bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Metabolic Risk Factors on the Risk of Bacterial Infections in Hepatitis B-Related Cirrhosis: A 10-Year Cohort Study
Authors: Yang Qiao , Tong Yifan , Pi Borui , Yu Hong , Lv Fangfang 
Published: April 2022

AimThe effect of metabolic factors on the risk of bacterial infections (BIs) in patients with hepatitis B virus (HBV)-related cirrhosis has not been demonstrated. This study aimed to explore specific metabolic factors associated with the BIs in these patients.MethodsA population-based cohort of 471 patients with HBV-related cirrhosis was retrospectively enrolled between 2009 and 2019. The primary end point was the incidence of BIs during hospitalization, which were compared according to the metabolism-related indicators, namely, presence of diabetes, level of high-density lipoprotein cholesterol (HDLC) and triglyceride, and body mass index (BMI). The propensity score matching (PSM) was adopted to eliminate baseline discrepancies.ResultsCompared with the non-diabetic group, the incidences of BIs were higher in the diabetic group before and after PSM (p = 0.029 and p = 0.027). Similar results were found in the low HDLC group as compared with the normal HDLC group before and after PSM (p &lt; 0.001 and p = 0.025). Further analysis showed that the incidences of BIs in patients with low HDLC alone were lower than patients with both low HDLC and diabetes before and after PSM (p = 0.003 and p = 0.022). Similarly, the incidence of BIs in patients with diabetes alone was lower than those in patients with both low HDLC and diabetes both before and after PSM (p = 0.002 and p = 0.018). However, neither triglyceride nor BMI level was related to BIs in our cohort.ConclusionIn patients with HBV-related cirrhosis, the presence of diabetes and low level of HDLC were risk factors of BIs, showing a synergistic effect.
Identifying Recall Under Sedation by a Novel EEG Based Index of Attention—A Pilot Study
Authors: Baron Shahaf Dana , Weissman Avi , Priven Leonid , Shahaf Goded 
Published: April 2022

OverviewRecall is an accepted consequence of sedation. But due to the very low prevalence of the more devastating awareness under anesthesia (AUA), it might be of value to assess first the efficacy of new markers for AUA by their efficacy in discovering the more prevalent recall under sedation (RUS). In this pilot study we assessed whether a novel index for attentional effort, the cognitive effort index (CEI), derived in real-time from one forehead EEG channel, could differentiate between patients with or without RUS.MethodsEEG was sampled from 2 groups: (1) Patients who underwent deep sedation (n = 25) (using drugs according to the anesthesiologist preference, but generally combining either Midazolam or Propofol together with either Fentanyl or Remifentanil). (2) Patients who underwent general anesthesia (GA, n = 13, a negative control for recall). In recovery, recall was assessed using the BRICE questionnaire.ResultsOf the 25 sedated patients, 11 experienced recall. The CEI marker was high during significantly longer periods in patients with recall, compared to sedated patients, or patients under GA, without recall. Moreover, the increase in CEI was evident mainly toward the end of the procedure.ConclusionRUS seems to associate with higher level of attention, which is identified in real-time by the easy-to-extract CEI marker.
Renal Function and Body Mass Index Contribute to Serum Neurofilament Light Chain Levels in Elderly Patients With Atrial Fibrillation
Authors: Polymeris Alexandros A. , Helfenstein Fabrice , Benkert Pascal , Aeschbacher Stefanie , Leppert David , Coslovsky Michael , Willemse Eline , Schaedelin Sabine , Blum Manuel R. , Rodondi Nicolas , Reichlin Tobias , Moschovitis Giorgio , Wuerfel Jens , De Marchis Gian Marco , Engelter Stefan T. , Lyrer Philippe A. , Conen David , Kühne Michael , Osswald Stefan , Bonati Leo H. , Kuhle Jens ,   the Swiss-AF Investigators
Published: April 2022

ObjectiveSerum neurofilament light chain (sNfL) is increasingly used as a neuroaxonal injury biomarker in the elderly. Besides age, little is known about how other physiological factors like renal function and body mass index (BMI) alter its levels. Here, we investigated the association of estimated glomerular filtration rate (eGFR) and BMI with sNfL in a large sample of elderly patients with atrial fibrillation (AF).MethodsThis is a cross-sectional analysis from the Swiss-AF Cohort (NCT02105844). We measured sNfL using an ultrasensitive single-molecule array assay. We calculated eGFR using the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine (eGFRcrea) and creatinine–cystatin C (eGFRcrea–cys) formulas, and BMI from weight and height measurements. We evaluated the role of eGFR and BMI as determinants of sNfL levels using multivariable linear regression and the adjusted R2 (R2adj).ResultsAmong 2,277 Swiss-AF participants (mean age 73.3 years), eGFRcrea showed an inverse curvilinear association with sNfL after adjustment for age and cardiovascular comorbidities. BMI also showed an independent, inverse linear association with sNfL. The R2adj of models with age, eGFRcrea, and BMI alone was 0.26, 0.35, and 0.02, respectively. A model with age and eGFRcrea combined explained 45% of the sNfL variance. Sensitivity analyses (i) further adjusting for vascular brain lesions (N = 1,402 participants with MRI) and (ii) using eGFRcrea–cys yielded consistent results.InterpretationIn an elderly AF cohort, both renal function and BMI were associated with sNfL, but only renal function explained a substantial proportion of the sNfL variance. This should be taken into account when using sNfL in elderly patients or patients with cardiovascular disease.
Discussion on the Treatment Strategy for Stage ⅡA1 Cervical Cancer (FIGO 2018)
Authors: Chen Xiaolin , Liang Wentong , Duan Hui , Wu Minling , Zhan Xuemei , Dai Encheng , Lv Qiubo , Xie Qinghuang , Liu Ruilei , Xu Yan , Bin Xiaonong , Lang Jinghe , Liu Ping , Chen Chunlin 
Published: April 2022

ObjectiveThis study aimed to explore the best treatment strategy for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIA1 cervical cancer patients by comparing the survival outcomes of two treatment methods: abdominal radical hysterectomy (ARH) with standard postoperative therapy and radio-chemotherapy (R-CT).MethodsPatients with FIGO2018 stage IIA1 cervical cancer who underwent ARH or received R-CT were screened from the clinical diagnosis and treatment for cervical cancer in China (Four C) database. The recurrence cases between the two groups were analyzed. The 5-year overall survival (OS) and disease-free survival (DFS) of patients diagnosed with stage IIA1 cervical cancer in 47 hospitals in mainland China between 2004 and 2018 were compared by using propensity score matching (PSM).ResultsA total of 724 patients met the inclusion criteria. In the total study population, The R-CT group had higher recurrence (22.8% for the R-CT group and 11.2% for the ARH group, P&lt;0.001) rates compared to the ARH group.The 5-year OS and DFS of the ARH group (n=658) were significantly higher than those of the R-CT group (n=66) (OS: 85.9% vs. 71.2%, P=0.009; DFS: 79.2%vs. 70.5%, P=0.027). R-CT was associated with worse 5-year OS (HR=3.19, 95% CI: 1.592-6.956, P=0.001) and DFS (HR=2.089, 95% CI: 1.194-3.656, P=0.01). After 1:2 PSM, the 5-year OS and DFS of the ARH group (n=126) were significantly higher than those of the R-CT group (n=64) (OS:88.9% vs. 70.1%, P=0.04; DFS:82.8% vs. 69.8%, P=0.019). R-CT was still associated with worse 5-year OS (HR=2.391, 95% CI: 1.051-5.633, P=0.046) and DFS (HR=2.6, 95% CI: 1.25-5.409, P=0.011).ConclusionOur study demonstrated that for stage FIGO2018 stage IIA1 cervical cancer patients, ARH offers better oncological outcomes than R-CT.
Survival Outcomes and Pattern of Relapse After SABR for Oligometastatic Prostate Cancer
Authors: Mercier Carole , Claessens Marc , De Troyer Bart , Debacker Tibaut , Fransis Karen , Vandeursen Hendrik , Ost Piet , Dirix Piet 
Published: April 2022

IntroductionThe addition of stereotactic ablative radiotherapy (SABR) to standard of care for patients with oligometastatic prostate cancer has the potential of improving survival and delaying further metastases. The primary aim of this analysis is to report survival outcomes and pattern of recurrence of patients with hormone-sensitive (HSPC) and castrate-resistant (CRPC) oligometastatic prostate cancer treated with SABR.MethodsThis is a single-center retrospective study of patients with oligometastatic prostate cancer treated in Iridium Network between 2014 and 2018. All patients with oligometastatic (≤3 active lesions) HSPC and CRPC treated with SABR were included. Data were collected using electronic records. Patterns of first progression following SABR were reported. Kaplan-Meier methods were used to determine survival outcomes.ResultsEighty-seven men received SABR to 115 metastases. Nineteen patients were castrate-resistant and 68 hormone-sensitive at the time of SABR. Median follow-up was 41.6 months. In 25% of patients, no decline from baseline PSA was recorded. Median bPFS was 11.7 months (95% CI 7.6 - 18.3) for HSPC as well as CRPC (95% CI 6.4 - 24.0) (p=0.27). Median DMFS was 21.8 (95% CI 16.9 - 43.2) versus 17.6 months (95% CI 6.7 - 26.2) for HSPC versus CRPC, respectively (p=0.018). Median OS was 72.6 months (95% CI 72.6 – not reached) for HSPC and not reached for CRPC (95% CI 35.4 months – not reached) (p=0.026). For the subgroup of oligorecurrent HSPC, short-term androgen-deprivation therapy was associated with improved bPFS (median 6.0 vs. 18.3 months, HR 0.31, p&lt;0.001) and DMFS (median 15.8 vs 29.6 months, HR 0.5, p=0.06). Information on pattern of relapse was retrieved for 79 patients: 45% (36/79) of these patients were long-term disease-free (&gt;18 months), 28% (22/79) of patients wmere oligoprogressive (≤3 new lesions) and 27% (21/79) developed a polymetastatic relapse.ConclusionIn this cohort, oligometastatic HSPC showed potential benefit from SABR with a median DMFS of 21.8 months. Well-selected patients with oligometastatic CRPC may also benefit from SABR. For patients with metachronous and repeat oligorecurrent HSPC, combining SABR with short-term androgen-deprivation therapy was associated with improved bPFS and DMFS. Overall, 36/87 (41%) of patients were still free from clinical relapse at 18 months.
Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America
Authors: López-Medina Eduardo , Camacho-Moreno German , Brizuela Martin E. , Dávalos Diana M. , Torres Juan Pablo , Ulloa-Gutierrez Rolando , López Pio , Debbag Roberto , Pérez Paola , Patiño Jaime , Norero Ximena , Mariño Cristina , Luengas Miguel A. , Ensinck Gabriela , Daza Carlos , Luciani Kathia , Quintana Kuhner Paola , Rodriguez Mónica , Rodríguez-Auad Juan Pablo , Estrada-Villarroel Alejandra , Carnevale Mayli , Mantese Orlando Cesar , Berezin Eitan N. , Castillo José Iván , Mascareñas Abiel , Jimenez-Zambrano Andrea , Dueñas Lourdes , Melgar Mario , Galvez Nancy , Cantor Erika , Asturias Edwin J. 
Published: April 2022

BackgroundLimited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19.ObjectiveTo describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America.MethodMulticenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children &lt;18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models.ResultsA total of 1063 children with COVID-19 were included; 500 (47%) hospitalized, with 419 (84%) to the pediatric wards and 81 (16%) to the ICU. In multivariable analyses, age &lt;1 year (Odds Ratio [OR] 1.78; 95% CI 1.08–2.94), native race (OR 5.40; 95% CI 2.13–13.69) and having a co-morbid condition (OR 5.3; 95% CI 3.10–9.15), were associated with hospitalization. Children with metabolic or endocrine disorders (OR 4.22; 95% CI 1.76–10.11), immune deficiency (1.91; 95% CI 1.05–3.49), preterm birth (OR 2.52; 95% CI 1.41–4.49), anemia at presentation (OR 2.34; 95% CI 1.28–4.27), radiological peribronchial wall thickening (OR 2.59; 95% CI 1.15–5.84) and hypoxia, altered mental status, seizures, or shock were more likely to require PICU admission. The presence of pharyngitis (OR 0.34; 95% CI 0.25–0.48); myalgia (OR 0.47; 95% CI 0.28–0.79) or diarrhea (OR 0.38; 95% CI 0.21–0.67) were inversely associated with hospital admission.ConclusionsIn this data analysis reported to the SLIPE research network in Latin America, infants, social inequalities, comorbidities, anemia, bronchial wall thickening and specific clinical findings on presentation were associated with higher rates of hospitalization or PICU admission. This evidence provides data for prioritization prevention and treatment strategies for children suffering from COVID-19.
The Effect of Blood Flow-Restricted Low Resistance Training on Microvascular Circulation of Myocardium in Spontaneously Hypertensive Rats
Authors: Tan Zhaowen , Zhao Yan , Zheng Yuchan , Pan Ying 
Published: April 2022

Objective: The purpose of this study was to explore the effect of blood flow-restricted low resistance training on microvascular rarefaction in the myocardium of spontaneously hypertensive rats (SHRs).Methods: Four-week-old male SHRs were randomly divided into the following groups: Wistar-Kyoto (WKY), SHR control (SHR-SED), high-intensity resistance training (HIRT), low-intensity resistance training (LIRT), and blood flow-restricted low resistance training (BFRT). The exercise groups began to receive exercise intervention for 8 weeks at the age of 7 weeks. Blood pressure (BP), heart rate (HR), cardiac function, capillary density, and Vascular endothelial growth factor -Phosphatidylinositol 3-kinase-Protein kinase B-Endothelial nitric oxide synthetase (VEGF-Pi3k-Akt-eNOS) were assessed.Results: 1) BP and HR of BFRT decreased significantly, Ejection fraction (EF) and Fraction shortening (FS) increased, and the effect of BFRT on lowering BP and HR was better than that of other groups (p &lt; 0.05); 2) The expression of VEGF, VEGFR2, p-VEGFR2, Pi3k, Akt, p-Akt, eNOS and p-eNOS in the myocardium of the BFRT was significantly upregulated, and eNOS expression was significantly higher than other groups (p &lt; 0 05); 3) the expression of VEGF in the blood of the BFRT was significantly upregulated, higher than SHR-SED, lower than HIRT (p &lt; 0.05), and there was no significant difference between BFRT and LIRT(p &gt; 0.05); 4) the capillary density in the myocardium of BFRT was significantly higher than other exercise groups (p &lt; 0 05).Conclusion: Blood flow-restricted low resistance training can activate the VEGF-Pi3k-Akt-eNOS pathway, upregulate the expression of VEGF in blood, improve microvascular rarefaction, and promote myocardial microvascular circulation, thereby improving cardiac function and lowering blood pressure, achieving the preventive effect of early hypertension.
An Evaluation of the Acceptability, Appropriateness, and Utility of a Bibliotherapy for Children of Parents With a Mental Illness
Authors: Vetri Kelly , Piché Geneviève , Villatte Aude 
Published: April 2022

BackgroundChildren of parents with a mental illness are at higher risk for various psychiatric problems and adaptive difficulties compared to those of parents without mental health problems. Certain preventive psychoeducational interventions target these children to promote their well-being and resilience and prevent the emergence of adaptive difficulties. However, few such interventions have been developed and evaluated specifically for elementary school-aged children of parents with a mental illness.ObjectivesThis study aims to evaluate an interpersonal psychotherapy-based book targeting children living with a parent with a mental illness.MethodsThe study examines children, parents and psychosocial workers' perception of the acceptability, appropriateness and utility of the book. In total, 22 participants answered online open-ended questions after reading the book.ResultsThe book was highly appreciated and positively perceived by the families and psychosocial workers. Results suggest that children, parents and psychosocial workers viewed it as an appropriate and useful tool for supporting children with a parent with a mental illness. The present study reveals that the bibliotherapy appears well adapted to the developmental level of school-age children.DiscussionThis study presents a book that shows promise for supporting the resilience of elementary school-aged children having a parent with a mental illness. Results highlight the importance of tailoring the content and modalities of interventions to the developmental level, needs and preferences of elementary school-aged children. The relevance of a collaborative method is also discussed, thus providing knowledge regarding this type of approach for the development of interventions targeting children.
Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study
Authors: Kaggwa Mark Mohan , Arinaitwe Innocent , Nduhuura Elicana , Muwanguzi Moses , Kajjimu Jonathan , Kule Moses , Ajuna Noble , Machacha Ivan , Nkola Rahel , Najjuka Sarah Maria , Wamala Nicholas Kisaakye , Bongomin Felix , Griffiths Mark D. , Rukundo Godfrey Zari , Mamun Mohammed A. 
Published: April 2022

BackgroundThe COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda.MethodsA cross-sectional study was conducted among undergraduates [N = 540; 363 males; mean age = 23.3 (± 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation.ResultsThe prevalence of moderate to severe depression was 20% (n = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% (n = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13–2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10–3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32–0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03–0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10–21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08–3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23–0.70, p = 0.001).ConclusionApproximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.
Psychotherapists' Knowledge of Guideline Recommendations for the Treatment of Depressed Suicidal Patients
Authors: Teismann Tobias , Düwel Helena , Eidt Leandra , Brailovskaia Julia , Cwik Jan Christopher 
Published: April 2022

ObjectiveClinical practice guidelines present expert consensus on the treatment of mental disorders. Yet, studies have shown that knowledge of and adherence to recommendations are moderate. The aim of the present study was to investigate, whether and to what extent psychotherapists are aware of and follow the German guideline recommendations for the treatment of suicidal depressed patients.Methods174 participants (licensed psychotherapists, psychotherapists-in-training) were presented with five groups of guideline recommendations (referring to inpatient admission, psychotherapy, acute pharmacotherapy, pharmacologic relapse prevention, follow-up appointments) and were asked to identify the guideline recommendation and indicate whether they provided treatment according to the guideline.ResultsKnowledge and adherence to the guidelines recommendations on psychotherapy and inpatient admission were well present. However, knowledge about pharmacological treatment recommendations was low; same as the knowledge on the necessity of immediate follow-up appointments after discharge of patients hospitalized due to suicidality.DiscussionThe results highlight the importance of greater dissemination of various facts about the management of suicidal patients.