bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of marijuana, tobacco and alcohol use with estimated glomerular filtration rate in women living with HIV and women without HIV
Authors: Fisher Molly C. , Hoover Donald R. , Shi Qiuhu , Sharma Anjali , Estrella Michelle M. , Adimora Adaora , Alcaide Maria , Collins Lauren F. , French Audrey , Gao Wei , Koletar Susan L. , Mcfarlane Samy I. , Mckay Heather , Dionne Jodie A. , Palella Frank , Sarkar Sudipa , Spence Amanda , Witt Mallory D. , Ross Michael J. 
Published: June 2023

Objective:
Marijuana, tobacco and alcohol use are prevalent among people living with HIV and may adversely affect kidney function in this population. We determined the association of use of these substances with estimated glomerular filtration rate (eGFR) among women living with HIV (WLWH) and women without HIV.

Design:
We undertook a repeated measures study of 1043 WLWH and 469 women without HIV within the United States Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-seropositive and HIV-seronegative women.

Methods:
We quantified substance exposures using semi-annual questionnaires. Using pooled eGFR data from 2009–2019, we used linear regression models with multivariable generalized estimating equations to ascertain associations between current and cumulative substance use exposures with eGFR, adjusting for sociodemographics, chronic kidney disease risk factors and HIV-related factors.

Results:
Marijuana use of 1–14 days/month versus 0 days/month was associated with 3.34 mL/min/1.73m2 (95% CI -6.63, -0.06) lower eGFR and marijuana use of >0.02–1.6 marijuana-years versus 0–0.2 marijuana-years was associated with 3.61 mL/min/1.73m2 (95% CI -5.97, -1.24) lower eGFR. Tobacco use was not independently associated with eGFR. Alcohol use of >7 drinks/week versus 0 drinks/week was associated with 5.41 mL/min/1.73m2 (95% CI 2.34, 8.48) higher eGFR and alcohol use of >0.7–4.27 drink-years and >4.27 drink-years versus 0–0.7 drink-years were associated with 2.85 mL/min/1.73m2 (95% CI 0.55, 5.15) and 2.26 mL/min/1.73m2 (95% CI 0.33, 4.20) higher eGFR, respectively.

Conclusion:
Among a large cohort of WLWH and women without HIV, marijuana use was associated with a lower eGFR while alcohol use was associated with a higher eGFR.
Sex modifies the risk of HIV-associated obstructive lung disease in ugandans post-pneumonia
Authors: Abelman Rebecca A. , Fitzpatrick Jessica , Zawedde Josephine , Sanyu Ingvar , Byanyima Patrick , Kaswabuli Sylvia , Musisi Emmanuel , Hsieh Jenny , Gardner Kendall , Zhang Michelle , Byanova Katerina L. , Sessolo Abdul , Hunt Peter W. , Lalitha Rejani , Davis J. Lucian , Crothers Kristina , Worodria William , Huang Laurence 
Published: June 2023

Objectives:
Spirometric abnormalities are frequent and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD.

Design and Methods:
To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a post-bronchodilator forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) ratio <0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, body mass index (BMI), smoking status, and TB status.

Results:
Among 348 participants, 147 (42%) were women and 135 (39%) were HIV positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease (p = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11, 12.0; p = 0.04) increased odds of having OLD compared to men with HIV. Women without HIV did not have increased odds of having OLD compared to men without HIV.

Conclusions:
HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.
HIV-positive Ukrainian refugees in the Czech Republic: a retrospective, observational study
Authors: Massmann Ricardo , Groh Tomáš , Jilich David , Bartková Daniela , Bartovská Zofia , Chmelař Josef , Chrdle Aleš , Dlouhý Pavel , Cimrman Štěpán , da Silva Simona Guimaraes , Kapla Jaroslav , Kubiska Miroslav , Snopková Svatava , Svačinka Radek , Zlámal Milan , Samsonová Olena , Sedláček Dalibor 
Published: June 2023

Objective:
Over 480 000 Ukrainian refugees have arrived in the Czech Republic since the Russian invasion of Ukraine in 2022, including over 500 people with HIV. This study describes the demographics, characteristics, and management of Ukrainian refugees with HIV in the Czech Republic.

Design:
Retrospective, observational, non-interventional study.

Methods:
Ukrainian nationals registering at HIV centers in the Czech Republic with war refugee status were included. Data were collected from medical records between 1 March and 31 July 2022. The study was registered with the Czech State Institute for Drug Control, ID number 2301200000.

Results:
482 patients were included in the study. Most patients were female (69.5%; n = 335/482) with well-controlled HIV. The median [interquartile range] CD4+ cell count was 597 [397] cells/mm3 of blood, and 79.3% (n = 361/455) of patients had HIV RNA <40 copies/ml. Coinfections of hepatitis C virus, hepatitis B virus, and/or tuberculosis were reported for 17.4% (n = 78/449), 9% (n = 40/446) and 1.3% (n = 6/446) of patients, respectively. In Ukraine, 85.7% (n = 384/448) of patients had been receiving an integrase strand transfer inhibitor-based regimen and most (69.7%; n = 310/445) did not switch therapy upon arrival in the Czech Republic.

Conclusion:
Migration from Ukraine is changing the characteristics of HIV epidemiology in the Czech Republic. Ukrainian refugees with HIV have been provided with a high standard of medical care in the Czech Republic. Improved coordination between medical services within the Czech Republic and between countries in the European Union is necessary to optimize patient care.
68Ga-FAPI-04 PET/CT in Selected Breast Cancer Patients With Low FDG Affinity
Authors: Alçın Göksel , Arslan Esra , Aksoy Tamer , Cin Merve , Erol Fenercioğlu Özge , Beyhan Ediz , Ergül Nurhan , Çermik Tevfik Fikret 
Published: June 2023

PurposeIn this prospective study, PET findings of18F-FDG PET/CT in breast cancer staging were compared with68Ga–FAP inhibitor (FAPI) 04 PET/CT findings in selected cases with relatively low18F-FDG uptake in the primary tumor or with suspected nodal or distant metastases.Patients and MethodsTwenty-four women with a median age of 45 years (range, 36–67 years) who underwent initial staging18F-FDG PET/CT for breast cancer underwent68Ga-FAPI-04 PET/CT imaging within the same week. SUVmaxand quantities of primary tumors and locoregional and distant metastatic lesions were recorded from both images, and these data were compared statistically.ResultsThe histological subtypes of primary tumors were 11 invasive lobular, 8 invasive ductal, and 5 mucinous subtypes. More intense68Ga-FAPI-04 uptake (mean, 17.1 ± 7.9; 7.4–38.5) was detected in all primary tumoral lesions compared with18F-FDG (mean, 6.3 ± 3.9; 1.5–20.5) (P= <0.001,Z= 4.107). Additional lesions showing68Ga-FAPI-04 uptake in the breast were detected in 29.2% (n = 7) of patients. In 8.3% (n = 2) of the patients, the primary lesion showed only68Ga-FAPI-04 uptake. In68Ga-FAPI-04 PET/CT, 25% (n = 6) of the patients showed more lymph node involvement and more intense uptake in the ipsilateral axilla. In addition, infraclavicular (level 3) lymph nodes in 4 patients (16.7%), supraclavicular lymph nodes in 1 patient, and internal mammary lymph nodes in 1 patient were detected only on68Ga-FAPI-04 PET/CT. In a patient with lung and bone metastases,68Ga-FAPI-04 uptake was higher, and the lung nodule showed only68Ga-FAPI-04 uptake.ConclusionsIn selected low-FDG-affinity breast cancer patients,68Ga-FAPI-04 PET/CT showed the primary tumor with higher sensitivity and higher SUVmaxvalues compared with18F-FDG PET/CT. In addition, it is believed that this method may contribute to the management of patients' treatment by increasing the nodal stage.
Omental Hibernoma Revealed by 18F-FDG PET/CT
Authors: Qi Jin , Kurian Elizabeth , Öz Orhan K. 
Published: June 2023

AbstractHibernomas are “pseudolipomas” originating from remnants of fetal brown adipose tissue. These rare benign tumors may occur throughout the body but most commonly in the thigh, shoulder, back, and neck, and are rarely found in the abdominal cavity, retroperitoneum, breast, bones, scrotum, and perirectum. We present a case of a 58-year-old woman with a known mediastinal mass, who was incidentally found to have a very FDG-avid fat-containing lesion in the omentum abutting the stomach. Subsequent endoscopic ultrasound-guided fine-needle aspiration confirmed hibernoma. The review of the literature shows the location is very unusual.
Evaluation of Microvascular Autologous Breast Reconstruction in Patients Older Than 60 Years
Authors: Parmeshwar Nisha , Barnes Laura L. , Dugan Catherine L. , Patterson Anne K. , Lem Melinda , Piper Merisa 
Published: June 2023

Background
While free-flap breast reconstruction becomes more common, it is still approached with caution in older patients. Outcomes in the elderly population have not been well characterized, especially with regard to donor-site sequalae. This study compares microvascular autologous breast reconstruction outcomes in patients older and younger 60 years.

Methods
A single-institution retrospective review was performed for microvascular autologous breast reconstruction from January 2004 through January 2021. Demographic, intraoperative, and postoperative variables, including breast flap and donor-site complications, were evaluated.

Results
Five hundred forty-five breast free flaps were identified, of which 478 (87.8%) were performed on patients younger than 60 years (mean, 46.2 years) and 67 (12.2%) older than 60 years (mean, 64.8 years; P = 0.000). Hyperlipidemia was significantly higher in older patients (19.4% vs 9.6%, P = 0.016). Mean operative time was 46.3 minutes faster in the older cohort (P = 0.030). There were no significant differences in free-flap loss, venous congestion, takeback, hematoma, seroma, wound healing, or infection. Interestingly, there were significantly more total breast flap complications (28.5% vs 16.4%, P = 0.038) and higher rates of fat necrosis (9.6% vs 1.5%, P = 0.026) in the younger cohort. Significantly more abdominal donor-site complications (43.3% vs 21.3%, P = 0.000) were seen in the older people, with increased wound breakdown (P = 0.000) and any return to the operating room (20.9% vs 9.8%, P = 0.007). Older patients were also significantly more likely to require surgical correction of an abdominal bulge or hernia (10.4% vs 4%, P = 0.020). The mean follow-up was 1.8 years.

Conclusions
Our data showed no worsening of individual breast flap outcomes in the older people. However, there were significantly more abdominal complications including surgical correction of abdominal bulge and hernia. This may be related to the inherent qualities of tissue aging and should be taken into consideration for flap selection. These results support autologous breast reconstruction in patients older than 60 years, but patients should be counseled regarding potentially increased abdominal donor-site sequelae.
Association between right heart catheterization hemodynamics and glycosylated hemoglobin levels in adults with heart failure with reduced ejection fraction
Authors: Del Rio-Pertuz Gaspar , Morataya Cristina , Parmar Kanak , Elharabi Zeyad , Davis Daniel , Abohelwa Mostafa , Ochoa Ozman , Tran Alison , Nugent Kenneth , Paniagua David , Argueta-Sosa Erwin 
Published: June 2023

Background
This study hypothesized that elevated glycosylated hemoglobin (HbA1c) levels are associated with abnormal right heart catheterization (RHC) hemodynamic parameters in patients with heart failure with reduced ejection fraction (HFrEF) and no prior diagnosis of diabetes.

Methods
Retrospective cohort study of adult patients with HFrEF and no prior diagnosis of diabetes who underwent RHC and had HbA1c levels measured 30 days before or after the RHC. This study excluded patients who had received blood transfusions within 90 days prior to HbA1c measurement and patients with known diabetes. Univariate and multivariate regression analyses adjusted for age, sex, and BMI were used to test for an association between RHC hemodynamic parameters and HbA1c levels.

Results
A total of 136 patients were included with a mean age of 55 ± 15 years and mean HbA1c was 5.99 ± 0.64%. Unadjusted univariate models showed that HbA1c is significantly associated with cardiac index (CI) by the Fick method and thermodilution, right atrial pressure (RAP), and mean pulmonary arterial pressure (MPAP). After multivariate analysis, for every one unit increase in HbA1c, there was a 0.19 and 0.26 L/min/m2 decrease in expected CI by thermodilution and by the Fick method (P = 0.03 and P < 0.01), respectively. For every one unit increase in HbA1c, there was a 2.39 mmHg increase in expected RAP (P = 0.01).

Conclusion
Elevated HbA1c levels measured within 30 days before or after the index RHC in patients with a left ventricular ejection fraction <40% were associated with congestive hemodynamic parameters.
First episode psychosis and weight gain a longitudinal perspective in Cheshire UK: a comparison between individuals with nonaffective versus affective psychosis
Authors: Heald Adrian H. , Stedman Mike , Daly Chris , Warner-Levy John Julian , Livingston Mark , Hussain Lamiece , Anderson Simon 
Published: June 2023

Introduction
Early weight gain following initiation of antipsychotic treatment predicts longer-term weight gain, with attendant long-term consequences including premature cardiovascular events/death. An important question is whether there is a difference in weight change over time between people with affective versus nonaffective psychosis. Here we describe the results of a real-world analysis of the BMI change in the months postdiagnosis with affective versus nonaffective psychosis.

Methods
We undertook an anonymised search across one Primary Care Network in Cheshire, UK with a total population of 32 301 individuals. We reviewed the health records of anyone who had been diagnosed over a 10-year period between June 2012 and June 2022 for the first time with first episode nonaffective psychosis versus psychosis associated with depression or bipolar affective disorder (affective psychosis).

Results
The overall % change in BMI was +8% in nonaffective psychosis individuals and +4% in those with a diagnosis of affective psychosis – however, the distribution was markedly skewed for nonaffective psychosis patients. Using caseness as >30% increase in BMI; affective = 4% cases and nonaffective = 13% cases, there was a three-fold difference in terms of increase in BMI. In regression analysis, the r
2 linking the initial BMI to % change in BMI was 0.13 for nonaffective psychosis and 0.14 for affective psychosis.

Conclusion
The differences observed here in the distribution of weight change over time between individuals with affective versus nonaffective psychosis may relate to underlying constitutional differences. The phenotypic and genetic factors underlying this difference remain to be defined.
Leadership and Impostor Syndrome in Surgery
Authors: Iwai Yoshiko , Yu Alice Yunzi L , Thomas Samantha M , Fayanju Oluseyi A , Sudan Ranjan , Bynum Debra L , Fayanju Oluwadamilola M 
Published: June 2023

Background:
Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine.

Study Design:
A cross-sectional survey was distributed to US physicians from 6/2021-12/2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t-test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome.

Results:
2183 attending and retired physicians were included in the analytic cohort; 1471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (OR=1.4, 95% CI 1.16-1.69; p<0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (OR=0.3, 95% CI 0.16-0.55; p<0.001). Having a leadership position was associated with lower odds of impostor syndrome (OR=0.54, 95% CI 0.43-0.68; p<0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p<0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male non-surgeons. Impostor syndrome rates did not differ by race/ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role.

Conclusions:
Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. While several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.
Target temperature management and post-extracorporeal cardiopulmonary resuscitation outcome: A post hoc analysis of the SAVE-J II Study
Authors: Kanda Jun , Nakahara Shinji , Inoue Akihiko , Hifumi Toru , Okazaki Tomoya , Kikuchi Migaku , Yokobori Shoji , Miyake Yasufumi , Morimura Naoto , Sakamoto Tetsuya , Kuroda Yasuhiro 
Published: June 2023

AbstractBackgroundThe conflicting results of previous analyses about hypothermia management in patients with out-of-hospital cardiopulmonary arrest have hindered the establishment of a uniform standard temperature setting for temperature control. This study investigated and compared the clinical outcomes of hypothermic (target temperature: 32–34°C) and normothermic (35–36°C) management of out-of-hospital cardiac arrest (OHCA) patients, treated with extracorporeal cardiopulmonary resuscitation (ECPR).MethodsThis secondary analysis of the SAVE-J II study, a retrospective, multicenter, registry study involving 36 participating institutions in Japan, was undertaken, and ECPR patients with a suspected cardiac etiology were included in this cohort. The primary outcome was survival at hospital discharge. Favorable neurological outcomes (5-point Glasgow-Pittsburgh Cerebral Performance Categories 1–2) constituted the secondary outcome. Multivariable logistic analysis, which was adjusted for potential confounders, was performed for the primary and secondary outcomes.ResultsOf the 949 participants of this study, 57% underwent hypothermic management. A total favorable neurological outcome at hospital discharge was identified in 164 patients (17%), and the survival rate was 35%. In multivariable analysis, with the primary and secondary endpoints as each dependent variable, and gender, age, witness, bystander CPR, electrocardiogram, low flow time, and causative disease as categorical covariates, hypothermic management compared to normothermic management in OHCA patients treated with ECPR, was not significantly associated with a favorable neurological outcome (adjusted odds ratio (aOR): 1.22: 95% CI: 0.85–1.74), but was associated with survival (aOR: 1.74: 95% CI: 1.31–2.32).ConclusionsCompared to normothermic management, hypothermic management of OHCA patients treated with ECPR was not significantly associated with a favorable neurological outcome, but was associated with survival at hospital discharge.
Patterns and outcomes of cardiovascular complications among adult patients with chronic kidney diseases attending Benjamin Mkapa Hospital in Dodoma, Tanzania A protocol of a prospective longitudinal study
Authors: Mbalazi Mohamed , Baraka Alphonce , Meremo Alfred , Meda John 
Published: June 2023

AbstractIntroductionChronic Kidney Disease (CKD) affects more than 800 million people globally, the high cardiovascular mortality and morbidity related to CKD result from unique CKD-related risk factors such as anemia and mineral metabolism disturbances and underlying CKD risk factors such as hypertension, diabetes mellitus, and dyslipidemia. The presence of CKD-related structural and functional alterations in the heart and blood vessels increases the risk of hypertension, left ventricular hypertrophy, and heart failure. In advanced CKD stages, the increased risk of hospitalization, heart failure worsening, stroke and death are commonly seen due to increased risk of ischemic heart disease, arrhythmias, and pericarditis.MethodologyThe study will follow a prospective longitudinal design recruiting patients 18 and above years with CKD stage 3 confirmed by estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2 for the past 3 months, or proteinuria of greater than 200mg/g attending Benjamin Mkapa nephrology and cardiology clinics. Cardiovascular complications will be identified following screening .as per operational definition and a comprehensive baseline assessment. A monthly assessment of cardiovascular complications will be done for a period of 6 months through clinical examinations, imaging and laboratory tests. Cornell and Sokolow-Lyon’s ECG criteria will detect LVH, but ECHO will rule it out. The Framingham criteria will be used to diagnose heart failure. A 12-lead ECG will detect arrhythmias, and an ECG plus cardiac markers will be used to diagnose ischemic heart disease. ECG and ECHO findings of pericardial sac thickening or fluid presence will indicate pericarditis. Continuous and discrete variables will be summarized as mean ±standard deviation (SD), medians, and interquartile ranges, while categorical data will be summarized as frequency and proportion. A binomial logistic regression model will be used to assess the association between independent variables and CVD outcomes