bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuity of Care Versus Language Concordance as an Intervention to Reduce Hospital Readmissions From Home Health Care
Authors: Squires Allison , Engel Patrick , Ma Chenjuan , Miner Sarah M. , Feldman Penny H. , McDonald Margaret V. , Jones Simon A. 
Published: August 2023

Background:
Language concordance between health care practitioners and patients have recently been shown to lower the risk of adverse health events. Continuity of care also been shown to have the same impact.

Objective:
The purpose of this paper is to examine the relative effectiveness of both continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency.

Design:
A multivariable logistic regression model using rehospitalization as the dependent variable was built. The variable of interest was created to compare language concordance and continuity of care.

Participants:
The final sample included 22,103 patients from the New York City area between 2010 and 2015 who were non–English-speaking and admitted to their home health site following hospital discharge.

Measures:
The odds ratio (OR) average marginal effect (AME) of each included variable was calculated for model analysis.

Results:
When compared with low continuity of care and high language concordance, high continuity of care and high language concordance significantly decreased readmissions (OR=0.71, 95% CI: 0.62–0.80, P<0.001, AME=−4.95%), along with high continuity of care and low language concordance (OR=0.80, 95% CI: 0.74–0.86, P<0.001, AME=−3.26%). Low continuity of care and high language concordance did not significantly impact readmissions (OR=1.04, 95% CI: 0.86–1.26, P=0.672, AME=0.64%).

Conclusion:
In the US home health system, enhancing continuity of care for those with language barriers may be helpful to address disparities and reduce hospital readmission rates.
Matrikines in kidney ageing and age-related disease
Authors: Eckersley Alexander , Yamamura Tomohiko , Lennon Rachel 
Published: August 2023

Purpose of review
Matrikines are cell-signalling extracellular matrix fragments and they have attracted recent attention from basic and translational scientists, due to their diverse roles in age-related disease and their potential as therapeutic agents. In kidney, the matrix undergoes remodelling by proteolytic fragmentation, so matrikines are likely to play a substantial, yet understudied, role in ageing and pathogenesis of age-related diseases.

Recent findings
This review presents an up-to-date description of known matrikines with either a confirmed or highly anticipated role in kidney ageing and disease, including their point of origin, mechanism of cleavage, a summary of known biological actions and the current knowledge which links them to kidney health. We also highlight areas of interest, such as the prospect of matrikine cross-tissue communication, and gaps in knowledge, such as the unexplored signalling potential of many kidney disease-specific matrix fragments.

Summary
We anticipate that knowledge of specific matrikines, and their roles in controlling processes of kidney pathology, could be leveraged for the development of exciting new future therapies through inhibition or even with their supplementation.
Does cooled dialysate still have a role in reducing intradialytic stress? Implications of the MyTEMP trial
Authors: Hull Katherine L. , McIntyre Chris , Burton James O. 
Published: August 2023

Purpose of review
There is an excess of cardiovascular morbidity and mortality in the maintenance haemodialysis population. Targeting traditional risk factors (e.g. hypercholesterolaemia) do not improve cardiovascular outcomes. Repeated myocardial stunning during haemodialysis is an important nontraditional risk, resulting in pathological cardiac remodelling and fibrosis. This review explores dialysate cooling as a management strategy to promote haemodynamic stability, reduce myocardial injury, and improve cardiovascular disease outcomes for individuals receiving maintenance haemodialysis.

Recent findings
Observational data and small interventional studies demonstrate dialysate cooling has the potential to reduce end-organ damage and provide cardioprotection, renal protection and neuroprotection compared with standard care. These data are limited by the small sample sizes, short follow-up times and lack of long-term patient important outcomes. The MyTEMP study, a multicentre pragmatic randomized controlled trial, demonstrated cooled dialysate (0.5°C below body temperature) vs. standard care did not improve cardiovascular outcomes for prevalent haemodialysis patients.

Summary
Dialysate cooling has been widely adopted into routine clinical practice; the MyTEMP study challenges the unit-level approach to implementing dialysate cooling. Due to methodological limitations, the absence of other important patient outcome measures, and lack of granularity of patient-level data, dialysate cooling should not be hastily removed from all dialysis care and warrants further research.
Giant staghorn stone causing inferior vena cava compression: a novel case report
Authors: Alghafees Mohammad A. , Abdul Rab Saleha , Raheel Hiba M. , Sabbah Belal N. , Maklad Ahmed E. , El Sarrag Mazin I. , Abouelkhair Ahmed E. , Aljurayyad Abdulaziz , Alotaibi Tariq , Alotaibi Mohammed T. , Alomar Mohammad 
Published: August 2023

Introduction and Importance:
Staghorn calculi (SC) are defined as large kidney stones that fill the renal pelvis and at least one renal calyx. They represent 10–20% of all renal stones in developing countries and require prompt diagnosis and management. Massive SC (over 5 cm) are treated exclusively via open surgery, despite percutaneous nephrolithotomy (PCNL) being the gold standard treatment for large stones. Descriptions of PCNL for massive SC are very limited in the literature.

Case Presentation:
We report a case of a 63-year-old male who presented with chronic abdominal pain, hepatosplenomegaly, and normal renal function. He was later diagnosed with polycythemia vera. Computed tomography of the abdomen revealed massive, bilateral staghorn stones measuring 7.3×5.5 cm and 1.8×4.5 cm on the right and left, respectively. Additionally, the right stone was found to be compressing the inferior vena cava (IVC). The patient was promptly scheduled for right-sided PCNL and the target of 80% stone fragmentation was successfully attained.

Discussion:
We present the first case of a stone of such size in the Middle East, as well as the first known case of a renal stone compressing the IVC. Unlike previous reports, the stone was successfully fragmented via PCNL – a procedure that has not been described for stones of such size.

Conclusion:
This report highlights that ultrasound-guided PNCL without any other intervention is sufficient for the successful treatment of giant SC. Greater research is needed on the potential utility of using ultrasound-guided PCNL for the fragmentation of stones sized over 5 cm.
Systemic sclerosis with interstitial lung disease and myocardial infarction: a case report
Authors: Adhikari Sagar , Poudel Priyanka , Pathak Sujan 
Published: August 2023

Introduction and importance:
Systemic sclerosis (SSc) is a rare autoimmune connective tissue disorder that causes fibrosis due to an accelerated inflammatory response. One of the most frequent co-morbidities with SSc is interstitial lung disease (ILD), which is also one of the biggest killers among SSc patients.

Case presentation:
The authors present a rare case of diffuse SSc with ILD and myocardial infarction having a history of Raynaud phenomenon, skin thickening, and shortness of breath. Antinuclear antibody and antitopoisomerase antibody tests were positive. The patient was managed medically and the condition of patient is improving.

Clinical discussion:
SSC can affect the skin as well as other organs, with the lungs being the most frequently involved and seriously impacted. SSc patients can have multiple organ involvement like the skin, lungs, heart, kidneys, and gastrointestinal tract. Because ILD is the leading cause of death among people with SSC, early diagnosis and high suspicion of lung involvement can reduce mortality.

Conclusion:
The mortality rate for SSC associated with ILD is extremely high. Even though ILD is common in SSc, it might be difficult to identify and detect early for which a high-resolution CT scan can be used. In SSc patients, heart involvement can coexist with ILD.
Immunohistochemical expression of beta-catenin in ampullary adenocarcinoma: a cross-sectional retrospective study
Authors: Mirza Sazan Abdulwahab , Hilmi Mohammed N. , Al jaleeli Azza N. 
Published: August 2023

Introduction:
Ampullary carcinomas are uncommon malignant tumours of the digestive system, they usually are adenocarcinomas presenting histologically as three types: intestinal, pancreaticobiliary and mixed. β-catenin is a multifunctional protein involved in physiological homoeostasis and intracellular adhesion. Abnormal nuclear accumulation of β-catenin has been described in many malignancies such as colon, breast, liver and others. The relationships between the immunohistochemical expression of β-catenin and the subtype, the grade and the stage of ampullary carcinoma are studied.

Material and methods:
A cross-sectional retrospective study was done on 25 formalin-fixed paraffin-embedded blocks of ampullary carcinoma: Cases were collected from the archives of the pathology department in the Gastroenterology and hepatology teaching hospital, medical city/ Baghdad from January 2019 to March 2022. The data of the patients and the characteristics of the tumour were derived from the pathological reports; additional sections from the block were stained with β-catenin immunohistochemically.

Results:
25 paraffin blocks from patients with ampullary carcinoma (12 males, 13 females) were included in the study. 64% of the cases are classified as pancreaticobiliary, 20% as mixed, 12% as intestinal and 4% as adenosquamous type. Eighty-four percent of the cases are moderately differentiated, and the remaining is poorly differentiated. Most cases show strong β-catenin membranous staining and 80% express 3+ staining of cytoplasmic β-catenin. Regarding nuclear β-catenin staining, 56% has negative staining.

Conclusion:
No significant association was found between the cytoplasmic and the nuclear expression of β-catenin and the tumour type, size and lymph node status. The grade of the tumour showed a significant correlation with the cytoplasmic expression; while, no correlation was noted with the nuclear expression. This study results do not support the use of beta-catenin as a diagnostic marker or prognostic marker in ampullary cancers.
Reinforced technique of tension band wiring for tibial tuberosity fracture in adolescents: a case report for surgical technique
Authors: Park Yong-Geun , Yoo Seung J. , Kim Yong-Beom , Jang Youjeong , Lim Chaemoon 
Published: August 2023

Introduction and importance:
Most of the fractures had been previously treated with open reduction and internal fixation. Although there are a number of fixation methods, a consensus on the treatment options has not been reached yet.

Case presentation:
We demonstrated the reinforced technique of tension band wiring and its surgical outcomes in the tibial tuberosity fracture of a 14-year-old male basketball player. For the modified technique, the wire was inserted between the patellar tendon and tibial tuberosity (insertion site of patellar tendon) and passed distally through the 2-mm-sized predrill cortical hole. Tightening the figure of the eight loops draws the fractured fragments together and anatomically reduces under appropriate compression. This technique can achieve the reduction and fixation of the fracture simultaneously. We confirmed the fixation stability with a range of knee joint motions. The patient was able to return back to the pre-injury level of sports activity at postoperative 2 months.

Clinical discussion:
The original technique of tension band wiring utilized the Kirschner wire to make a figure-of-eight loop. However, we used the patellar tendon and its insertion site of the tibial tuberosity for making a figure-of-eight loop. Moreover, the reduction and fixation of fracture were achieved simultaneously by tightening the tension band wire. This reinforced technique was firm enough for postoperative rehabilitation.

Conclusion:
The most certain advantage of this technique was to be able to reduce anatomically and fixate firmly with appropriate compression simultaneously. We recommend open reduction internal fixation with the reinforced technique of tension band wiring for displaced tibial tuberosity fracture in adolescent athletes.
Evaluation of IL-17F A7488G polymorphism in Helicobacter pylori-infected patients: a case–control study
Authors: Hormati Ahmad , Mirtalebi Roknabadi Fateme S. , Aghaali Mohammad , Shams Saeed 
Published: August 2023

Objective:
Interleukin 17 (IL-17) plays an important role in the inflammation of the gastric mucosa and, in severe cases, the development of gastric cancer. Thus, the authors aimed to evaluate the IL-17F A7488G polymorphism in Helicobacter pylori (H. pylori) patients.

Patients and methods:
A total of 86 adults (in two H. pylori-positive and H. pylori-negative groups) were included in the study. To identify the infection, rapid urease test and polymerase chain reaction (PCR) were performed. The cagA gene was also evaluated as a bacterial virulence factor. PCR–restriction fragment length polymorphism was used to investigate the IL-17F A7488G polymorphism in gastric biopsies using the NlaIII enzyme.

Results:
96.5% of patients in both groups did not show any mutation and had AA genotype, and only three patients infected with cagA-carrying H. pylori strains had polymorphism in the IL-17F A7488G gene, which included AG (one case) and GG (two cases) patterns. No significant relationship was found between these polymorphisms in the two groups of H. pylori-positive and H. pylori-negative patients, while, interestingly, a significant difference was observed between the polymorphisms and the presence of the cagA gene.

Conclusion:
This report is one of the first to demonstrate the association of IL-17F A7488G polymorphism with H. pylori infection and the presence of the cagA gene. Although no significant association between IL-17F polymorphism and H. pylori infection was found in the population of this study, the patients with mutated genotypes were positive for the cagA gene, which was statistically significant. Therefore, the possibility of the role of pathogenic strains in causing mutations in cytokine genes is more conceivable.
Polypharmacy among patients with hypertension attending primary healthcare centres
Authors: Alsanosi Safaa M. , Mousa Ahmed H. , Ahmadini Hind A. , Qadhi Rawabi S. , Ikram Nadeem , Felemban Alaa H. , Alqashqri Hamsah S. , Hariri Nahla H. , Alhindi Yosra Z. , Ayoub Nahla 
Published: August 2023

Introduction:Saudi Arabia has several hypertensive patients who require close attention and specialised care for their medications. Polypharmacy is one of the reasons for the failure of patient compliance with antihypertensive medications. Therefore, this study aims to gain a better perspective on polypharmacy in hypertensive patients attending primary healthcare (PHC) centres in Makkah, Saudi Arabia.Methods:This was an observational, cross-sectional, descriptive study of hypertensive patients followed up at 10 PHC centres in Makkah, Saudi Arabia, from 1 July 2019 to 30 June 2022. Frequencies and percentages were used to present categorical data, and Pearson’sχ2test was used to measure differences. APvalue less than 0.05 was considered statistically significant.Results:A total of 506 patients were included in this study. The mean age of the patients was 60 years, and more than half (69%) were females. Regarding antihypertensive medication use, 64% were on antihypertensive combination therapy, 76% on dual therapy, 21% on triple therapy, and 3% on quadruple therapy. Moreover, 21% of the hypertensive patients were exposed to polypharmacy. There was a significant relationship (P<0.001) between the overall number of chronic medications used per day and the duration of hypertension.Conclusion:More clinical research is needed to identify the impact of polypharmacy on the quality of healthcare in PHC centres in general and hypertensive patients specifically in different regions of Saudi Arabia.
Spontaneous liver rupture after uncomplicated delivery: medical case report
Authors: Merbouh Manal , El Aidouni Ghizlane , Bkiyar Houssam , Housni Brahmin 
Published: August 2023

Introduction and importance:
Spontaneous hepatic rupture is an uncommon and fatal complication that most often occurs in the setting of severe pre-eclampsia.

Case presentation:
In this article, the authors describe a case of spontaneous liver rupture occurring on the sixth day of an uncomplicated pregnancy in postpartum.

Discussion:
According to the literature, liver rupture in the obstetrical setting is mostly linked to pre-eclampsia and HELLP syndrome.

Conclusion:
A collaborative multidisciplinary approach is required to define adequate medical and surgical management when there is suspicion of liver rupture in pregnant women.
Big data, big consortia, and pain: UK Biobank, PAINSTORM, and DOLORisk
Authors: Hébert Harry L. , Pascal Mathilde M.V. , Smith Blair H. , Wynick David , Bennett David L.H. 
Published: August 2023

Abstract
Chronic pain (CP) is a common and often debilitating disorder that has major social and economic impacts. A subset of patients develop CP that significantly interferes with their activities of daily living and requires a high level of healthcare support. The challenge for treating physicians is in preventing the onset of refractory CP or effectively managing existing pain. To be able to do this, it is necessary to understand the risk factors, both genetic and environmental, for the onset of CP and response to treatment, as well as the pathogenesis of the disorder, which is highly heterogenous. However, studies of CP, particularly pain with neuropathic characteristics, have been hindered by a lack of consensus on phenotyping and data collection, making comparisons difficult. Furthermore, existing cohorts have suffered from small sample sizes meaning that analyses, especially genome-wide association studies, are insufficiently powered. The key to overcoming these issues is through the creation of large consortia such as DOLORisk and PAINSTORM and biorepositories, such as UK Biobank, where a common approach can be taken to CP phenotyping, which allows harmonisation across different cohorts and in turn increased study power. This review describes the approach that was used for studying neuropathic pain in DOLORisk and how this has informed current projects such as PAINSTORM, the rephenotyping of UK Biobank, and other endeavours. Moreover, an overview is provided of the outputs from these studies and the lessons learnt for future projects.
Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities
Authors: Di Stefano Giulia , Falco Pietro , Galosi Eleonora , De Stefano Gianfranco , Di Pietro Giuseppe , Leone Caterina , Litewczuk Daniel , Tramontana Lorenzo , Strano Stefano , Truini Andrea 
Published: August 2023

Abstract

Introduction:
Previous clinical observations raised the possibility that COVID-19 vaccination might trigger a small-fibre neuropathy.

Objectives:
In this uncontrolled observational study, we aimed to identify small fibre damage in patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination.

Methods:
We collected clinical data, including a questionnaire for assessing autonomic symptoms (Composite Autonomic Symptom Score-31), and investigated quantitative sensory testing (QST) and skin biopsy in 15 prospectively enrolled patients with generalized sensory symptoms and pain after COVID-19 vaccination. Nine patients complaining of orthostatic intolerance also underwent cardiovascular autonomic tests.

Results:
We found that all patients experienced widespread pain, and most of them (11 of 15) had a fibromyalgia syndrome. All patients had normal skin biopsy findings, and in the 9 patients with orthostatic intolerance, cardiovascular autonomic tests showed normal findings. Nevertheless, 5 patients had cold and warm detection abnormalities at the QST investigation.

Conclusions:
In our study, most patients complaining of generalized sensory symptoms and pain after COVID-19 vaccination had clinical and diagnostic test findings compatible with a fibromyalgia syndrome. Although the abnormal QST findings we found in 5 patients might be compatible with a small-fibre neuropathy, they should be cautiously interpreted given the psychophysical characteristics of this diagnostic test. Further larger controlled studies are needed to define precisely the association between small fibre damage and COVID-19 vaccination.
Changes in short-term (in-ICU and in-hospital) mortality following Intensive Care Unit admission in adults Living with HIV: 2000–2019
Authors: Kanitkar Tanmay , Dissanayake Oshani , Bakewell Nicholas , Symonds Maggie , Rimmer Stephanie , Adlakha Amit , Lipman Marc C.I. , Bhagani Sanjay , Sabin Caroline A. , Agarwal Banwari , Miller Robert F. 
Published: August 2023

Objective:
Limited data suggest intensive care unit (ICU) outcomes have improved in people with HIV (PWH). We describe trends in in-ICU/in-hospital mortality among PWH following admission to ICU in a single UK-based HIV referral centre, from 1 January 2000 to 31 December 2019.

Methods:
Modelling of associations between ICU admission and calendar year of admission was done using logistic regression with adjustment for age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, CD4+ T-cell count and diagnosis of HIV at/within the past 3 months.

Results:
Among 221 PWH (71% male, median [interquartile range (IQR)] age 45 years [38–53]) admitted to ICU, median [IQR] APACHE II score and CD4+ T-cell count were 19 [14–25] and 122 cells/mm3 [30–297], respectively; HIV-1 viral load was ≤50 copies/ml in 46%. The most common ICU admission diagnosis was lower respiratory tract infection (30%).
In-ICU and in-hospital, mortality were 29% and 38.5%, respectively. The odds of in-ICU mortality decreased over the 20-year period by 11% per year [odds ratio (OR): 0.89 (95% confidence interval (CI): 0.84–0.94)] with in-hospital mortality decreasing by 14% per year [0.86 (0.82–0.91)]. After adjusting for patient demographics and clinical factors, both estimates were attenuated, however, the odds of in-hospital mortality continued to decline over time [in-ICU mortality: adjusted OR: 0.97 (0.90–1.05); in-hospital mortality: 0.90 (0.84–0.97)].

Conclusion:
Short-term mortality of critically ill PWH admitted to ICU has continued to decline in the ART era. This may result from changing indications for ICU admission, advances in critical care and improvements in HIV-related immune status.