. Similarly, the pooled analysis also demonstrated a reduced risk of hemothorax with USG-guided biopsies. Conclusion While there seems to be no difference in the adequacy of the sample obtained with either imaging modality, retrospective data show that USG guidance offers better diagnostic yield compared to CT guidance for peripheral lung and pleural biopsies. The risk of pneumothorax and hemothorax is also significantly lower with USG-guided biopsies. Results should be interpreted with caution owing to selection bias among studies. There is a need for large-scale RCTs to enhance current evidence.
Consumer values, perspectives and experiences of psychological health when living with dialysis at home: An in-depth interview study
Authors: Walker Rachael C , Walker Curtis , Reynolds Annie , Haselden Rachel , Hay Sandra , Palmer Suetonia C 
Published: October 2023

Background: People treated with home dialysis report social and emotional isolation, fear of catastrophic events and concern about being a burden. There is a paucity of research exploring psychological well-being among consumers dialysing at home. We aimed to explore the psychological health issues related to home dialysis, and how these issues may impact on sustaining home-based treatment. Methods: We conducted a qualitative interview study with 36 consumers. We included patients with experience of home dialysis and caregivers. Thirteen participants had experienced peritoneal dialysis, seven home haemodialysis, seven had experienced both and nine caregivers. Data were analysed inductively to generate themes and a conceptual framework. Results: We identified four themes and subthemes: overwhelming isolation and disconnection (devastating isolation of home dialysis; abandoned from support; escalating anxiety; compounding impact of feeling like a burden); importance of support systems (impact on relationships; need for emotional support; reassurance through shared experiences; valuing trustworthy and committed clinicians); burden of distress (individualised feelings of low mood; grappling with stigma surrounding diagnosis; contemplating treatment withdrawal and suicide); seeking mental health support (normalising mental health support as a distinct entity in dialysis care; overcoming barriers to seeking mental health support; additional tools for mental health support and connection). Conclusion: Consumers may experience intense psychological distress during home-based dialysis care. Increasing clinician and health services literacy about the management of psychological impacts of home-based dialysis may improve consumer safety, quality of life and sustainability of home treatment.
Proximal fibular axis is a reliable landmark for tibial coronal alignment in patients with or without knee osteoarthritis: A radiological comparative study
Authors: Tang Shangkun , Pan Xuelin , Xu Renyuan , Shi Xiaojun 
Published: October 2023

Background Proper coronal alignment of the limb is of vital importance in the progression of knee osteoarthritis even in the long-term survivorship of component after total knee arthroplasty (TKA). Nevertheless, to the best of our knowledge, the relationship between coronal fibular axis and tibial mechanical axis had not reached a consensus in the literatures available. The current study aimed to explore the anatomic relationship between tibia and fibula alignment. Methods A total of 100 patients with knee osteoarthritis scheduled for total knee arthroplasty were enrolled in this study (Group A), and radiographic measurement was compared to a control group of 100 healthy volunteers without knee osteoarthritis (Group B). Full-length standing hip-to-ankle radiographs were used to assess limb alignment. The angle between coronal proximal fibular anatomic axis and tibia mechanical axis (PFTA) was used to represent the anatomic relationship between tibia and fibula alignment. A negative value indicates fibula varus relative to tibia mechanical axis, while a positive value indicates fibula valgus. Results The mean PFTAs were −0.9° ± 0.9° and −1.0° ± 0.8° in Groups A and B. There was no significant difference between the two groups. No significant difference was detected in PFTA distribution in the group A and B. When the mean value of PFTA is used as baseline data, the percentage of subjects in which the PFTA deviation was within 0.5°, 1°, and 1.5° was 51%, 84%, and 94% in Group A and 53%, 87%, and 96% in Group B. There was also no significant difference in distribution deviation between the two groups. No patient-specific factors were correlated with the PFTA. Conclusions The proximal fibular anatomic axis is a reliable landmark for tibial mechanical axis in the coronal plane in patients with or without knee osteoarthritis.
Value of Acid-Fast Bacilli and Fungal Cultures in Foot and Ankle Surgery in a US Hospital System
Authors: Dean Robert S. , El-Zein Zein , Bohr Margaret , Audet Megan , Fortin Paul T. , Vaupel Zachary M. 
Published: October 2023

Background: Acid-fast bacilli(AFB) and fungi are generally slow-growing, difficult to culture, and rarely the cause of infection. The goal of this study was to evaluate the value of routinely obtaining AFB and fungal cultures in foot and ankle surgery at a US hospital. Methods: A retrospective review was conducted to determine the number of positive AFB and fungal cultures out of the total number of foot and ankle samples tested. Between 2014 and 2019, patients who underwent surgery for a foot and ankle infection for soft tissue infection, septic arthritis, infectious postoperative complications were identified. Charts were reviewed to identify the results of the microbiological tests performed. To determine the value of running AFB and fungal cultures, the costs of each were provided by the microbiology lab at our institution. Results: Of the 322 patient charts reviewed, there were 434 AFB and 525 fungal cultures performed. None of these cultures were indicated to be positive for AFB (0%), and 22 (4.19%) were positive for fungi. The total labor and material costs were calculated to be $38 767. The AFB cultures cost $23 967, the positive fungal cultures cost $2371, and the negative fungal cultures cost $36 395.36. Conclusion: This 322-case series of surgically managed foot and ankle infections showed 0% and 4.1% positivity rates of AFB and fungal cultures, respectively. Additionally, only 20% of cases with positive cultures were identified as pathologic requiring antifungal treatment. Further analysis is needed to determine best practices for obtaining vs declining to culture for AFB or fungal species, including assessing patient outcomes in the series of culture-positive(fungal-only) cases. Our results suggest that in our clinical setting of a US hospital system, routine fungal and AFB cultures may not be necessary but should be considered for chronic/recalcitrant infections, immunocompromised patients, and those with high surgeon suspicion. Level of Evidence: Level IV, case series.
Pediatric Dermatology in Canada: A Broad Review of Population Needs, Workforce and Training With Proposed Solutions
Authors: Pope Elena , Lara-Corrales Irene , Rehmus Wingfield , Ramien Michele , Spring Shanna , McCuaig Catherine , Fiorillo Loretta , Sibbald Cathryn , Bergman James 
Published: October 2023

Introduction The need for pediatric dermatology services is increasing across Canada. In parallel, the complexity of treatment with novel targeted therapeutics has increased. Currently, there is no accredited and limited non-accredited fellowship training access to pediatric dermatology in Canada. Hypothesis Understanding the current state of pediatric dermatology training in Canada will provide insight into opportunities for strategic improvement. Methods A survey was distributed to 44 pediatric dermatology providers. In addition, a review of the burden of pediatric skin disease and education/training in Canada was performed. Results Thirty-four specialists responded to the survey (77% response rate). One third of current pediatric dermatology providers are over 50 years old and half of these (15%) plan to retire within the next 5 years. Half of respondents were dermatologists, 35% were pediatricians, and 11% were double boarded. Almost all respondents practiced in an academic setting (94%). Most had further fellowship training in pediatric dermatology (82.4%) but only 57% achieved this training in Canada, due to lack of accredited or non-accredited funded fellowship positions. Conclusion There is a high and growing need for pediatric dermatology specialty care in a diverse range of settings. The current provider population and training programs are insufficient to meet current and future demands. We highlighted solutions to close this gap between supply and demand including increased double board certification in Pediatrics and Dermatology, a protected pediatric stream within existing Dermatology residency training programs and accredited fellowships in Pediatric Dermatology for both dermatologists and pediatricians.
Opportunities for clinical decision support targeting medication safety in remote primary care management of chronic kidney disease: A qualitative study in Northern Australia
Authors: Tan Madeleine SA , Patel Bhavini K , Roughead Elizabeth E , Ward Michael , Reuter Stephanie E , Roberts Gregory , Andrade Andre Q 
Published: October 2023

Introduction This study aimed to identify opportunities for clinical decision support targeting medication safety in remote primary care, by investigating the relationship between clinical workflows, health system priorities, cognitive tasks, and reasoning processes in the context of medicines used in people with chronic kidney disease (CKD). Methods This qualitative study involved one-on-one, semistructured interviews. The participants were healthcare professionals employed in a clinical or managerial capacity with clinical work experience in a remote health setting for at least 1 year. Results Twenty-five clinicians were interviewed. Of these, four were rural medical practitioners, nine were remote area nurses, eight were Aboriginal health practitioners, and four were pharmacists. Four major themes were identified from the interviews: (1) the need for a clinical decision support system to support a sustainable remote health workforce, as clinicians were “constantly stretched” and problems may “fall through the cracks”; (2) reliance on digital health technologies, as medical staff are often not physically available and clinicians-on-duty usually “flick an email and give a call so that I can actually talk it through to our GP”; (3) knowledge gaps, as “it takes a lot of mental space” to know each patient's renal function and their medication history, and clinicians believe “mistakes can be made”; and (4) multiple risk factors impacting CKD management, including clinical, social and behavioural determinants. Conclusions The high prevalence of CKD and reliance on digital health systems in remote primary health settings can make a clinical decision support system valuable for supporting clinicians who may not have extensive experience in managing medicines for people with CKD.
Neurological Outcomes of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer: A Systematic Review and Meta-Analysis
Authors: Suzuki Katsuyoshi , Morishita Shinichiro , Nakano Jiro , Okayama Taro , Inoue Junichiro , Tanaka Takashi , Fukushima Takuya 
Published: October 2023

Background: This systematic review and meta-analysis aimed to determine whether chemotherapy-induced peripheral neuropathy (CIPN) affects the risk of falls and physical function in patients with cancer. Methods: A literature search was conducted in the CINAHL, Scopus, and PubMed databases for articles published from January 1950 to April 2022. Seven review authors retrieved studies using predetermined eligibility criteria, extracted the data, and evaluated the quality. Results: Nine studies were included in the analysis. Patients with CIPN had a significantly higher risk of falls than those without CIPN (risk ratio = 1.38, 95% confidence interval [CI] =1.18-1.62). Patients with CIPN had lower grip strength (standardized mean difference [SMD] =−0.42, 95% CIs = −0.70 to −0.14, P = .003), longer chair stand time (SMD = 0.56, 95% CIs = −0.01 to 1.17, P = .05), worse timed up and go test time (SMD = 0.79, 95% CIs = 0.41 to 1.17, P < .0001), and lower mean Fullerton Advanced Balance scale score (SMD = −0.81, 95% CIs = −1.27 to −0.36, P = .005) than patients without CIPN. There were no significant differences in gait speed ( P = .38) or Activities-specific Balance Confidence Scale score ( P = .09) between patients with and without CIPN. Conclusions: This systematic review and meta-analysis demonstrated that patients with CIPN are prone to falls and impaired balance function and muscle strength.
The Auxiliary Effects of Low-Molecular-Weight Fucoidan in Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy Before Surgery: A Double-Blind, Randomized, Placebo-Controlled Study
Authors: Tsai Hsiang-Lin , Yeh Yung-Sung , Chen Po-Jung , Chang Yu-Tang , Chen Yen-Cheng , Su Wei-Chih , Chang Tsung-Kun , Huang Ching-Wen , Wang Jaw-Yuan 
Published: October 2023

Patients with cancer use low-molecular-weight fucoidan (LMF) as a supplement to therapy. However, most studies of LMF are in vitro or conducted using animals. Concurrent chemoradiotherapy (CCRT) is the gold standard for locally advanced rectal cancer (LARC). This study investigated the quality of life (QoL) and clinical outcomes of patients with LARC taking LMF as a supplement to neoadjuvant CCRT. This was a double-blind, randomized, placebo-controlled study. The sample comprised 87 patients, of whom 44 were included in a fucoidan group and 43 were included in a placebo group. We compared their QoL scores and clinical outcomes before treatment, and at 1 month, 2 months, and 3 months posttreatment. Pretreatment and posttreatment gut microbiota differences were also compared. Although enhanced physical well-being (PWB) at 2 months and 3 months posttreatment in the fucoidan group were observed (both P < .0125), the improvements of the Functional Assessment of Cancer Therapy for Patients with Colorectal Cancer (FACT-C) were nonsignificant (all P > .0125). Skin rash and itching and fatigue were less common in the fucoidan group (both P < .05). Posttreatment, the genus Parabacteroides was significantly more common in the gut microbiota of the fucoidan group. LMF administration improved the QoL, skin rash and itching, fatigue, and gut microbiota composition of the patients with LARC receiving CCRT. Clinical Trial Registration: NCT04342949
Axillary Artery Injuries Associated With Proximal Humerus Fractures: A Literature Review and a Proposal of a Novel Multidisciplinary Surgical Approach
Authors: Ripoll Thomas , Fairag Rayan , Bonomo Iris , Gastaud Olivier , Psacharopulo Daniele 
Published: October 2023

Introduction Proximal humerus fractures (PHF) are common injuries that can lead to axillary artery injury, which carries the risk of not being identified during initial assessment. The aim of this study was to describe the management of suspected axillary artery injury associated with PHF according to our experience and to describe a new multidisciplinary surgical approach. Methods This was a single-center retrospective study. A database was created for patients admitted for PHF to the emergency department of the Hospital of Cannes between October 2017 and October 2019. Patients admitted with PHF associated with suspected ipsilateral upper limb ischemia, and/or massive diaphysis displacement, and/or upper limb ipsilateral neurological deficits were included in this study. Results In total, 301 patients diagnosed with PHF were admitted within these periods. Among these patients, 12 presented with suspected axillary artery lesions, of whom, 6 were included in the present study and treated according to our new approach. A description of these 6 cases, along with an extensive literature review is presented. Conclusion Based on our experience, the endovascular approach proposed for the management of axillary artery injury associated with proximal humerus fractures is effective, feasible and reproducible.