bluuebunny/crossref_metadata_2025_split huggingface dataset:
The experience of informal caregiving within Saudi society: expressed needs and expectations
Authors: Almehmadi Soha , Alrashed Abeer M. 
Published: February 2023

AbstractBackgroundEven though informal caregivers have always been a major element within any society, their contribution to the healthcare system has only recently been recognized. Accordingly, the sustainability of their informal social role is becoming a major concern to policymakers. In Saudi Arabia, recognition of informal caregiving is still limited. This study was carried out to investigate the experience of caregiving in informal settings through identifying the needs of the caregivers along with their expectations of the formal system.MethodsA cross-sectional study was conducted to measure the experience of Saudi informal caregivers who were caring for at least one individual with a dependency resulting from either disability, aging, or both. A self-administered questionnaire was designed specifically for this study with 88% reliability. A convenient sample of 300 caregivers was invited electronically through 14 websites supporting families with dependent individuals.ResultsOf the eligible participants (n = 271), about two-thirds were caring for one elderly person or more, while one-third were caring for individual(s) with disabilities. The two groups did not differ in their needs; their greatest perceived needs were necessary equipment for care recipients, free time to socialize, alternative care setting, and proper income. Overall, the needs on the system level were the highest, followed by the needs on the financial level, then on the social level. On the other hand, the caregivers of individuals with disabilities had greater expectations of formal support than caregivers of the elderly. The greatest expectation among the participants was facilitating care recipients’ mobility within their communities. Overall, the expectations of information support were the highest followed by the expectations of financial support and then material support.ConclusionThe participants expressed great expectations of formal support along with some unmet needs. Further research is recommended to emphasize the role of primary caregivers along with the nature of the assistance received throughout the caregiving process. The needs of individuals with dependencies along with those of the caregivers must be considered in the planning process of healthcare services. Finally, the expectations of informal caregivers should lead the priorities of the development decisions of long-term care services.
Relationship between expression levels of TDRD7 and CRYBB3 and development of age-related cortico-nuclear cataracts
Authors: Yildiz Saliha Handan , Karaosmanoğlu Cem , Duman Rahmi , Varol Nuray , Özdemir Erdoğan Müjgan , Solak Mustafa , Duman Reşat , Elmas Muhsin 
Published: February 2023

Abstract
Background
The human lens develops age-related cataracts (ARCs) because of the complicated effects of aging and stressful conditions. Under conditions involving oxidative stress, cells form stress granules (SGs). TDRD7 has been identified as an RNA granule component and an important component of SGs. TDRD7 plays a role in the post-transcriptional expression of genes, such as the crystallin gene CRYBB3. Therefore, the present study investigated TDRD7 and CRYBB3 mRNA expressions in relation to age-related cortico-nuclear cataracts.

Methods
Quantitative real-time PCR was used to determine the expression levels of TDRD7 and CRYBB3 in 52 patients with ARC and 52 healthy controls. Anterior lens capsules and peripheral blood samples from patients with ARC were included in the patient group, and peripheral blood samples from healthy subjects and human lens epithelial cells (HLE-B3) were included in the control group. Gene expression levels in the different age groups were compared. Correlation analysis was used to assess the gene expression levels and age.

Results
The expression of TDRD7 and CRYBB3 was significantly up-regulated (P < 0.0001) in anterior lens capsules compared to that in HLE-B3 cells. Similarly, the expression of TDRD7 (P = 0.0004) and CRYBB3 (P < 0.0001) was higher in the peripheral blood samples of patients with ARC than in those of healthy subjects. Significant upregulation (P < 0.05) was observed in the 71–81-year age group of patients. No correlation was found between gene expression levels and age.

Conclusion
Significantly higher expression levels of TDRD7 and CRYBB3 in patients with ARC than in controls suggest that TDRD7 and CRYBB3 are associated with the development of age-related cortico-nuclear cataracts and the aging process under chronic stress.
Electrocardiographic substrates of arrhythmias in patients with end-stage and chronic kidney diseases: a case–control study
Authors: Yehia Hesham , Youssef Ghada , Gamil Mona , Elsaeed Mahmoud , Sadek Khaled M. 
Published: February 2023

Abstract
Background
Cardiovascular disease (CVD) is the most common cause of death in patients with renal diseases. Cardiac arrhythmia and sudden cardiac death are particularly important, and the burden is higher in patients on hemodialysis. The aim of this study is to compare specific ECG changes as markers of arrhythmias in patients with CKD and patients with end-stage renal disease (ESRD); all without clinically manifest heart disease, with normal control subjects.

Results
Seventy-five ESRD patients on regular hemodialysis, 75 patients with stage 3–5 CKD and 40 healthy control subjects were included. All candidates were subjected to thorough clinical evaluation and laboratory tests including serum creatinine, glomerular filtration rate calculation, serum potassium, magnesium, calcium, phosphorus, iron, parathyroid hormone, and total iron binding capacity (TIBC). Resting twelve-lead ECG was done to calculate P wave dispersion (P-WD), corrected QT interval, QTc dispersion, Tpeak-Tend interval (Tp-e), and Tp-e/QT. Patients with ESRD had a significantly higher QTc dispersion (p < 0.001) and P-WD (p = 0.001) when compared to the other 2 groups. In the ESRD group, males had a significantly higher P-WD (p = 0.045), insignificantly higher QTc dispersion (p = 0.445), and insignificantly lower Tp-e/QT ratio (p = 0.252) as compared to females. Multivariate linear regression analysis for ESRD patients showed that serum creatinine (β = 0.279, p = 0.012) and transferrin saturation (β =  − 0.333, p = 0.003) were independent predictors of increased QTc dispersion while ejection fraction (β = 0.320, p = 0.002), hypertension (β =  − 0.319, p = 0.002), hemoglobin level (β =  − 0.345, p = 0.001), male gender (β =  − 0.274, p = 0.009) and TIBC (β =  − 0.220, p = 0.030) were independent predictors of increased P wave dispersion. In the CKD group, TIBC (β =  − 0.285, p = 0.013) was an independent predictor of QTc dispersion while serum calcium (β = 0.320, p = 0.002) and male gender (β =  − 0.274, p = 0.009) were independent predictors of Tp-e/QT ratio.

Conclusions
Patients with stage 3–5 CKD and those with ESRD on regular hemodialysis exhibit significant ECG changes that are considered substrates for ventricular as well as supraventricular arrhythmias. Those changes were more evident in patients on hemodialysis.
Perioptic cerebro-spinal fluid transudation: case report of an unusual finding of optic hydrops in idiopathic intracranial hypertension
Authors: Kuroedov Danila Sergeyevich , Lobo Gonçalo Gama , Morais Teresa P. , Vieira José Pedro , Conceição Carla 
Published: February 2023

Abstract
Background
Idiopathic intracranial hypertension (IIH) has well-described imaging findings, typically reversible with the adequate treatment. We hereby report a case of IIH with a peculiar imaging finding, that to our knowledge and by the research conducted, has never been described before—cerebro-spinal fluid (CSF) transudation across the optic nerve sheath.

Case presentation
A 15-year-old girl with a 2-week history of occipital headache, nausea and vomiting, diplopia, blurred vision and tinnitus in her right ear, was admitted in the neuropediatric department and after extensive diagnostic work-up was diagnosed with IIH. The MRI showed typical signs of idiopathic intracranial hypertension, including enlargement of the perioptic CSF spaces associated with a peculiar finding described as a blurred hyperintensity T2/FLAIR of the perioptic fat, which was likely related to transudation of CSF. The adequate medical therapy (including corticosteroids and acetazolamide) for 2 weeks didn’t revert the signs and symptoms and so a lumboperitoneal shunt was placed with complete resolution of the clinical picture and the imaging findings described.

Conclusions
The documentation of CSF transudation around the optic nerve in the setting of hydrops has never been reported before and should be recognized by the neuroradiologist. It seems to be reversible, like the other findings of IIH and its physiopathology is not clear.
Anticancer plant-derivatives: deciphering their oncopreventive and therapeutic potential in molecular terms
Authors: Gahtori Rekha , Tripathi Ankita H. , Kumari Amrita , Negi Nidhi , Paliwal Ashutosh , Tripathi Prabhanshu , Joshi Penny , Rai Ramesh C. , Upadhyay Santosh K. 
Published: February 2023

Abstract
Background
Over the years, phytomedicines have been widely used as natural modalities for the treatment and prevention of various diseases by different ethnic groups across the globe. Although, 25% of drugs in the USA contain at least one plant-derived therapeutic compound, currently there is a paucity of plant-derived active medicinal ingredients in the pharmaceutical industry. Scientific evidence-based translation of plant-derived ethnomedicines for their clinical application is an urgent need. The anticancer and associated properties (antioxidative, anti-inflammatory, pro-apoptotic and epithelial-mesenchymal transition (EMT) inhibition) of various plant extracts and phytochemicals have been elucidated earlier. Several of the plant derivatives are already in use under prophylactic/therapeutic settings against cancer and many are being investigated under different phases of clinical trials.

Main body
The purpose of this study is to systematically comprehend the progress made in the area of prophylactic and therapeutic potential of the anticancerous plant derivatives. Besides, we aim to understand their anticancer potential in terms of specific sub-phenomena, such as anti-oxidative, anti-inflammatory, pro-apoptotic and inhibition of EMT, with an insight of the molecules/pathways associated with them. The study also provides details of classes of anticancer compounds, their plant source(s) and the molecular pathway(s) targeted by them. In addition to the antioxidative and antiproliferative potentials of anticancer plant derivatives, this study emphasizes on their EMT-inhibition potential and other ‘anticancer related’ properties. The EMT is highlighted as a phenomenon of choice for targeting cancer due to its role in the induction of metastasis and drug resistance. Different phytochemicals in pre-clinical or clinical trials, with promising chemopreventive/anticancer activities have been enlisted and the plant compounds showing synergistic anticancer activity in combination with the existing drugs have been discussed. The review also unravels the need of carrying out pan-signalome studies for identifying the cardinal pathways modulated by phytomedicine(s), as in many cases, the molecular pathway(s) has/have been randomly studied.

Conclusion
This review systematically compiles the studies regarding the impact of various plant derivatives in different cancers and oncogenic processes, as tested in diverse experimental model systems. Availability of more comprehensive information on anticancer phyto-constituents, their relative abundance in crude drugs, pathways/molecules targeted by phytomedicines, their long-term toxicity data and information regarding their safe use under the combinatorial settings, would open greater avenues of their utilization in future against this dreaded disease.

Graphical Abstract
Cost-effectiveness of polymyxin B hemoperfusion for septic shock: an observational study using a Japanese nationwide administrative database
Authors: Fujimori Kenji , Tarasawa Kunio , Fushimi Kiyohide 
Published: February 2023

Abstract
Background
Polymyxin B hemoperfusion (PMX) removes endotoxin from septic shock patients. Although the treatment has been clinically used for more than 20 years, its cost-effectiveness has not been evaluated in detail.

Methods
This study used the Japanese diagnosis procedure combination (DPC) administrative database from April 2018 to March 2021. We selected adult patients with a primary diagnosis of sepsis and the SOFA score at the sepsis diagnosis was between 7 and 12. The patients were divided into the PMX group that received PMX treatment and the control group that did not receive PMX. After adjusting the patient background by propensity score matching, we calculated the incremental cost-effectiveness ratio (ICER) by determining the difference in quality-adjusted life-year (QALY) and medical cost between the PMX and the control groups.

Results
Nineteen thousand two hundred eighty-three patients were included in the study. Among them, 1492 patients received PMX treatment, and 17,791 did not. As a result of 1:3 propensity score matching, 965 patients in the PMX group and 2895 patients in the control group were selected and analyzed. Twenty-eight-day mortality and hospital mortality were significantly lower in the PMX group. The average medical cost per patient of the PMX group was 31,418 ± 21,144 Euro and that of the control group was 24,483 ± 21,762 Euro, with a difference of 6935 Euro. Life expectancy, life year-gained (LYG), and the QALY were 1.70, 0.86, and 0.60 years longer in the PMX group, respectively. The ICER was calculated to be 11,592 Euro/year, which was lower than the reported willingness-to-pay threshold of 38,462 Euro/year.

Conclusion
Polymyxin B hemoperfusion was shown to be an acceptable treatment in terms of the medical economy.
Toward Predicting 30-Day Readmission Among Oncology Patients: Identifying Timely and Actionable Risk Factors
Authors: Hwang Sy , Urbanowicz Ryan , Lynch Selah , Vernon Tawnya , Bresz Kellie , Giraldo Carolina , Kennedy Erin , Leabhart Max , Bleacher Troy , Ripchinski Michael R. , Mowery Danielle L. , Oyer Randall A. 
Published: February 2023

PURPOSE Predicting 30-day readmission risk is paramount to improving the quality of patient care. In this study, we compare sets of patient-, provider-, and community-level variables that are available at two different points of a patient's inpatient encounter (first 48 hours and the full encounter) to train readmission prediction models and identify possible targets for appropriate interventions that can potentially reduce avoidable readmissions. METHODS Using electronic health record data from a retrospective cohort of 2,460 oncology patients and a comprehensive machine learning analysis pipeline, we trained and tested models predicting 30-day readmission on the basis of data available within the first 48 hours of admission and from the entire hospital encounter. RESULTS Leveraging all features, the light gradient boosting model produced higher, but comparable performance (area under receiver operating characteristic curve [AUROC]: 0.711) with the Epic model (AUROC: 0.697). Given features in the first 48 hours, the random forest model produces higher AUROC (0.684) than the Epic model (AUROC: 0.676). Both models flagged patients with a similar distribution of race and sex; however, our light gradient boosting and random forest models were more inclusive, flagging more patients among younger age groups. The Epic models were more sensitive to identifying patients with an average lower zip income. Our 48-hour models were powered by novel features at various levels: patient (weight change over 365 days, depression symptoms, laboratory values, and cancer type), hospital (winter discharge and hospital admission type), and community (zip income and marital status of partner). CONCLUSION We developed and validated models comparable with the existing Epic 30-day readmission models with several novel actionable insights that could create service interventions deployed by the case management or discharge planning teams that may decrease readmission rates over time.
Delirium as a Risk Factor for Mortality in Critically Ill Patients With Cancer
Authors: Tao Jing , Seier Kenneth , Marasigan-Stone Carina B. , Simondac Justina-Sheila S. , Pascual Analin V. , Kostelecky Natalie T. , SantaTeresa Evangelina , Nwogugu Stella O. , Yang Jennifer J. , Schmeltz Joseph , Tan Kay See , Chawla Sanjay , Voigt Louis P. 
Published: February 2023

PURPOSE: Although delirium is known to negatively affect critically ill patients, little data exist on delirium in critically ill patients with cancer. METHODS: We analyzed 915 critically ill patients with cancer between January and December 2018. Delirium screening was performed using the Confusion Assessment Method for the intensive care unit (ICU), performed twice daily. Confusion Assessment Method-ICU incorporates four features of delirium: acute fluctuations in mental status, inattention, disorganized thinking, and altered levels of consciousness. Multivariable analysis controlling for admitting service, pre-ICU hospital length of stay (LOS), metastatic disease, CNS involvement, Mortality Probability Model II score on ICU admission, mechanical ventilation, and others was performed to determine precipitating factors for delirium, ICU, and hospital mortality and LOS. RESULTS: Delirium occurred in 40.5% (n = 317) of patients; 43.8% (n = 401) were female; the median age was 64.9 (interquartile range, 54.6-73.2) years; 70.8% (n = 647) were White, 9.3% (n = 85) were Black, and 8.9% (n = 81) were Asian. The most common cancer types were hematologic (25.7%, n = 244) and gastrointestinal (20.9%, n = 191). Delirium was independently associated with age (OR, 1.01; 95% CI, 1.00 to 1.02; P = .038), longer pre-ICU hospital LOS (OR, 1.04; 95% CI, 1.02 to 1.06; P < .001), not resuscitating on admission (OR, 2.18; 95% CI, 1.07 to 4.44; P = .032), CNS involvement (OR, 2.25; 95% CI, 1.20 to 4.20; P = .011), higher Mortality Probability Model II score (OR, 1.02; 95% CI, 1.01 to 1.02; P < .001), mechanical ventilation (OR, 2.67; 95% CI, 1.84 to 3.87; P < .001), and sepsis diagnosis (OR, 0.65; 95% CI, 0.43 to 0.99; P = .046). Delirium was also independently associated with higher ICU mortality (OR, 10.75; 95% CI, 5.91 to 19.55; P < .001), hospital mortality (OR, 5.84; 95% CI, 4.03 to 8.46; P < .001), and ICU LOS (estimate, 1.67; 95% CI, 1.54 to 1.81; P < .001). CONCLUSION: Delirium significantly worsens outcome in critically ill patients with cancer. Delirium screening and management should be integrated into the care of this patient subgroup.
Spin-multiplexing phase-driven varifocal metalenses for multidimensional beam splitting and binary switching
Authors: Huang Yafeng , Xu Junwei , Tian Ximin , Ding Pei , Yu Zhanjun , Li Jie , Xu Yaning , Zhang Shenglan , Ma Xiaolong , Duan Xiangyang , Li Zhi-Yuan 
Published: February 2023

Abstract
The Pancharatnam-Berry (PB) phase, subject to geometric phase, is currently utilized to implement spin-dependent optical functions. Simultaneously achieving spin-multiplexing and varifocal performances via a single-cell-designed metasurface that purely relies on PB phases has been scarcely proposed due to the quite sophisticated degrees of freedom to be taken into account. Here, by virtue of pure PB phases composed of convex and concave phases, spin-multiplexing and varifocal metalenses based on a single-cell-designed approach are developed. The unit cell consists of Ge2Sb2Se4Te1 (GSST) nanopillar pairs setting on CaF2 substrate. By adopting the specified pure PB phases, the proposed metalenses can focus the left-handed and right-handed circularly polarized (LCP and RCP) incidences into different positions. By ingenious design, the Ge2Sb2Se4Te1-based unit cell can work like a half-wave plate at two wavelength bands depending on the Ge2Sb2Se4Te1 phase states, enabling the proposed metalenses phase-driven zoom focusing. Particularly, the unique phase transition of GSST empowers the proposed schemes with binary switching focusing merit and large switching contrast ratio. The new design strategy constitutes a novel avenue in designing spin-multiplexing and varifocal optical devices, showing great potential in imaging, optical storage and optical interconnections.
Pelvis Magnetic Resonance Imaging to Diagnose Familial Partial Lipodystrophy
Authors: Adiyaman Suleyman Cem , Altay Canan , Kamisli Berfu Y , Avci Emre Ruhat , Basara Isil , Simsir Ilgin Yildirim , Atik Tahir , Secil Mustafa , Oral Elif A , Akinci Baris 
Published: February 2023

Abstract

Context
The diagnosis of familial partial lipodystrophy (FPLD) is currently made based on clinical judgment.

Objective
There is a need for objective diagnostic tools that can diagnose FPLD accurately.

Methods
We have developed a new method that uses measurements from pelvic magnetic resonance imaging (MRI) at the pubis level. We evaluated measurements from a lipodystrophy cohort (n = 59; median age [25th-75th percentiles]: 32 [24-44]; 48 females and 11 males) and age- and sex-matched controls (n = 29). Another dataset included MRIs from 289 consecutive patients.

Results
Receiver operating characteristic curve analysis revealed a potential cut-point of ≤13 mm gluteal fat thickness for the diagnosis of FPLD. A combination of gluteal fat thickness ≤13 mm and pubic/gluteal fat ratio ≥2.5 (based on a receiver operating characteristic curve) provided 96.67% (95% CI, 82.78-99.92) sensitivity and 91.38% (95% CI, 81.02-97.14) specificity in the overall cohort and 100.00% (95% CI, 87.23-100.00) sensitivity and 90.00% (95% CI, 76.34-97.21) specificity in females for the diagnosis of FPLD. When this approach was tested in a larger dataset of random patients, FPLD was differentiated from subjects without lipodystrophy with 96.67% (95% CI, 82.78-99.92) sensitivity and 100.00% (95% CI, 98.73-100.00) specificity. When only women were analyzed, the sensitivity and the specificity was 100.00% (95% CI, 87.23-100.00 and 97.95-100.00, respectively). The performance of gluteal fat thickness and pubic/gluteal fat thickness ratio was comparable to readouts performed by radiologists with expertise in lipodystrophy.

Conclusion
The combined use of gluteal fat thickness and pubic/gluteal fat ratio from pelvic MRI is a promising method to diagnose FPLD that can reliably identify FPLD in women. Our findings need to be tested in larger populations and prospectively.
Diabetic Muscle Infarction: An Uncommon Diabetic Complication With a Lack of Standardized Treatment
Authors: Botero Suarez Carlos S , Matos Moises , Suryanarayanan Sowmya 
Published: February 2023

AbstractDiabetic muscle infarction (DMI) is a rare yet serious complication that has been strongly associated with uncontrolled diabetes, although other risk factors are unclear. DMI is an uncommon complication of diabetes with a lack of structured guidelines for evaluation or management. End-stage renal disease (ESRD) could have further implications in patients with DMI in terms of management given that nonsteroidal anti-inflammatory drugs (NSAIDs), which have been shown to reduce the recovery times and recurrence of DMI, could be contraindicated. We present a rare case of DMI in an African American man with ESRD who presented for new-onset right lower-extremity pain and swelling. We discuss the challenges involved with the diagnosis and treatment of this rare condition. This case adds to the knowledge of DMI, which is limited because of the low incidence of this condition, and it helps us understand how this condition affects the African American population and patients with ESRD.