bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Patient and Procedural Factors on Outcomes Following Mesenteric Bypass
Authors: Zickler William P. , Zambetti Benjamin R. , Zickler Christine L. , Zickler Michael K. , Byerly Saskya , Garrett H. Edward , Magnotti Louis J. 
Published: September 2023

Background Mesenteric bypass (MB) for patients with acute (AMI) and chronic mesenteric ischemia (CMI) is associated with cardiovascular (CV) and pulmonary morbidity. Methods Patients with AMI and CMI from 2008 to 2019 were identified to determine independent predictors of CV (cardiac arrest, MI, DVT, and stroke) and pulmonary (pneumonia and ventilator time>48 h) morbidities in patients undergoing MB. Results 377 patients were identified. Patients with AMI had higher rates of preoperative SIRS/sepsis (28 vs 12%, P < .0001), were more likely to be ASA class 4/5 (55 vs 42%, P = .005), were more likely to require bowel resection (19 vs 3%, P < .0001), and were more likely to have vein utilized as their bypass conduit (30 vs 14%, P < .0001). There were no differences in use of aortic or iliac inflow ( P = .707) nor in return to the OR (24 vs 19%, P = .282). Both postoperative sepsis (12 vs 2.6%, P = .003) and mortality (31.4% vs 9.8%, P < .0001) were significantly increased in patients with AMI. After adjusting for both patient and procedural factors, multivariable logistic regression (MLR) identified international normalized ratio (INR) (OR 3.16; 95% CI 1.56-6.40, P = .001) and chronic heart failure (CHF) (OR 5.88; 95% CI 1.15-29.97, P = .033) to be independent predictors of pulmonary morbidity, while preoperative sepsis (OR 1.96; 95% CI 1.45-2.66, P < .0001) alone was predictive of CV morbidity in all patients undergoing MB. Discussion Mesenteric bypass for mesenteric ischemia leads to high rates of morbidity and mortality, whether done in an acute or chronic setting. Preoperative sepsis, independent of AMI or CMI, predicts CV morbidity, regardless of bypass configuration or conduit, while elevated INR or underlying CHF carries a higher risk of pulmonary morbidity.
To the bone: Prevalence and correlates of depression and anxiety among orthopedic residents in Mexico
Authors: Fresán Ana , Robles-García Rebeca , Yoldi-Negrete María , Guízar-Sánchez Diana , Tovilla-Zárate Carlos-Alfonso 
Published: September 2023

Objective Examining orthopedic residents in Mexico, researchers explore the relationship between the presence of depressive or anxious symptoms and the degree of perfectionism, perceived work-related distress, and involvement in the care of patient(s) who died. Methods This was a cross-sectional online survey of 642 orthopedic residents from October 2019 to April 2021. Results Of orthopedic residents contacted, 50.6% responded rate (70.9% male, average age 29.8 years). A total of 12.5% reported significant depressive symptoms and 18.4% reported significant anxious symptoms. On a scale from 0-100, the mean score of perceived work-related distress was 51.9. One-third (33.6%) reported being involved in the care of patient(s) who had died. Higher levels of work-related distress and higher scores on perfectionism were associated with depressive and anxiety symptoms. In particular, being involved in the care of patient(s) who had died was associated with anxious symptoms (OR = 1.79; 95%CI = 1.18-2.72). Conclusions These results highlight the need for systematic monitoring of the mental health of orthopedic residents in Mexico, particularly those who report a high level of work-related distress or perfectionism or who have recently experienced the death of a patient.
Circuit change in neonatal and pediatric extracorporeal membrane oxygenation is associated with adverse outcomes
Authors: Hafezi Niloufar , Markel Troy A , Mark Natalie M , Colgate Cameron L , Shah Supriya , Ninad Nehal , Masso Maldonado Sarina , Gray Brian W 
Published: September 2023

Introduction Extracorporeal membrane oxygenation (ECMO) circuits may be changed during the run for multiple reasons; however, these circuit changes may be associated with adverse events. Predictors for undergoing a circuit change (CC) and their outcomes remain unclear. We hypothesized that neonatal and pediatric CC correlates with increased morbidity and mortality. Methods Pediatric and neonatal patients who underwent one ECMO run lasting <30 days at a tertiary children’s hospital from 2011 through 2017 were retrospectively reviewed. Bivariate regression analysis evaluated factors associated with ECMO mortality and morbidity. LASSO logistic regression models identified independent risk factors for undergoing a CC. p < .05 was significant. Results One hundred 85 patients were included; 137 (74%) underwent no CC, while 48 (26%) underwent one or more. Undergoing a CC was associated with longer ECMO duration ( p < .001), higher blood transfusion volumes ( p < .001), increased hemorrhagic complications ( p < .001) and increased mortality ( p = .002). Increased platelet ( p = .001) and FFP ( p = .016) transfusion volumes at any time while on ECMO were independent factors associated with undergoing a CC. Conclusions Changing the circuit during the ECMO run occurs frequently and may be associated with poorer outcomes. Understanding the outcomes and predictors for CC may guide management protocols for more efficient circuit changes given its important association with overall outcomes.
Effect of atrial fibrillation on plasma galectin-3 and soluble CD40 ligand levels in patients with ischemic cardiomyopathy
Authors: Zhang Chi , Li HongJun , Han Mei 
Published: September 2023

Objective To reveal the significance of plasma galectin-3 and soluble CD40 ligand (sCD40L) levels in patients with ischemic cardiomyopathy (ICM) combined with atrial fibrillation. Methods In this case–control study, the case group comprised 60 patients with ICM combined with atrial fibrillation and the control group comprised patients with ICM without atrial fibrillation. Plasma galectin-3 and sCD40L levels, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), and left ventricular diameter (LVD) were compared. Results The plasma galectin-3 and sCD40L levels, LAD, and LVD were higher and the LVEF was lower in the case than control group. In the case group, the plasma galectin-3 and sCD40L levels were positively correlated with the LAD and LVD but negatively correlated with the LVEF. The area under the receiver operating characteristic curve of the plasma galectin-3 and sCD40L levels in the diagnosis of ICM combined with atrial fibrillation was 0.857 (95% confidence interval, 0.792–0.923) and 0.724 (95% confidence interval, 0.634–0.814), respectively. Conclusion The plasma galectin-3 and sCD40L levels are significantly elevated in patients with ICM combined with atrial fibrillation. Although both may have predictive value in the diagnosis of ICM combined with atrial fibrillation, galectin-3 may have the higher predictive value.
MRI radiomics-based evaluation of tuberculous and brucella spondylitis
Authors: Wang Wenhui , Fan Zhichang , Zhen Junping 
Published: September 2023

Objectives We analyzed magnetic resonance imaging (MRI) and radiomics labels from tuberculous spondylitis (TBS) and brucella spondylitis (BS) to build machine learning models that differentiate TBS from BS and culture-positive TBS (TBS(+)) from culture-negative TBS (TBS(−). Methods This retrospective study included 56 patients with BS, 63 patients with TBS(+) and 71 patients with TBS(−). Radiomics labels were extracted from T2-weighted fat-suppression images. MRI labels were analyzed via logistic regression (LR); radiomics labels were analyzed by t-tests, SelectKBest, and least absolute shrinkage and selection operator (LASSO). Random forest (RF) and support vector machine (SVM) models were established using radiomics or joint (radiomics+MRI) labels. Models were evaluated by receiver operating characteristic curves, areas under the curve (AUCs), decision curve analysis (DCA), and Hosmer–Lemeshow tests. Results When joint-label models were used to compare BS vs TBS(+) and BS vs TBS(−) groups, SVM AUCs were 0.904 and 0.944, respectively, whereas RF AUCs were 0.950 and 0.947, respectively; these were higher than the AUCs of the MRI label-based LR model. DCA showed that radiomics-based machine learning models had a greater net benefit; Hosmer–Lemeshow tests demonstrated good prediction consistency for all models. Conclusions Radiomics can help distinguish TBS from BS and TBS(+) from TBS(−).
A diagnostic biomarker of acid glycoprotein 1 for distinguishing malignant from benign pulmonary lesions
Authors: Chen Ying , Zhang Yueyang , Huang Ankang , Gong Yongsheng , Wang Weidong , Pan Jicheng , Jin Yanxia 
Published: September 2023

Background The acid glycoprotein 1 (AGP1) is downregulated in lung cancer. However, the performance of AGP1 in distinguishing benign from malignant lung lesions is still unknown. Methods The expression of AGP1 in benign diseases and lung cancer samples was detected by Western blot. The receiver operating characteristic curves, bivariate correlation, and multivariate analysis was analyzed by SPSS software. Results AGP1 expression levels were significantly downregulated in lung cancer and correlated with carcinoembryonic antigen (CEA), CA199, and CA724 tumor biomarkers. The diagnostic performance of AGP1 for distinguishing malignant from benign pulmonary lesions was better than the other four clinical biomarkers including CEA, squamous cell carcinoma-associated antigen, neuron-specific enolase, and cytokeratin 19 fragment 21-1, with an area under the curve value of 0.713 at 88.8% sensitivity. Furthermore, the multivariate analysis indicated that the variates of thrombin time and potassium significantly affected the AGP1 levels in lung cancer. Conclusions Our study indicates that AGP1 expression is decreased in lung cancer compared to benign samples, which helps distinguish benign and malignant pulmonary lesions.
Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data
Authors: Singh Shipra , Polavarapu Mounika , Vallerand Katharine , Moore Sundaye S. 
Published: September 2023

This study aimed to examine changes in health behaviors and outcomes during early-pandemic (2020) vs pre-pandemic (2019) years by age groups and race/ethnicity. Multivariable logistic regressions were conducted using Behavioral Risk Factor Surveillance System datasets from 2019 (n = 418 268) and 2020 (n = 401 958). All participants reported less likelihood to exercise (aOR, .78; 95% CI: .73-.83) and have poor physical health (aOR, .91; 95% CI: .86-.98) but more likelihood to have excellent general health (aOR, 1.33; 1.17-1.53) during 2020 vs 2019. Compared to 2019, during 2020 (i) Blacks were more likely to exercise (aOR, 1.24; 95% CI: 1.02-1.51) and have excellent general health (aOR, 1.69; 95% CI: 1.13-2.54); (ii) Hispanics were less likely to exercise (aOR, .80; 95% CI: .74-.88), but more likely to have excellent general health (aOR, 2.44; 95% CI: 1.79-3.33) and mental health (aOR, 1.41; 95% CI: 1.15-1.72); and (iii) Whites were less likely to exercise (aOR, .58; 95% CI: .50-.67) and have good physical health (aOR, 0.89; 95% CI: .82-.95). All age groups, except 18-24 years, were less likely to exercise by 18%-39% during 2020 vs 2019. Furthermore, the 55-64 years age-group was 36% more likely to report excellent general health but 14% less likely to have good physical health. Identifying the most vulnerable racial/ethnic and age groups is pivotal to prioritizing public health resources and interventions to mitigate the impact of health crises.
CFO Demographics and Working Capital Management in China
Authors: Hu Qida , Bhuiyan Md. Borhan Uddin , Houqe Muhammad Nurul 
Published: September 2023

This research examines whether Chief Finance Officer (CFO) demographics (including age, educational background, gender and tenure) impact firm working capital policies. We argue that the personal characteristics of the CFO impact corporate financial policy, such as working capital management. Using a sample of listed companies in the China Stock market over 2000–2021, we find that CFO age, gender, education, and tenure determine firm working capital management. Further, we identified that findings are more pronounced within firms that do not have state ownership, suggesting that private ownership firms are likely to have aggressive working capital management. In terms of economic significance, our results demonstrated that a one-standard-deviation rise in CFO age is associated with a decrease in working capital of 1.09% to 1.39% for the sample firms. This implies that the effect of CFO age on working capital management is economically significant, implying that it considerably impacts the financial situation. JEL Codes: G32, G34, G39
Midterm Results of AAA Ankle Arthroplasty
Authors: Endstrasser Franz , Lindtner Richard A. , Landegger Anna , Wagner Moritz , Eichinger Martin , Schönthaler Hannes , Kaufmann Gerhard , Brunner Alexander 
Published: September 2023

Background: Outcome reports for Alpha Ankle Arthroplasty (AAA), a third-generation implant relying on a mobile bearing design for total ankle replacement, are sparse. This retrospective study evaluated the midterm survivorship, clinical, and radiologic outcomes after implantation of this implant. Methods: For 64 patients who received 65 Triple A ankle implants between 2009 and 2020, implant survival was calculated using the Kaplan-Meier curve. Clinical outcomes were evaluated by measuring the range of motion, stability, Western Ontario and McMaster Universities Osteoarthritis Questionnaire score (WOMAC), and American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS). The average pain level and satisfaction with the postoperative result were rated on a numeric rating scale (0-10). Additionally, radiologic analysis was performed using anteroposterior and lateral radiographs and tibiotalar alignment was assessed. Results: The implant-survival rate was 61.5% at a mean follow-up of 8.2 years. Twenty-five patients (38.5%) required revision surgery (average time to revision, 3.1 years, 95% CI 2.1-4.1 years). For patients without revisions, the average range of motion in dorsiflexion and plantarflexion were 3.6 ± 4.2 degrees and 21.9 ± 7.8 degrees, respectively. The mean WOMAC and AOFAS scores were 44.7 ± 47.5 and 75.1 ± 14.0, respectively. The average pain and subjective satisfaction scores were 2.0 ± 1.7 and 8.5 ± 1.9, respectively. Mean alignment values did not differ significantly for patients who required revision surgery. Conclusion: We found a high revision rate with use of the AAA. However, patients who did not require revision surgery had, on average, high satisfaction and good functional outcomes. Level of Evidence: Level IV, case series.
Determinants of Cervical Cancer Screening Among Women Aged 30–49 Years Old in Four African Countries: A Cross-Sectional Secondary Data Analysis
Authors: Alie Melsew Setegn , Negesse Yilkal , Ayenew Mengistu 
Published: September 2023

Background Early-stage cervical cancer screening is essential for providing women with a better chance of receiving effective treatment for precancerous and cancer stages. Delay in cervical cancer screening results in late presentation and cancer metastasis. National-level cervical cancer screening in resource-limited countries was scarce and not well studied in Africa based on national data specifically in Kenya, Cameroon, Nambia, and Zimbabwe. Objective To determine the prevalence and determinants of cervical cancer screening among eligible women in Kenya, Cameroon, Nambia, and Zimbabwe. Methods This study analyzed demographic and health survey data from Kenya, Cameroon, Nambia, and Zimbabwe. The data were extracted and analyzed by STATA version 15 and further analysis was done. Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated to check the appropriateness of multilevel analysis. Variables with P-value < .25 were selected for multivariable multilevel logistic regression analysis. Finally, statistical significance between dependent and independent variables was assessed by odds ratios and 95% confidence intervals. Results The prevalence of cervical cancer screening in 4 African countries (Nambia, Kenya, Cameroon, and Zimbabwe) was 23.4 [95%CI: 22.8-24.1]. The determinants identified in this study were women of age 41–50 years [AOR = 1.47; 95% CI 1.24, 1.73], rural residence [AOR = .67; 95% CI .55, .81], women who have their own work [AOR = 1.1; 95% CI 1.0, 1.37], smoking status [AOR = 1.89; 95% CI 1.17, 3.0], age at first birth >=35 [AOR = 5.27; 95% CI 1.29-21.52], condom use [AOR = 1.79; 95% CI 1.46,2.19], husbands having worked [AOR = 1.5; 95% CI 1.08,2.11], rich household wealth [AOR = 1.43; 95% CI 1.13,1.8], and having health insurance [AOR = 2.2; 95% CI 1.8,2.7]. Conclusion The prevalence of cervical cancer screening in Kenya, Cameroon, Nambia, and Zimbabwe was low as compared to World Health Organization (WHO) recommendations. Age, residence, work status, smoking status, women’s age at first birth, condom use, husbands having work, wealth status, and health insurance were the identified determinants of cervical cancer screening. Programme and policy interventions could address younger, rural residence women, poor wealth status women, women without work, and those who never use health insurance for the uptake of cervical cancer screening.
Utilization and toxicity patterns of 2-weekly (Q2W) versus 4-weekly (Q4W) nivolumab for treatment of adjuvant and metastatic melanoma at BC cancer
Authors: Truong Jennifer , Yeung Shirley S.T. , Kletas Victoria , de Lemos Mario , Schaff Kimberly , Nakashima Lynne 
Published: September 2023

Background Nivolumab, an immune checkpoint inhibitor used to treat several malignancies, is associated with immune-related adverse events (IrAEs). Original dosing for melanoma was 3 mg/kg (maximum 240 mg) every 2 weeks (Q2W). Based on simulation studies depicting similar efficacy and toxicity to original dosing, extended interval dosing of 6 mg/kg (maximum 480 mg) every 4 weeks (Q4W) was introduced. Objective This study will compare safety between Q2W and Q4W dosing at BC Cancer in melanoma patients. Methods Retrospective chart review for reported incidence, onset, and severity of IrAEs in melanoma patients treated with nivolumab Q2W and Q4W dosing was completed. Fisher's test was conducted for first incidence IrAEs using Microsoft Excel. Results Seventy-one patients were identified (Q2W n = 35, Q4W n = 36). Baseline characteristics were similar in both groups. No statistically significant difference was found in incidence of IrAEs between Q2W and Q4W dosing (Q2W 40% vs Q4W 50%, p = 0.477). Rash was most common (Q2W 79% vs Q4W 50%) followed by hypothyroidism (Q2W 33% vs Q4W 20%). Median onset of IrAEs seemed later with Q4W dosing (Q2W cycle 1 vs Q4W cycle 4). Regardless of dosing, most IrAEs were grade 1–2 in severity (Q2W 100% vs Q4W 89%). Conclusion Q4W dosing is associated with comparable incidence and potentially later onset of IrAEs compared to Q2W dosing. Most IrAEs in both dosing groups were similar and mild. Therefore, Q4W dosing offers a safe alternative to Q2W dosing while providing benefits including decreased workload for staff, decreased clinic visits, and viral exposure by patients.
Endovascular Thrombectomy With or Without Thrombolysis for Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Morsi Rami Z. , Zhang Yuan , Carrión-Penagos Julián , Desai Harsh , Tannous Elie , Kothari Sachin , Khamis Assem , Darzi Andrea J. , Tarabichi Ammar , Bastin Reena , Hneiny Layal , Thind Sonam , Coleman Elisheva , Brorson James R. , Mendelson Scott , Mansour Ali , Prabhakaran Shyam , Kass-Hout Tareq 
Published: September 2023

Background To this date, whether to administer intravenous thrombolysis (IVT) prior to endovascular thrombectomy (EVT) for stroke patients still stirs some debate. We aimed to systematically update the evidence from randomized trials comparing EVT alone vs EVT with bridging IVT. Methods We searched MEDLINE, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing EVT with or without IVT in patients presenting with stroke secondary to a large vessel occlusion. We conducted meta-analyses using random-effects models to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH), between EVT and EVT with IVT. We assessed risk of bias using the Cochrane risk-of-bias tool and certainty of evidence for each outcome using the GRADE approach. Results Of 11,111 citations, we included 6 studies with a total of 2336 participants. We found low-certainty evidence of possibly a small decrease in the proportion of patients with functional independence (risk difference [RD] −2.0%, 95% CI −5.9% to 2.0%), low-certainty evidence that there is possibly a small increase in mortality (RD 1.0%, 95% CI −2.2% to 4.7%), and moderate-certainty evidence that there is probably a decrease in sICH (RD −1.0%, 95% CI −1.6% to .7%) for patients with EVT alone compared to EVT plus IVT, respectively. Conclusion Low-certainty evidence shows that there is possibly a small decrease in functional independence, low-certainty evidence shows that there is possibly a small increase in mortality, and moderate-certainty evidence that there is probably a decrease in sICH for patients with EVT alone compared to EVT plus IVT.
Aerobic and Resistance Training Attenuate Differently Knee Joint Damage Caused by a High-Fat–High-Sucrose Diet in a Rat Model
Authors: Abughazaleh Nada , Boldt Kevin , Rios Jaqueline Lourdes , Mattiello Stela Marcia , Collins Kelsey H. , Seerattan Ruth-Anne , Herzog Walter 
Published: September 2023

Objective Obesity and associated low-level local systemic inflammation have been linked to an increased rate of developing knee osteoarthritis (OA). Aerobic exercise has been shown to protect the knee from obesity-induced joint damage. The aims of this study were to determine (1) if resistance training provides beneficial metabolic effects similar to those previously observed with aerobic training in rats consuming a high-fat/high-sucrose (HFS) diet and (2) if these metabolic effects mitigate knee OA in a diet-induced obesity model in rats. Design Twelve-week-old Sprague-Dawley rats were randomized into 4 groups: (1) a group fed an HFS diet subjected to aerobic exercise (HFS+Aer), (2) a group fed an HFS diet subjected to resistance exercise (HFS+Res), (3) a group fed an HFS diet with no exercise (HFS+Sed), and (4) a chow-fed sedentary control group (Chow+Sed). HFS+Sed animals were heavier and had greater body fat, higher levels of triglycerides and total cholesterol, and more joint damage than Chow+Sed animals. Results The HFS+Res group had higher body mass and body fat than Chow+Sed animals and higher OA scores than animals from the HFS+Aer group. Severe bone lesions were observed in the HFS+Sed and Chow+Sed animals at age 24 weeks, but not in the HFS+Res and HFS+Aer group animals. Conclosion In summary, aerobic training provided better protection against knee joint OA than resistance training in this rat model of HFS-diet-induced obesity. Exposing rats to exercise, either aerobic or resistance training, had a protective effect against the severe bone lesions observed in the nonexercised rats.