bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiating the effects of fine and coarse particulate air pollution on the onset of stable and unstable angina: a case-crossover study in 305 Chinese cities
Authors: Jiang Yixuan , Zhang Qingli , Zhu Xinlei , Xue Xiaowei , He Qinglin , Gao Ya , Chen Renjie 
Published: June 2023

Background and purpose:
Associations between fine and coarse particulate matters (i.e., PM2.5 and PM2.5–10, respectively) and the onset of angina have rarely been investigated. We aimed to systematically explore the impacts of PM2.5 as well as PM2.5–10 on the onset of stable and unstable angina at the hourly timescale.

Methods:
We performed a time-stratified case-crossover study among 995,734 angina patients from 1,655 hospitals in 305 Chinese cities from January 2015 to December 2021. Concentrations of PM2.5 and PM2.5–10 were collected at the hourly timescale from nearby fixed-site monitoring stations. Hourly onset information of unstable and stable angina was obtained from the Chinese Cardiovascular Association Database-Chest Pain Center. We applied conditional logistic regressions combined with polynomial distributed lag models to explore the lagged exposure–response associations. Subgroup analyses were performed to explore potential effect modifiers including age, sex, season, and region.

Results:
Transient exposure to PM2.5 was significantly associated with elevated risk of unstable and stable angina onset. The associations occurred immediately in the concurrent hour of exposure, attenuated thereafter, and turned to null at approximately lag 12 h for unstable angina and 9 h for stable angina. Each interquartile range increase in the PM2.5 concentrations over 0 to 12 h was associated with 1.32% (95% confidence interval [95% CI]: 0.94%–1.70%) and 1.69% (95% CI: 0.99%–2.39%) increase in the onset risk of unstable and stable angina, respectively. The results remained similar after controlling for co-pollutants. Greater magnitudes of associations were found among females and during cold season. Null associations were observed between PM2.5–10 and any type of angina.

Conclusion:
Our study indicates that acute exposure to PM2.5, rather than PM2.5–10, was significantly associated with the onset of both unstable and stable angina, underscoring the need of continued efforts in controlling particulate matter air pollution.
Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer
Authors: Sato Shunsuke , Tanaka Toshiaki , Maehana Takeshi , Hashimoto Kohei , Kobayashi Ko , Masumori Naoya 
Published: June 2023

Abstract

Background
We retrospectively evaluated the postoperative renal function in patients who had undergone radical prostatectomy to compare the incidences of postoperative acute kidney injury (AKI) among the patients who had undergone robot-assisted radical prostatectomy (RARP), retropubic radical prostatectomy (RRP), and extraperitoneal laparoscopic radical prostatectomy (exLRP).

Materials and methods
Patients with prostate cancer who had undergone radical prostatectomy at our institution between 2008 and 2014 were included. Robot-assisted radical prostatectomy was performed using an intraperitoneal approach in a 25-degree Trendelenburg position, whereas other procedures were performed with the patient in the supine position. We evaluated the serum creatinine levels and estimated glomerular filtration rates immediately after surgery and on postoperative day 1. We evaluated the incidence of AKI after prostatectomy using the Acute Kidney Injury Network criteria of the Kidney Disease: Improving Global Outcomes guidelines.

Results
A total of 150 consecutive patients were included, with each of the 3 groups (RARP, RRP, and exLRP) comprising 50 patients. Postoperative AKI was observed in 15 (30.0%), 1 (2.0%), and 3 (6.0%) patients in the RARP, RRP, and exLRP groups, respectively. Stage 1 AKI was observed in all the patients except one. The incidence of AKI in RARP group was significantly higher than that in the other groups (p < 0.001). In the RARP group, the serum creatinine level was significantly elevated immediately after the surgery; however, it returned to baseline on postoperative day 1. Surgical procedures were the only independent factor associated with AKI incidence.

Conclusions
This study suggest that compared with RRP and exLRP, RARP is associated with a higher incidence of postoperative AKI, although most patients recover rapidly. Intra-abdominal pneumoperitoneum may contribute to AKI onset.
Proton pump inhibitor treatment is associated with acute-on-chronic liver failure in patients with advanced cirrhosis
Authors: Sturm Lukas , Gahm Chiara , Schultheiss Michael , Reincke Marlene , Huber Jan Patrick , Boettler Tobias , Thimme Robert , Bettinger Dominik 
Published: June 2023

Background:
Acute-on-chronic liver failure (ACLF) is a fatal complication of cirrhosis. Hence, identification of risk factors for ACLF is crucial. Previous studies have linked proton pump inhibitor (PPI) treatment to complications of cirrhosis, however, a possible effect of PPI treatment on the risk of ACLF has not been investigated yet. Therefore, the present study aimed to characterize the impact of PPI treatment on ACLF development.

Methods:
A total of 642 patients hospitalized due to complications of cirrhosis were retrospectively identified, and PPI treatment during an observation period of 3 years following the hospitalization was reviewed. Subsequently, 74 patients with newly initiated PPI treatment at the time of hospitalization (PPI group) were 1:1 propensity score matched to 74 patients who received no PPI treatment (no-PPI group). Primary end point was the development of ACLF during the observation period, and secondary endpoints were mortality and upper gastrointestinal bleeding.

Results:
PPI and no-PPI groups had comparably severe chronic liver disease at baseline. Nevertheless, the cumulative incidence of ACLF in the presence of death as competing risk was markedly higher in the PPI group compared with the no-PPI group. ACLF-related deaths contributed significantly to a higher 3-year mortality in the PPI group. Uni and multivariable competing risk regression models confirmed that PPI treatment was an independent predictor of ACLF in the study collective (subdistribution HR: 1.892, 95% CI: 1.092–3.281, p = 0.023). The impact of PPI treatment on ACLF development was particularly strong in patients with a model for end-stage liver disease score >12. Upper gastrointestinal bleeding was slightly less frequent in the PPI group.

Conclusions:
The present results indicate that PPI treatment could be a risk factor for ACLF in patients with advanced cirrhosis.
Ectrodactyly–Ectodermal Dysplasia–Cleft Syndrome: Ocular Findings and Surgical Treatment
Authors: Grauhan Lea D. , Gericke Adrian , Brueggemann Felix B. , Pfeiffer Norbert , Wasielica-Poslednik Joanna 
Published: June 2023

Purpose:
Ectrodactyly–ectodermal dysplasia–cleft (EEC) syndrome is a rare genetic disorder. We present ocular findings and their treatment in patients with EEC.

Methods and Results:
We report on 3 female patients (aged 59, 45, and 11 years) suffering from EEC with varying extraocular and ocular severity of phenotypic expression of the disease. Slit-lamp biomicroscopy, visual acuity, and medical treatment were evaluated over 4 months to 4 years. All patients experienced visual impairment and foreign body sensation. Examination revealed bilateral chronic blepharitis, dry eye syndrome, and corneal vascularization and clouding due to limbal stem cell deficiency (LSCD). Patient #1 presented a corneal ulcer with severe stromal thinning on the right eye. Allogeneic simple limbal epithelial transplantation (allo SLET), penetrating keratoplasty combined with allo SLET, and in total 5 amniotic membrane transplantation were performed to preserve the integrity of the eye. In patients #2 and #3, conservative therapy with lubricant eye drops, topical steroids, and antibiotics was sufficient to stabilize LSCD. In all cases, corneal epithelialization and improvement of visual acuity were achieved.

Conclusions and Importance:
To the best of our knowledge, this is the first report of surgical treatment in a patient with EEC. Allo SLET may be a surgical option to treat LSCD associated with EEC.
Inflammatory biomarkers and nanotechnology: new insights in pancreatic cancer early detection
Authors: Caputo Damiano , Quagliarini Erica , Coppola Alessandro , La Vaccara Vincenzo , Marmiroli Benedetta , Sartori Barbara , Caracciolo Giulio , Pozzi Daniela 
Published: June 2023

Background:
Poor prognosis of pancreatic ductal adenocarcinoma (PDAC) is mainly due to the lack of effective early-stage detection strategies. Even though the link between inflammation and PDAC has been demonstrated and inflammatory biomarkers proved their efficacy in predicting several tumors, to date they have a role only in assessing PDAC prognosis. Recently, the studies of interactions between nanosystems and easily collectable biological fluids, alone or coupled with standard laboratory tests, have proven useful in facilitating PDAC diagnosis. Notably, tests based on magnetic levitation (MagLev) of biocoronated nanosystems have demonstrated high diagnostic accuracy in compliance with the criteria stated by World Health Organization. Herein, we developed a synergistic analysis that combines a user-friendly Maglev-based approach and common inflammatory biomarkers for discriminating PDAC subjects from healthy ones.

Materials and Methods:
Plasma samples from 24 PDAC subjects and 22 non-oncological patients (NOPs) have been collected and let to interact with Graphene Oxide (GO) nanosheets.
Biomolecular corona formed around GO nanosheets have been immersed in a Magnetic Levitation- (Maglev) platform to study the levitation profiles.
Inflammatory biomarkers such as NLR, dNLR and PLR have been calculated and combined with results obtained by the Maglev platform.

Results:
Maglev profiles resulted significantly different between NOPs and PDAC and allowed to identify a Maglev fingerprint for PDAC. Four inflammatory markers were significantly higher in PDAC subjects: neutrophils (P=0.04), NLR (P=4.7 ×10-6), dNLR (P=2.7 ×10-5) and PLR (P=0.002). Lymphocytes were appreciably lower in PDACs (P=2.6 ×10-6).
Combining the MagLev fingerprint with dNLR and NLR returned global discrimination accuracy for PDAC of 95.7% and 91.3% respectively.

Conclusions:
The multiplexed approach discriminated PDAC patients from healthy volunteers in up to 95% of cases. If further confirmed in larger-cohort studies, this approach may be used for PDAC detection.
Proportion of early extubation and short-term outcomes after esophagectomy: a retrospective cohort study
Authors: Hirano Yuki , Konishi Takaaki , Kaneko Hidehiro , Itoh Hidetaka , Matsuda Satoru , Kawakubo Hirofumi , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Daiko Hiroyuki , Itano Osamu , Yasunaga Hideo , Kitagawa Yuko 
Published: June 2023

Background:
The proportion of early extubation after esophagectomy varies among hospitals; however, the impact on clinical outcomes is unclear. The aim of this retrospective study was to evaluate associations between the proportion of early extubation in hospitals and short-term outcomes after esophagectomy. Because there is no consensus regarding the optimal timing for extubation, we considered that hospitals’ early extubation proportion reflects the hospital-level extubation strategy.

Materials and methods:
Data of patients who underwent oncologic esophagectomy (July 2010–March 2019) were extracted from a Japanese nationwide inpatient database. The proportion of patients who underwent early extubation (extubation on the day of surgery) at each hospital was assessed and grouped by quartiles: very low- (<11%), low- (11–37%), medium- (38–83%), and high-proportion (≥84%) hospitals. The primary outcome was respiratory complications; secondary outcomes included reintubation, anastomotic leakage, other major complications, and hospitalization costs. Multivariable regression analyses were performed, adjusting for patient demographics, cancer treatments, and hospital characteristics. Restricted cubic spline analysis was also performed for the primary outcome.

Results:
Among 37,983 eligible patients across 545 hospitals, early extubation was performed in 17,931 (47%) patients. Early extubation proportions ranged from 0–100% across hospitals. Respiratory complications occurred in 10,270 patients (27%). Multivariable regression analyses showed that high- and medium-proportion hospitals were significantly associated with decreased respiratory complications (odds ratio, 0.46 [95% confidence interval, 0.36–0.58] and 0.43 [0.31–0.60], respectively), reintubation, and hospitalization costs when compared with very low-proportion hospitals. The risk of anastomotic leakage and other major complications did not differ among groups. The restricted cubic spline analysis demonstrated a significant inverse dose-dependent association between the early extubation proportion and risk of respiratory complications.

Conclusion:
A higher proportion of early extubation in a hospital was associated with a lower occurrence of respiratory complications, highlighting a potential benefit of early extubation after esophagectomy.
Novel techniques for assessment of bone tissue material properties
Authors: Rao Ajay D. 
Published: June 2023

Purpose of review
The purpose of this review will be to shed light on novel techniques for assessment of bone tissue material properties.

Recent findings
Recently there has been an increase in modalities to investigate bone tissue material properties. Historically, clinicians treating patients with bone disorders have relied upon the use of bone mineral density (BMD) as assessed by dual-energy X-ray absorptiometry (DXA). Although DXA provides an ability to screen at a large-scale population level, it only explains about 60% of the fracture risk. Recent advances include the use of imaging modalities, responses to load, and novel infrared (IR) techniques.

Summary
These newer techniques have not reached a point for population level screening; however, they may inform the science of bone biology further and help discern various bone disease states.
Reducing Medication Math Anxiety of Prelicensure Nursing Students Using Social Media Tutorials
Authors: Gaffney Mary Kathryn 
Published: June 2023

Background:
First-semester prelicensure nursing students commonly report experiencing math anxiety that negatively affects academic performance and triggers fear of causing patient harm. Students often turn to social media platforms to supplement their learning experience.

Purpose:
To explore the feasibility of using Instagram tutorials to reduce math anxiety of first-semester prelicensure nursing students.

Methods:
A quasi-experimental descriptive survey design was used to evaluate the utility of posting supplemental math tutorials on Instagram and examined the effect of tutorials on math anxiety levels. A convenience sample of 20 students used the tutorials. Math anxiety levels were evaluated using the Single-Item Math Anxiety Scale.

Results:
A statistically significant inverse relationship was observed between math anxiety levels and tutorial use. The Instagram platform was familiar to students and simple to access. Brief tutorials appealed to audio-visual learners.

Conclusions:
Using Instagram-based tutorials is feasible and appears effective in reducing medication math anxiety.
99mTc-MDP Bone Scan Findings of Recurrent Langerhans Cell Histiocytosis in an Adult Involving Femur After Joint Replacement
Authors: Xu Tingting , Cen Bing , Li Hongmei , Wang Yudi , Chen Yue 
Published: June 2023

AbstractLangerhans cell histiocytosis (LCH) is a rare proliferative histiocytic disorder. It mainly occurs in children and is rare in adults. We reported99mTc-MDP bone scan findings of recurrent LCH in an adult, which involved the right femur after right-side total hip arthroplasty. This case emphasizes that the possibility of LCH should be considered in osteolytic lesions in adults, especially after joint replacement. In addition, LCH should be included in the differential diagnosis of prosthetic joint pain and abnormal 3-phase bone scan after prosthesis arthroplasty.
Harnessing the power of endogenous pain control mechanisms for novel therapeutics: how might innovations in neuroimaging help?
Authors: Howard Matthew A. , Lawn Timothy , Kowalczyk Olivia S. 
Published: June 2023

Purpose of review
This review explores the potential of using novel imaging approaches to deepen our understanding of descending modulatory mechanisms in pain, focussing on functional magnetic resonance imaging (fMRI) of the spinal cord and novel approaches to combining molecular and fMRI data. This review sheds light on the neural processes involved in pain modulation, paving the way for the development of targeted treatments.

Recent findings
The reviewed literature demonstrates significant advancements in pain research. Recent studies show the potential of using fMRI to investigate the spinal cord’s role in pain modulation. Furthermore, novel analytical approaches integrating molecular and fMRI data show promise in elucidating the complex neurobiological processes underlying pain regulation. The main themes explored here include the identification of neurochemical markers associated with pain modulation and the characterisation of neural circuits involved in descending pain control.

Summary
A comprehensive understanding of descending modulatory mechanisms in pain can inform the development of novel treatments, targeting dysfunction of these key pathways. By leveraging spinal fMRI and integrating molecular data into brain fMRI, researchers can identify potential therapeutic targets throughout the neuraxis. These advances may contribute to the development of personalised medicine approaches, allowing for tailored interventions based on individual pain profiles.
Reproductive and Child Health Indicators at Primary Health Centers: A Trend of last four years and their comparison with National And State averages
Authors: Desai Dev , Shukla Aparajita 
Published: June 2023

AbstractBackgroundLarge amount of data is gathered by Community health centers but remain unanalyzed resulting in poor resource allocation and subsequent poor health outcomes.objectivesto study RCH indicators and compare them with NFHS and SFHSMethodsA record based study for 2017–2021 was carried out among all urban and rural primary health centers of Ahmedabad. RCH indicators were compiled and compared with NFHS and SFHS to draw conclusions about the performance of these centers.Resultsin all selected centers, in last 4 years, almost all women who registered pregnancy have come for ANC visits; home deliveries, Health Centre based Cesarean-section, Vasectomy and malnutrition along with Severe Acute Malnutrition has decreased. Female sterilization has remained same. Immunizations has remained satisfactorily. Newborn Mortality Rate, Neonatal Mortality Rate, Infant Mortality Rates, Under-5 Mortality Rate and Maternal Mortality rates all have decreased. This results are similar in both Rural and Urban areas and are along the lines of recent NFHS and SFHS. It was particularly found that Data Management at various levels is faulty and there are mistakes in Data Collection, Data Gathering, Data Analysis and Data preserving. There is a visible difference between how Rural data is managed versus how Urban data is managed.ConclusionsValuable information is generated which can be utilized by local governing bodies. Better methodology and techniques are now a necessity for quality Data Recording, Management and Safe-keeping. Use of technology can reduce these limitations in the field and improve decision making.
Rapid nanopore metagenomic sequencing and predictive susceptibility testing of positive blood cultures from intensive care patients with sepsis
Authors: Harris Patrick N. A. , Bauer Michelle J. , Lüftinger Lukas , Beisken Stephan , Forde Brian M. , Balch Ross , Cotta Menino , Schlapbach Luregn , Raman Sainath , Shekar Kiran , Kruger Peter , Lipman Jeff , Bialasiewicz Seweryn , Coin Lachlan , Roberts Jason A. , Paterson David L. , Irwin Adam D. 
Published: June 2023

ABSTRACTBackgroundDirect metagenomic sequencing from positive blood culture (BC) broths, to identify bacteria and predict antimicrobial susceptibility, has been previously demonstrated using Illumina-based methods, but is relatively slow. We aimed to evaluate this approach using nanopore sequencing to provide more rapid results.MethodsPatients with suspected sepsis in 4 intensive care units were prospectively enrolled. Human-depleted DNA was extracted from positive BC broths and sequenced using nanopore (MinION). Species abundance was estimated using Kraken2, and a cloud-based artificial intelligence (AI) system (AREScloud) providedin silicoantimicrobial susceptibility testing (AST) from assembled contigs. These results were compared to conventional identification and phenotypic AST.ResultsGenus-level agreement between conventional methods and metagenomic whole genome sequencing (MG-WGS) was 96.2% (50/52), but increased to 100% in monomicrobial infections. In total, 262 high quality AREScloud AST predictions across 24 samples were made, exhibiting categorical agreement (CA) of 89.3%, with major error (MA) and very major error (VME) rates of 10.5% and 12.1%, respectively. Over 90% CA was achieved for some taxa (e.g.Staphylococcus aureus), but was suboptimal forPseudomonas aeruginosa(CA 50%). In 470 AST predictions across 42 samples, with both high quality and exploratory-only predictions, overall CA, ME and VME rates were 87.7%, 8.3% and 28.4%. VME rates were inflated by false susceptibility calls in a small number of species / antibiotic combinations with few representative resistant isolates. Time to reporting from MG-WGS could be achieved within 8-16 hours from blood culture positivity.ConclusionsDirect metagenomic sequencing from positive BC broths is feasible and can provide accurate predictive AST for some species and antibiotics, but is sub-optimal for a subset of common pathogens, with unacceptably high VME rates. Nanopore-based approaches may be faster but improvements in accuracy are required before it can be considered for clinical use. New developments in nanopore sequencing technology, and training of AI algorithms on larger and more diverse datasets may improve performance.
Next-Generation Phenotyping: Introducing PhecodeX for Enhanced Discovery Research in Medical Phenomics
Authors: Shuey MM , Stead WW , Aka I , Barnado AL , Bastarache JA , Brokamp E , Campbell Joseph MS , Carroll RJ , Goldstein JA , Lewis A , Malow BA , Mosley JD , Osterman T , Padovani-Claudio DA , Ramirez A , Roden DM , Schuler BA , Siew E , Sucre J , Thomsen I , Tinker RJ , Van Driest S , Walsh C , Warner JL , Wells QS , Wheless L , Bastarache L 
Published: June 2023

AbstractSummaryPhecodes are widely-used and easily adapted phenotypes based on International Classification of Diseases (ICD) codes. The current version of phecodes (v1.2) was designed primarily to study common/complex diseases diagnosed in adults. Here we present phecodeX, an expanded version of phecodes with a revised structure and 1,761 new codes. PhecodeX adds granularity to phenotypes in key disease domains that are under-represented in the current phecode structure-including infectious disease, pregnancy, congenital anomalies, and neonatology- and is a more robust representation of the medical phenome for global use in discovery research.Availability and implementationphecodeX is available athttps://github.com/PheWAS/phecodeX.Contactlisa.bastarache@vumc.orgSupplementary informationSupplemental Tables 1-4, Bastarache_bioRxiv_20220907.pdfWC-1999