bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of respiratory training in home-based pulmonary rehabilitation for elderly patients with stable COPD: Study protocol for a randomized controlled trial
Authors: Shen Xiaoyu , Zhong Jianguo , Shan Cuihua , Zhang Dailiang 
Published: September 2023

Introduction:
Chronic Obstructive Pulmonary Disease (COPD) brought a heavy risk of morbidity, hospital admission, and death. Respiratory training as an important part of pulmonary rehabilitation has not been validated in home-based elderly patients with stable COPD. This study aims to demonstrate the efficacy of a standardized respiratory training in home-based elderly patients with stable COPD.

Methods:
The prospective, randomized controlled trial will be designed and conduced in the Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital),China. Eligible patients with stable COPD will be randomly divided into experimental group and control group, both of the 2 groups will carry out regular home-based pulmonary rehabilitation for 3 months, additionally experimental group will receive a standardized respiratory training for 3 months. The primary outcome is the pulmonary function test before and after 3 months exercises.

Discussion:
The study will provide a objective basis for the use of respiratory training in home-based pulmonary rehabilitation for elderly patients with stable COPD.
Renal osteodystrophy: something old, something new, something needed
Authors: David Valentin , Salusky Isidro B. , Malluche Hartmut , Nickolas Thomas L. 
Published: September 2023

Purpose of review
Renal osteodystrophy (ROD) is a complex disorder of bone metabolism that affects virtually all adults and children with chronic kidney disease (CKD). ROD is associated with adverse clinical outcomes including bone loss, mineralization and turnover abnormalities, skeletal deformities, fractures, cardiovascular events, and death. Despite current therapies, fracture incidence is 2-fold to 100-fold higher in adults and 2-fold to 3-fold higher in children when compared to without CKD. Limited knowledge of ROD pathogenesis, due to the lack of patient-derived large-scale multimodal datasets, impedes development of therapeutics aimed at reducing morbidity and mortality of CKD patients. The purpose of the review is to define the much needed infrastructure for the advancement of RDO treatment.

Recent findings
Recently, we created a large-scale data and tissue biorepository integrating clinical, bone quality, transcriptomic, and epigenomic data along with stored urine, blood, and bone samples. This database will provide the underpinnings for future research endeavors leading to the elucidation and characterization of the pathogenesis of ROD in CKD patients with and without dialysis.

Summary
The availability of an open-access NIH-funded resource that shares bone-tissue-based information obtained from patients with ROD with the broad scientific community represents a critical step in the process of discovering new information regarding unrecognized bone changes that have severe clinical complications. This will facilitate future high-impact hypothesis-driven research to redefine our understanding of ROD pathogenesis and pathophysiology and inform the development of disease-modifying and prevention strategies
Blood pressure targets in chronic kidney disease: still no consensus
Authors: Lucas Bethany , Taal Maarten W. 
Published: September 2023

Purpose of review
Despite a strong consensus that treatment of hypertension is fundamental to strategies seeking to slow chronic kidney disease (CKD) progression and reduce the associated risk of cardiovascular events (CVE), controversy persists regarding optimal blood pressure (BP) targets. This article reviews the evidence for different targets, discusses associated controversies and suggests approaches to improve BP control.

Recent findings
Landmark clinical trials established the principle that lower BP targets are associated with slower progression of CKD in people with a greater magnitude of proteinuria and previous guidelines recommended a target BP of <130/80 mmHg for those with proteinuria. However, the Systolic Blood Pressure Intervention Trial provided new evidence that a systolic BP target of <120 mmHg was associated with a reduced risk of CVE, though there was no impact on CKD progression and there was concern about an increase in renal adverse events. Nevertheless, 2021 Kidney Disease Improving Global Outcomes guidelines recommended systolic BP <120 mmHg, though other updated guidelines did not follow this trend. All guidelines emphasise the importance of standardised BP measurement and a personalised approach.

Summary
An individualised and shared decision-making approach to BP target setting and management is recommended, guided by standardised BP measurement.
The mediating effect of the built environment on the relationship between socioeconomic status and mental health: findings from the 2019 Shanghai Community Survey
Authors: Xiaohua Zhong , Fuqin Wang 
Published: September 2023

Abstract

Objective:
Based on the theory of spatial production, the built environment is considered a mediating mechanism for health inequality. This study tested the hypothesis that communities, where populations with a higher socioeconomic status live, have a higher-quality built environment, which, in turn, promotes their mental health.

Methods:
Based on data from the 2019 Shanghai Community Survey (n = 3233), the general linear regression model (Ordinary Least Squares) and the classic three-step method developed by Baron and Kenny (1986) were used to test the mediation effects; subsequently, a structural equation model (bootstrap) was used to examine average direct effects and average causal mediation effects.

Results:
There were fewer types of aversive facilities, more green spaces or sports fields conducive to leisure and exercise, and better environmental hygiene in communities with higher-income populations, all of which improved their mental health. The total effect of income on mental health was 0.145 (P < 0.001), of which the average causal mediation effect through the built environment was 0.013 (P < 0.05), accounting for ~8.97%. Among the 3 dimensions of the built environment, the sanitation environment had a greater effect, accounting for 55.07% of the total mediation effect. Surrounding facilities accounted for 34.73%, whereas community green and sports spaces accounted for ~10.19%.

Conclusions:
The built environment quality of communities where low-income groups reside is worse, resulting in lower levels of their mental health. In the spatial planning of built environments, the socioeconomic characteristics of different residential groups should be considered, and the environmental quality of low-income communities should be improved using targeted measures.
Predictors of the social participation of adults with Down syndrome: an analysis based on the biopsychosocial model of the International Classification of Functioning, Disability, and Health
Authors: Lacerda de Andrade Michele , Silva Soraia Micaela , Ferreira de Moraes Janaina , Cardoso de Jesus Stephanie , dos Santos Pedro Emily , Ferrari Corrêa João Carlos , Corrêa Fernanda Ishida 
Published: September 2023

Abstract

Objective
Identify the predictors of social participation in Down Syndrome (DS) adults from the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF).

Methods
An exploratory, analytical, cross-sectional study was conducted with DS adults. The social participation was assessed using the Life Habits Assessment (LIFE-H 3.1). The independent variables were determined using the ICF biopsychosocial model: Body functions were assessed by body mass index (BMI), cognition function (Mini-Mental State Examination-MMSE), and lower limbs muscle strength (Sit to Stand Test). Activities were assessed by the 8-Foot Up and Go Test (8-FUGT). Environmental factors were assessed by the measure of the quality of the environment (MQE), and personal factors were assessed by age, sex, and education level.

Results
The total LIFE-H score indicates that individuals show moderate restriction in social participation, with major restriction in the education, employment, and responsibilities domains. The 8-FUGT was the best social participation predictor variable, followed by MMSE, and the Sit-to-Stand Test. Contextual factors were not predictors of participation.

Conclusion
It was concluded that individuals with DS present the most restrictions to social participation in activities that involve social roles. The predictors influencing social participation are functional mobility, cognition, and lower limb muscle strength.
Dynamic CZT-SPECT
Authors: Bailly Matthieu , Courtehoux Maxime , Metrard Gilles , Angoulvant Denis , Ribeiro Maria Joao 
Published: September 2023

Abstract
CZT-SPECT myocardial perfusion enables quantification of myocardial blood flow (MBF). Normal values and thresholds have been accurately defined in PET but remain unclear in SPECT. The aim of this study was to report normal MBF and myocardial flow reserve values in very low-risk patients referred for coronary artery disease screening with dynamic SPECT, in comparison with patients experiencing coronary artery disease. Eighty-four patients (31 male) were analyzed. The mean 10 years risk of fatal cardiovascular events score was 2.7% ± 1.4%. The mean global stress MBF and myocardial flow reserve were 1.6 ± 0.6 mL/min/g and 2.7 ± 0.7.
Could 68Ga-DOTA-UBI-29-41 Help Identify Chronic Osteomyelitis on PET/CT Images? A Pilot Study
Authors: Nogueira Solange Amorim , de Barboza Marycel F. , Dell’Aquila Adriana M. , Santos Durval C. B , Osawa Akemi 
Published: September 2023

Abstract
This pilot study aimed to confirm the presence of infectious agents in infection foci using PET/CT imaging with 68Ga-DOTA-UBI (29–41) in 7 patients with chronic osteomyelitis and with indications for surgical cleaning at the site of the infection focus. The whole-body PET/CT was performed on Biograph mCT 40 PET/CT scanner (Siemens Healthineers); the image began 45–60 minutes postinjection of the radiotracer (148–260 MBq). This study demonstrated that, in 6 patients in whom the PET/CT was classified as positive for identified infectious foci, confirmed by culture of the secretion sample collected during surgery, only 1 patient in antibiotic therapy was negative.
Epidemiology and Pattern of Pediatric Maxillofacial Trauma: A 5-Year Retrospective Study
Authors: Kelimu Keyimu , Wusiman Patiguli , Li Weidong , Huang Bi , Wu Jianming , Zhan Jinliang , Moming Adili 
Published: September 2023

Purpose:
To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China.

Patients and Methods:
Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ2 test, and logistic regression analyses.

Results:
Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries.

Conclusion:
The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients.
An Updated Systematic Review and Meta-Analysis of the Impact of Graduated Compression Stockings in Addition to Pharmacological Thromboprophylaxis for Prevention of Venous Thromboembolism in Surgical Inpatients
Authors: Turner Benedict R H , Machin Matthew , Salih Marwah , Jasionowska Sara , Lawton Rebecca , Siracusa Francesca , Gwozdz Adam M , Shalhoub Joseph , Davies Alun H 
Published: September 2023

Objective:
This systematic review and meta-analysis compares the rate of venous thromboembolism (VTE) in surgical inpatients with pharmacological thromboprophylaxis and additional graduated compression stockings (GCS) versus pharmacological thromboprophylaxis alone.

Summary Background Data:
Surgical inpatients have elevated VTE risk; recent studies cast doubt whether GCS confer additional protection against VTE, compared to pharmacological thromboprophylaxis alone.

Methods:
The review followed PRISMA guidelines using a registered protocol (CRD42017062655). The MEDLINE and Embase databases were searched to November 2022. Randomised trials reporting VTE rate after surgical procedures, utilising pharmacological thromboprophylaxis, with or without GCS, were included. The rates of deep venous thrombosis (DVT), pulmonary embolism (PE), VTE-related mortality were pooled via fixed and random effects.

Results:
In head-to-head meta-analysis, the risk of DVT for GCS and pharmacological thromboprophylaxis was 0.85 (95% CI 0.54-1.36) versus for pharmacological thromboprophylaxis alone (2 studies, 70 events, 2653 participants). The risk of DVT in pooled trial arms for GCS and pharmacological thromboprophylaxis was 0.54 (95% CI 0.23-1.25) versus pharmacological thromboprophylaxis alone (33 trial arms, 1228 events, 14,108 participants). The risk of PE for GCS and pharmacological prophylaxis versus pharmacological prophylaxis alone was 0.71 (95% CI 0.0-30.0) (27 trial arms, 32 events, 11,472 participants). There were no between-group differences in VTE-related mortality (27 trial arms, 3 events, 12,982 participants).

Conclusions:
Evidence from head-to-head meta-analysis and pooled trial arms demonstrates no additional benefit for GCS in preventing VTE and VTE-related mortality. GCS confer a risk of skin complications and an economic burden; current evidence does not support their use for surgical inpatients.
Are Metastatic Central Lymph Nodes (D3 volume) in right-sided Colon Cancer a Sign of Systemic Disease? A sub-group Analysis of an Ongoing Multicenter Trial
Authors: Banipal Gurpreet Singh , Stimec Bojan Vladimir , Andersen Solveig Norheim , Edwin Bjorn , Nesgaard Jens Marius , Šaltytė Benth Jurate , Ignjatovic Dejan ,   For the RCC study group
Published: September 2023

Objective:
Assess outcomes of patients with right-sided colon cancer with metastases in the D3 volume after personalized surgery.

Background:
Patients with central lymph node metastasis (D3-PNG) are considered to have a systemic disease with a poor prognosis. A 3-dimensional definition of the dissection volume allows the removal of all central nodes.

Methods:
D3-PNG includes consecutive patients from an ongoing clinical trial. Patients were stratified into residual disease negative (D3-RDN) and residual disease positive (D3-RDP) groups. D3-RDN was further stratified into four periods to identify a learning curve. A personalized D3 volume (defined through arterial origins and venous confluences) was removed “en bloc” through medial-to-lateral dissection, and the D3 volume of the specimen was analyzed separately.

Results:
D3-PNG contained 42(26 females, 63.1SD9.9 y) patients, D3-RDN:29(17 females, 63.4SD10.1 y), and D3-RDP:13(9 females, 62.2SD9.7 y). Mean overall survival (OS) days D3-PNG:1230, D3-RDN:1610, D3-RDP:460. Mean disease-free survival (DFS) was D3-PNG:1023, D3-RDN:1461, D3-RDP:74 days. The probability of OS/ DFS in D3-PNG:52.1%/50.2%, D3-RDN:72.9%/73.1%, D3-RDP: 7.7%/0%. There is a significant change in OS/DFS in the D3-RDN from 2011-2013 to 2020-2022(both P=0.046) and from 2014-2016 to 2020-2022 (P=0.028 and P=0.005,respectively).

Conclusion:
Our results indicate that surgery can achieve survival in most patients with central lymph node metastases by removing a personalized and anatomically defined D3 volume. The extent of mesenterectomy and the quality of surgery are paramount since a learning curve has demonstrated significantly improved survival over time, despite the low number of patients. These results imply a place for the centralization of this patient group, where feasible.
Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes
Authors: Awtry Jake A. , Abernathy James H. , Wu Xiaoting , Yang Jie , Zhang Min , Hou Hechuan , Kaneko Tsuyoshi , de la Cruz Kim I. , Stakich-Alpirez Korana , Yule Steven , Cleveland Joseph C. , Shook Douglas C. , Fitzsimons Michael G. , Harrington Steven D. , Pagani Francis D. , Likosky Donald S. ,   on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators
Published: September 2023

Objective:
To associate surgeon-anesthesiologist team familiarity with cardiac surgery outcomes.

Background:
Team Familiarity (TF), a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.

Methods:
This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between 01/01/2017-09/30/2018. Team familiarity was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within six months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.

Results:
The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median(interquartile range)=8(6,11)] and lowest [44307 patients, TF=0(0,1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs. 3.1%, P=0.001), 90-day mortality (4.2% vs. 4.5%, P=0.023), composite morbidity (57.4% vs. 60.6%, P<0.001), and 30-day mortality or composite morbidity (57.9% vs. 61.1%, P<0.001). Familiar teams had lower overall risk-adjusted odds of 30-day mortality or composite morbidity [aOR 0.894(0.868,0.922), P<0.001], and for SAVR significantly lower 30-day mortality [aOR 0.724(0.547,0.959), P=0.024], 90-day mortality [aOR 0.779(0.620,0.978), P=0.031], and 30-day mortality or composite morbidity [aOR 0.856(0.791,0.927), P<0.001].

Conclusions:
Given its relationship with improved 30-day cardiac surgical outcomes, increasing TF should be considered among strategies to advance patient outcomes.
Rate of Emergency Lower Extremity Amputations in the United States among Medicare Beneficiaries
Authors: Dualeh Shukri H.A. , Powell Chloe A. , Kunnath Nicholas , Corriere Matthew A. , Ibrahim Andrew M. 
Published: September 2023

Objective:
To determine the rate of emergency versus elective lower extremity amputations in the United States

Background:
Lower extremity amputation is a common endpoint for patients with poorly controlled diabetes and multilevel peripheral vascular disease. While the procedure is ideally performed electively, patients with limited access may present later and require an emergency operation. To what extent rates of emergency amputation for lower extremity vary across the United States is unknown.

Methods:
Evaluation of Medicare beneficiaries who underwent lower extremity amputation between 2015-2020. The rate was determined for each zip code and placed into rank order from lowest to highest rate. We merged each beneficiary’s place of residence and location of care with the American Hospital Association Annual Survey using Google Maps Application Programming Interface to determine the travel distance for patients to undergo their procedure.

Results:
Of 233,084 patients, 66.3%(154,597) were men, 69.8%(162,786) were White. Average age(SD) was 74 year(8). There was wide variation in rates of emergency lower extremity amputation. The lowest quintile of zip codes demonstrated an emergency amputation rate of 3.7% while the highest quintile demonstrated 90%. Median travel distance in the lowest emergency surgery rate quintile was 34.6 miles compared to 10.5 miles in the highest quintile of emergency surgery (P<0.001).

Conclusion:
There is wide variation in the rate of emergency lower extremity amputations among Medicare beneficiaries, suggesting variable access to essential vascular care. Travel distance and rate amputation have an inverse relationship, suggesting that barriers other than travel distance are playing a role.
EEG Source Localization in Temporal Encephaloceles: Concordance With Surgical Resection and Clinical Outcomes
Authors: Cox Benjamin C. , Agashe Shruti H. , Smith Kelsey M. , Kanth Kiran M. , Van Gompel Jamie J. , Krecke Karl N. , Witte Robert J. , Wong-Kisiel Lily C. , Brinkmann Benjamin H. 
Published: September 2023

Purpose:
Temporal encephaloceles are a cause of drug-resistant temporal lobe epilepsy; however, their relationship with epileptogenesis is unclear, and optimal surgical resection is uncertain. EEG source localization (ESL) may guide surgical decision-making.

Methods:
We reviewed patients at Mayo Clinic Rochester with drug-resistant temporal lobe epilepsy and temporal encephaloceles, who underwent limited resection and had 1-year outcomes. EEG source localization was performed using standard density scalp EEG of ictal and interictal activity. Distance from dipole and standardized low-resolution brain electromagnetic tomography (sLORETA) solutions to the encephalocele were measured. Concordance of ESL with encephalocele and surgical resection was compared with 1-year surgical outcomes.

Results:
Seventeen patients met criteria. The mean distances from ESL results to encephalocele center for dipole and sLORETA analyses were 23 mm (SD 9) and 22 mm (SD 11), respectively. Ten patients (55.6%) had Engel I outcomes at 1 year. Dipole-encephalocele distance and sLORETA-encephalocele distance were significantly longer in patients with Engel I outcome and patients whose encephalocele was contained by sLORETA had worse outcome as well; however, multiple logistic regression analysis found that only containment of encephalocele by the sLORETA current density was significant (P < 0.05), odds ratio 0.12 (95% confidence interval [0.021, 0.71]).

Conclusions:
EEG source localization of scalp EEG localizes near encephaloceles, however, typically not in the encephalocele itself; this may be due to scalp EEG sampling propagated activity or alternatively that the seizure onset zone extends beyond the herniated cortex. Surprisingly, we observed increased ESL to encephalocele distances in patients with excellent surgical outcomes. Larger cohort studies including intracranial EEG data are needed to further explore this finding.