bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brolucizumab for recalcitrant macular neovascularization in age-related macular degeneration with pigment epithelial detachment
Authors: Chronopoulos Argyrios , Huynh Elisa , Ashurov Agharza , Schutz James S , Jonas Jost B , Hattenbach Lars-Olof 
Published: July 2023

Purpose To analyze anatomic and functional response to intravitreal brolucizumab in age-related macular degeneration recalcitrant to previous intravitreal anti-VEGF therapies. Methods In this monocentric, one arm, retrospective study, eyes affected by neovascular age-related macular degeneration (nAMD) resistant to other intravitreally injected anti-vascular endothelial growth factor inhibitors were switched to intravitreal brolucizumab. All patients underwent ophthalmological examinations at baseline and in regular follow-up intervals. Best registered visual acuity (BRVA), Goldmann tonometry, intraocular pressure (IOP), central retinal thickness (CRT) and pigment epithelial detachment (PED) characteristics were analyzed at initiation of anti-VEGF treatment, at treatment switch, and at the end of brolucizumab loading phase. Results The study included 20 eyes of 18 consecutively treated patients (age: 77 ± 6 years). All eyes had macular neovascularization with PED. Previous treatments included intravitreal aflibercept, bevacizumab, and ranibizumab and had not resulted in a significant improvement in BRVA (0.5 ± 0.5 logMAR vs 0.5 ± 0.6 logMAR) or mean CRT (320 ± 60 µm vs 313 ± 83 µm) up to treatment switch to brolucizumab. At the end of the brolucizumab loading phase, there was significant improvement for both BRVA (0.3 ± 0.2 logMAR, P < 0.05) and CRT (264 ± 55 µm, P < 0.05). Under previous anti-VEGF therapy, there was a significant increase/deterioration in both PED area (2.68 mm2 to 5.18 mm2, P < 0.05) and PED volume (0.39 mm3 to 1.07 mm3, P < 0.05); however, both parameters improved after switching to brolucizumab (3.81 mm2 and 0.37 mm3, P < 0.05). Conclusion Our results suggest a favourable anatomical and visual response after treatment switch to brolucizumab in patients with nAMD refractory to previous anti-VEGF agents.
Impact of the SARS-CoV-2 Pandemic on Treatment Pathways and Outcomes of Esophagogastric Cancer: A Pre- Versus Post-Pandemic Comparison of International Prospective Cohort Data
Authors: Griffiths Ewen A. , Kamarajah Sivesh K. 
Published: July 2023

Introduction: This study aimed to characterize the outcomes of esophagogastric (OG) cancer patients and compare perioperative outcomes with pre-pandemic data. Methods: Three international prospective cohort studies were included in this analysis. First, COVIDSurg-Cancer (n = 1999) included patients with an OG cancer planned for surgery from the start of the pandemic up to 14th April 2020 with follow-up until 31st August 2020. Treatment pathways and outcomes were compared against patients undergoing treatment for OG cancers before the pandemic, Oesophagogastric Anastomosis Audit (OGAA, n = 2246) and GlobalSurg 3 (n = 1256) study. The surgical composite outcome was defined as in patients achieving margin negative resection, resectability and no postoperative mortality. Results: This study included 1999 patients during the COVID-19 pandemic, of which 32.4% had a change from standard pre-pandemic management. Patients with delay to surgery had significantly higher rates of no surgery (24.7%vs 7.5%, P < .001) and less likely to have achieve a composite outcome (57.8%vs 73.4%, P < .001) than those without any delay in surgery. There was no significant difference in 30-day mortality (3.5% vs 3.4%; OR: 0.98, CI95%: 0.69-1.37) or anastomotic leak rate (10.9% vs 10.2%%; OR: 1.11, CI95%: 0.90-1.37) but higher reoperation rates (13.6% vs 10.4%; OR: 1.59, CI95%: 1.30-1.92) in patients between pre-pandemic and pandemic cohorts. Conclusion: The pandemic appears to have led to widespread changes in management pathways affecting one-third of patients. Developing elective surgical pathways resilient to periods of system “stress” are key to minimizing future harm from treatment delay for OG cancer patients.
Operative Facial Fracture Patterns in Cannabis Users: A Propensity Score-Matched Analysis
Authors: Oleru Olachi , Sicard Ryan M. , Seyidova Nargiz , Horn Callie , Brozynski Martina , Taub Peter J. 
Published: July 2023

Introduction: Cannabis is the third most used recreational substance in the United States. Each year, more and more states pass legislation to legalize it for both medical and recreation use. As the prevalence of cannabis use increases, it is important to study the implications for patient care, not simply the potential interactions with wound healing, and perioperative analgesia. Facial fractures are among the most common traumatic presentations for the plastic surgeon. As such, the present study aims to characterize the operative facial fracture patterns in cannabis users. Methods: The IBM MarketScan Research Databases were queried from the years 2017 to 2021. Cohorts were identified in the inpatient dataset using International Classification for Disease, 10th Revision Procedure Coding System (ICD-10-PCS) codes for facial fracture repair procedures. The cannabis cohort was separated based on presence of ICD-10 codes pertaining to cannabis use diagnoses. The cohorts were propensity-score matched using an approximate 4:1 matching ratio. Baseline cohort demographics were reported and compared including age, gender, geographic region, employment status, insurance plan type, and fracture repair type. Multivariate regression analysis was used to determine the relationship between cannabis use and fracture repair patterns. Results: There were 104 patients in the cannabis cohort and 480 in the control cohort after propensity score matching. The cannabis group had a higher proportion of male patients (80.8%vs 69.0%, P = .016) and a lower proportion of the age range from 18 to 34 years (4.8%vs 15.8%, P = .035). Employment types were different between the 2 cohorts, with more patients in the control cohort working full time (82.3%vs 69.2%, P = .045). Cannabis users had significantly less maxillary fracture repairs (1.9%vs 19.4%, P < .001). Cannabis users also had significantly more frontal fracture repairs (1.9%vs 0.2%, P = .027) and mandibular fracture repairs (76.9%vs 63.8%, P = .010). Multivariate regression revealed that cannabis users have 1.8 times greater odds of undergoing mandibular fracture repair ( P = .020) and significantly lower odds of undergoing maxillary (OR 0.07, P = .001). Conclusion: There are significant differences in the fracture patterns for cannabis users undergoing operative management and those who do not use cannabis. While mandibular fractures were the most common fracture repair type overall, cannabis users had significantly higher odds of undergoing mandibular fracture repair. This may indicate that cannabis users are more likely to sustain injuries that require operative intervention. Further study is needed to identify the relative incidences of facial fractures among cannabis users and its implications on operative considerations.
Early application of metagenomics next-generation sequencing may significantly reduce unnecessary consumption of antibiotics in patients with fever of unknown origin
Authors: Chen Hongmei , Tang Mingze , Yao Lemeng , Zhang Di , Zhang Yubin , Zhao Yingren , Xia Han , Chen Tianyan , Zheng Jie 
Published: July 2023

Abstract
Background
Metagenomic next-generation sequencing (mNGS) is a novel nucleic acid method for the detection of unknown and difficult pathogenic microorganisms, and its application in the etiological diagnosis of fever of unknown origin (FUO) is less reported. We aimed to comprehensively assess the value of mNGS in the etiologic diagnosis of FUO by the pathogen spectrum and diagnostic performance, and to investigate whether it is different in the time to diagnosis, length of hospitalization, antibiotic consumption and cost between FUO patients with and without early application of mNGS.

Methods
A total of 149 FUO inpatients underwent both mNGS and routine pathogen detection was retrospectively analyzed. The diagnostic performance of mNGS, culture and CMTs for the final clinical diagnosis was evaluated by using sensitivity, specificity, positive predictive value, negative predictive value and total conforming rate. Patients were furtherly divided into two groups: the earlier mNGS detection group (sampling time: 0 to 3 days of the admission) and the later mNGS detection group (sampling time: after 3 days of the admission). The length of hospital stay, time spent on diagnosis, cost and consumption of antibiotics were compared between the two groups.

Results
Compared with the conventional microbiological methods, mNGS detected much more species and had the higher negative predictive (67.6%) and total conforming rate (65.1%). Patients with mNGS sampled earlier had a significantly shorter time to diagnosis (6.05+/-6.23 vs. 10.5+/-6.4 days, P < 0.001) and days of hospital stay (13.7+/-20.0 vs. 30.3 +/-26.9, P < 0.001), as well as a significantly less consumption (13.3+/-7.8 vs. 19.5+/-8.0, P < 0.001) and cost (4543+/-7326 vs. 9873 +/- 9958 China Yuan [CNY], P = 0.001) of antibiotics compared with the patients sampled later.

Conclusions
mNGS could significantly improve the detected pathogen spectrum, clinical conforming rate of pathogens while having good negative predictive value for ruling out infections. Early mNGS detection may shorten the diagnosis time and hospitalization days and reduce unnecessary consumption of antibiotics.
Hospitalization burden and epidemiology of the COVID-19 pandemic in Spain (2020–2021)
Authors: Garcia-Carretero Rafael , Vazquez-Gomez Oscar , Gil-Prieto Ruth , Gil-de-Miguel Angel 
Published: July 2023

AbstractBackgroundSpain had some of Europe’s highest incidence and mortality rates for coronavirus disease 2019 (COVID-19). Here we describe the epidemiology and trends in hospitalizations, the number of critical patients, and deaths in Spain in 2020 and 2021.MethodsWe performed a descriptive, retrospective, nationwide study using an administrative database, the Minimum Basic Data Set at Hospitalization, which includes 95–97% of discharge reports for patients hospitalized in Spain in 2020 and 2021. We analyzed the number of hospitalizations, admissions to intensive care units, and deaths and their geographic distribution across regions of Spain.ResultsAs of December 31, 2021, a total of 498,789 patients (1.04% of the entire Spanish population) had needed hospitalization. At least six waves of illness were identified. Men were more prone to hospitalization than women. The median age was 66. A total of 54,340 patients (10.9% of all hospitalizations) had been admitted to the intensive care unit. We identified 71,437 deaths (mortality rate of 14.3% among hospitalized patients). We also observed important differences among regions, with Madrid being the epicenter of hospitalizations and mortality.ConclusionsWe analyzed Spain’s response to COVID-19 and describe here its experiences during the pandemic in terms of hospitalizations, critical illness, and deaths. This research highlights changes over several months and waves and the importance of factors such as vaccination, the predominant variant of the virus, and public health interventions in the rise and fall of the outbreaks.
Evaluation of laboratory values affecting mortality of end-stage renal disease patients: a competing risks approach
Authors: Malek Rayka , Baghestani Ahmadreza , Rashid-Farokhi Farin , Shafaghi Shadi , Minoo Farzanehsadat , Eghbali Foolad , Chandra Navin , Shafaghi Masoud , Bonyadi Kaveh , Hosseini-Baharanchi Fatemeh Sadat 
Published: July 2023

Abstract
Background
Chronic Kidney Disease (CKD) is a prevalent and life-threatening situation recognized as an emerging health issue. The present study aimed to evaluate the effect of demographic and laboratory parameters on the survival of patients with End-Stage Renal Disease (ESRD) in a hemodialysis (HD) center in Iran.

Materials and methods
This study was conducted on patients receiving chronic HD in Iran Helal Pharmaceutical and Clinical Complex between 2014 and 2018. The survival time was considered as the time interval between HD initiation and death. Receiving kidney transplantation was regarded as a competing risk, and an improper form of two-parameter Weibull distribution was utilized to simultaneously model the time to both death and renal transplantation. The Bayesian approach was conducted for parameters estimation.

Results
Overall, 29 (26.6%) patients expired, and 19 (17.4%) received kidney transplants. The male gender was related to poor survival, having nearly 4.6 folds higher hazard of mortality (90% HPD region: 1.36–15.49). Moreover, Serum calcium levels $$\ge$$9.5 mg/dL (adjusted Sub-hazard ratio (S-HR)=2.33, 90% HPD region: 1.05–5.32) and intact parathyroid hormone (iPTH) $$\le$$150 pg/mL (adjusted S-HR = 2.56, 90% HPD region: 1.09–6.15) were associated with an elevated hazard of mortality. The cumulative incidence function (CIF) for transplantation was greater than death in the first two years of the study. Subsequently, the CIF for death exceeded transplantation in the following two years. The 4-year cumulative incidence of death and kidney transplantation was 63.7% and 36.3%, respectively.

Conclusion
Male gender, hypercalcemia, and hypoparathyroidism were associated with worse outcomes. Correcting mentioned laboratory parameters may improve patients’ survival in the HD population.
Different words for stroke: the same concept? an analysis of associated symptoms and intended reaction in Brazil
Authors: de Mélo Silva Júnior Mário Luciano , Oliveira Ana Gabriella Camelo , Gois Weslley Medeiros , Oliveira Matheus Franco Andrade , de Góis Lourdes Maria Dantas , Ferreira Lucas Pereira , Vilanova Marcos Vinícius de Souza 
Published: July 2023

Abstract
Background
Different names for stroke might mislead physicians and emergency medical service workers. This study aimed to assess the different words for stroke in Brazil and both intended response and related symptoms associated with those names.

Methods
Cross-sectional study enrolling healthy individuals from urban areas in Northeast of Brazil for an open-ended survey. We presented a typical clinical case of a stroke (an elderly who had sudden onset of hemiparalysis and slurred speech) and asked “what is happening?”, “what would you do?” and “which other symptoms could happen in this condition?”.

Resuts
From 1,475 interviewed individuals, 1,220 (82,7%) recognized the scenario as a stroke. There were 3 words to correctly identify (based on correct intended response and spontaneously evoked associated symptoms) the stroke, which were “AVC” (acronym for cerebrovascular accident, in Portuguese), “derrame” (spillage) and “trombose” (thrombosis). There were significant differences among them concerning demographic, economic, educational and geographical aspects, but there was no difference according to the intended reaction among them. The most cited associated symptoms (excluding those present in the case) were impaired consciousness (10.6%), headache (8.9%) and dysesthesia (7.7%). “Aneurisma” (aneurism) was also cited, by 3 individuals.

Conclusion
There are at least three words for stroke in Portuguese (“AVC”, “derrame” and “trombose”); they were similar in terms of correct intended responses and spontaneously cited accompanying symptoms. Stroke campaigns should apply different names to reach a broader audience and to improve stroke recognition.
Potential prognostic and therapeutic value of ANXA8 in renal cell carcinoma: based on the comprehensive analysis of annexins family
Authors: Wang Li-Hui , Cao Bo , Li Yun-Long , Qiao Bao-Ping 
Published: July 2023

Abstract
Background
Annexins are a family of proteins involved in a wide variety of cellular processes such as inflammation, proliferation, differentiation, apoptosis, migration and membrane repair. However, the role of most Annexins in renal cell carcinoma (RCC) remained unclear.

Methods
The differentially expressed Annexins in RCC compared with normal controls were screened applying the TCGA database. The correlation of differentially expressed Annexins with clinical stages, grades and overall survival was analyzed to explore the clinical significance of Annexins in RCC. Then ANXA8 was selected and further stained in the discover and validation RCC cohort. The correlation of ANXA8 expression with clinical parameter was verified at the protein level. To explore the potential function of ANXA8, ANXA8 was knockdown in the RCC cell line and further analyzed using transcriptome and bioinformatic analysis.

Results
mRNA expression of ANXA1, ANXA2R, ANXA4, ANXA8, ANXA8L1 and ANXA13 were significantly upregulated in RCC compared with normal kidney tissues. In contrast, ANXA3 and ANXA9 mRNA expression was significantly downregulated. Higher expression of ANXA2R, ANXA8 and ANXA8L1 were correlated with worse overall survival, while lower expression of ANXA3, ANXA9 and ANXA13 were associated with worse clinical outcomes in RCC patients. We further demonstrated that ANXA8 expression was significantly increased in RCC compared with normal renal tissues at the protein level. And higher protein expression of ANXA8 was associated with higher clinical grades. Through the bioinformatics analysis and cell cycle analysis, we found knockdown of ANXA8 mainly influenced the cell cycle and DNA replication. The top ten hub genes consist of CDC6, CDK2, CHEK1, CCNB1, ORC1, CHEK2, MCM7, CDK1, PCNA and MCM3.

Conclusions
Multiple members of Annexins were abnormally expressed and associated with the prognosis of RCC. The expression of ANXA8 was significantly increased in RCC and associated with poor prognosis. ANXA8 might influence the cell cycle and could be a potential biomarker and therapeutic target for RCC.
Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study
Authors: Alexopoulos Panagiotis , Skondra Maria , Charalampopoulou Marina , Georgiou Eliza Eleni-Zacharoula , Demertzis Antonios Alexandros , Aligianni Suzana Ιoanna , Gourzis Philippos , Politis Antonios , Εconomou Polychronis , Daoussis Dimitrios 
Published: July 2023

Abstract
Background
Recently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer’s disease (MiND) and to individuals without cognitive impairment.

Methods
Cognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models.

Results
The study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups.

Conclusions
Patients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.
Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial
Authors: Boumparis Nikolaos , Noroozi Alireza , Naghizadeh Eisa , Meyer Andreas , Wenger Andreas , Rahimi-Movaghar Afarin , Schaub Michael P. 
Published: July 2023

Abstract
Background
The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms.

Objective
We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran.

Method
Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models.

Discussion
This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT.

Trial Registration
https://en.irct.ir/trial/53578.