bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family history of hypertension and its relation to other variables in hypertensive patients: a cross-sectional study from a tertiary care hospital
Authors: KC Kanchan , Katwal Srijana , Yadav Gopal K. , Adhikari Alisha , Thapa Raj Kumar , Jha Saroj Kumar , Sharma Arun , Rijal Thaneshwar , Giri Santoshi , Khadka Sitaram 
Published: August 2023

Background:Hypertension, a key determinant of cardiovascular disease, is one of the major public health burdens worldwide. Family history is a known nonmodifiable risk factor for hypertension. This study aims to identify the family history of hypertension in terms of its prevalence and its association with various risk factors.Methods:A descriptive cross-sectional study was conducted among 423 hypertensive patients visiting the general outpatient department of Shree Birendra Hospital using a simple random sampling method. The data were collected using a preformed questionnaire through a face-to-face interview approach. Data were entered into Microsoft Excel 2019 v16.0 and were analyzed using Statistical Packages for Social Sciences version 21.Results:Out of 423 hypertensive individuals, 131 (30.97%) had a family history of hypertension, with grandparents having the greatest frequency (56.49%). In the multivariable model, the participants with age 60 years or older [adjusted odds ratio (AOR): 2.54, 95% CI: 1.60–4.02,P< 0.001], female (AOR: 2.11, 95% CI: 1.35–3.29,P= 0.001), and participants with government or private jobs, including farming (AOR: 2.63, 95% CI: 1.59–4.35,P<0.001), were significantly associated with a family history of hypertension.Conclusions:Family history is an influencing factor in hypertension. Thus, it is possible to target people who have a family history of hypertension to identify undiagnosed hypertension cases in the community, as well as to modify risk factors and provide necessary interventions.
Contrast-enhanced ultrasound liver imaging reporting and data system: clinical validation in a prospective multinational study in North America and Europe
Authors: Lyshchik Andrej , Wessner Corinne E. , Bradigan Kristen , Eisenbrey John R. , Forsberg Flemming , Yi Misung , Keith Scott W. , Kono Yuko , Wilson Stephanie R. , Medellin Alexandra , Rodgers Shuchi K. , Planz Virginia , Kamaya Aya , Finch Lisa , Fetzer David T. , Berzigotti Annalisa , Sidhu Paul S. , Piscaglia Fabio ,   CEUS LI-RADS Trial Group
Published: August 2023

Background and Aims:
The objective of this study is to determine the diagnostic accuracy of the American College of Radiology Contrast-Enhanced Ultrasound (CEUS) Liver Imaging Reporting and Data System LR-5 characterization for HCC diagnosis in North American or European patients.

Approach and Results:
A prospective multinational cohort study was performed from January 2018 through November 2022 at 11 academic and nonacademic centers in North America and Europe. Patients at risk for HCC with at least 1 liver observation not previously treated, identified on ultrasound (US), or multiphase CT or MRI performed as a part of standard clinical care were eligible for the study. All participants were examined with CEUS of the liver within 4 weeks of CT/MRI or tissue diagnosis to characterize up to 2 liver nodules per participant using ACR CEUS Liver Imaging Reporting and Data System. Definite HCC diagnosis on the initial CT/MRI, imaging follow-up, or histology for CT/MRI-indeterminate nodules were used as reference standards. A total of 545 nodules had confirmed reference standards in 480 patients, 73.8% were HCC, 5.5% were other malignancies, and 20.7% were nonmalignant. The specificity of CEUS LR-5 for HCC was 95.1% (95% CI 90.1%–97.7%), sensitivity 62.9% (95% CI 57.9%–67.7%), positive predictive value 97.3% (95% CI 94.5%–98.7%), and negative predictive value 47.7% (95% CI 41.7%–53.8%). In addition, benign CEUS characterization (LR-1 or LR-2) had 100% specificity and 100% positive predictive value for nonmalignant liver nodules.

Conclusions:
CEUS Liver Imaging Reporting and Data System provides an accurate categorization of liver nodules in participants at risk for HCC.
Investigation of the Radiographic Imaging Volume and Occupational Dose of Radiologic Technologists before and during the COVID-19 Pandemic
Authors: Shubayr Nasser 
Published: August 2023

Abstract
This study aimed to assess occupational radiation doses for radiologic technologists (RTs) in Saudi Arabia shortly before and during the COVID-19 pandemic, considering changes in imaging volume during that time. This retrospective study included the imaging volume data and the RTs’ occupational dose records from a central hospital for 2019 and 2020. The occupational dose—in terms of annual and quarterly mean effective doses (AMEDs and QMEDs)—was estimated for 115 RTs using thermoluminescent dosimeter records. There was a 22% increase in the AMED in 2020 compared with 2019, though the overall imaging volume decreased by 9% in 2020. The percentage changes in AMEDs between 2019 and 2020 for general radiography (GR), computed tomography (CT), interventional radiology (IR), nuclear medicine (NM), and mammography (MG) were 45%, 56%, 9%, 18% and −2%, respectively. The highest contribution to AMEDs in 2020 for modalities was due to GR and CT procedures, accounting for 0.50 mSv and 0.58 mSv, respectively. The percentage change in imaging volumes between 2019 and 2020 depicted a slight decrease in Q2 (−1%) and a substantial decrease in Q1 (−10%), Q3 (−12%), and Q4 (−11%) for 2020. The overall percentage changes in imaging volumes in 2020 for GR (conventional and mobile), CT, IR, NM, and MG were −7% (−19% and 48%), −11%, 13%, −26%, and −46%, respectively. Investigating the changes in 2020 by comparing Q1 of 2020 (before the pandemic restrictions) with Q2 (during the pandemic restrictions and changes in workflow) revealed that the QMED during Q2 increased by 5% with a 17.4% decrease in the imaging volume. However, CT procedures were increased by 11.1% during the pandemic restrictions in Q2 of 2020, with an increase in the corresponding QMED of 66%. Moreover, mobile GR procedures increased by 21% in Q2 of 2020 compared to Q1. This study indicated the impact of the COVID-19 pandemic on imaging volume and occupational dose. Overall, the study observed a decrease in the imaging volume and an increase in RTs’ effective doses by 2020. However, there was an increase in mobile GR and CT examinations during the COVID-19 pandemic restrictions in 2020. This study suggested that the increased mobile GR and CT examinations contributed to greater effective doses for RTs in 2020.
Effectiveness of repetitive influenza vaccination against SARS-CoV-2 infection among a cohort of health care workers in Portugal
Authors: Sá Silva Susana , Severo Milton , Norton Pedro , Moreira André 
Published: August 2023

Abstract
Vaccination for influenza has been essential over the years to protect the most vulnerable populations. Moreover, it was recently suggested that influenza vaccination might confer some nonspecific immunity to other viruses and be associated with a lower risk for coronavirus disease 2019 (COVID-19) morbidity and mortality. Therefore, we aimed to assess the effectiveness of repetitive influenza vaccination against SARS-CoV-2 infection in a cohort of health care workers (HCWs). This study was conducted among HCWs at São João University Hospital Center (CHUSJ), Porto, Portugal, a tertiary reference hospital for diagnosis and therapy, one of the largest hospitals in the country with approximately 6000 HCWs. We analyzed databases for influenza vaccination conducted between 2012 and 2019 and COVID-19 laboratory testing retrieved from the first and last registered positive COVID test date before HCW's COVID-19 vaccination started. The study outcome was the incidence of the first SARS-CoV-2 infection, as determined by reverse transcription polymerase chain reaction (RT-PCR). Age and sex were considered potential confounders. We used multivariable Cox regression to estimate odds ratios. Neither the absolute number nor the proportion of influenza shots influenced the risk of getting infected by SARS-CoV-2 (adjusted odds ratio 1.02, 95% CI: 0.9–1.06 and 1.17 95% CI: 0.86–1.58, respectively). Similar findings were observed in most cases when the analysis was restricted by year. The findings from our retrospective observational analysis of a HCWs cohort failed to support any protective effect between repetitive influenza vaccination and SARS-CoV-2 infection.
Inflammation and bone marrow fibrosis: novel immunotherapeutic targets
Authors: Calledda Francesca Rossella , Malara Alessandro , Balduini Alessandra 
Published: August 2023

Purpose of review
Myelofibrosis (MF) is primarily driven by constitutive activation of the Janus kinase/signal transducer of activators of transcription (JAK/STAT) pathway. While JAK inhibitors have shown to alleviate disease symptoms, their disease-modifying effects in MF are limited. The only curative treatment remains allogeneic stem cell transplantation, which can be applied to a minority of patients. As a result, there is a need to explore novel targets in MF to facilitate appropriate drug development and therapeutic pathways.

Recent findings
Recent research has focused on identifying novel signals that contribute to the abnormal cross-talk between hematopoietic and stromal cells, which promotes MF and disease progression. Inflammation and immune dysregulation have emerged as key drivers of both the initiation and progression of MF. A growing number of actionable targets has been identified, including cytokines, transcription factors, signalling networks and cell surface-associated molecules. These targets exhibit dysfunctions in malignant and nonmalignant hematopoietic cells, but also in nonhematopoietic cells of the bone marrow. The study of these inflammation-related molecules, in preclinical models and MF patient's samples, is providing novel therapeutic targets.

Summary
The identification of immunotherapeutic targets is expanding the therapeutic landscape of MF. This review provides a summary of the most recent advancements in the study of immunotherapeutic targets in MF.
Monitoring Practices After Pediatric Liver Transplantation
Authors: Slowik Voytek , Ryan Jamie L. , Shah Amit A. , Lobritto Steven J. 
Published: August 2023

Objectives:
This study sought to understand the current monitoring practices after pediatric liver transplantation (LT), specifically regarding follow-up clinic visits, outpatient laboratory testing, protocol biopsies, and diagnostic imaging, and to identify potential center and provider characteristics associated with such practices.

Methods:
A cross-sectional survey of pediatric LT providers at centers participating in the Society of Pediatric Liver Transplantation (SPLIT) registry was conducted from February 2020 to April 2021.

Results:
The overall response rate was 79% (38/48 SPLIT centers), with the majority representing large volume centers (>10 LTs per year). Frequency of clinic visits and laboratory monitoring varied by center, but all centers decreased frequency after the first post-transplant year. The most common practice included an annual clinic visit and laboratory sampling every 2–3 months. Surveillance liver biopsy is seldom done during the first post-transplant year, while being routinely performed by 50% of centers after this time period. Centers forgoing surveillance biopsies assert that the results would likely not change management. Only 39% of centers have a hepatologist perform the liver biopsy while the remaining centers consult interventional radiology. Most diagnostic imaging is obtained only as needed. Routine abdominal ultrasounds were obtained by only 50% of responding centers after the first year post-transplant.

Conclusions:
SPLIT centers vary widely in the routine management of LTs after the first year post-transplant. While common themes emerge, future studies will be needed to connect protocols to outcomes to determine best practice.
The Diagnostic Concept of Unipolar Mania
Authors: Bartoli Francesco 
Published: August 2023

Abstract
Although the traditional nosological view interprets mania as strictly connected with depression in the context of manic-depressive illness, unipolar mania (UM), that is, the lifetime occurrence of mania or hypomania in the absence of depression, has been proposed as a necessary diagnostic entity. Epidemiological data estimate that at least 5% of people with type I bipolar disorder never experienced depression. These subjects are more often males with a hyperthymic temperament, a younger age at onset, and more psychotic features. Current classification systems do not formally recognize UM, but different definitions of mania without depression have been proposed. UM should be assessed according to the number of mood episodes, the predominance of manic or hypomanic episodes, and its clinical course. More generally, UM should be considered in the context of an affective spectrum including different clinical phenotypes based on the predominance of depressive or manic symptoms. Additional clinical and epidemiological research in this field is needed.
Medicolegal Death Investigation of Railroad-Related Fatalities
Authors: Brooks Jared , Grande Abigail , Prahlow Joseph A. , Brown Theodore 
Published: August 2023

Abstract
Railroad-related fatalities in the United States are increasing. A paucity of literature exists regarding the medicolegal death investigation of railroad-related deaths. We report on a subset of deaths in western Michigan, propose protocols for investigating train-related deaths, and propose a stepwise approach for the medicolegal investigation of railroad-related fatalities. Fourteen railroad-related fatalities from 2015 to 2019 were reviewed. Each case was analyzed for demographics, investigative components, train variables, and death certification. The average age was 32 years. Nine decedents involved pedestrians versus trains, and 5 involved motor vehicles versus trains. Male victims were more common, and 50% of the cases were associated with mental illness or recent stressors. Accident was the most common manner of death. With the exception of basic weather conditions, the remaining investigative variables were rarely reported. Image and audio recordings were taken in 3 cases, but railroad companies refused to allow the recordings to be viewed by the medical examiner. We conclude that in addition to a thorough medicolegal death scene investigation and postmortem examination, audio/video recordings are crucial components of death certification in railroad-related fatalities and advocate that medical examiners/coroners be given the legal right to view and retain them.
Acute Organophosphate Poisoning Case Review With Consideration of Off-Gassing During Postmortem Examination
Authors: Hanson Courtney , Huddle Lauren N. , Kockanowski Julia , Whaley Kevin D. 
Published: August 2023

Abstract
Although self-harm via ingestion of organophosphorus compounds is relatively common in the developing world, it is rare in the United States. This article reviews the signs and symptoms associated with acute organophosphate poisoning and highlights the effects of organophosphate off-gassing during postmortem examinations to increase awareness of this potentially dangerous workplace exposure.
Paramedics responded to a 42-year-old man with pulseless electrical activity. Spontaneous circulation was restored after aggressive resuscitation. Before loss of consciousness, the patient exhibited diaphoresis, vomiting, and diarrhea. Upon admission, the patient had a Glasgow Coma Scale score of 3. Significant laboratory values included a pH of 6.8, pco
2 of 72 mm Hg, and lactic acid of 21.8 mmol/L. Electrocardiography suggested inferior ST-elevation myocardial infarction. Electroencephalogram revealed severe cerebral dysfunction. The patient died shortly thereafter.
Scene investigation revealed suicidal ideations, which included a snapshot of a bottle containing granular sediment associated with statements that he had imbibed fertilizer. During the postmortem examination, the decedent exuded a petroleum-like odor. In addition, autopsy personnel developed symptoms consistent with organophosphate exposure.
A reported history of suspected organophosphate exposure in a decedent should prompt increased safety practices to avoid potential harm to autopsy personnel.
PEComa of the Adrenal Gland
Authors: Wakefield Craig B. , Sadow Peter M. , Hornick Jason L. , Fletcher Christopher D.M. , Barletta Justine A. , Anderson William J. 
Published: August 2023

PEComas are a family of mesenchymal neoplasms composed of histologically distinctive perivascular epithelioid cells which demonstrate myomelanocytic differentiation. PEComas of the adrenal gland are very rare and can represent a considerable diagnostic challenge given their morphologic overlap with more common adrenal cortical neoplasms. We present the clinicopathologic features of 7 primary adrenal PEComas. The cohort comprised 5 male and 2 female patients with a median age of 63 years (range: 31 to 71 y). One patient had Birt-Hogg-Dubé syndrome and another had Lynch syndrome; however, none had a history of tuberous sclerosis complex. Histologically, tumors showed nested and/or sheet-like growth and epithelioid cytomorphology with pale-to-eosinophilic granular cytoplasm. Two tumors had an admixed spindle cell component. There was a median of 4 mitoses per 10 HPFs (range: 0 to 8). Necrosis was present in 4 tumors and lymphovascular invasion in 1. Four tumors were classified as malignant. By immunohistochemistry, tumors were positive for HMB-45 (3/7), MITF (3/3), Melan-A (3/7), smooth muscle actin (5/7), desmin (5/7), and caldesmon (1/1). Two tumors were positive for TFE3 (2/4). Inhibin and SF1 were negative in all tumors assessed (0/6). Of 3 patients with available clinical follow-up information, 1 patient developed locally recurrent and metastatic disease (at 18 mo) and was alive with persistent disease at the last follow-up. Two patients had no recurrent or metastatic disease at the last follow-up (60 and 25 mo). Although PEComas of the adrenal gland are rare, pathologists need to be alert to this entity in the differential diagnosis of primary adrenocortical neoplasms. In suspected cases, the judicious use of melanocytic and smooth muscle markers, in addition to TFE3 and markers of adrenocortical differentiation (such as SF1 and inhibin) can assist in diagnosis. As in PEComas arising at other visceral sites, an association with tuberous sclerosis complex seems to be uncommon.
Factors involved in higher knee extension torque induced by repetitive peripheral magnetic stimulation
Authors: KAMIUE∗ Masanori , ITO∗ Tomotaka , TSUBAHARA∗ Akio , KISHIMOTO∗ Tomoya 
Published: August 2023

ABSTRACT

Objective
The study aimed to determine the relationship between knee extension torque induced by repetitive peripheral magnetic stimulation (rPMS) and the characteristics of the participants.

Design
This was a basic study with non-invasive intervention. Knee extension torque induced by rPMS (rPMS-induced torque) and maximum voluntary contraction (MVC) were measured. Stepwise method of multiple regression was performed to determine the factors affecting rPMS-induced torque at 100% intensity and rPMS-induced torque divided by MVC (%MVC). Subcutaneous fat thickness, VL muscle thickness measured by ultrasound, MVC, and mean power frequency of electromyography (EMG) during MVC were selected as independent variables.

Results
rPMS was applied to the right vastus lateralis (VL) of 30 young healthy adults (average age, 21.1 ± 0.3 years). In the multiple regression analysis, rPMS-induced torque (p < 0.001) was shown to be independently and significantly associated with MVC (β = 0.510), subcutaneous fat thickness (β = -0.358), and VL muscle thickness (β = 0.208), while %MVC value (p < 0.05) was independently and significantly associated with VL muscle thickness (β = 1.059).

Conclusion
rPMS-induced torque decreases with thicker subcutaneous fat and increases with stronger MVC or with thicker muscle.
Effect of Knee Hyperextension on Femoral Cartilage Thickness in Stroke Patients
Authors: Korkusuz Süleyman , Kibar Sibel , Özgören Nihat , Arıtan Serdar , Seçkinoğulları Büşra , Balkan Ayla Fil 
Published: August 2023

Objective
Knee hyperextension is one of the most common compensatory mechanisms in stroke patients. The first aim of the study was to measure knee hyperextension and femoral cartilage thickness in stroke patients. The second aim was to compare the femoral cartilage thickness of the paretic and nonparetic limbs in stroke patients with and without knee hyperextension.

Design
Forty stroke patients were included in the study. The patients were divided into two groups according to the presence of knee hyperextension based on kinematic analyses performed during walking with a three-dimensional motion analysis system. The medial femoral cartilage, lateral femoral cartilage, and intercondylar cartilage thicknesses of the paretic and nonparetic sides of the patients were measured by ultrasonography.

Results
In the study group, medial femoral cartilage, intercondylar, and lateral femoral cartilage thicknesses were less on the paretic side than on the nonparetic side, while the femoral cartilage thicknesses on the paretic and nonparetic sides were similar in the control group. Paretic side medial femoral cartilage and intercondylar thicknesses were less in the study group compared with the control group, and lateral femoral cartilage thickness was similar between the two groups.

Conclusions
Knee hyperextension during walking causes femoral cartilage degeneration in stroke patients.

Clinical Trial code: NCT05513157
Pediatric ED Saves: Analyzing the ED Screen of Direct Admissions
Authors: Ramirez-Cueva Fatima , Prusky Grinberg Gary , Kuchinski Ann Marie , Gibson Robert , Xu Hongyan , Zhang Li Fang , Seeyave Desiree 
Published: August 2023

Introduction:
Direct admissions (DAs) are a routine hospital entry portal with few guidelines to assess patient safety during this process. This study assessed the effectiveness of an institutional screen for patients presenting as DA. It investigated patient variables that may predict appropriateness for DA and those at high risk for deterioration.

Methods:
The study includes patients who received the institutional screen between June 1, 2019, and May 31, 2020. We placed charts into three groups: group 1 (stable), group 2 (unstable), and group 3 (stable then transferred to pediatric intensive care unit within 6 hours). We assessed effectiveness by calculating sensitivity, specificity, and predictive values. We used comparative analysis between groups to identify patients safe for DA and those at high risk for deterioration,

Results:
The screen was 80% sensitive and 100% specific, predicting 97.7% of stable patients. Of the 652 charts reviewed, 384 met the inclusion criteria. Group 1 (31.60, 26.45%, 5.23%) had lower respiratory rate, respiratory diagnosis, and oxygen requirement compared to group 2 (45.00, 78.13%, 15.63%) and group 3 (44.50, 75.00%, 50.00%). For SpO2, group 1 (98.70) was higher than group 2 (96.03). For the Pediatric Early Warning Score, group 2 (1.72) was higher than group 1 (0.31) and group 3 (0.63).

Conclusions:
The institutional screen is an effective tool to identify patients presenting as DA needing immediate emergency department intervention and/or pediatric intensive care unit care. The screen benefits patients with a respiratory diagnosis, oxygen requirement, high respiratory rate or low SpO2.