bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the relationship of hydration status on the clinical outcomes of COVID-19 patients
Authors: Rezaei Mahdiye , Salari Nader , Naghibzadeh Amirhossein , Mohammadi Mohammad , Abdi Alireza 
Published: January 2025

Abstract
Background
Existing evidence suggests that the hydration status of COVID-19 patients may influence clinical indicators and outcomes of the disease. However, there is a lack of research specifically investigating this aspect. Therefore, this study aimed to ascertain the correlation between hydration status and clinical outcomes among COVID-19 patients.

Method
This descriptive-analytical study included 110 patients hospitalized with COVID-19 at hospitals affiliated with Kermanshah University of Medical Sciences. Hydration status was assessed using the Free Water Deficit tool, mortality was evaluated using the Sequential Organ Failure Assessment (SOFA) tool, and the severity of COVID-19 was determined using the COVID-GRAM Risk Score tool. Data were obtained from clinical examinations and patient records and analyzed using SPSS software, version 24.

Results
The study included 110 participants with an average age of 58.2 ± 17.9 years. Females constituted 52.3% of the patient population. Additionally, 54% of patients had a history of underlying diseases, and 24.5% exhibited fluid deficiency. Data analysis revealed no statistically significant difference in average hydration scores when considering the main variables of SOFA and COVID-GRAM risk score results, and other variables such as gender, age, underlying diseases, place of residence, tobacco and drug use, respiratory distress, and PCR test results. Furthermore, the Pearson correlation test revealed no significant relationship between the Free Water Deficit tool results and levels of sodium, potassium, urea, creatinine, blood osmolality, total and direct bilirubin, blood lactate, PaO2, FiO2, platelet counts, mean arterial pressure and patient weight.

Conclusion
The findings of this study did not support the initial research objectives and hypotheses, as no significant relationship was found between hydration status and clinical outcomes in COVID-19 patients. Additionally, 24.5% of the subjects exhibited a fluid deficit. Given that this study is the first to explore this specific aspect, further research is recommended to investigate the hydration status of critically ill patients.
Lupus activity in lupus nephritis patients with end-stage renal disease treated with hemodialysis
Authors: Morad Caroline Samy , Zaiema Shams ElDoha Galal , Hafez Eman Ahmed , Mansour Mohammed Maher Mohammed Mohammed , Khalil Amr Elsayed Mohammed Abd-Allah , Hassan Shaymaa Gamal Arafa 
Published: January 2025

Abstract
Background
Lupus nephritis is one of the major causes of ESRD, which may necessitate renal replacement therapy, especially hemodialysis. Evaluating post-HD lupus flares in LN patients is pivotal in improving their outcomes. This issue is still under consideration by researchers. This research analyzed lupus activity in LN patients with ESRD treated with HD.

Methods
A number of 70 LN patients diagnosed by renal biopsy were divided into age- and sex-matched two groups: They were divided into two groups: the HD Group, which were LN patients who progressed to ESRD treated with HD (n = 35), and the CKD Group, which contains LN patients’ stage III, IV by renal biopsies and HD free (n = 35). The non-renal systemic lupus erythematosus (SLE) disease activity index (nrSLEDAI) score was used to estimate lupus flares in both groups regardless of the stage of renal affection.

Results
The HD group exhibited considerably declined lupus activity compared to the CKD group, irrespective of the progression of renal pathology. With long-term period maintenance on HD, there was an obvious remission in both clinical and serological parameters of SLE recorded by the nrSLEDAI scoring system. Current doses of oral corticosteroids were less in the HD group than in the CKD group.

Conclusion
Using the nrSLEDAI score, our current research provides evidence of a reverse association between the longevity of hemodialysis (HD) and lupus activity, a "Cut-down phenomenon.” We believe that performing clinical trials and developing new post-HD evidence-based treat-to-target management guidelines for LN patients is now mandatory to improve their clinical outcomes and quality of life.
Melanoma Among Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Authors: Rotz Seth J. , Stratton Kayla , Leisenring Wendy M. , Smith Susan A. , Howell Rebecca M. , Bates James E. , Pappo Alberto S. , Neglia Joseph P. , Armstrong Gregory T. , Turcotte Lucie M. 
Published: January 2025

PURPOSE
Melanoma as a subsequent malignant neoplasm has been described among childhood cancer survivors; however, the risk factors and long-term survival are not well understood.

METHODS
We assessed incidence, risk factors, and outcomes for melanoma among participants in the Childhood Cancer Survivor Study cohort. Cumulative incidence and standardized incidence ratios (SIRs) were calculated, and multivariable Cox models were used to determine hazard ratios (HRs) and associated 95% CI for melanoma risk factors. Radiation exposure to seven body regions and melanoma status for each of eight regions per survivor were integrated into the Cox model.

RESULTS

Among 25,716 participants, 177 melanomas developed in 160 survivors (110 invasive, 62 in situ cutaneous, five ocular). The 40-year melanoma cumulative incidence was 1.1% (95% CI, 0.9 to 1.4) for all participants and 1.5% (95% CI, 1.0 to 2.1) among those receiving a cumulative radiation dose of ≥40 Gy. Compared with the general population, the SIR for invasive skin or ocular melanoma was 2.0 (95% CI, 1.6 to 2.4). A cumulative radiation dose of ≥40 Gy to the corresponding body region(s) of the melanoma (HR, 2.0 [95% CI, 1.1 to 3.7]), a cumulative cyclophosphamide equivalent dose of ≥20,000 mg/m
2
(HR, 1.9 [95% CI, 1.1 to 3.6]), and bleomycin exposure (HR, 2.2 [95% CI, 1.2 to 4.1]) were associated with increased cutaneous melanoma. Invasive melanoma at any site was associated with an increased risk of death (HR, 2.4 [95% CI, 1.7 to 3.3]).

CONCLUSION
Childhood cancer survivors have more than a two-fold increased risk of melanoma compared with the general population, and those with an invasive melanoma have more than a two-fold risk of death. High-dose radiation and alkylating agent exposure, and bleomycin are important risk factors for melanoma and should be considered in future patient guidance and screening.
Neoadjuvant Nivolumab Plus Ipilimumab Versus Chemotherapy in Resectable Lung Cancer
Authors: Awad Mark M. , Forde Patrick M. , Girard Nicolas , Spicer Jonathan , Wang Changli , Lu Shun , Mitsudomi Tetsuya , Felip Enriqueta , Broderick Stephen R. , Swanson Scott J. , Brahmer Julie , Kerr Keith , Saylors Gene B. , Chen Ke-Neng , Gharpure Vishwanath , Neely Jaclyn , Balli David , Hu Nan , Provencio Pulla Mariano 
Published: January 2025

PURPOSE
Neoadjuvant immune checkpoint blockade with nivolumab plus ipilimumab improves overall survival (OS) in non–small cell lung cancer (NSCLC); however, randomized data for resectable lung cancer are limited. We report results from the exploratory concurrently randomized nivolumab plus ipilimumab and chemotherapy arms of the international phase III CheckMate 816 trial.

METHODS
Adults with stage IB-IIIA (American Joint Committee on Cancer seventh edition) resectable NSCLC received three cycles of nivolumab once every 2 weeks plus one cycle of ipilimumab or three cycles of chemotherapy (on day 1 or days 1 and 8 of each 3-week cycle) followed by surgery. Analyses included event-free survival (EFS), OS, pathologic response, surgical outcomes, biomarker analyses, and safety.

RESULTS
A total of 221 patients were concurrently randomly assigned to nivolumab plus ipilimumab (n = 113) or chemotherapy (n = 108). At a median follow-up of 49.2 months, the median EFS was 54.8 months (95% CI, 24.4 to not reached [NR]) with nivolumab plus ipilimumab versus 20.9 months (95% CI, 14.2 to NR) with chemotherapy (HR, 0.77 [95% CI, 0.51 to 1.15]); 3-year EFS rates were 56% versus 44%. Higher rates of EFS events were initially seen, with later benefit favoring nivolumab plus ipilimumab; 3-year OS rates were 73% versus 61% (HR, 0.73 [95% CI, 0.47 to 1.14]); pathologic complete response rates were 20.4% versus 4.6%, respectively. In the respective arms, 83 (74%) and 82 patients (76%) underwent definitive surgery. Grade 3-4 treatment-related adverse events occurred in 14% and 36% of patients, respectively.

CONCLUSION
Neoadjuvant nivolumab plus ipilimumab showed potential long-term clinical benefit versus chemotherapy, despite early crossing of EFS curves in the preoperative phase and a lower rate of high-grade toxicity.
Menthol-based Novel Ultra-Deformable Vesicle: Formulation, Optimization and Evaluation of an Antifungal Drug
Authors: Manjushree Hema , Nayak Devika , Halagali Praveen , Rathnanand Mahalaxmi , Tawale Roshan , Ananthmurthy Koteshwara , Aranjani Jesil Mathew , Tippavajhala Vamshi Krishna 
Published: January 2025

Abstract
The current study aims to establish a novel ultra-deformable vesicular system to enhance the drug penetration across the skin by preparing the ketoconazole-loaded menthosomes. It was achieved through regular thin-film evaporation & hydration techniques. To examine the effect of formulation parameters on menthosome characteristics, a 23 full factorial design was used using Design-Expert® software. The optimized batch exhibited a vesicle size (107.6 nm), a polydispersity index (PDI) (0.248), entrapment efficiency (% EE) (76.9%), and a zeta potential (-33.7 mV). Results from ex vivo skin permeation studies and in vitro drug release demonstrated enhanced improved skin permeation and drug release compared to other formulations. An in vitro antifungal and in vivo pharmacodynamic study, elucidated the enhanced effectiveness of the optimized formulation against Candida albicans. In summary, menthosomes could serve as a potent vehicle to enhance drug penetration via the skin to improve its antifungal activity.

Graphical Abstract
Outcomes After Standardized Burr-Hole Surgery for Chronic Subdural Hematomas: A Population-Based Consecutive Cohort Study of 2655 Patients
Authors: Buwaider Ali , Sæmundsson Bjartur , Nemer Edisson , Anderberg John , Strom Isabelle , Wong San-San , Backelin Ina , Ahlsson Karl , Ståhl Martin , Thelin Eric P. , Fletcher-Sandersjöö Alexander , Bartek Jiri 
Published: January 2025

BACKGROUND AND OBJECTIVES:
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. However, current evidence on postoperative outcomes exhibits variability due to small sample sizes, nonstandardized outcome assessment, and variations in surgical techniques. The aim of this study was to overcome these limitations by assessing standardized outcome measures after surgical intervention for CSDH at a high-volume population-based center favoring a uniform burr-hole craniotomy (BHC) approach.

METHODS:
Adult patients (≥15 years) who underwent surgical treatment of a CSDH at the Karolinska University Hospital from 2006 to 2022 were retrospectively included. Outcome measures included 6-month ipsilateral hematoma reoperation, postoperative complications categorized by the Landriel-Ibanez grading system, neurological function, and mortality. Predictors of outcomes were assessed using multivariable logistic regression models.

RESULTS:
In total, 2655 patients were included, with 2407 evacuated using BHC and 248 requiring a minicraniotomy. Reoperation for a hematoma recurrence occurred in 11%. Independent predictors of reoperation were male sex, diabetes, preoperative antithrombotic therapy, midline shift, and bilateral surgery. Postoperative complications occurred in 11% of cases, with 3.9% classified as moderate to severe. A complication leading to death was reported in 22 patients (0.8%). The most common postoperative complications were urinary tract infections (1.5%), subdural empyema (1.4%), and seizures (0.7%). Independent predictors of moderate-to-severe complications were higher preoperative Charlson Comorbidity Index and lower Glasgow Coma Scale score. The 1-year postoperative mortality rate was 12%.

CONCLUSION:
This study provided standardized outcome measures in a large cohort of patients treated for CSDH at a center where BHC was consistently used. Most postoperative complications were mild and either did not require intervention or were managed with pharmacological treatment. The identified predictors of CSDH reoperation and moderate-to-severe postoperative complications offer considerations for clinical management and patient care.
External Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study
Authors: Şahin Mustafa , Güngör Abuzer , Doğruel Yücel , Luzzi Sabino , Yilmaz Adem , Türe Uğur 
Published: January 2025

BACKGROUND AND OBJECTIVES:
The middle fossa approaches are tremendously versatile for treating small vestibular schwannomas, selected petroclival meningiomas, midbasilar trunk aneurysms, and lesions of the petrous bone. Our aim was to localize the internal acoustic canal and safely drill the petrous apex with these approaches. This study demonstrates a new method to locate the internal acoustic canal during surgery in the middle fossa.

METHODS:
The microsurgical anatomy of the middle fossa floor was studied in 11 formalin-fixed and silicone-injected cadaveric heads. Extradural dissection of the skull base was completed from the posterior to the anterior side. A zero-degree rigid endoscope was inserted perpendicularly into the external auditory canal. The light beam was first directed through the tympanic membrane, avoiding injury to the tympanic membrane. The room lights were dimmed to provide a clearer view of the transilluminated bony area. Drilling was performed with transillumination guidance.

RESULTS:
The transilluminated area included the tympanic and mastoid tegmen up to the arcuate eminence. The nonilluminated area was bounded posteriorly by the arcuate eminence, laterally by the greater superficial petrosal nerve, and posteromedially by the petrous ridge. In all specimens, drilling the transition line between the Kawase triangle and the transilluminated area unroofed the internal auditory canal (IAC). No transillumination of the carotid canal was seen after anterior petrosectomy in any of the specimens. The entire contents of the IAC were preserved in both anterior petrosectomy and unroofing of the IAC.

CONCLUSION:
In this anatomical study, transillumination of the external auditory canal proved to be feasible, accurate, and safe in guiding the middle fossa approaches. The ease of implementation and cost-effectiveness of the technique may suggest a possible application in operative scenarios.
Trochlear Nerve Decompression by Endoscopic Suboccipital Supracerebellar Infratentorial Approach: A Technical Note: 2-Dimensional Operative Video
Authors: Vignolles-Jeong Joshua , Finger Guilherme , Damante Mark , Weber Matthieu D. , Wu Kyle C. , Prevedello Daniel M. 
Published: January 2025

BACKGROUND AND IMPORTANCE:
Superior oblique myokymia (SOM) is a rare, acquired aberration of the innervation of the superior oblique, resulting in episodic monocular contraction of the superior oblique muscle characterized by intermittent rotatory eye movement causing diplopia and oscillopsia. Several treatment modalities have been described to treat SOM, including medication and surgical interventions. There is a paucity of reports describing microvascular decompression (MVD) of the trochlear nerve near the root entry zone for the treatment of a neurovascular conflict. The authors describe a case report of a patient who presented with SOM by a supracerebellar infratentorial approach using microscopic and endoscopic visualization.

CLINICAL PRESENTATION:
A 40-year-old woman presented with an 8-month history of rhythmic contractions of her right orbit with worsening double vision and occasional balance issues. Neuro-ophthalmological evaluation which revealed a right-sided SOM. MRI evaluation demonstrated a potential vascular compression by the superior cerebellar artery near the origin of the trochlear nerve. She underwent MVD by a supracerebellar infratentorial approach using microscopic and endoscopic visualization. The patient experienced resolution of her SOM in the immediate postoperative period and a Trochlear nerve palsy that resolved within 6 months.

CONCLUSION:
The endoscopic supracerebellar infratentorial approach for MVD of the trochlear nerve is a safe and efficacious approach that provides superior visualization of the trochlear nerve at its origin and in the setting of SOM. This approach shows outcomes comparable with those used in previously described cases.
An implementation trial to mAnage siCkle CELl disEase through incReased AdopTion of hydroxyurEa in Nigeria (ACCELERATE): Study protocol
Authors: Peprah Emmanuel , Gyamfi Joyce , Patena John , Kayalioglu Hazal , Hameed Tania , Ogedegbe Gbenga , Do Hyungrok , Ojji Dike , Adenikinju Deborah , Ajaye Oba Tayo , Nwegbu Maxwell , Isa Hezekiah , Shedul Grace , Sopekan Alayo Y. , Nnodu Obiageli E. 
Published: January 2025

Background
Despite the proven efficacy of evidence-based healthcare interventions in reducing adverse outcomes and mortality associated with Sickle Cell Disease (SCD), a vast majority of affected individuals in Africa remain deprived of such care. Hydroxyurea (HU) utilization among SCD patients in Sub-Saharan Africa (SSA) stands at less than 1%, while in Nigeria, approximately 13% of patients benefit from HU therapy. To enhance HU utilization, targeted implementation strategies addressing provider-level barriers are imperative. Existing evidence underscores the significance of addressing barriers such as inadequate healthcare worker training to improve HU adoption. The ACCELERATE study aims to evaluate the adoption of HU among providers through the Screen, Initiate, and Maintain (SIM) intervention, facilitated by healthcare worker training, clinical reminders, and task-sharing strategies, thereby enhancing patient-level SCD management in Nigeria.

Methods
This study will implement the SIM intervention, encompassing patient screening, initiation of HU treatment, and maintenance of dosage, which will be implemented via the TAsk-Strengthening Strategy for Hemoglobinopathies (TASSH TCP), derived from our team’s TAsk-Strengthening Strategy for Hypertension control (TASSH) trials. Employing a sequential exploratory mixed-methods approach within the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, this study will assess SIM adoption by providers in Nigeria. The primary outcome is the rate of SIM adoption at clinical sites at 12 months, with secondary outcomes including sustainability/maintenance of SIM intervention and implementation fidelity.

Discussion
This study’s findings will offer crucial insights into effective SCD management strategies, leveraging existing SCD clinical networks and resources in Nigeria to enhance HU adoption among providers in a scalable and sustainable manner. Additionally, the study will inform best practices for implementing HU therapy in resource-constrained settings, benefiting healthcare providers, policymakers, and stakeholders invested in improving SCD care delivery.

Trial registration
NCT06318143.
Evaluation of keratometric and total corneal astigmatism measurements from optical biometers and anterior segment tomographers and mapping to reconstructed corneal astigmatism vector components
Authors: Langenbucher Achim , Szentmáry Nóra , Cayless Alan , Hoffmann Peter , Wendelstein Jascha , Pantanelli Seth 
Published: January 2025

Purpose
To investigate different measures for corneal astigmatism in the context of reconstructed corneal astigmatism (recCP) as required to correct the pseudophakic eye, and to derive prediction models to map measured corneal astigmatism to recCP.

Methods
Retrospective single centre study of 509 eyes of 509 cataract patients with monofocal (MX60P) IOL. Corneal power measured with the IOLMaster 700 keratometry (IOLMK), and Galilei G4 keratometry (GK), total corneal power (TCP2), and Alpin’s integrated front (CorT) and total corneal power (CorTTP). Feedforward shallow neural network (NET) and linear regression (REG) prediction models were derived to map the measured C0 and C45 power vector components to the respective recCP components.

Results
Both the NET and REG models showed superior performance compared to a constant model correcting the centroid error. The mean squared prediction errors for the NET/REG models were: 0.21/0.33 dpt for IOLMK, 0.23/0.36 dpt for GK, 0.24/0.35 for TCP2, 0.23/0.39 dpt for CorT and 0.22/0.36 dpt for CorTTP respectively (training data) and 0.27/0.37 dpt for IOLMK, 0.26/0.37 dpt for GK, 0.38/0.42 dpt for TCP2, 0.35/0.36 dpt for CorT, and 0.44/0.45 dpt for CorTTP respectively on the test data. Crossvalidation with model optimisation on the training (and validation) data and performance check on the test data showed a slight overfitting especially with the NET models.

Conclusions
Measurement modalities for corneal astigmatism do not yield consistent results. On training data the NET models performed systematically better, but on the test data REG showed similar performance to NET with the advantage of easier implementation.
Does a priming warm-up influence the incidence of V˙O2pl during a ramp test and verification phase?
Authors: Qiao JianBo , Rosbrook Paul , Sweet Daniel K. , Pryor Riana R. , Hostler David , Looney David , Pryor J. Luke 
Published: January 2025

Objective
This study compared the effects of two different warm-up protocols (normal vs. priming) on the oxygen plateau (V˙O2pl) incidence rate during a ramp test. It also compared the cardiopulmonary responses during the ramp test and subsequent verification phase.

Methods
Eleven recreational cyclists performed two experimental visits. The first visit required a normal warm-up (cycling at 50 W for 10 min) followed by the ramp test (30 W.min-1) and supramaximal verification phase with 30 min rest between tests. The second visit required a priming warm-up (cycling at 50 W for 4 min increasing to 70% difference between the gas exchange threshold [GET] and maximum work rate [WRmax] for 6 min) followed by the same protocol as in the first visit. Physiological responses were collected during the exercise and compared. Oxygen kinetics (V˙O2 Kinetics) and V˙O2pl incidence rate were determined during the ramp tests for both visits.

Results
As planned, following the warm-up the priming visit experienced greater physiological response. However, the incidence rate of V˙O2pl during the ramp test was the same between visits (73%), and maximal oxygen uptake was not different between visits after the ramp test (normal, 4.0 ± 0.8; primed, 4.0 ± 0.7 L·min−1, p = 0.230) and verification phase (normal, 3.8 ± 0.6; primed, 3.8 ± 0.7 L·min−1, p = 0.924) using a Holm-Bonferroni correction for controlling family-wise error rate. V˙O2 Kinetics were not different between visits during the ramp test (normal, 10.8 ± 1.1; primed, 10.8 ± 1.2 mL·min−1·W-1, p = 0.407). The verification phase confirmed V˙O2max in 100% for both the normal and priming visits.

Conclusion
Our hypothesis that a priming warm-up facilitates the incidence rate of V˙O2pl during a ramp test is not supported by the results. The verification phase remains a prudent option when determining a ‘true’ V˙O2max is required.