bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Anemia Status and the Risk of Different Types of Heart Failure: A RCSCD-TCM Study in China
Authors: Ni Tongyao , Liu Yijia , Huang Mengnan , Ma Mei , Li Lin , Li Chunjie , Yang Rongrong , Yu Chunquan 
Published: March 2023

We investigated the association between anemia status and the risk of heart failure (HF) in patients with coronary heart disease (CHD) based on a multi-center, large-sample and retrospective cross-sectional study including 89,207 patients. Heart failure was categorized as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mid-range ejection fraction (HFmrEF). In multi-adjusted models, compared with patients without anemia, mild anemia (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.53–1.91; P < .001), moderate anemia (OR 3.68; 95% CI, 3.25–4.17; P < .001), and severe anemia (OR 8.02; 95% CI, 6.50–9.88; P < .001) were associated with the risk of HF among CHD patients. Men aged <65 years were more likely to develop HF. In subgroup analyses, the multi-adjusted ORs and 95% CI of HFpEF, HFrEF, and HFmrEF related to anemia were 3.24 (95% CI 1.43–7.33), 2.22 (95% CI 1.28–3.84), and 2.55 (95% CI 2.24–2.89), respectively. These findings suggest that anemia might be associated with increased risk of different types of HF, especially HFpEF.
Association Between Metabolic Syndrome and Outcomes in Complex Head and Neck Surgery
Authors: Vasudev Milind , Goshtasbi Khodayar , Meller Leo L.T. , Tjoa Tjoson , Kuan Edward C. , Haidar Yarah M. 
Published: March 2023

Objectives: We aim to evaluate the impact of MetS on the short-term postoperative outcomes of complex head and neck surgery patients. Methods: This is a retrospective cohort analysis of the 2005 to 2017 National Surgical Quality Improvement Program (NSQIP) database. NSQIP database was queried for 30-day outcomes of patients undergoing complex head and neck surgeries, defined as laryngectomy or mucosal resection followed by free tissue transfer, similar to prior NSQIP studies. Patients with hypertension, diabetes, and body mass index (BMI) >30 kg/m2 were defined as having MetS. Adverse events were defined as experiencing readmission, reoperation, surgical/medical complications, or mortality. Results: A total of 2764 patients (27.0% female) with a mean age of 62.0 ± 11.7 years were included. Patients with MetS (n = 108, 3.9%) were more likely to be female ( P = .017) and have high ASA classification ( P = .030). On univariate analysis, patients with MetS were more likely to require reoperation (25.9% vs 16.7%, P = .013) and experience medical complications (26.9% vs 15.4% P = .001) or any adverse events (61.1% vs 48.7%, P = .011) compared to patients without MetS. On multivariate logistic regression after adjusting for age, sex, race, ASA classification, and complex head and neck surgery type, MetS was an independent predictor of medical complications (odds ratio 2.34, 95% CI 1.28-4.27, P = .006). Conclusion: Patients with MetS undergoing complex head and neck surgery are at increased risk of experiencing medical complications. Identifying patients with MetS can therefore aid surgeons in preoperative risk assessment and help improve postoperative management. Level of Evidence: N/A
Love under lockdown: How changes in time with partner impacted stress and relationship outcomes during the COVID-19 pandemic
Authors: Derbyshire Kaitlin , Thai Sabrina , Midgley Claire , Lockwood Penelope 
Published: March 2023

With the onset of COVID-19, governments around much of the world implemented strict social distancing and stay-at-home orders that profoundly affected the amount of time many couples were spending together. In the present research, we examined whether perceptions of a change in time spent with a partner were associated with stress, and whether stress levels in turn predicted relationship commitment and satisfaction, both in the short term (Time 1) and longer term (Time 2; i.e., after 10 months). Results indicated partial mediation, such that less (vs. more) time spent with the partner was associated with greater stress at Time 1, which in turn partly accounted for lower commitment and relationship satisfaction both at Time 1, and satisfaction at Time 2. Less (vs. more) time spent with partner at Time 1 also predicted a greater likelihood of relationship dissolution at Time 2, again partially mediated by stress. An increase in quality time spent together at Time 2 predicted stress and relationship outcomes over and above the change in time spent together more generally. This research has important implications for understanding the ongoing effects of the pandemic on romantic relationships. In addition, this study provides new evidence regarding how changes in time spent with a partner are associated with stress and subsequent relationship outcomes.
A comparison of bilateral and unilateral cerebral perfusion for total arch replacement surgery for non-marfan, type A aortic dissection
Authors: Jiang Qin , Huang Keli , Wang Deliang , Xia Jiaqi , Yu Tao , Hu Shengshou 
Published: March 2023

Objectives Acknowledging lacking of consensus exist in total aortic arch (TAA) surgery for acute type A aortic dissection (AAD), this study aimed to investigate the neurologic injury rate between bilateral and unilateral cerebrum perfusion on the specific population. Methods A total of 595 AAD patients other than Marfan syndrome receiving TAA surgery since March 2013 to March 2022 were included. Among them, 276 received unilateral cerebral perfusion (via right axillary artery, RCP) and 319 for bilateral cerebral perfusion (BCP). The primary outcome was neurologic injury rate. Secondary outcomes were 30-day mortality, serum inflammation response (high sensitivity C reaction protein, hs-CRP; Interleukin-6, IL-6; cold-inducible RNA binding protein, CIRBP) and neuroprotection (RNA-binding motif 3, RBM3) indexes. Results The BCP group reported a significantly lower permanent neurologic deficits [odds ratio: 0.481, Confidence interval (CI): 0.296–0.782, p = 0.003] and 30-day mortality (odds ratio: 0.353, CI: 0.194–0.640, p < 0.001) than those received RCP treatment. There were also lower inflammation cytokines (hr-CRP: 114 ± 17 vs. 101 ± 16 mg/L; IL-6: 130 [103,170] vs. 81 [69,99] pg/ml; CIRBP: 1076 [889, 1296] vs. 854 [774, 991] pg/ml, all p < 0.001), but a higher neuroprotective cytokine (RBM3: 4381 ± 1362 vs 2445 ± 1008 pg/mL, p < 0.001) at 24 h after procedure in BCP group. Meanwhile, BCP resulted in a significantly lower Acute Physiology, Age and Chronic Health Evaluation (APACHE) Ⅱscore (18 ± 6 vs 17 ± 6, p < 0.001) and short stay in intensive care unit (4 [3,5] vs. 3 [2,3] days, p < 0.001) and hospital (16 ± 4 vs 14 ± 3 days, p < 0.001). Conclusions This present study indicated that BCP compared with RCP was associated with lower permanent neurologic deficits and 30-day mortality in AAD patients other than Marfan syndrome receiving TAA surgery.
A standardized technique for lateral unicompartmental knee arthroplasty
Authors: Wen Tao , Xue Huaming , Ma Tong , Yang Tao , Xue Long , Tu Yihui 
Published: March 2023

Objectives We developed a new standardized procedure for lateral unicompartmental knee arthroplasty (UKA) to maximize the benefits and minimize the risks of surgery in patients with osteoarthritis (OA). Methods This retrospective study recruited patients who underwent lateral UKA at our hospital between January 2014 and January 2016. Demographic characteristics and preoperative and postoperative American Knee Society (AKS) clinical scores (including pain, clinical, and knee mobility scores) were collected. Results A total of 158 patients (35 male and 123 female) who underwent 160 lateral UKAs were analyzed. Their AKS clinical scores (0–100 points) improved from 53.1 ± 4.1 (range 45–62) preoperatively to 97.0 ± 1.7 (range 92–99) ( p < 0.001) postoperatively with additional improvements of 9.1 ± 1.8 (range 3–14) to 47.3 ± 1.5 (range 45–49) ( p < 0.001) for pain, 49.7 ± 9.7 (range 35–70) to 97.1 ± 4.1 (range 90–100) ( p < 0.001) for function, and 105.0 ± 4.4° (equivalent to ∼100–115°) to 125.5 ± 5.3° (∼110–135°) ( p < 0.001) for a range of motion (ROM). No patients required reoperations or revisions. Two patients were readmitted within 60 days due to severe knee swelling. Conclusion The lateral UKA protocol was reproducible and the patients had a good postoperative outcomes. Yet, large-scale, multi-center, prospective studies are needed to further confirm our findings.
Characterizing Interventions and Family Assistance of a Nurse Navigation Program in Orofacial Cleft Care
Authors: Wagner Connor S , Barrero Carlos E , Kumar Satvika L , Pontell Matthew E , Salinero Lauren K , Bartlett Scott P , Taylor Jesse A , Folsom Nancy , Swanson Jordan W 
Published: March 2023

Objective Characterize the interventions and assistance employed by a cleft nurse navigator (CNN) which have mediated improvement in care equity at our institution. Design Retrospective study. Setting Academic tertiary care center. Patients, Participants Patients presenting with cleft lip and/or cleft palate presenting between August 2020 and August 2021 with exclusions for syndromic diagnosis, Pierre-Robin sequence, late (> 6 months) presentation, and prior cleft surgery at outside institutions. Interventions Multidisciplinary cleft nurse navigator program Main Outcome Measure(s) Family interactions with the CNN by phone, text, and email across the first year of life including feeding support, nasoalveolar molding (NAM) assistance, appointment scheduling, financial assistance, addressing perioperative concerns, and facilitating physician consults. Patient weight and surgical timing were also recorded. Results Sixty-nine patients were included with a total of 639 interactions between the CNN and families. Scheduling support (30%), addressing perioperative concerns (22%), and feeding support (20%) were the most common interactions. Feeding support and NAM assistance were heavily distributed in the first 3 months of life compared to after 3 months ( P < .001). Median age at first contact was 1 week (range: 22 weeks gestation-14 weeks). There was no difference in the proportion of families receiving feeding support, NAM assistance, or scheduling assistance based on insurance status or race ( P > .05 for all). Conclusions Scheduling assistance, addressing perioperative concerns, and feeding support are the predominant methods by which the CNN interacts with and assists families of patients with cleft conditions. CNN service distribution is largely equitable between demographic groups.
Prescribing practices of oncology pharmacists working in ambulatory cancer centers in Alberta
Authors: Hynes Kyia , Folkman Frances , Dersch-Mills Deonne , Marin Helen , Ghosh Sunita , Chambers Carole 
Published: March 2023

Objective To describe and quantify independent prescribing of oncology pharmacists working in adult, ambulatory cancer centers in Alberta, Canada. Methods A retrospective chart review of oncology pharmacists prescribing in the electronic health record, ARIA® was conducted. Prescriptions from January 1, 2018 to June 30, 2018 were analyzed. Descriptive statistics were used to quantify prescription volume and class of medications prescribed. A cross-sectional analysis was then performed on a random sample to determine the type of prescription intervention and evaluate pharmacist documentation. Results Over 6 months, 3474 prescriptions were ordered by 33 clinically deployed pharmacists. The median number of medications prescribed was 7 per month (interquartile range: 1.50–27.00; Range: 0.17–79.5). When prescribing was standardized by pharmacist's time clinically deployed, the median was 21.67 (interquartile range: 5.00–79.67; range: 0.67–216.67) prescriptions per month per full-time equivalent. The most prescribed class of medication was antiemetic (24.1%). From a sample of 346 prescriptions, 172 (50%) were new medications initiated, 160 (46%) were the continuation of existing prescriptions and 14 (4%) were prescription dosage adjustments. Adherence to the specified documentation standards was 47%. Conclusions Oncology pharmacists utilize their independent prescribing to initiate and continue supportive care medications for cancer patients. The prescribing volume varied greatly among pharmacists. Opportunities exist to further engage pharmacist prescribing.
A qualitative study of the sources of chronic obstructive pulmonary disease-related emotional distress
Authors: Zanolari Diana , Händler-Schuster Daniela , Clarenbach Christian , Schmid-Mohler Gabriela 
Published: March 2023

Objective The aim of this study is to identify the sources of illness-related emotional distress from the perspective of individuals living with mild to severe chronic obstructive pulmonary disease (COPD). Methods A qualitative study design with purposive sampling was applied at a Swiss University Hospital. Eleven interviews were conducted with individuals who suffered from COPD. To analyze data, framework analysis was used, guided by the recently presented model of illness-related emotional distress. Results Six main sources for COPD-related emotional distress were identified: physical symptoms, treatment, restricted mobility, restricted social participation, unpredictability of disease course and COPD as stigmatizing disease. Additionally, life events, multimorbidity and living situation were found to be sources of non-COPD-related distress. Negative emotions ranged from anger, sadness, and frustration to desperation giving rise to the desire to die. Although most patients experience emotional distress regardless of the severity of COPD, the sources of distress appear to have an individual manifestation. Discussion There is a need for a careful assessment of emotional distress among patients with COPD at all stages of the disease to provide patient-tailored interventions.
Intravascular Lithotripsy and Drug-Coated Balloon Angioplasty for Severely Calcified Common Femoral Artery Atherosclerotic Disease
Authors: Stavroulakis Konstantinos , Torsello Giovanni , Chlouverakis Gregory , Bisdas Theodosios , Damerau Sarah , Tsilimparis Nikolaos , Argyriou Angeliki 
Published: March 2023

Objectives: Intravascular lithotripsy (IVL) followed by drug-coated balloon (DCB) angioplasty might be a valuable alternative to surgery for calcified common femoral artery (CFA) atherosclerotic disease. Nonetheless, the 12 months performance of this treatment strategy remains unknown. This study reports on the 12 months outcomes of IVL with adjunctive DCB angioplasty for calcified CFA lesions. Methods: This is a retrospective single-center, single-arm study. Consecutive patients treated by IVL and DCB for calcified CFA disease between February 2017 and September 2020 were evaluated. The primary measure outcome of this analysis was primary patency. Procedural technical success (<30% stenosis), freedom from target lesion revascularization (TLR), secondary patency, and overall mortality were additionally analyzed. Results: Thirty-three (n=33) patients were included in this study. The majority presented with lifestyle limiting claudication (n=20, 61%), 52% (n=17) of the patients had chronic kidney disease (CKD) and 33% (n=11) had diabetes. The procedural technical success was 97% (n=32). A flow-limiting dissection post IVL was observed in 2 patients (6%) and a peripheral embolization in a single patient (3%), while the bail-out stenting rate amounted to 12% (n=4). No perforation was observed. The median length of hospital stay was 2 days (interquartile range 2–3). At 12 months, the primary patency was 72%. The freedom from TLR and the secondary patency rates were 94% and 88%, respectively. The 12-month survival amounted to 100% and 75% (n=25) of the patients were asymptomatic or presented with mild claudication. The presence of chronic limb-threatening ischemia (CLTI) (hazard ratio [HR], 0.92; confidence interval (CI); 0.18–4.8, p=0.7) or CKD (HR, 1.30; 95% CI, 0.29–5.8; p=0.72), as well as the use of a 7 mm IVL catheter (HR, 0.59; 95% CI, 0.13–2.63; p=0.49) or of high-dose DCB (HR, 0.68; 95% CI, 0.13–3.53; p=0.65) did not influence the primary patency. Conclusions: In this study, the combination of IVL and DCB angioplasty for calcified CFA disease was associated with low risk for periprocedural complications, acceptable 12 months clinical outcomes, and low rates of reinterventions. Clinical Impact Intravascular lithotripsy in combination with DCB angioplasty can be an alternative to surgery in highly selected patients with CFA atherosclerotic disease. In this Cohort the combination therapy lead to acceptable clinical results and low reintervention rates at 12 months.
Preoperative Serum Albumin Level Predicts Length of Stay and Perioperative Adverse Events Following Vertebral Corpectomy and Posterior Stabilization for Metastatic Spine Disease
Authors: Hirase Takashi , Taghlabi Khaled M. , Cruz-Garza Jesus G. , Faraji Amir H. , Marco Rex A. W. , Saifi Comron 
Published: March 2023

Study Design Retrospective review of a prospectively collected national database Objectives To determine the association between preoperative serum albumin levels and perioperative adverse events (AEs) following vertebral corpectomy and posterior stabilization for metastatic spine disease. Methods The 2010 to 2019 American College of Surgeons’ National Surgical Quality Improvement (ACS-NSQIP) database was used to identify all patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Receiver operative characteristic (ROC) curve analysis was used to determine preoperative serum albumin cut-off values for predicting perioperative AEs. Low preoperative serum albumin was defined as serum albumin below this cut-off value. Results A total of 301 patients were included in the study. ROC curve analysis demonstrated serum albumin < 3.25 g/dL as a cut-off value for predicting perioperative AEs. The low serum albumin group had a higher overall perioperative AEs ( P = .041), longer post-operative LOS ( P < .001), higher 30-day reoperation rate ( P = .014), and a higher in-hospital mortality rate ( P = .046). Multivariate analysis demonstrated that low preoperative serum albumin was associated with higher perioperative AEs. Conclusions Low serum albumin level is associated with higher perioperative AEs, longer postoperative LOS, and higher rates of 30-day reoperation and in-hospital mortality among patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Strategies to improve preoperative nutritional status in patients undergoing this procedure may improve these perioperative outcome measures within this surgical population. Level of Evidence III
Patient and Family Perpetrated Cyber-Incivility and Cyber-Aggression Within Healthcare: A Cross-Sectional Descriptive Study
Authors: Spencer Cara , Loehr Kelsey , Byrd Abby 
Published: March 2023

Introduction Verbal violence may manifest in written form as cyber incivility within patient portal communications. As a form of digital technology, patient portal messages create a physical and emotional distance leading the sender to be disinhibited and disassociated from the recipient nurse. Written patient portal messages may contain uncivil language deemed verbally violent when the content escalates beyond professional standards. When these messages are encountered as part of patient care, they may lead to nurses’ psychological distress. Although cyber-incivility has been studied within social media and business, little is known about cyber-incivility within healthcare. Objectives The purpose of the study was to define cyber-incivility as it manifests within healthcare compared to business, determine sender demographics, and quantify the impact on nurses. Methods A cross-sectional descriptive study was conducted to analyze portal communications. Nurses forwarded aggressive messages to leadership and quantified their level of distress after receiving the message. Sender demographics were tracked, and content was analyzed using Braun and Clarke's Thematic Analysis. Results Of the 31 included messages, senders were of varying ages, genders, and marital statuses. Messages rarely related to medications and rarely contained expletives. The most distressing messages were ad hominem, demanding, accusatory, or contained threats. These messages illustrated how healthcare cyber-incivility manifested and deviated from appropriate professional standards to become a form of verbal workplace violence. Message content also identified antecedents; related to unmet expectations, patient accountability, or difficulty navigating healthcare. Conclusions Written incivil/uncivil/aggressive patient portal messages contained personal attacks and professionally degrading content, which were distressing to nurses. A healthcare-specific framework was created and provided context to understand the difficult and aggressive messages nurses received while providing digital patient care. Awareness of cyber-incivility within healthcare allows for better support of nurses who are exposed to this form of workplace violence and is foundational to future intervention development.
Ischemic stroke recurrence and mortality in different imaging phenotypes of ischemic cerebrovascular disease: The SMART-MR Study
Authors: Lucci Carlo , Rissanen Ina , de Jong Pim A , Kappelle L Jaap , Hendrikse Jeroen , Geerlings Mirjam I 
Published: March 2023

Background: Diagnosis of cerebrovascular disease is based on both clinical and radiological findings, however, they do not always correlate. Aims: To investigate ischemic stroke recurrence and mortality in patients with different imaging phenotypes of ischemic cerebrovascular disease. Methods: Within the SMART-MR study, a prospective patient cohort with arterial disease, cerebrovascular diseases of participants at baseline were classified as no cerebrovascular disease (reference group, n = 828), symptomatic cerebrovascular disease ( n = 204), covert vascular lesions ( n = 156), or imaging negative ischemia ( n = 90) based upon clinical and MRI findings. Ischemic strokes and deaths were collected at 6 month-intervals up to 17 years of follow-up. With Cox regression, relationships between phenotype and ischemic stroke recurrence, cardiovascular mortality, and non-vascular mortality were studied adjusted for age, sex, and cardiovascular risk factors. Results: Compared to reference group risk for recurrent ischemic stroke was increased not only in the symptomatic cerebrovascular disease (HR 3.9, 95% CI 2.3–6.6), but also in the covert vascular lesion (HR 2.5, 95% CI 1.3–4.8) and the imaging negative ischemia groups (HR 2.4, 95% CI 1.1–5.5). Risk for cardiovascular mortality was increased in the symptomatic cerebrovascular disease (HR 2.2, 95% CI 1.5–3.2) and covert vascular lesions groups (HR 2.3, 95% CI 1.5–3.4), while the risk was less strong but also increased in the imaging negative ischemia group (HR 1.7, 95% CI 0.9–3.0). Conclusions: People with all imaging phenotypes of cerebrovascular disease have increased risk of recurrent ischemic stroke and mortality compared to other arterial diseases. Strict preventive measures should be performed even when imaging findings or clinical symptoms are absent. Data access statement: For use of anonymized data, a reasonable request has to be made in writing to the UCC-SMART study group and the third party has to sign a confidentiality agreement.