bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and survival of neuroendocrine neoplasms in China with comparison to the United States
Authors: Zheng Rongshou , Zhao Hong , An Lan , Zhang Siwei , Chen Ru , Wang Shaoming , Sun Kexin , Zeng Hongmei , Wei Wenqiang , He Jie 
Published: April 2023

Abstract

Background:
Neuroendocrine neoplasms (NENs) are rare tumors characterized by variable biology and delayed diagnosis. However, the nationwide epidemiology of NENs has never been reported in China. We aimed to estimate the incidence and survival statistics of NENs in China, in comparison to those in the United States during the same period.

Methods:
Based on the data from 246 population-based cancer registries covering 272.5 million people of China, we calculated age-specific incidence on NENs in 2017 and multiplied by corresponding national population to estimate the nationwide incidence in China. The data of 22 population-based cancer registries were used to estimate the trends of NENs incidence from 2000 to 2017 through the Joinpoint regression model. We used the cohort approach to analyze the 5-year age-standardized relative survival by sex, age group, and urban-rural area between 2008 and 2013, based on data from 176 high-quality cancer registries. We used data from the Surveillance, Epidemiology, and End Results (SEER) 18 program to estimate the comparable incidence and survival of NENs in the United States.

Results:
The overall age-standardized rate (ASR) of NENs incidence was lower in China (1.14 per 100,000) than in the United States (6.26 per 100,000). The most common primary sites were lungs, pancreas, stomach, and rectum in China. The ASRs of NENs incidence increased by 9.8% and 3.6% per year in China and the United States, respectively. The overall 5-year relative survival in China (36.2%) was lower than in the United States (63.9%). The 5-year relative survival was higher for female patients than male patients, and was higher in urban areas than in rural areas.

Conclusions:
The disparities in burden of NENs persist across sex, area, age group, and site in China and the United States. These findings may provide a scientific basis on prevention and control of NENs in the two countries
Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study
Authors: Zhou Chen , Yi Qun , Luo Yuanming , Wei Hailong , Ge Huiqing , Liu Huiguo , Li Xianhua , Zhang Jianchu , Pan Pinhua , Yi Mengqiu , Cheng Lina , Liu Liang , Zhang Jiarui , Peng Lige , Aili Adila , Liu Yu , Pu Jiaqi , Zhou Haixia 
Published: April 2023

Abstract

Background:
Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients.

Methods:
Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes.

Results:
Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53–3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32–2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24–1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality.

Conclusion:
Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients.

Clinical Trial Registration:
Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Lifetime Prevalence of Psychiatric Disorders in Adolescents with Unexplained Weight Loss, Underweight, or Poor Appetite
Authors: Witte Micaela A. , Harbeck Weber Cynthia , Lebow Jocelyn , LeMahieu Allison , Geske Jennifer , Witte Nathaniel , Whiteside Stephen , Loth Katie , Sim Leslie 
Published: April 2023

ABSTRACT:

Background:
When adolescents present with symptoms of unexplained weight loss, underweight, or poor appetite, eating disorders (EDs) are commonly on the list of differential diagnoses. However, the relationship of these symptoms to other psychiatric disorders is often less clear.

Methods:
Using the Rochester Epidemiology Project database, a retrospective cohort study of adolescents (13–18 years) with billing diagnoses of weight loss, underweight, or loss of appetite was conducted between January 2005 and December 2017. Patients who presented with conditions commonly associated with weight loss, underweight, or poor appetite (e.g., cancer) were excluded. This study sought to examine the proportion of patients who received ED and psychiatric diagnoses within 5 years of the index visit and patient characteristics associated with these diagnoses.

Results:
Of 884 patients diagnosed with symptoms of unexplained weight loss, underweight, or poor appetite, 662 patients (M age = 15.8; SD = 1.6; 66.0% female) met study criteria. Within 5 years of the index visit, the lifetime prevalence of all psychiatric disorders was 70% (n = 461) and of EDs was 21% (n = 141). For both psychiatric disorders and EDs, sex and race were significantly associated with receiving a diagnosis within 5 years. Decrease in body mass index (BMI) percentile was associated with receiving an ED diagnosis, whereas the highest historical BMI percentile was associated with receiving a psychiatric diagnosis.

Conclusion:
Patients presenting with symptoms of unexplained weight loss, underweight, or poor appetite are at risk not only for EDs but also for other psychiatric disorders that may require further assessment and follow-up.
Prenatal Ambient Air Pollutant Mixture Exposure and Early School-age Lung Function
Authors: Hsu Hsiao-Hsien Leon , Wilson Ander , Schwartz Joel , Kloog Itai , Wright Robert O. , Coull Brent A. , Wright Rosalind J. 
Published: April 2023

Introduction:
Research linking prenatal ambient air pollution with childhood lung function has largely considered one pollutant at a time. Real-life exposure is to mixtures of pollutants and their chemical components; not considering joint effects/effect modification by co-exposures contributes to misleading results.

Methods:
Analyses included 198 mother-child dyads recruited from two hospitals and affiliated community health centers in Boston, Massachusetts, USA. Daily prenatal pollutant exposures were estimated using satellite-based hybrid chemical-transport models, including nitrogen dioxide(NO2), ozone(O3), and fine particle constituents (elemental carbon [EC], organic carbon [OC], nitrate [NO3
–], sulfate [SO4
2–], and ammonium [NH4
+]). Spirometry was performed at age 6.99 ± 0.89 years; forced expiratory volume in 1s (FEV1), forced vital capacity (FVC), and forced mid-expiratory flow (FEF25-75) z-scores accounted for age, sex, height, and race/ethnicity. We examined associations between weekly-averaged prenatal pollution mixture levels and outcomes using Bayesian Kernel Machine Regression-Distributed Lag Models (BKMR-DLMs) to identify susceptibility windows for each component and estimate a potentially complex mixture exposure-response relationship including nonlinear effects and interactions among exposures. We also performed linear regression models using time-weighted-mixture component levels derived by BKMR-DLMs adjusting for maternal age, education, perinatal smoking, and temperature.

Results:
Most mothers were Hispanic (63%) or Black (21%) with ≤12 years of education (67%). BKMR-DLMs identified a significant effect for O3 exposure at 18–22 weeks gestation predicting lower FEV1/FVC. Linear regression identified significant associations for O3, NH4
+, and OC with decreased FEV1/FVC, FEV1, and FEF25-75, respectively. There was no evidence of interactions among pollutants.

Conclusions:
In this multi-pollutant model, prenatal O3, OC, and NH4
+ were most strongly associated with reduced early childhood lung function.
Identifying chronic low back pain phenotypic domains and characteristics accounting for individual variation: a systematic review
Authors: Hassan Samah , Nesovic Karlo , Babineau Jessica , Furlan Andrea D. , Kumbhare Dinesh , Carlesso Lisa C. 
Published: April 2023

Abstract
Interpatient variability is frequently observed among individuals with chronic low back pain (cLBP). This review aimed at identifying phenotypic domains and characteristics that account for interpatient variability in cLBP. We searched MEDLINE ALL (through Ovid), Embase Classic and EMBASE (through Ovid), Scopus, and CINAHL Complete (through EBSCOhost) databases. Studies that aimed to identify or predict cLBP different phenotypes were included. We excluded studies that focused on specific treatments. The methodological quality was assessed using an adaptation of the Downs and Black tool. Forty-three studies were included. Although the patient and pain-related characteristics used to identify phenotypes varied considerably across studies, the following were among the most identified phenotypic domains and characteristics that account for interpatient variability in cLBP: pain-related characteristics (including location, severity, qualities, and duration) and pain impact (including disability, sleep, and fatigue), psychological domains (including anxiety and depression), behavioral domains (including coping, somatization, fear avoidance, and catastrophizing), social domains (including employment and social support), and sensory profiling (including pain sensitivity and sensitization). Despite these findings, our review showed that the evidence on pain phenotyping still requires further investigation. The assessment of the methodological quality revealed several limitations. We recommend adopting a standard methodology to enhance the generalizability of the results and the implementation of a comprehensive and feasible assessment framework to facilitate personalized treatments in clinical settings.
Gastrointestinal Talaromyces marneffei infection in a man with AIDS: A case report
Authors: Peng Renping , Peng Zhipeng , Mou Minhong , Wang Qiudong , Huang Man , Zou Jun 
Published: April 2023

Rationale:
Reports of intestinal Talaromyces marneffei infection have increased year by year, but those of gastric infection remain rare. Here, we report disseminated talaromycosis with gastric and intestinal ulcers in an AIDS patient who was treated by antifungal agents and a proton pump inhibitor and achieved a satisfactory outcome.

Patient concerns:
A 49-year-old man developed a gastrointestinal illness with main abdominal distension, poor appetite and a positive HIV infection to our AIDS clinical treatment center.

Diagnoses:
Electronic gastrointestinal endoscopy showed that the patient had multiple ulcers in the gastric angle, gastric antrum and large intestine. Gastric Helicobacter pylori infection was ruled out by paraulcerative histopathological analysis and a C14 urea breath test. The diagnosis was confirmed by gastroenteroscopic biopsy and metagenomic next-generation sequencing of gastric ulcer tissue.

Interventions:
Symptomatic and supportive treatments [a proton pump inhibitor and gastrointestinal motility promotion] were initiated. The patient was prescribed sequential antifungal therapy with amphotericin B (0.5 mg/kg·d, 2 weeks) and itraconazole (200 mg, q12h, 10 weeks), and then followed with itraconazole for long-term secondary prevention (200 mg, qd).

Outcomes:
The combined use of antifungal agents and a proton pump inhibitor improved the patient’s condition, and he was discharged home 20 days later. He had no gastrointestinal symptom during 1 year of telephone-based follow-up.

Lessons:
In endemic areas, clinicians should be alert to the possibility of Talaromyces marneffei infection presenting with gastric ulcers in patients with AIDS, after excluding Helicobacter pylori infection.
Intractable hyponatremia secondary to syndrome of inappropriate antidiuresis complicated with empty sella: A case report
Authors: Zheng Wenli , Fan Shiqin , Chen Jie , Ma Jing 
Published: April 2023

Rationale:
Hyponatremia is a common electrolyte disorder in elderly critically ill patients, and it may be associated with poor outcomes, higher morbidity, and mortality. Syndrome of inappropriate antidiuresis (SIAD) is one of the main causes of hyponatremia, with an insidious onset that is highly misdiagnosed. Primary empty sella lesions are specific, mostly asymptomatic, and easily overlooked. SIAD combined with empty sella is much rarer in clinic, this article focuses on the diagnosis and management of an elderly patient with intractable hyponatremia secondary to syndrome of inappropriate antidiuresis complicated with empty sella.

Patient concerns:
An 85-year-old male patient with severe pneumonia presented with progressive and intractable hyponatremia.

Diagnoses:
The patient had clinical signs of persistent hyponatremia, low plasma osmolality, elevated urinary sodium excretion, and hyponatremia that worsened with increased intravenous rehydration and was effective with appropriate fluid restriction. The diagnosis of SIAD combined with empty sella was made in combination with the findings of the pituitary and its target gland function.

Interventions:
Numerous screenings were performed to clarify the cause of hyponatremia. His overall condition was poor due to recurrent episodes of hospital-acquired pneumonia. We treated with ventilation support, circulatory support, nutritional support, anti-infection, and continuous correction of electrolyte imbalance.

Outcomes:
His hyponatremia gradually improved through aggressive infection control, appropriate fluid restriction (intake controlled at 1500–2000mL/d), continuous electrolyte correction, supplementation with hypertonic salt solution, and potassium replacement therapy.

Lessons:
Electrolyte disorders, especially hyponatremia, are very common in critically ill patients, but the etiology of hyponatremia is challenging to diagnose and treat, and timely attention and proper diagnosis of SIAD and individualized treatment are the significance of this article.
Pancreatic insulinoma misdiagnosed as atrial fibrillation: A case report from Iraq
Authors: Mahmood Aqeel Shakir , Al-Obaidi Ahmed Dheyaa , Ibrahim Mazin Judy , Al-Obaidi Mustafa Najah , Shakir Ahmed A. , Bakose Reema Yousif , Wajdi Naseem , Hashim Hashim Talib 
Published: April 2023

Rationale:
Pancreatic insulinomas are the most frequent pancreatic endocrine neoplasms. They are insulin-secreting pancreatic tumors that induce extreme, recurrent, and near-fatal hypoglycemia. Insulinomas affect 1 to 4 individuals in a million of the general population and account for about 1% to 2% of all pancreatic tumors.

Patient concerns:
Recurrent episodes of sweating, tremor, weakness, confusion, palpitation, blurred vision, and fainting for 2 months and was misdiagnosed as having atrial fibrillation.

Diagnosis:
He was misdiagnosed as having atrial fibrillation to highlight the importance of atrial fibrillation as unusual mimicker of insulinoma and to encourage clinicians about the importance of early and appropriate management in such cases.

Interventions:
Endoscopic ultrasound for the pancreatic parenchyma was done, and it showed a hypoechoic homogenous mass located at the pancreatic head measuring 12 mm × 15 mm with no local vascular involvement, blue in elastography, hypervascular with Doppler study, and a normal pancreatic duct diameter.

Outcomes:
His condition was stable, and he was discharged home 2 days later.

Conclusion:
The diagnosis of insulinoma is usually difficult and late due to the extremely low incidence of the disease and the similarity of its clinical presentation to numerous other conditions, the most reported is epilepsy.
Patterns and Correlates of Nurse Departures From the Health Care Workforce
Authors: Medvec Barbara R. , Marriott Deanna J. , Khadr Lara , Ridge Laura J. , Lee Kathryn A. , Friese Christopher R. , Titler Marita G. 
Published: April 2023

Background:
Health care executives and policymakers have raised concerns about the adequacy of the US nursing workforce to meet service demands. Workforce concerns have risen given the SARS-CoV-2 pandemic and chronically poor working conditions. There are few recent studies that directly survey nurses on their work plans to inform possible remedies.

Methods:
In March 2022, 9150 nurses with a Michigan license completed a survey on their plans to leave their current nursing position, reduce their hours, or pursue travel nursing. Another 1224 nurses who left their nursing position within the past 2 years also reported their reasons for departure. Logistic regression models with backward selection procedures estimated the effects of age, workplace concerns, and workplace factors on the intent to leave, hour reduction, pursuit of travel nursing (all within the next year), or departure from practice within the past 2 years.

Results:
Among practicing nurses surveyed, 39% intended to leave their position in the next year, 28% planned to reduce their clinical hours, and 18% planned to pursue travel nursing. Top-ranked workplace concerns among nurses were adequate staffing, patient safety, and staff safety. The majority of practicing nurses (84%) met the threshold for emotional exhaustion. Consistent factors associated with adverse job outcomes include inadequate staffing and resource adequacy, exhaustion, unfavorable practice environments, and workplace violence events. Frequent use of mandatory overtime was associated with a higher likelihood of departure from the practice in the past 2 years (Odds Ratio 1.72, 95% CI 1.40–2.11).

Conclusions:
The factors associated with adverse job outcomes among nurses—intent to leave, reduced clinical hours, travel nursing, or recent departure—consistently align with issues that predated the pandemic. Few nurses cite COVID as the primary cause for their planned or actual departure. To maintain an adequate nursing workforce in the United States, health systems should enact urgent efforts to reduce overtime use, strengthen work environments, implement anti-violence protocols, and ensure adequate staffing to meet patient care needs.
Short-course Venetoclax With Standard Chemotherapy Is Effective in Early T-cell Precursor Acute Lymphoblastic Leukemia
Authors: Borah Pronamee , Dayal Nitin , Pathak Sangeeta , Naithani Rahul 
Published: April 2023

Background:
Early T-cell precursor acute lymphoblastic leukemia (ETP ALL) is a high-risk subgroup of acute lymphoblastic leukemia characterized by unique immune phenotype and disease biology. ETP ALL cells share similarities with hematopoietic stem cells and myeloid progenitor cells. These patients have lower rates of complete remission and overall survival. High BCL2 expression is the main rationale for using venetoclax in ETP ALL.

Results:
We report the treatment outcomes of 2 patients with ETP ALL who achieved minimal residual disease negative remission with the short course of venetoclax.

Conclusions:
Combination therapy of short-course venetoclax with Berlin-Frankfurt-Meunster 95 regimen is an effective regimen for treating patients with ETP ALL.
Increased comfortable gait speed is associated with improved gait biomechanics in persons with chronic stroke completing an 8-week forced-rate aerobic cycling intervention: a preliminary study
Authors: Linder Susan M. , Learman Ken , Miller Koop Mandy , Espy Debbie , Haupt Michael , Streicher Matt , Davidson Sara , Bethoux Francois , Nadler Nathan , Alberts Jay L. 
Published: April 2023

ABSTRACT
Task-specific gait training is recommended to improve locomotor function post-stroke. Our objective was to determine the effects of a forced-rate aerobic exercise (FE) intervention on gait velocity and biomechanics in the absence of task-specific gait training. Individuals with chronic stroke (N = 14) underwent 24 sessions of FE, at a targeted aerobic intensity of 60-80% of their heart rate reserve. Change in comfortable walking speed in addition to spatiotemporal, kinematic, and kinetic variables were measured using 3D motion capture. Overground walking capacity was measured by the six-minute walk test (6MWT). To determine gait biomechanics associated with increased walking speed, spatiotemporal, kinematic, and kinetic variables were analyzed separately for those who met the minimal clinically important difference (MCID) for change in gait velocity compared with those who did not. Participants demonstrated a significant increase in gait velocity from 0.61 to 0.70 m/s (P = 0.004) and 6MWT distance from 272.1 to 325.1 meters (P < 0.001). Those who met the MCID for change in gait velocity demonstrated significantly greater improvements in spatiotemporal parameters (P = 0.041), ground reaction forces (P = 0.047), and power generation (P = 0.007) compared to those who did not. Improvements in gait velocity were accompanied by normalization of gait biomechanics.
Cancer Rehabilitation Veterans Affairs Extension for Community Healthcare Outcomes (VA-ECHO) Virtual Education Program – A Model for Virtual Learning in the COVID-19 Era
Authors: Qin Evelyn , Monda Jason , Mattox Elizabeth , Yantsides Konstantina , Ward Joan , Gorukanti Sre , Howard Ileana 
Published: April 2023

Abstract
Rehabilitation is important in the care of patients with cancer for improving function, pain, and quality of life. However, only a small number of clinicians are formally trained in cancer rehabilitation. Virtual learning environments may play a promising role in cancer rehabilitation education, especially in the coronavirus pandemic era where in-person learning is not readily available. A national, interprofessional cancer rehabilitation education program involving a monthly longitudinal webinar series and a two-day virtual bootcamp was developed through the US Department of Veterans Affairs Extension for Community Healthcare Outcomes (VA-ECHO) to improve VA clinician understanding of cancer rehabilitation and ultimately increase the availability of cancer rehabilitation services in the Veterans Health Administration (VHA). From March 2020 to July 2022, 923 individuals participated with an average of 72 participants per session and 204 participants per session in the bootcamp. Participants’ most common disciplines were physical therapy, occupational therapy, nursing, medicine (physicians), advanced practice providers, speech therapy, and pharmacy. Participants reported improved knowledge of cancer rehabilitation and anticipated that the knowledge would change their practice. Virtual education can be a useful means to educate VA-based healthcare professionals about cancer rehabilitation and improve access to rehabilitation services for Veterans with cancer.