bluuebunny/crossref_metadata_2025_split huggingface dataset:
#4368 THE PERSISTENT UNDERREPRESENTATION OF PEOPLE WITH CHRONIC KIDNEY DISEASE IN CARDIOVASCULAR TRIALS: A SYSTEMATIC REVIEW AND EVIDENCE MAP
Authors: Colombijn Julia Mt , Idema Demy , van Beem Sanne , Blokland Anna Marthe , van der Braak Kim , Handoko M Louis , Veld Linde Huis In't , Kaul Tabea , Kolagasigil-Akdemir Nurda , Kusters Mike Pt , Meijvis Sabine , Oosting Ilse J , Spijker Rene , Bots Michiel , Hooft Lotty , Verhaar Marianne , Vernooij Robin 
Published: June 2023

Abstract

Background and Aims
People with chronic kidney disease (CKD) have a markedly higher risk for cardiovascular disease. Systematic underrepresentation of people with CKD in cardiovascular randomised controlled trials (RCTs) limits evidence to guide cardiovascular risk management (CVRM). In this systematic review we aimed to identify evidence gaps regarding CVRM medication for people with CKD and evaluated the prevalence of exclusion of people with CKD from cardiovascular RCTs.

Method
We searched Clinicaltrials.gov through the Cochrane Central Register of Controlled Trials from inception until October 2021. Eligible studies were randomised controlled trials (RCTs) that investigate the efficacy of guideline-recommended CVRM medications on (cardiovascular) mortality, cardiovascular morbidity, and end-stage kidney disease in adults with a history of cardiovascular disease or one or more major risk factors for cardiovascular disease. Two reviewers independently determined the eligibility of references and extracted data. Outcomes were an overview of studies that report results for people with CKD, evidence gaps in results, and the rate of exclusion of people with CKD.

Results
We included 1180 of the 2794 eligible RCTs involving 2,158,869 participants (mean age 63±6 years, 36% female). Overall, 841 (71%) RCTs excluded (subgroups of) people with CKD based on heterogenous exclusion criteria. Since 2000, this prevalence has increased from 70% to 75%. Of included RCTs, only 157 (13%) reported results for people with CKD (again in heterogenous subgroups). The prevalence of RCTs with results for people with CKD has increased since 2000 from 10% to 23%. Nevertheless, significant evidence gaps remain for most CVRM interventions, particularly for those with an eGFR &lt;30 ml/min/1.73m2 (22 RCTs), and people who are treated with dialysis (14 RCTs) or received a kidney transplant (1 RCTs).

Conclusion
The majority of cardiovascular RCTs continues to exclude (subgroups of) people with CKD and this has only increased over the years. Although more RCTs report results for people with CKD, evidence gaps for the efficacy most CVRM medications persist, particularly for those with severe CKD.
#4784 IDENTIFICATION OF FACTORS ASSOCIATED WITH DEATH IN DIALYSIS PATIENTS USING A MACHINE LEARNING-BASED PREDICTIVE MODEL
Authors: Vicentini Carolina Aparecida de Almeida , de Andrade Luis Gustavo Modelli , Ponce Daniela 
Published: June 2023

Abstract

Background and Aims
Few studies including unplanned dialysis starts have used machine learning for the prediction of death in dialysis patients. The objective of the study was to use R software algorithms to develop machine learning predictive models for the identification of death-related factors in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD).

Method
This study included adult patients undergoing HD and PD started in a planned or urgent manner in a dialysis center between January 2014 and January 2019. Epidemiological, clinical and laboratory data were collected. Univariate analysis was followed by ML-based analyses. Then, multivariate regressions were obtained using stepwise and Cox regression analyses. Finally, a Random Forest predictive model was generated after variables with missing values &gt;30% were removed.

Results
Of 581 patients included, 170 died (29,2%). On univariate analysis death was associated with age, number of comorbidities, dialysis modality switching, creatinine, PTH and albumin values at dialysis initiation, presence of diabetes (DM), hospitalization, function recovery and central venous catheter (CVC) for dialysis access. Patients who started dialysis with a CVC had a worse survival (p = 0.0034) than those who did not use CVC, started HD with AVF, or received PD (Figure 1). Data were split into 20% for testing the regression model, and 80% for training the model. Data preprocessing for Cox regression included imputing some values using bag impute (decision trees), creating dummy variables, and removing collinear variables. Death was associated with older age (p &lt; 0.001), fewer ESI-free months (p &lt; 0.001) and lower initial creatinine (p = 0.008) (Table 1). The model C-index was 0.8099. Random forest ranked the following variables predictive of death in descending order of importance: ESI-free months; age; initial levels of creatinine, PTH and albumin; number of comorbidities; dialysis-related infection; initial phosphorus and hemoglobin; hospitalizations; male gender; modality switching (Figure 2). The agreement of the model obtained was 0.8110.

Conclusion
ESI-free months, age and initial levels of creatinine were associated with death on both multivariate and ML-based analyses.
#5736 IDENTIFICATION AND CHARACTERIZATION OF URINARY AND SERUM AMINOACIDS IN DIABETIC KIDNEY DISEASE PATIENTS USING MS-HPLC
Authors: Mogos Maria , Socaciu Carmen , Socaciu Andreea , Vlad Adrian , Gadalean Florica , Bob Flaviu , Milas Livia Oana , Cretu Octavian , Suteanu-Simulescu Anca , Glavan Mihaela , Balint Lavinia , Silvia Ienciu , Jianu Catalin , Petrica Ligia 
Published: June 2023

Abstract

Background and Aims
Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease, but few biomarkers of early identification of DKD are available. The aim of the study was to asses new urinary and plasma biomarkers in early stages of DKD, especially in normoalbuminuric type 2 diabetes mellitus (DM) patients.

Method
This cross-sectional pilot study performed an integrated metabolomic profiling of blood and urine in 90 patients with type 2 DM, classified into 3 stages (30 normo-, 30 micro-, and 30 macroalbuminuric, respectively) and 30 age- and gender-matched healthy controls through high-performance liquid chromatography and mass spectrometry (UPLC-QTOF-ESI* MS). Metabolites were discovered and processed by the advanced Metaboanalyst 5.0. online software using multi- and univariate untargeted analysis. Both multivariate and univariate bioinformatics confirmed the relevance of certain amino acids as biomarkers to be responsible for the occurrence of early renal involvement in the course of type 2 DM.

Results
A total of 5 metabolites, namely Taurine, Tiglylglycine, Tryptophan, Kynurenic acid, and L-acetylcarnitine were discovered as potential biomarkers for the early identification of DKD. UPLC-QTOF-ESI* MS revealed that: (1) the urinary amino acids levels were increased in normoalbuminuric type 2 DM patients as compared with healthy control subjects; (2) a number of key biomarkers have been identified in the urine, which reflect kidney injury at specific sites along the nephron, including glomerular injury and tubular damage, oxidative stress, inflammation, and activation of the intrarenal renin-angiotensin system.

Conclusion
High-performance liquid chromatography coupled with mass spectrometry showed that the urinary amino acids levels were increased in normoalbuminuric type 2 DM patients. The results of the study provide a particular metabolomic profile related to blood and urine metabolites which could impact both the glomeruli and the tubules, even in the early stages of DKD.
#6949 MPO ANCA-ASSOCIATED VASCULITIS IN A PATIENT WITH A HISTORY OF METHAMPHETAMINE ABUSE
Authors: Sánchez Jesús Alejandro Rico , Arreguin Yuliana López 
Published: June 2023

Abstract

Background and Aims
Methamphetamines cause kidney damage by different mechanisms. The most common is the tubular lesion associated with myoglobinuria secondary to rhabdomyolysis. Other renal effects include prerenal azotemia, acute tubular necrosis, malignant hypertension, and necrotizing vasculitis have been reported. It is important to consider this drug as a possible cause of glomerulonephritis.

Method
We present the case report of a patient with suspected MPO ANCA-associated vasculitis from methamphetamines.

Results
A 24-year-old male, he was admitted to nephrology due to hematuria and proteinuria accompanied by serum creatinine elevation (2.5 mg/dl). He reported inhaled methamphetamine abuse since the age of 14, smoking and occasional ethylism. His symptoms began in October 2022 with asthenia and adinamia, accompanied by generalized pallor and edema in both malleoli. At admission with normal blood pressure (112/70 mmHg). Laboratory tests revealed: leukocytes 6.35 thousand/UL, hemoglobin 7.7 g/dl, platelets 698,000 thousand/UL, urea 70.81 mg/dl, sodium 137 mmol/L, potassium 4.72 mmol/L, albumin 3.85 g/dl, urine test with proteinuria 25 mg/dl, hemoglobinuria 250 eri/microL, leukocytes 15-20 field and countless erythrocytes, albuminuria 450.87 mg/day, globular sedimentation rate 18 mm/hr, reactive protein C 37 mg/L. Complement levels were normal, negative serologies for hepatitis B, C, human immunodeficiency viruses, antinuclear antibodies, double-stranded anti DNA and anti-proteinase 3, but was positive for IgG anti myeloperoxidase (anti-MPO) 33.6 U/ml. Urinary sediment showed the presence of dysmorphic erythrocytes, as well as abundant erythrocyte and granular casts. Ultrasound-guided renal biopsy was performed; light microscopy reported 21 glomeruli, 6 globally sclerosed, 4 with irregular segmental sclerosis, 4 with destruction and granuloma formation. Immunofluorescence showed traces of mesangial IgM, the rest negative for IgG, IgA, C3, C1q, fibrinogen, kappa and lambda. The patient received 3 pulses of methylprednisolone 500 mg followed by oral prednisone and rituximab. Baseline creatinine decreased to 1.88 mg/dl.

Conclusion
Inhaled methamphetamine is commonly used in young people, it is important to consider this drug as a possible cause of crescentic and necrotizing glomerulonephritis.
#3737 RENAL RESERVE IN LIVING KIDNEY DONORS: THE HIDDEN ROLE OF OVERWEIGHT
Authors: Sorensen Cristian Acosta , Porrini Esteban , Lima Sergio Luis , Perera Coriolano Cruz , Martin Laura Díaz , Mena Natalia Negrãn , Puga Ana Ramírez , Morales Adelaida , Vega-Diaz Nicanor , Gallego Eduardo , Martin Edduin , Moya Elisa Cabello , Gil Marta Gómez , Cabrera Beatriz Escamilla , González-Rinne Ana 
Published: June 2023

Abstract

Background and Aims
Renal reserve (RR) is the capacity to increase glomerular filtration rate (GFR) under certain stimuli such as obesity, hyperglycaemia, metabolic syndrome, etc. The importance of the presence or absence of RR is unknown. We investigated the prevalence and factors associated with RR in a group of living donors for renal transplantation.

Method
We investigated RR before donation in 52 living kidney donors. GFR was measured by iohexol clearance before and after the stimulation of RR by endovenous amino acid infusion. The presence of RR was defined as an increase greater than 10% of basal GFR. According with the presence or absence of RR, subjects were grouped in those without RR; with RR and using RR. The latter was defined as the lack of increase in GFR after stimulation in patients with GFR &gt; 100 mL/min. GFR was unadjusted to body surface area (BSA). The characteristics of these three groups were evaluated.

Results
13 (25%) had no RR, 24 (46%) had RR and 15 (29%) were using RR. Subjects without RR was predominantly female (92%) with lower BSA and BMI than those with RR or using RR (BMI: 22 ± 3 vs 28 ± 3 and 29 ± 4, p &lt; 0.005); also had a lower GFR than the other groups (84 ± 10 vs 95 ± 14 and 131 ± 22, p &lt; 0.005). Subjects with RR or using RR had more frequently metabolic syndrome traits i.e. prediabetes than those without RR. Finally, subject using RR present larger kidney length than the other groups (right kidney: 11.3 ± 0.8 vs 10.3 ± 0.36 and 10.4 ± 0.8, p &lt; 0.005; left kidney: 11.8 ± 0.5 vs 10.4 ± 0.6 and 10.7 ± 0.7, p &lt; 0.005). No differences were observed regarding dyslipidaemia and arterial hypertension.

Conclusion
overweight and prediabetes may be factors that stimulate RR in a healthy population such as living kidney donors. Future implications of these factors, particularly after donation both in donors and recipients, deserve attention.
Molecular Advances in the Treatment of Advanced Gastrointestinal Stromal Tumor
Authors: Venkataraman Vinayak , George Suzanne , Cote Gregory M 
Published: June 2023

AbstractMost gastrointestinal stromal tumors (GIST) are driven by activating mutations in Proto-oncogene c-KIT (KIT) or PDGFRA receptor tyrosine kinases (RTK). The emergence of effective therapies targeting these mutations has revolutionized the management of advanced GIST. However, following initiation of first-line imatinib, a tyrosine kinase inhibitor (TKI), nearly all patients will develop resistance within 2 years through the emergence of secondary resistance mutations in KIT, typically in the Adenosine Triphosphate (ATP)-binding site or activation loop of the kinase domain. Moreover, some patients have de novo resistance to imatinib, such as those with mutations in PDGFRA exon 18 or those without KIT or PDGFRA mutation. To target resistance, research efforts are primarily focused on developing next-generation inhibitors of KIT and/or PDGFRA, which can inhibit alternate receptor conformations or unique mutations, and compounds that impact complimentary pathogenic processes or epigenetic events. Here, we review the literature on the medical management of high-risk localized and advanced GIST and provide an update on clinical trial approaches to this disease.
KSIM: simulating KIDSpec, a Microwave Kinetic Inductance Detector spectrograph for the optical/NIR
Authors: Hofmann V Benedict , O’Brien Kieran 
Published: June 2023

Abstract
KIDSpec, the Kinetic Inductance Detector Spectrometer, is a proposed optical to near-IR Microwave Kinetic Inductance Detector (MKID) spectrograph. MKIDs are superconducting photon counting detectors which are able to resolve the energy of incoming photons and their time of arrival. KIDSpec will use these detectors to separate incoming spectral orders from a grating, thereby not requiring a cross-disperser. In this paper, we present a simulation tool for KIDSpec’s potential performance upon construction to optimize a given design. This simulation tool is the KIDSpec Simulator (KSIM), a Python package designed to simulate a variety of KIDSpec and observation parameters. A range of astrophysical objects are simulated: stellar objects, an SDSS observed galaxy, a Seyfert galaxy, and a mock galaxy spectrum from the JAGUAR catalogue. Multiple medium spectral resolution designs for KIDSpec are simulated. The possible impact of MKID energy resolution variance and dead pixels was simulated, with impacts on KIDSpec performance observed using the Reduced Chi-Squared (RCS) value. Using dead pixel percentages from current instruments, the RCS result was found to only increase to 1.21 at worst for one of the designs simulated. SNR comparisons of object simulations between KSIM and X-Shooter’s ETC were also simulated. KIDSpec offers a particular improvement over X-Shooter for short and faint observations. For a Seyfert galaxy (mR = 21) simulation with a 180 s exposure, KIDSpec had an average SNR of 4.8, in contrast to 1.5 for X-Shooter. Using KSIM the design of KIDSpec can be optimized to improve the instrument further.
Strategies for Developing Journal Peer Reviewers: A Scoping Review
Authors: Gazza Elizabeth A. , Matthias April D. , Griffin Jeff , Chick Katie 
Published: June 2023

Abstract

AIM
This scoping review examined development strategies for preparing reviewers to critically appraise the content of manuscripts submitted to peer-reviewed journals.

BACKGROUND
The journal peer review process is the crux of building the science of nursing education to inform teaching and learning.

METHOD
Using the Joanna Briggs Institute procedure for scoping reviews, five databases were searched for articles published in English in peer-reviewed health sciences journals between 2012 and 2022 that included strategies for developing journal peer reviewers.

RESULTS
Of the 44 articles included in the review, a majority were commentaries (52%) published by medicine (61%), followed by nursing (9%) and multidisciplinary journals (9%). Reviewer development strategies aligned with three themes: pedagogical approaches, resources, and personal practices.

CONCLUSION
Although multiple disciplines addressed peer reviewer development, a comprehensive and effective approach was not reported in the reviewed literature. The findings can inform a multilevel reviewer development program led by academic nurse educators.
Comparative review of airway anesthesia and sedation methods for awake intubation
Authors: Rao Prashant N. , Soffin Ellen M. , Beckman James D. 
Published: June 2023

Purpose of review
Successful awake intubation hinges upon adequate airway anesthesia and sedation for patient comfort. This review will summarize relevant anatomy and regional anesthesia techniques to achieve airway anesthesia, and compare various airway anesthesia and sedation regimens.

Recent findings
Overall, nerve blocks consistently provided superior airway anesthesia, shorter time to intubation, higher patient comfort, and higher postintubation patient satisfaction. Additionally, ultrasound guidance can further provide benefit by reducing the amount of local anesthetic administered, leading to denser blockade, and proving invaluable in challenging clinical situations. Regarding sedation methods, numerous studies supported the use of dexmedetomidine, with or without the addition of supplemental sedation, such as midazolam, ketamine, or opioids.

Summary
Emerging evidence has indicated that nerve blocks for airway anesthesia may be superior to other methods of topicalization. Additionally, dexmedetomidine can be useful, both as monotherapy and with supplemental sedatives, to safely provide anxiolysis for the patient and increase success. However, it is crucial to note that the method of airway anesthesia and sedation regimen should be adapted to each patient and clinical situation, and knowledge of multiple techniques and sedation regimens can best equip anesthesiologists to do so.
The Relationship Between Nitrate-Induced Headache and -Blood Viscosity: An Observational Prospective Study
Authors: Toprak Kenan , Kaplangöray Mustafa , Memioglu Tolga , İnanır Mehmet , Biçer Asuman , Demirbağ Recep , Erdoğdu Hamza 
Published: June 2023

Abstract:
Nitrates are one of the most prescribed medications in the treatment of angina pectoris today. Headache is the most common side effect of nitrates, and there is limited prospective data on the determinants of this effect. Our aim in this study is to open a foresight window for clinicians in clinical practice by explaining the possible relationship between nitrate-induced headache and whole-blood viscosity (WBV). After coronary revascularization treatment, 869 patients with angina who were prescribed nitrate preparations were divided into groups according to the development of headache or not and categorized according to the 4-grade scale level. Those who had no headache during nitrate use were graded as grade 0, those who felt mild headache were grade 1, those who felt moderate headache were grade 2, and those who described severe headache were graded as grade 3. The groups were compared according to WBV values. A total of 869 participants were included in the study. Most patients (82.1%) experienced some level of headache. Headache severity correlated with both WBV at high shear rate (r = 0.657; P < 0.001) and WBV at low shear rate (r = 0.687; P < 0.001). In multivariate analysis, WBV was determined as an independent predictor of headache experience. WBV predicted nitrate-induced headache with 75% sensitivity and 75% specificity at high shear rate and 77% sensitivity and 77% specificity at low shear rate. WBV seems to be one of the major determinants for nitrate-induced headache. WBV may be a guide for initiating alternative antianginal drugs without prescribing nitrates to the patient to increase patient compliance.
No Cancer Occurrences in 10-year Follow-up after Prophylactic Nipple-sparing Mastectomy
Authors: Boyd Carter J. , Bekisz Jonathan M. , Ramesh Sruthi , Hemal Kshipra , Guth Amber A. , Axelrod Deborah M. , Shapiro Richard L. , Hiotis Karen , Schnabel Freya R. , Choi Mihye , Karp Nolan S. 
Published: June 2023

Background:
Prophylactic nipple-sparing mastectomies (NSM) have become increasingly common, although there is little long-term data on its efficacy in prevention of breast cancer. The objective of this study was to assess the incidence of breast cancer in a cohort of patients undergoing prophylactic NSM with a median follow-up of 10 years.

Methods:
Patients receiving prophylactic NSM at a single institution from 2006 to 2019 were included in a retrospective nature. Patient demographics, genetic mutations, operative details, and specimen pathology were recorded, and all postoperative patient visits and documentation were screened for cancer occurrence. Descriptive statics were performed where appropriate.

Results:
Two hundred eighty-four prophylactic NSMs were performed on 228 patients with a median follow-up of 120.5 ± 15.7 months. Roughly, a third of patients had a known genetic mutation, with 21% BRCA1 and 12% BRCA2. The majority (73%) of prophylactic specimens had no abnormal pathology. The most commonly observed pathologies were atypical lobular hyperplasia (10%) and ductal carcinoma in situ (7%). Cancer was identified in 10% of specimens, with only one case of lymphovascular invasion. Thus far, there have been no incidences of locoregional breast cancer occurrence in this cohort.

Conclusions:
The long-term breast cancer occurrence rate in this cohort of prophylactic NSM patients at the time of this study is negligible. Despite this, continued surveillance of these patients is necessary until lifetime risk of occurrence following NSM has been established.