bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a dynamic online nomogram for predicting acute kidney injury in cirrhotic patients upon ICU admission
Authors: Feng Lu-Huai , Lu Yang , Ren Shuang , Liang Hengkai , Wei Lu , Jiang Jianning 
Published: January 2023

BackgroundAcute kidney injury (AKI) is one of the most common and deadly complications among cirrhotic patients at intensive care unit (ICU) admission. We aimed to develop and validate a simple and clinically useful dynamic nomogram for predicting AKI in cirrhotic patients upon ICU admission.MethodsWe analyzed the admission data of 4,375 patients with liver cirrhosis in ICU from 2008 to 2019 in the intensive care unit IV (MIMIC-IV) database. The eligible cirrhotic patients were non-randomly divided into derivation (n = 2,188) and validation (n = 2,187) cohorts at a ratio of 1:1, according to the order of admission. The least absolute shrinkage and selection operator regression model was used to identify independent predictors of AKI in the derivation cohort. A dynamic online nomogram was built using multivariate logistic regression analysis in the derivation cohort and then validated in the validation cohort. The C-index, calibration curve, and decision curve analysis were used to assess the nomogram’s discrimination, calibration, and clinical usefulness, respectively.ResultsThe incidence of AKI in 4,375 patients was 71.3%. Ascites, chronic kidney disease, shock, sepsis, diuretic drugs, hepatic encephalopathy, bacterial infections, vasoactive drugs, admission age, total bilirubin, and blood urea nitrogen were identified using the multivariate logistic regression analysis as significant predictors of AKI upon ICU admission. In the derivation cohort, the model showed good discrimination (C-index, 0.786; 95% CI, 0.765–0.806) and good calibration. The model in the validation cohort yielded good discrimination (C-index, 0.774; 95% CI, 0.753–0.795) and good calibration. Decision curve analysis demonstrated that the dynamic online nomogram was clinically useful.ConclusionOur study presents a dynamic online nomogram that incorporates clinical predictors and can be conveniently used to facilitate the individualized prediction of AKI in cirrhotic patients upon ICU admission.
Prevalence of HDV infection in people living with HIV: Data from a multicenter Italian cohort
Authors: Nicolini Laura Ambra , Menzaghi Barbara , Ricci Elena , Pontali Emanuele , Cenderello Giovanni , Orofino Giancarlo , Cascio Antonio , Pellicanò Giovanni Francesco , Valsecchi Laura , Molteni Chiara , Vichi Francesca , Bonfanti Paolo , Di Biagio Antonio 
Published: January 2023

ObjectivesThe development of novel antiviral agents active against Hepatitis Delta Virus (HDV) might change the natural history of chronic infection, reducing the risk for end-stage liver disease. People living with HIV (PWH) are at risk for bloodborne pathogens infection, but limited data on epidemiology of HDV infection is available in this setting. The aim of this study was to investigate HDV prevalence and attitude toward HDV testing and treatment in infectious diseases centers.MethodsA cross sectional survey was performed among centers participating in the CISAI (Coordinamento Italiano per lo Studio dell’Allergia in Infezione da HIV) Group. The survey addressed anti-HDV prevalence and HDV-RNA detectability rates in PWH as well as perceived obstacles to treatment.ResultsOverall, responses from ten sites were collected. Among participating centers, 316 PWH with HBV chronic infection are currently followed. Of them, 15.2% had positive anti-HDV antibodies, while 13.9% were not tested yet. Overall, 17% of anti-HDV positive PWH tested at least once for HDV-RNA had active HDV infection, and 71% of them had advanced liver disease. Most infectious diseases centers intend to treat locally HDV infection with upcoming anti-HDV drugs, but some concerns exist regarding treatment schedule.DiscussionHDV testing needs to be implemented in PWH. At present, few patients followed in the CISAI centers seem to be candidate to receive new direct active anti-HDV agents, but repeated HDV-RNA measures could change this proportion.
Diagnostic performance of dynamic 3D magnetic resonance angiography in daily practice for the detection of intracranial arteriovenous shunts in patients with non-traumatic intracranial hemorrhage
Authors: Roumi Arnaud , Ben Hassen Wagih , Hmeydia Ghazi , Posener Sacha , Pallud Johan , Sharshar Tarek , Calvet David , Mas Jean-Louis , Baron Jean-Claude , Oppenheim Catherine , Naggara Olivier , Turc Guillaume 
Published: January 2023

IntroductionIdentification of treatable causes of intracranial hemorrhage (ICH) such as intracranial arteriovenous shunt is crucial to prevent recurrence. However, diagnostic approaches vary considerably across centers, partly because of limited knowledge of the diagnostic performance of first-line vascular imaging techniques. We assessed the diagnostic performance of dynamic three-dimensional magnetic resonance angiography (dynamic 3D MRA) in daily practice to detect intracranial arteriovenous shunts in ICH patients against subsequent digital subtraction angiography (DSA) as reference standard.MethodsWe reviewed all adult patients who underwent first-line dynamic 3D MRA and subsequent DSA for non-traumatic ICH between January 2016 and September 2021 in a tertiary center. Sensitivity, specificity, accuracy, positive and negative predictive values of dynamic 3D MRA for the detection of intracranial arteriovenous shunt were calculated with DSA as reference standard.ResultsAmong 104 included patients, 29 (27.9%) had a DSA-confirmed arteriovenous shunt [19 pial arteriovenous malformations, 10 dural arteriovenous fistulae; median onset-to-DSA: 17 (IQR: 3–88) days]. The sensitivity and specificity of dynamic 3D MRA [median onset-to-dynamic 3D MRA: 14 (3–101) h] for the detection of intracranial arteriovenous shunt were 66% (95% CI: 48–83) and 91% (95% CI: 84–97), respectively. The corresponding accuracy, positive and negative predictive values were 84% (95% CI: 77–91), 73% (95% CI: 56–90), and 87% (95% CI: 80–95), respectively.ConclusionThis study suggests that although first-line evaluation with dynamic 3D MRA may be helpful for the detection of intracranial arteriovenous shunts in patients with ICH, additional vascular imaging work-up should not be withheld if dynamic 3D MRA is negative. Comparative prospective studies are needed to determine the best imaging strategy to diagnose arteriovenous shunts after non-traumatic ICH.
Pituitary stalk changes on magnetic resonance imaging following pituitary adenoma resection using a transsphenoidal approach
Authors: Zhang Huijian , Zhang Shuai , Shang Mingchao , Wang Jiaxing , Wei Liangfeng , Wang Shousen 
Published: January 2023

ObjectiveWe aimed to investigate the magnetic resonance imaging (MRI) findings and clinical significance of position and changes in morphology of the pituitary stalk following pituitary adenoma (PA) resection using a transsphenoidal approach.MethodsWe collected clinical and MRI data of 108 patients with PA after transsphenoidal surgery. Diameter, length, and coronal deviation of the pituitary stalk were measured pre-, post-, and mid-term post-operatively, to observe pituitary stalk morphology.ResultsOf 108 patients, 53 pituitary stalks were recognisable pre-operatively. The angle between the pituitary stalk and the median line was 7.22°-50.20° (average, 25.85°) in 22 patients with left-sided pituitary stalks and 5.32°-64.05° (average, 21.63°) in 20 patients with right-sided pituitary stalks. Of 42 patients with preoperative pituitary stalk deviation, 41 had an early postoperative recovery and 1 had increased deviation. In the mid-term postoperative period, 21 of 42 patients had pituitary stalks located centrally. In 53 patients, the pituitary stalk length was 1.41–11.74 mm (mean, 6.12 mm) pre-operatively, 3.61–11.63 mm (mean, 6.93 mm) in the early postoperative period, and 5.37–17.57 mm (mean, 8.83 mm) in the mid-term postoperative period. In the early postoperative period, 58 (53.70%) patients had posterior pituitary bright spots (PPBS) and 28 (25.92%) had diabetes insipidus (DI).ConclusionPre-operatively, the pituitary stalk was compressed and thinned. Post-operatively, it could be stretched to a “normal state”, and its position showed a gradual centring trend. Post-operatively, the length of the pituitary stalk gradually increased. The PPBS in the early postoperative period negatively correlated with postoperative DI.
Visualization balloon occlusion-assisted technique in the treatment of large or giant paraclinoid aneurysms: A study of 17 cases series
Authors: Zhang Tingbao , Cai Yuankun , Wang Lesheng , Yang Liu , Li Zhengwei , Wei Wei , Feng Yu , Xiong Zhongwei , Zou Yichun , Sun Weiyu , Zhao Wenyuan , Chen Jincao 
Published: January 2023

ObjectiveAlthough balloon-assisted techniques are valuable in aneurysm clipping, repeated angiography and fluoroscopy are required to understand the location and shape of the balloon. This study investigated the value of visualization balloon occlusion-assisted techniques in aneurysm hybridization procedures.MethodsWe propose a visualization balloon technique that injects methylene blue into the balloon, allowing it to be well visualized under a microscope without repeated angiography. This study retrospects the medical records of 17 large or giant paraclinoid aneurysms treated by a visualization balloon occlusion-assisted technique in a hybrid operating room. Intraoperative surgical techniques, postoperative complications, and immediate and long-term angiographic findings are highlighted.ResultsAll 17 patients had safe and successful aneurysm clipping surgery with complete angiographic occlusion. Under the microscope, the balloon injected with methylene blue is visible through the arterial wall. The position and shape of the balloon can be monitored in real time without repeated angiography and fluoroscopic guidance. Two cases of intraoperative visualization balloon shift and slip into the aneurysm cavity were detected in time, and there were no cases of balloon misclipping or difficult removal. Of 17 patients, four patients (23.5%) experienced short-term complications, including pulmonary infection (11.8%), abducens nerve paralysis (5.9%), and thalamus hemorrhage (5.9%). The rate of vision recovery among patients with previous visual deficits was 70% (7 of 10 patients). The mean follow-up duration was 32.76 months. No aneurysms or neurological deficits recurred among all patients who completed the follow-up.ConclusionOur study indicates that microsurgical clipping with the visualization balloon occlusion-assisted technique seems to be a safe and effective method for patients with large or giant paraclinoid aneurysms to reduce the surgical difficulty and simplify the operation process of microsurgical treatment alone.
A study based on functional near-infrared spectroscopy: Cortical responses to music interventions in patients with myofascial pain syndrome
Authors: Zhang Jiayue , Shi Ping , Du Jiahao , Yu Hongliu 
Published: January 2023

ObjectThis study measured cerebral blood oxygen changes in patients with myofascial pain syndrome (MPS) using functional near-infrared spectroscopy (fNIRS). The aim was to investigate the effect of music intervention on pain relief in MPS patients.Materials and methodsA total of 15 patients with MPS participated in this study. A self-controlled block task design was used to collect the oxy-hemoglobin ([HbO2]) and deoxy-hemoglobin ([HbR]) concentrations in the prefrontal cortex (PFC) and motor cortex using fNIRS. The cerebral cortex response and channel connectivity were further analyzed. In the experiment, the therapist was asked to apply compression of 3–4 kg/cm2vertically using the thumb to induce pain. Soothing synthetic music with frequencies of 8–150 Hz and 50–70 dB was used as the audio for the music intervention.ResultCompared to the group without music intervention, the activation of brain regions showed a decreasing trend in the group with music intervention under the onset of pain. The results of pairedt-tests showed that nine of the data were significantly different (p&lt; 0.05). It was also found that with music intervention, inter-channel connectivity was diminished. Besides, their dorsolateral prefrontal cortex (dlPFC) was significantly correlated with the anterior prefrontal cortex (aPFC) for pain response (r = 0.82), and weakly correlated with the premotor cortex (r = 0.40).ConclusionThis study combines objective assessment indicators and subjective scale assessments to demonstrate that appropriate music interventions can be effective in helping to relieve pain to some extent. The analgesic mechanisms between relevant brain regions under music intervention were explored in depth. New insights into effective analgesic methods and quantitative assessment of pain conditions are presented.
Neuroplasticity to autophagy cross-talk in a therapeutic effect of physical exercises and irisin in ADHD
Authors: Abdulghani Alhasan , Poghosyan Mikayel , Mehren Aylin , Philipsen Alexandra , Anderzhanova Elmira 
Published: January 2023

Graphical abstractPhysical activity results in irisin release. Irisin facilitates autophagy in the brain acting via glia activation. Autophagy activation favors maturation of BDNF and neuroplasticity.
Decision-making factors for an autologous stem cell transplant for older adults with newly diagnosed multiple myeloma: A qualitative analysis
Authors: Mian Owais , Puts Martine , McCurdy Arleigh , Wildes Tanya M. , Fiala Mark A. , Kang Matthew , Salib Mary , Alibhai Shabbir , Mian Hira 
Published: January 2023

PurposeA utologous stem cell transplant (ASCT) remains a standard of care among older adults (aged ≥65) with multiple myeloma (MM). However, heterogeneity in the eligibility and utilization of ASCT remains. We identified decision-making factors that influence ASCT eligibility and utilization among older adults with MM.MethodsA qualitative study across two academic and two community centres in Ontario was conducted between July 2019-July 2020. Older adults with MM (newly diagnosed MM aged 65-75 in whom a decision had been made about ASCT in &lt;12 months) and treating oncologists completed a baseline survey and a subsequent interview, which was analyzed using thematic analysis.ResultsEighteen patients completed the survey and 9 follow-up interviews were conducted. Patients were happy with their treatment decision with “trust in their oncologist” and “wanting the best treatment” as the most important to proceed with ASCT. “Afraid of side effects” was the most common reason for declining ASCT. Fifteen oncologists completed the survey and 10 follow-up interviews were conducted. Most relied on the ‘eye-ball’ test for ASCT eligibility over geriatric screening tools. The lack of both high-quality evidence and local guidelines impacted decision-making. Both oncologists and patients felt that chronological age alone should not affect ASCT eligibility.ConclusionWhile decision-making factors regarding ASCT can be variable, both oncologists and patients indicated that chronological age alone should not represent a barrier for ASCT among older adults. Future simplification and incorporation of ASCT eligibility geriatric assessment tools in studies as well as the inclusion of these tools in local guidelines may further improve ASCT decision-making.
Identify optimal HAP series scores for unresectable HCC patients undergoing TACE plus sorafenib: A Chinese multicenter observational study
Authors: Zhu Yejing , Wang Enxin , Zhao Shoujie , Han Dandan , Zhao Yan , Chen Hui , Zhu Jun , Han Tenghui , Bai Yang , Lou Yanju , Zhang Yongchao , Yang Man , Zuo Luo , Fan Jiahao , Chen Xing , Jia Jia , Wu Wenbin , Ren Weirong , Bai Tingting , Ma Shouzheng , Xu Fenghua , Tang Yuxin , Han Ying , Zhao Junlong , Qi Xingshun , Li Jing , Du Xilin , Chen Dongfeng , Liu Lei 
Published: January 2023

BackgroundHepatoma arterial-embolization prognostic (HAP) series scores have been proposed for prognostic prediction in patients with unresectable hepatocellular carcinoma (uHCC) undergoing transarterial chemoembolization (TACE). However, their prognostic value in TACE plus sorafenib (TACE-S) remains unknown. Here, we aim to evaluate their prognostic performance in such conditions and identify the best model for this combination therapy.MethodsBetween January 2012 and December 2018, consecutive patients with uHCC receiving TACE-S were recruited from 15 tertiary hospitals in China. Cox regression analyses were used to investigate the prognostic values of baseline factors and every scoring system. Their prognostic performance and discriminatory performance were evaluated and confirmed in subgroup analyses.ResultsA total of 404 patients were enrolled. In the whole cohort, the median follow-up period was 44.2 (interquartile range (IQR), 33.2–60.7) months, the median overall survival (OS) time was 13.2 months, and 336 (83.2%) patients died at the end of the follow-up period. According to multivariate analyses, HAP series scores were independent prognostic indicators of OS. In addition, the C-index, Akaike information criterion (AIC) values, and time-dependent area under the receiver operating characteristic (ROC) curve (AUC) indicated that modified HAP (mHAP)-III had the best predictive performance. Furthermore, the results remained consistent in most subsets of patients.ConclusionHAP series scores exhibited good predictive ability in uHCC patients accepting TACE-S, and the mHAP-III score was found to be superior to the other HAP series scores in predicting OS. Future prospective high-quality studies should be conducted to confirm our results and help with treatment decision-making.
Minimally invasive versus open McKeown esophagectomy for patients with esophageal squamous cell carcinoma after neoadjuvant PD-1 inhibitor plus chemotherapy
Authors: Chen Qiuming , Mo Shaocong , Aizemaiti Rusidanmu , Cheng Jun , Wu Ziheng , Ye Peng 
Published: January 2023

IntroductionThe purpose of this study was to compare short and mid-term outcomes in esophageal squamous cell carcinoma (ESCC) patients undergoing open or minimally invasive McKeown esophagectomy (MIE) after neoadjuvant PD-1 inhibitor plus chemotherapy.MethodsPatients with locally advanced ESCC underwent open or minimally invasive McKeown esophagectomy after neoadjuvant PD-1 inhibitor plus chemotherapy were retrospectively included from June 2019 to June 2021. The baseline characteristics, pathological data, short-and mid-term outcomes were collected and compared based on the surgical approach.ResultsA total of 35 patients were included in the study. An open procedure was performed for 13 patients (37.1%), and 22 (62.9%) patients underwent MIE after neoadjuvant therapy. Compared with open group, MIE group had shorter operative times (350.8± 117.8 vs. 277.9 ± 30.2 min, P = 0.009). The total number of resected lymph nodes was not significantly different, but more left recurrent laryngeal lymph nodes were harvested from the Open group (2.6 ± 3.2 vs. 0.9 ± 1.7, P = 0.047). The median follow-up time was 1.42 years (range, 0.35–2.59 years) from the first day of treatment. Three patients (8.6%) died during follow-up, one in the open surgery group and two in the MIE group. There were six (17.1%) patients developed recurrence, three in each group. The 2-year cumulative survival rates were 92.3 ± 7.4% and 89.5 ± 7.1% for the open and MIE groups, respectively. Overall survival was not different between the two surgical approaches.ConclusionsMIE might be safe and feasible for patients with locally advanced ESCC undergoing neoadjuvant PD-1 inhibitor plus chemotherapy.
Ovarian Real-World International Consortium (ORWIC): A multicentre, real-world analysis of epithelial ovarian cancer treatment and outcomes
Authors: Cheeseman Sue , Levick Bethany , Sopwith Will , Fenton Hayley , Nam Eun Ji , Kim DongKyu , Lim Subin , Martin Elodie , Frenel Jean-Sébastien , Bocquet François , Kubelac Paul , Achimas-Cadariu Patriciu , Vlad Catalin , Chevrier Marion , Rouzier Roman , Carton Matthieu , Savva-Bordalo Joana , Magalhães Marta , Borges Marina , Wolf Andrea , Becker Sven , Niklas Nicolas , Guergova-Kuras Mariana , Hall Geoff 
Published: January 2023

IntroductionMuch drug development and published analysis for epithelial ovarian cancer (EOC) focuses on early-line treatment. Full sequences of treatment from diagnosis to death and the impact of later lines of therapy are rarely studied. We describe the establishment of an international network of cancer centers configured to compare real-world treatment pathways in UK, Portugal, Germany, South Korea, France and Romania (the Ovarian Real-World International Consortium; ORWIC).Methods3344 patients diagnosed with EOC (2012-2018) were analysed using a common data model and hub and spoke programming approach applied to existing electronic medical records. Consistent definition of line of therapy between sites and an efficient approach to analysis within the limitations of local information governance was achieved.ResultsMedian age of participants was 53-67 years old and 5-29% were ECOG &gt;1. Between 62% and 84% of patients were diagnosed with late-stage disease (FIGO III-IV). Sites treating younger and fitter patients had higher rates of debulking surgery for those diagnosed at late stage than sites with older, more frail patients. At least 21% of patients treated with systemic anti-cancer therapy (SACT) had recurrent disease following second-line therapy (2L); up to 11 lines of SACT treatment were recorded for some patients. Platinum-based SACT was consistently used across sites at 1L, but choices at 2L varied, with hormone therapies commonly used in the UK and Portugal. The use (and type) of maintenance therapy following 1L also varied. Beyond 2L, there was little consensus between sites on treatment choice: trial compounds and unspecified combinations of other agents were common.DiscussionSpecific treatment sequences are reported up to 4L and the establishment of this network facilitates future analysis of comparative outcomes per line of treatment with the aim of optimizing available options for patients with recurrent EOC. In particular, this real-world network can be used to assess the growing use of PARP inhibitors. The real-world optimization of advanced line treatment will be especially important for patients not usually eligible for involvement with clinical trials. The resources to enable this analysis to be implemented elsewhere are supplied and the network will seek to grow in coverage of further sites.