bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Violaceous Skin Discoloration during the COVID-19 Pandemic: Conducting Research in Resource Scarcity
Authors: Savage Elizabeth , Lieder Jessica , Liu Helen , Lebovits Sarah 
Published: February 2023

ABSTRACT

OBJECTIVE
To describe the observed patterns and presentations of violaceous discoloration that appeared to be related to the COVID-19 disease process.

METHODS
This retrospective observational cohort study included adults who were COVID-19 positive with purpuric/violaceous lesions in pressure-adjacent areas of the gluteus without preexisting pressure injury. Patients were admitted to an ICU at a single quaternary academic medical center between April 1 and May 15, 2020. Data were compiled by review of the electronic health record. The wounds were described by location, tissue type (violaceous, granulation, slough, eschar), wound margin (irregular, diffuse, nonlocalized), and periwound condition (intact).

RESULTS
A total of 26 patients were included in the study. Purpuric/violaceous wounds were found predominantly on White (92.3%) men (88.0%) aged 60 to 89 years (76.9%) with a body mass index 30 kg/m2 or higher (46.1%). The majority of wounds were located on the sacrococcygeal (42.3%) and fleshy gluteal regions (46.1%).

CONCLUSIONS
Wounds were heterogeneous in appearance (poorly defined violaceous skin discoloration of acute onset), and the patient population had clinical characteristics similar to acute skin failure (eg, concomitant organ failures and hemodynamic instability). Additional larger population-based studies with biopsies may assist in finding patterns related to these dermatologic changes.
Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care
Authors: Barch Daniel H. , Seibert Julie Hayes , Kandilov Amy , Bernacet Amarilys , Deutsch Anne , Wang Xiao (Joyce) , Scherer Elissa , McMullen Tara , Mandl Stella , Levitt Alan , Frank Jennifer , Stephanopoulos Cynthia , Smith Laura M. 
Published: February 2023

ABSTRACT

GENERAL PURPOSE
To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs).

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:
1. Compare the unadjusted PI incidence in SNF, IRF, and LTCH populations.
2. Explain the extent to which the clinical risk factors of functional limitation (bed mobility), bowel incontinence, diabetes/peripheral vascular disease/peripheral arterial disease, and low body mass index are associated with new or worsened stage 2 to 4 PIs across the SNF, IRF, and LTCH populations.
3. Compare the incidence of new or worsened stage 2 to 4 PI development in SNF, IRF, and LTCH populations associated with high body mass index, urinary incontinence, dual urinary and bowel incontinence, and advanced age.

OBJECTIVE
To compare the incidence of new or worsened pressure injuries (PIs) and associated risk factors for their development in inpatient post-acute care settings: long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs).

METHODS
The authors investigated Medicare Part A SNF resident stays and LTCH patient stays that ended between October 1, 2016 and December 31, 2016 and IRF patient stays that ended between October 1, 2016 and March 31, 2017. They calculated the incidence of new or worsened PIs using the specifications of the National Quality Forum-endorsed PI quality measure #0678: Percent of Residents or Patients with Pressure Ulcers that are New or Worsened.

RESULTS
The incidences of new or worsened stages 2 through 4 PIs varied across settings: 1.23% in SNFs, 1.56% in IRFs, and 3.07% in LTCHs. Seven risk factors were positively and consistently associated with new or worsened PIs across settings: limited bed mobility, bowel incontinence, low body mass index, diabetes/peripheral vascular disease/peripheral arterial disease, advanced age, urinary incontinence, and dual urinary and bowel incontinence.

CONCLUSION
These findings provide empirical support for the alignment of risk factors for the PI quality measures across post-acute care settings.
Pressure Injury Risk Assessment in Pediatric Intensive Care: A Prospective Validation Study of the Glamorgan Scale and Predictive Comparison with the Braden Q Scale
Authors: Vocci Marcelli Christine , Amante Miot Hélio , Mendes Bertoncello Fontes Cassiana , Fernandes Abbade Luciana Patricia 
Published: February 2023

ABSTRACT

OBJECTIVE
To validate the Glamorgan Scale and compare its predictive ability in assessing pressure injury risk among patients in a pediatric ICU (PICU) with that of the Braden Q Scale.

METHODS
A prospective cohort study was performed to validate the Glamorgan Scale and compare its predictive ability with the Braden Q Scale in a PICU population. A total of 83 patients admitted in the PICU between February and July 2020 met the inclusion criteria and were included in the study, leading to 639 measurements. The authors tested the psychometric properties of the Glamorgan Scale to validate whether the characteristics of the original version were preserved. To this end, reliability (internal consistency) and concurrent and predictive validity (sensitivity and specificity) were assessed. For the predictive comparison, the authors performed the same tests with the Braden Q Scale.

RESULTS
The predictive validity, as assessed by the receiver operator characteristic curve and calculation of the area under the curve, showed satisfactory performance for the Glamorgan Scale (0.77; CI, 0.72–0.82); the Braden Q Scale values were similar (0.78; CI 0.73–0.84). The Spearman correlation coefficient showed a strong correlation between the total scores of the Glamorgan Scale (ρ = −0.76; P < .01), corroborating its validation.

CONCLUSIONS
The Glamorgan Scale was validated and showed good accuracy and consistency for pressure injury risk assessment in critically ill pediatric patients in Brazil. Its accuracy was similar to that of the Braden Q Scale.
T2-weighted Imaging Hyperintensity and Transcranial Motor-evoked Potentials During Cervical Spine Surgery: Effects of Sevoflurane in 150 Consecutive Cases
Authors: LeClair Nicole , Ejimone Milca , Lynch Davene , Dasika Jayanth , Rao Dinesh , Hoefnagel Amie L. , Mongan Paul D. 
Published: February 2023

Background:
There is debate on the impact of inhalational esthetic agents on transcranial motor evoked potentials (TcMEPs) during intraoperative neuromonitoring. Current guidelines advise their avoidance, which contrasts with common clinical practice.

Methods:
This retrospective cohort study of 150 consecutive cervical spine surgeries at a single institution compared stimulation voltages and TcMEP amplitudes in patients who did and did not receive sevoflurane as part of a balanced anesthetic technique. Patients were divided into 3 groups stratified by the presence or absence of increased signal intensity within the cervical spinal cord on T2-weighted magnetic resonance imaging (indicative or myelopathy/spinal cord injury [SCI]) and sevoflurane use.

Results:
Patients with no magnetic resonance imaging evidence of myelopathy/SCI that received sevoflurane (n=80) had the lowest stimulation voltages and largest TcMEP amplitude responses in the lower extremities compared with those with no magnetic resonance imaging evidence of myelopathy/SCI (n=30). In patients with evidence of myelopathy/SCI who did not receive sevoflurane (n=19), lower extremity TcMEP amplitudes were similar to patients with a myelopathy/SCI that received sevoflurane. Six of these 19 patients had initial low-dose sevoflurane discontinued because of concerns of low/absent baseline TcMEP amplitudes.

Conclusions:
Balanced anesthesia with 0.5 MAC sevoflurane in patients with and without radiological evidence of myelopathy/SCI allows reliable TcMEP monitoring. However, in communication with surgical and neuromonitoring teams, it may be advisable in a subset of patients to avoid or discontinue sevoflurane in favor of a propofol/opioid-based anesthetic to ensure adequate and reproducible TcMEPs.
Risk and prognostic factors of brain metastasis in lung cancer patients: a Surveillance, Epidemiology, and End Results population‑based cohort study
Authors: Hao Yongping , Li Guang 
Published: February 2023

Background
Brain is a common metastasis site in lung cancer patients. However, homogeneous and heterogeneous risk/prognostic factors of brain metastasis for lung cancer patients have not been comprehensively elucidated. This study aimed to explore the brain metastasis risk and prognostic factors in lung cancer patients using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods
Lung cancer data were downloaded from SEER database to investigate risk factors for developing brain metastasis using logistic regression analysis. Univariate and multivariate Cox analyses were used to identify potential prognostic factors. Kaplan–Meier analysis was conducted to evaluate the survival. Propensity score matching was conducted to eliminate baseline differences between two groups.

Results
A total of 10 818 (14.1%) patients with brain metastasis were diagnosed among 76 483 lung cancer patients. For non–small-cell lung carcinoma (NSCLC), distant liver/bone/lymph node metastases, higher T, N stages were risk factors. Black race, bone metastases and distant lymph node metastases and T4 were brain metastasis risk factors for SCLC patients. Cox analysis suggested that older age, male, primary lesion at main bronchus, liver/ bone/distant lymph node metastases, T2-4, N1-3, no surgery/chemotherapy/radiotherapy were associated with worse prognosis of NSCLC-brain metastasis patients. Age older than 80, liver/bone metastases, without radiotherapy and chemotherapy were associated with worse prognosis of SCLC-brain metastasis patients. Surgery of primary site could prolong the overall survival (OS) of NSCLC patients with brain metastasis, but not SCLC.

Conclusion
In this study, we analyzed the homogeneous and heterogeneous risk/prognostic factors of brain metastasis in lung cancer patients. What is more, our results showed that surgery of primary site was associated with longer OS of NSCLC patients with brain metastasis.
Association between low ambient temperature during pregnancy and adverse birth outcomes: a systematic review and meta-analysis
Authors: Ruan Tiechao , Yue Yan , Lu Wenting , Zhou Ruixi , Xiong Tao , Jiang Yin , Ying Junjie , Tang Jun , Shi Jing , Wang Hua , Xiao Guoguang , Li Jinhui , Qu Yi , Mu Dezhi 
Published: February 2023

Abstract

Background:
Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein.

Methods:
Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis.

Results:
A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04–1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increasing risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07 [95% CI 1.03–1.12]). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63 [95% CI 3.99–5.38]).

Conclusions:
Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors.

Registration:
No. CRD42021259776 at PROSPERO.
Dual therapy for Helicobacter pylori infection
Authors: Duan Miao , Liu Jing , Zuo Xiuli 
Published: February 2023

Abstract
Bismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.
Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study
Authors: Skorochod Ron , Rysin Roman , Wolf Yoram 
Published: February 2023

Background:
Many transmasculine individuals face chest dysphoria, an emotional distress associated with breast development. The definitive management for reduction of existing breast tissue and alleviation of chest dysphoria comes in the form of chest masculinization surgery. Over the years, a substantial increase in the number of youth seeking gender-affirming chest masculinization surgery was observed globally. The study was hypothesized to answer the question as to whether the age limit of chest masculinization surgery should be lowered to include adolescents.

Methods:
A retrospective cohort study was conducted, based on the experience of a single surgeon over a period of 20 years.

Results:
Two-hundred eight patients were included in this cohort. Patients were divided into two equal groups based on their age. No statistically significant differences between the groups were observed in terms of resected breast tissue (P = 0.62 and 0.30, for the right and left breast, accordingly), auxiliary liposuction (P = 0.30), liposuction volume (P = 0.20), procedure (P = 0.15), postoperative drains (P = 0.79), and surgery duration (P = 0.72). Statistically significant differences were found in the 18 years or younger group, with lower rates of complication (P < 0.001), lower rates of revision surgery (P = 0.025), and higher satisfaction rankings (P < 0.001). Apart from age, no other factors were found to potentially explain the different rates of complications between the age groups.

Conclusion:
Patients aged 18 or younger opting for chest masculinization surgery experience fewer complications and revision procedures while having higher satisfaction rates with the surgical outcome.
Widening Aging Eyes and Ending Outdoor Tearing with Retrobulbar Injections of Dermal Fillers
Authors: Lemperle Gottfried , Kassem-Trautmann Katja , Schmidt Katarzyna 
Published: February 2023

Background:
As people age, the intraorbital fat may diminish and palpebral fissures may narrow, causing the eyes to increasingly tear outside in cold weather. As the bulbus recedes from the conjunctiva, a “wind trap” is formed in the lateral corner of the eye. This wind trap appears to irritate the adjacent lacrimal gland. In this article, an 84-year-old patient experienced annoying outdoor tearing despite having undergone three tarsal strip canthopexies during the past 20 years.

Methods:
Retrobulbar injections of 3.5-mL high-viscous dermal fillers (Bellafill or Radiesse) pushed the eyeballs forward, aligned the bulbus with the conjunctiva, and closed the wind trap behind the lateral canthus. Magnetic resonance imaging confirmed the filler material in the posterior lateral corner of the orbit.

Results:
The effect was immediate: the patient’s constant outdoor tearing had resolved after the first treatment of his senile enophthalmos. In addition, the narrow palpebral fissure had widened by 2 mm and rejuvenated his aging eyes.

Conclusions:
An eyeball that has receded with age can be pushed forward with a retrobulbar injection of a long lasting dermal filler to reattach to the eyelids.
Predicting obstetric anal sphincter injuries among laboring women: 2 prediction models and 1 risk calculator
Authors: Hu Yinchu , Lu Hong , Zhang Jie , Ren Lihua , Yang Minghui 
Published: February 2023

Abstract

Background:
Although several prediction models have been developed to estimate the risk of obstetric anal sphincter injuries (OASIS) among laboring women, none have been used in clinical practice because of controversial or unavailable predictors included in the prediction models and the format used to present them. Thus, it is essential to develop evidence-based prediction models for OASIS using known antenatal and modifiable intrapartum factors and to present them in user-friendly formats.

Objective:
The objective of this study was to develop evidence-based prediction models for OASIS and a risk calculator to present prediction models.

Methods:
Models were developed based on a systematic review and meta-analysis in which risk factors for OASIS were identified, and the pooled odds ratio for each risk factor was calculated. A logistic regression model was used to develop the prediction models, and MATLAB with a graphical user interface was used to develop the risk calculator.

Results:
Two prediction models for OASIS were established: Model I and Model II. Model I included 7 known antenatal variables: maternal age, parity, prior cesarean delivery, prepregnancy body mass index, gestational age, estimated birth weight, and fetal position. Model II added 5 modifiable intrapartum variables to Model I: epidural analgesia, labor induction, labor augmentation, episiotomy, and operative vaginal birth. The risk calculator developed by writing the parameters in the logistic regression models into MATLAB scripts included 2 interfaces, each consisting of risk factors for OASIS and the possibility of OASIS occurring.

Conclusions:
This study developed 2 prediction models and a risk calculator for OASIS based on a systematic review and meta-analysis. Although the models were more scientific in model development methods and predictors included in the prediction models, they should be externally validated and updated to ensure better performance before they can be widely applied to guide clinical practice.
Metabolic signatures and potential biomarkers in the progression of type 2 diabetes mellitus with cognitive impairment patients: a cross-sectional study
Authors: Zheng Jie , Cheng Fangxiao , Du Yage , Song Ying , Cao Zhaoming , Li Mingzi , Lu Yanhui 
Published: February 2023

Abstract

Background:
Type 2 diabetes mellitus (T2DM), a growing global chronic disease, can increase the risk of cognitive impairment. The microbiota-gut-brain axis has a crucial role in the development of neurological pathologies. Therefore, it is necessary to examine host-gut microbiota metabolites associated with diabetic cognitive impairment (DCI) progression.

Objective:
This study aimed to describe metabolic signatures, identify potential biomarkers in the progression from T2DM to DCI, and analyze the correlation between the potential biomarkers and clinical characteristics.

Methods:
A cross-sectional study involving 8 patients with T2DM and 8 with DCI was carried out between May 2018 and May 2020. The characteristic clinical data of the patients, such as demographics, hematological parameters, Mini-Mental State Examination, and Montreal Cognitive Assessment, were collected. Metabolomics profiling measured the host-gut microbiota metabolites in the serum. The potential biomarkers were found by getting intersection of the differential host-gut microbiota metabolites from multidimensional statistics (Orthogonal Partial Least Squares-Discriminant Analysis and permutation plot) and univariate statistics (independent-sample t test and Mann-Whitney U test). In addition, we examined the relationship between potential biomarkers and characteristic clinical data using the Spearman correlation coefficient test.

Results:
A total of 22 potential biomarkers were identified in the T2DM and DCI groups, including 15 upregulated potential biomarkers (such as gluconolactone, 4-hydroxybenzoic acid, and 3-hydroxyphenylacetic acid) and 7 downregulated potential biomarkers (such as benzoic acid, oxoglutaric acid, and rhamnose) in DCI group. Most of the potential biomarkers were associated with clinical characteristics, such as Mini-Mental State Examination, Montreal Cognitive Assessment, and glycated hemoglobin A1c.

Conclusion:
This study showed that metabolic signatures in the serum were associated with DCI development and clinical severity, providing new ideas for extensive screening and targeted treatment.
The Value of Immunohistochemical Expression of TOX, ICOS, and GATA-3 in the Diagnosis of Mycosis Fungoides
Authors: Atwa Hanaa A. , Abdelrahman Doaa I. 
Published: February 2023

Background:
Mycosis fungoides (MF) is considered the commonest type of cutaneous T-cell lymphoma representing about 50% of all primary cutaneous lymphomas. Differentiation between MF and another inflammatory dermatitis (BIDs) is important to ensure proper management.

Aim:
We aimed to evaluate the immunohistochemical expression of TOX, ICOS, and GATA binding protein 3 (GATA-3) in early stages MF (stage IA and IB) to establish their diagnostic value and to guide the use of inhibitors in the treatment of cutaneous T-cell lymphomas.

Materials and Methods:
A retrospective study of 75 skin paraffin blocks (punch biopsy) 40 cases of MF and 35 cases of eczematous dermatitis as a group representing other inflammatory dermatitis were retrieved from archives of the pathology department of our University, during the period from October 2017 to May 2021.

Results:
About 98% and 90% of patients in the MF group had positive TOX and ICOS, while 70% of them had positive GATA-3. High expression of TOX, ICOS, and GATA-3 was associated with higher stages.

Conclusions:

TOX is considered a diagnostic marker for early MF. The importance of identifying novel markers in MF expressed by immunohistochemistry, such as ICOS, has been established. According to our results, GATA-3 could be used as an accessory marker in the diagnosis of MF when combined with TOX and ICOS in a panel.