bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of the Implementation Strategies Used to Apply the 2013 Pain, Agitation/Sedation, Delirium or 2018 Pain, Agitation/Sedation, Delirium, Immobility, Sleep Disruption Guideline Recommendations: A Systematic Review and Meta-Analysis
Authors: Hume Nicole E. , Zerfas Isabelle , Wong Adrian , Klein-Fedyshin Michele , Smithburger Pamela L. , Buckley Mitchell S. , Devlin John W. , Kane-Gill Sandra L. 
Published: January 2024

OBJECTIVES:
To summarize the effectiveness of implementation strategies for ICU execution of recommendations from the 2013 Pain, Agitation/Sedation, Delirium (PAD) or 2018 PAD, Immobility, Sleep Disruption (PADIS) guidelines.

DATA SOURCES:
PubMed, CINAHL, Scopus, and Web of Science were searched from January 2012 to August 2023. The protocol was registered with PROSPERO (CRD42020175268).

STUDY SELECTION:
Articles were included if: 1) design was randomized or cohort, 2) adult population evaluated, 3) employed recommendations from greater than or equal to two PAD/PADIS domains, and 4) evaluated greater than or equal to 1 of the following outcome(s): short-term mortality, delirium occurrence, mechanical ventilation (MV) duration, or ICU length of stay (LOS).

DATA EXTRACTION:
Two authors independently reviewed articles for eligibility, number of PAD/PADIS domains, quality according to National Heart, Lung, and Blood Institute assessment tools, implementation strategy use (including Assess, prevent, and manage pain; Both SAT and SBT; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment [ABCDEF] bundle) by Cochrane Effective Practice and Organization of Care (EPOC) category, and clinical outcomes. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation.

DATA SYNTHESIS:
Among the 25 of 243 (10.3%) full-text articles included (n = 23,215 patients), risk of bias was high in 13 (52%). Most studies were cohort (n = 22, 88%). A median of 5 (interquartile range [IQR] 4–7) EPOC strategies were used to implement recommendations from two (IQR 2–3) PAD/PADIS domains. Cohort and randomized studies were pooled separately. In the cohort studies, use of EPOC strategies was not associated with a change in mortality (risk ratio [RR] 1.01; 95% CI, 0.9–1.12), or delirium (RR 0.92; 95% CI, 0.82–1.03), but was associated with a reduction in MV duration (weighted mean difference [WMD] –0.84 d; 95% CI, –1.25 to –0.43) and ICU LOS (WMD –0.77 d; 95% CI, –1.51 to 0.04). For randomized studies, EPOC strategy use was associated with reduced mortality and MV duration but not delirium or ICU LOS.

CONCLUSIONS:
Using multiple implementation strategies to adopt PAD/PADIS guideline recommendations may reduce mortality, duration of MV, and ICU LOS. Further prospective, controlled studies are needed to identify the most effective strategies to implement PAD/PADIS recommendations.
Bombarding Oligoprogression
Authors: Chou Brian , Lee Jae Han , Saetern Lonnie , Venkatesulu Bhanu Prasad , Welsh James S. , Harkenrider Matthew M. 
Published: January 2024

Objectives:
This study aims to evaluate the efficacy and toxicity of radiotherapy (RT) to oligoprogressive metastatic non–small cell lung cancer (NSCLC).

Methods:
This is a retrospective analysis of 23 patients with metastatic NSCLC on maintenance systemic therapy, developed oligoprogression (1 to 5 sites), and all oligoprogressive sites amenable to and treated with RT. The primary endpoints included progression-free survival (PFS) and median time to start next-line therapy (MTT). Kaplan-Meier survival analysis and log-rank testing were performed using R-Studio software.

Results:
Twenty-three patients met the inclusion criteria. The median overall survival for the entire cohort was 31.3 months (interquartile range [IQR]: 17.86 to 45.4). The median event-free survival for the entire cohort was 8.3 months (IQR: 2.7 to 12). Patients with no prior radiation had longer median event-free survival of 11.9 months (IQR: 8.4 to 18.2) compared with patients with a history of prior radiation at 4.1 months (IQR: 2.7 to 12; P = 0.041). The local control rate for the treated lesions was 97.5%. At 12 months follow-up, 6 (43%) of 14 living patients maintained systemic therapy without initiating next-line therapy. The median PFS for the entire cohort was 8.4 months (IQR: 4.1 to 17.5). Patients who did not receive prior radiation had longer median PFS of 11.9 months (IQR: 8.4 to 18.2) compared with patients who received prior radiation 6.2 months (IQR: 2.7 to 8.5; P = 0.018). Two patients (9%) had grade 3 chronic toxicity related to RT and were medically managed.

Conclusion:
We identified that in patients with oligoprogressive metastatic NSCLC, targeted RT to all progressive sites yielded high LC and favorable rates of PFS and MTT.
Identification of M2 Macrophage-Related Key Genes in Advanced Atherosclerotic Plaques by Network-Based Analysis
Authors: Yuan Yao , Wang Peng , Zhang Haigang , Liu Ya 
Published: January 2024

Abstract:
Atherosclerotic plaque accounts for major adverse cardiovascular events because of its vulnerability. The classically activated macrophage (M1) and alternatively activated macrophage (M2) are implicated in the progression and regression of plaque, respectively. However, the therapeutic targets related to M2 macrophages still remain largely elusive. In this study, cell-type identification by estimating relative subsets of RNA transcripts and weighted gene coexpression network analysis algorithms were used to establish a weighted gene coexpression network for identifying M2 macrophage-related hub genes using GSE43292 data set. The results showed that genes were classified into 7 modules, with the blue module (Cor = 0.67, P = 3e−05) being the one that was most related to M2 macrophage infiltration in advanced plaques, and then 99 hub genes were identified from blue module. Meanwhile, 1289 differentially expressed genes were produced in GSE43292 data set. Subsequently, the intersection genes of hub genes and differentially expressed genes, including AKTIP, ASPN, FAM26E, RAB23, PLS3, and PLSCR4, were obtained by Venn diagrams and named as key genes. Further validation using data sets GSE100927 and GSE41571 showed that 6 key genes all downregulated in advanced and vulnerable plaques compared with early and stable plaque samples (|Log2 (fold change)| > 0.5, P < 0.05 or 0.001), respectively. Receiver operator characteristic curve analysis indicated that the 6 key genes might have potential diagnostic value. The validation of key genes in the model in vitro and in vivo also demonstrated decreased mRNA expressions of AKTIP, ASPN, FAM26E, RAB23, PLS3, and PLSCR4 (P < 0.05 or 0.001). Collectively, we identified AKTIP, ASPN, FAM26E, RAB23, PLS3, and PLSCR4 as M2 macrophage-related key genes during atherosclerotic progression, proposing potential intervention targets for advanced atherosclerotic plaques.
Feasibility of Glaucoma Detection Programs for At-Risk Populations Using Existing Health Care Infrastructure
Authors: Girkin Christopher A. , Owsley Cynthia 
Published: January 2024

Précis:
Targeted glaucoma screening strategies performed within retail care–based clinics and Federally Qualified Health Centers (FQHCs) uncover a high prevalence of glaucoma.

Objective:
To summarize the glaucoma detection and maintenance programs that utilize existing health care infrastructure to promote up-scalable programs.

Methods:
Health care infrastructure that already exists may facilitate glaucoma detection. This infrastructure includes retail-based optometry practices and FQHC. Persons who are at risk for glaucoma are disproportionately represented within the patient populations served by much of this infrastructure, thus suggesting that it could be useful for deploying glaucoma screening programs. Glaucoma screening within FQHCs reveals a very high prevalence of glaucoma and related disease in the patients seeking care at these facilities.

Results:
These telemetric-based care delivery programs have a high patient acceptance. A simulated telemedicine program modeled after a telemedicine program based in Walmart Vision Centers for the diagnosis of glaucoma indicated that there was moderate diagnostic agreement between an ophthalmologist’s telemedicine diagnosis and an ophthalmologist’s in-person diagnosis. There was also moderate agreement between an optometrist’s telemedicine diagnosis and the ophthalmologist’s in-person diagnosis.

Conclusion:
Telemetric care delivery programs that capitalize on existing infrastructure within a retail-based care setting or FQHCs may provide a promising setting to cost-effectively screen for glaucoma and other eye diseases that are potentially expandable nationwide.
Glaucoma Screening Guidelines Worldwide
Authors: Gunzenhauser Robert , Coleman Anne L. 
Published: January 2024

Précis:
Recommendations for glaucoma screening vary significantly from organization to organization, and while worldwide screening is currently not recommended, there is support in many organizations for screening at-risk subgroups of the general population.

Objective:
To summarize and compare current glaucoma screening protocols of major national and international, governmental, and non-governmental organizations.

Methods:
A general review of the major medical, and more specifically ophthalmic, organizations within North America, South America, Europe, Asia, and Africa was undertaken. Protocols from recent international and regional meetings were reviewed and summarized and a comparative analysis was employed to highlight differences between national and regional policies.

Results:
In general, it was found that worldwide screening for glaucoma is currently of limited clinical utility and unlikely to be cost-effective. However, a more targeted approach is recommended by some major organizations, including the American Academy of Ophthalmology, the Pan-American Association of Ophthalmology, and the International Council of Ophthalmology in conjunction with a group of prominent ophthalmologists based in Sub-Saharan Africa recommend a targeted approach to screening specific populations that are deemed to be at higher risk of developing glaucoma.

Conclusion:
General population screening for glaucoma has been adopted as a recommendation by only a few organizations and only in specific situations. It is the screening of high-risk populations that has been demonstrated to be not only clinically useful in diagnosing and treating larger proportions of the general population benefiting from a higher positive-predictive value for screening protocols in these groups but also cost-effective. Further research is needed to create cost-effective protocols to successfully screen these high-risk populations for glaucoma using methods that are sufficiently sensitive and specific.
Seeking a Relevant Description of Major Trauma Bleeding: Comparison of Four Major Bleeding Definitions
Authors: Day Darcy L. , Ng Karen , Severino Richard , Ng-Kamstra Josh 
Published: January 2024

BACKGROUND:
The traditional definition of massive transfusion is 10 red blood cell units transfused within 24 hr. This definition has been faulted for excluding patients who die early from exsanguination. Alternative major bleeding definitions in the trauma literature include time-based (e.g., Resuscitation Intensity) and event based (e.g., Sharpe) transfusion thresholds.

OBJECTIVE:
The study objective was to compare four definitions of major bleeding, including a modification to the Sharpe definition, on clinically relevant processes and outcomes.

METHODS:
This is a retrospective cohort study of adult trauma patients admitted from the field to a Level I trauma center from 2014 to 2019. Data sources were the trauma registry, blood bank, and electronic medical records. Transfusion thresholds were defined as follows: Resuscitation Intensity—4 units of any combination of crystalloids, colloids, or blood products within the first 30 min of arrival; Sharpe—10 red blood cell units from trauma bay presentation to inpatient admission (a proxy for the interval of hemorrhage control); Modified Sharpe—10 units of any combination of blood products during the same interval. The study analysis consisted of descriptive statistics.

RESULTS:
The cohort contained 187 subjects. Of 39 deaths, 28 (72%) occurred within 6 hr following arrival. Modified Sharpe captured 27 (96%) of these 28 subjects, whereas Resuscitation Intensity captured 20 (71%). Sharpe and the traditional definition each captured 22 subjects (79%). Modified Sharpe captured 17%–25% of deaths missed by the other definitions.

CONCLUSION:
Modified Sharpe may optimally indicate major bleeding during trauma resuscitation.
First report of furmonertinib as a first-line treatment in advanced lung adenocarcinoma patients harboring EGFR exon 20 insertion mutations after the kinase domain αC-helix: Two case reports and a literature review
Authors: Han Huan , Zhang Xiao , Liu Xiao , Zhao Jiuzhou , Zhang Jianbo , Zhang Jianwei , Zhu Hui , Jiao Shuyue , Tang Hong 
Published: January 2024

Rationale:
Many studies have shown that first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors are less effective in patients with epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins) mutations. The efficacy of third-generation epidermal growth factor receptor tyrosine kinase inhibitors is still under investigation. Although new targeted tyrosine kinase inhibitors and monoclonal antibody-based agents have made significant advances in the treatment of epidermal growth factor receptor exon 20 insertion (EGFR ex20ins) mutation, the efficacy of these novel agents is not quite satisfactory. Platinum- and pemetrexed-based chemotherapy remains the standard first-line treatment for patients harboring EGFR ex20ins mutation.

Patient concerns:
We report for the first time 2 Chinese patients diagnosed with advanced lung adenocarcinoma with EGFR ex20ins mutations after analysis of the αC-helix sequence by next-generation sequencing. Both patients were treated with furmonertinib as the first-line therapy.

Interventions:
The first case included a 38-year-old female who had an EGFR ex20ins mutation (p.S768_D770dupSVD). After 1 month of treatment with furmonertinib, her symptoms of pain and cough were significantly alleviated. She achieved a partial response according to response evaluation criteria in solid tumors.[1] The final progression-free survival was 8.13 months. The second case included a 40-year-old male who had an EGFR ex20ins mutation (p.N771_P772insVal). He had a good response to furmonertinib and exhibited stable disease according to response evaluation criteria in solid tumors with a progression-free survival of 10.90 months.

Outcomes:
Both patients experienced significant improvement in symptoms and prolonged survival after furmonertinib was used as first-line treatment. Side effects were limited but manageable.

Conclusion:
The present study indicates that furmonertinib may be a first-line treatment option for patients with non-small cell lung cancer harboring EGFR ex20ins mutation.
Comparison of the antiemetic efficacy of a combination of midazolam with ramosetron and midazolam with palonosetron for postoperative nausea and vomiting prophylaxis in laparoscopic cholecystectomy
Authors: Lim Jung A , Jo Sungbin , Choi Eun Kyung 
Published: January 2024

Background:
A multimodal therapeutic strategy for preventing postoperative nausea and vomiting (PONV) benefits moderate- and high-risk surgical patients. We compared the efficacy of a combination of midazolam and ramosetron and a combination of midazolam and palonosetron for PONV prophylaxis in patients scheduled for laparoscopic cholecystectomy.

Methods:
We enrolled 68 patients aged 20 to 65 years undergoing laparoscopic cholecystectomy. Patients were randomly allocated to the midazolam 0.05 mg/kg with ramosetron 0.3 mg (MR) or midazolam 0.05 mg/kg with palonosetron 0.075 mg (MP) groups. The incidence of PONV, severity of nausea, use of rescue antiemetics, and pain severity were evaluated at 2, 24, and 48 hours after surgery.

Results:
The incidence (38.2% vs 5.9%) and severity of postoperative nausea were significantly lower in the MP group at 2 hours after surgery (P < .05). There were no significant differences in the incidence of vomiting, use of rescue antiemetics, or pain severity between the 2 groups.

Conclusion:
The combination of midazolam with palonosetron significantly decreased the incidence and severity of postoperative nausea compared with midazolam combined with ramosetron, especially in the early postoperative phase (0–2 hours) in patients undergoing laparoscopic cholecystectomy.
Association of 20-Year Longitudinal Depressive Symptoms With Left Ventricular Geometry Outcomes in the Coronary Artery Risk Development in Young Adults Study: A Role for Androgens?
Authors: Colangelo Laura A. , Carroll Allison J. , Perak Amanda M. , Gidding Samuel S. , Lima Joao A.C. , Lloyd-Jones Donald M. 
Published: January 2024

ABSTRACT

Objective
Depression is a risk factor for coronary heart disease and left ventricular hypertrophy (LVH) is a potent predictor of coronary heart disease events. Whether depression is associated with LVH has received limited investigation. This study assessed cross-sectional and 20-year longitudinal associations of depressive symptoms with LVH outcomes after accounting for important known confounders.

Methods
From 5115 participants enrolled in 1985–1986 in the Coronary Artery Risk Development in Young Adults Study, 2533 had serial measures of depressive symptoms and subsequent echocardiography to measure normal LV geometry, concentric remodeling, and LVH. The primary exposure variable was trajectories of the Center for Epidemiologic Studies Depression (CES-D) scale score from 1990–1991 to 2010–2011. Multivariable polytomous logistic regression was used to assess associations of trajectories with a composite LV geometry outcome created using echocardiogram data measured in 2010–2011 and 2015–2016. Sex-specific conflicting results led to exploratory models that examined potential importance of testosterone and sex hormone–binding globulin.

Results
Overall CES-D and Somatic subscale trajectories had significant associations with LVH for female participants only. Odds ratios for the subthreshold (mean CES-D ≈ 14) and stable (mean CES-D ≈ 19) groups were 1.49 (95% confidence interval = 1.05–2.13) and 1.88 (95% confidence interval = 1.16–3.04), respectively. For female participants, sex hormone–binding globulin was inversely associated with LVH, and for male participants, bioavailable testosterone was positively associated with concentric geometry.

Conclusions
Findings from cross-sectional and longitudinal regression models for female participants, but not male ones, and particularly for Somatic subscale trajectories suggested a plausible link among depression, androgens, and LVH. The role of androgens to the depression-LVH relation requires additional investigation in future studies.
Perceived Control and Inflammation: Mediating and Moderating Effects in the Relationship Between Cumulative Trauma and Depression
Authors: Magin Zachary E. , Park Crystal L. , Burke Jeffrey D. , Infurna Frank J. 
Published: January 2024

ABSTRACT

Objective
The effects of trauma exposure on depression risk and severity are well established, but psychosocial and biological factors that impact or explain those relationships remain poorly understood. This study examined the moderating and mediating effects of perceived control and inflammation in the relationship between trauma and depression.

Methods
Moderation analyses and longitudinal mediation analyses were conducted on data from 945 adults who completed all three waves (spanning around 19 years) of the Midlife Development in the United States (MIDUS) study and the MIDUS Biomarker Study. Data were collected during a phone interview, self-report surveys distributed in the mail, and an in-person blood draw. Two dimensions of perceived control—mastery and constraints—were examined separately in all analyses.

Results
Perceived control did not significantly moderate the relationship between trauma and depression severity at MIDUS 2 (b = 0.03, SE = .02, p = .091). Constraints significantly mediated the relationship between trauma and MIDUS 3 depression (indirect effect = 0.03, SE = 0.01, p = .016) but not after accounting for MIDUS 2 depression. Perceived control did not have a significant moderating effect in the relationships between trauma and inflammation or inflammation and depression.

Conclusions
Findings from this study revealed that perceived control may be better characterized as an explanatory factor rather than a buffer in trauma-associated depression. Perceived constraints in particular may be a useful treatment target for trauma-associated depression. Further research is needed to examine whether these results generalize to populations other than among mostly non-Hispanic White adults in the United States.
How the COVID-19 pandemic and the health system's response reduced HIV testing and increased late diagnoses in Mexico
Authors: Macías-González Fernando , Vermandere Heleen , Piñeirúa-Menendez Alicia , Bautista-Arredondo Sergio 
Published: January 2024

Objectives:
This study aims to evaluate the disruption in HIV screening and diagnoses due to the coronavirus disease 2019 (COVID-19) pandemic and to investigate the pandemic's subsequent influence on the HIV epidemic.

Design:
A retrospective examination of testing and confirmed diagnoses time series was undertaken from 2011 to 2022. The analysis encompassed testing, positive tests, positivity rates, and diagnosis outcomes, including new HIV diagnoses, asymptomatic HIV diagnoses, and symptomatic HIV diagnoses.

Methods:
We used Autoregressive Integrated Moving Average (ARIMA) models to estimate the COVID-19 epidemic's impact on screening and diagnosis outcomes. We gauged the pandemic's effect between January 2020 and December 2022 by comparing modeled predicted results with actual outcomes.

Results:
The advent of COVID-19 prompted a reduction of 50.7% in HIV testing, followed by a monthly escalation in testing afterward, estimated at 30.2 and 65.1% for 2021 and 2022, respectively. Although new diagnoses reported between 2020 and 2022 gradually increased to prepandemic levels, we estimate a gap of 13 207 new diagnoses, with symptomatic detections increasing more than proportionally in 2021 and 2022.

Conclusion:
Our results suggest that the COVID-19 pandemic resulted in missed HIV diagnoses and a rise in late HIV diagnoses. Implementing tailored post-COVID-19 strategies to accelerate timely HIV testing and prevention is needed to avert additional burdens and remain on track toward achieving the 2030 HIV management goals.