bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term cure of primary hyperparathyroidism after scan directed parathyroidectomy
Authors: Patel Neil , Mihai Radu 
Published: March 2022

Abstract

Background
The advent of sestamibi scintigraphy led to an enthusiastic acceptance of minimally invasive parathyroidectomy (MIP). Recently, doubts have been raised about the efficacy of limited neck exploration and some surgeons proposed bilateral neck exploration to be (once again) the gold standard operation for primary hyperparathyroidism.

Methods
A departmental database was used to identify patients who had MIP after concordant dual localisation. Long-term follow-up data was obtained to ascertain any further treatment for recurrent disease and confirm most recent biochemical status. Patients with negative localisation scans and those with familial disease were excluded.

Results
Between June 2001 – August 2014 a total of 404 patients (108M:296F, median age 63 years, range 17–90 years) underwent MIP and had normalisation of calcium in first 6 weeks after the operation. Data were missing in 14 patients therefore data on 390 patients was analysed. During follow-up, 375 patients remained normocalcaemic (2.36mmol/L IQR: 2.29–2.44 mmol/L) at a median 75 months (IQR: 20–118months). Only 15 (3.85%) patients had biochemical evidence of recurrent hypercalcaemia (2.70mmol/L, IQR: 2.63–2.75 mmol/L) at 92 months (IQR: 6–196 months) after initial operation. Of these, 5 (1.28%) patients underwent a second parathyroid procedure.

Conclusion
Recurrence after scan-directed unilateral neck exploration occurred in 4% of patients after a long disease-free interval. Only one patient had recurrent disease within 1 year of primary surgery. Bilateral neck exploration at the time of initial operation, in this selected cohort, is unlikely to had uncovered multi-gland disease and prevent disease recurrence. Focused parathyroidectomy in patients with convincing localisation studies should continue.
Surgical volume-patient outcome relationships for parathyroidectomy in the England: analysis of an administrative dataset for the Getting It Right First Time programme
Authors: Lansdown Mark , Gray William , Day Jamie , Wass John , Briggs Tim 
Published: March 2022

Abstract

Introduction
Previous studies suggest a relationship between surgical volume and patient outcomes for parathyroid surgery. However, most studies are small and from outside the UK. The aim of this study was to use Hospital Episodes Statistics to investigate volume-outcome relationships for parathyroid surgery in England.

Methods
We examined a five-year period (April 2014-March 2019 inclusive) for elective, adult admissions for surgery for primary hyperparathyroidism without a diagnosis of multiple endocrine neoplasia, parathyroid cancer or renal disease. Volume was the number of procedures conducted in the same financial year as the index procedure. The primary outcome measure was emergency readmission at 30 days or length of stay greater than 2 days which were taken to represent poorer outcomes.

Results
We included 17,498 parathyroidectomies. Across the period the number of surgeons conducting parathyroid surgery changed little (280 in 2014/15 and 2018/19), although the number of procedures conducted rose from 3,331 to 3,848 per annum. From the lowest surgeon volume category (1–10 per annum) to the highest (≥ 60 per annum) the proportion of patients readmitted at 30 days or with an extended length of stay decreased 11.7% to 7.0%, diagnosis of hypoparathyroidism within one year from 16.3% to 10.9%, repeat parathyroid procedures within one year from 2.5% to 1.0% and mortality rate at one year from 1.0% to 0.5%. These differences persisted after adjustment for demographic and procedural covariates.

Conclusion
Higher surgeon annual volume is associated with improved patient outcomes for parathyroid surgery. BAETS should consider recommending a minimum yearly workload.
Epithelial–mesenchymal transition in organ fibrosis development: current understanding and treatment strategies
Authors: Liu Lexin , Sun Qizhe , Davis Frank , Mao Jianhua , Zhao Hailin , Ma Daqing 
Published: March 2022

AbstractOrgan fibrosis is a process in which cellular homeostasis is disrupted and extracellular matrix is excessively deposited. Fibrosis can lead to vital organ failure and there are no effective treatments yet. Although epithelial–mesenchymal transition (EMT) may be one of the key cellular mechanisms, the underlying mechanisms of fibrosis remain largely unknown. EMT is a cell phenotypic process in which epithelial cells lose their cell-to-cell adhesion and polarization, after which they acquire mesenchymal features such as infiltration and migration ability. Upon injurious stimulation in different organs, EMT can be triggered by multiple signaling pathways and is also regulated by epigenetic mechanisms. This narrative review summarizes the current understanding of the underlying mechanisms of EMT in fibrogenesis and discusses potential strategies for attenuating EMT to prevent and/or inhibit fibrosis. Despite better understanding the role of EMT in fibrosis development, targeting EMT and beyond in developing therapeutics to tackle fibrosis is challenging but likely feasible.
Risk of outcomes in a Spanish population with chronic kidney disease
Authors: Alcázar Roberto , Escobar Carlos , Palacios Beatriz , Aranda Unai , Varela Luis , Capel Margarita , Sicras Antoni , Sicras Aram , Hormigo Antonio , Manito Nicolás , Botana Manuel 
Published: March 2022

ABSTRACT

Objectives
To assess mortality and cardiovascular and renal outcomes among patients with chronic kidney disease (CKD) (primary objective), with a particular focus on heart failure (HF) risk following diagnosis of CKD (secondary objective) in Spain.

Methods
We conducted an observational study comprising cross-sectional and longitudinal retrospective analyses using secondary data from electronic health records. For the primary objective, adults with prevalent CKD [estimated glomerular filtration rate (eGFR) &lt;60 or ≥60 mL/min/1.73 m2 with a urine albumin:creatinine ratio (UACR) ≥30 mg/g at the index date (1 January 2017)] were included. For the secondary objective, adults with incident CKD in 2017 were enrolled.

Results
In the prevalent population, 46 786 patients with CKD without HF [75.8 ± 14.4 years, eGFR 51.4 ± 10.1 mL/min/1.73 m2; 75.1% on renin–angiotensin system inhibitors (RASis)] and 8391 with CKD and HF (79.4 ± 10.9 years, eGFR 46.4 ± 9.8 mL/min/1.73 m2) were included. In the prevalent population, the risk of all-cause death {hazard ratio [HR] 1.107 [95% confidence interval (CI) 1.064–1.153]}, HF hospitalization [HR 1.439 (95% CI 1.387–1.493)] and UACR progression [HR 1.323 (95% CI 1.182–1.481)] was greater in those patients with CKD and HF versus CKD only. For the incident population, 1594 patients with CKD without HF and 727 with CKD and HF were included. Within 24 months from the CKD diagnosis (with/without HF at baseline), 6.5% of patients developed their first HF hospitalization. Although 60.7% were taking RASis, only 3.4% were at maximal doses and among diabetics, 1.3% were taking sodium-glucose cotransporter-2 inhibitors.

Conclusions
The presence of HF among CKD patients markedly increases the risk of outcomes. CKD patients have a high risk of HF, which could be partially related to insufficient treatment.
The resilience of the British and European goods industry: Challenge of Brexit
Authors: Uddin Moshfique , Chowdhury Anup , Wood Geoffrey 
Published: March 2022

Abstract
This is a study of the volume flexibility of the British and European goods industry, and its relative ability to cope with exogenous shocks, using the case of the Brexit process in a comparative context. It is located within the literature on comparative capitalism, and what it tells us in terms of how different institutional orders may be equipped to deal with such events. Using data for goods firms across 27 EU countries and the UK, we find that the UK goods industry has coped poorly with the shocks related to the Brexit process: its volume flexibility has declined. Brexit also has had an, albeit lesser, impact on the volume flexibility of their European firms counterparts. In particular, smaller firms in the EU coped better, a possible reflection of stronger institutional supports. However, firms that investing more in R&D, provide training to improve management efficiency, and apply innovation to improve asset efficiency, seem to be coping better. This study illustrates how the withdrawal of Britain from supra-national European institutions seems to have accentuated any negative effects of domestic institutions on firms, and, indeed, has had even worse consequences than the 2008 economic crisis for the British goods industry. The latter would suggest it is ill equipped to cope with further shocks, such as the 2020 pandemic. We draw out the implications for theorizing, policy and future research.
COVID-19 association with purpura fulminans: report of a life threatening complication in a fully vaccinated patient
Authors: Zhitny Vladislav Pavlovich , Lyons Mitchell , Perloff Andrea , Menezes John , Pistorio Ashley , Baynosa Richard 
Published: March 2022

AbstractSARS-CoV-2 manifestations have been an ongoing evolving topic that has spread beyond its initial respiratory associations. Recently, there have been reports of COVID-19 infections found to be associated with vascular pathologies. Here, we describe a case of a fully vaccinated COVID-19 adult male with past medical history of purpura fulminans that presented with diffuse necrotic cutaneous tissue sequelae resulting in intensive care unit management and dry gangrene of upper extremity. On admission, it was found that the patient had decreased activity rather than quantity of coagulation pathway protein S. Early recognition and work up are essential in patients with known history of vascular disease and confirmed cases of SARS-CoV-2 positive polymerase chain reaction.
Pneumatosis cystoides intestinalis with pneumoperitoneum in an 87-years-old male patient: a case report
Authors: Piltcher-da-Silva Rodrigo , Sasaki Vivian Laís , Zangari Matheus Antonio Chiconelli , Gallotti Felipe Melloto , Saenger Bruna Freitas , Piltcher-Recuero Mariana , de Melo Rocha Gabriela , da Costa Marco Raeder , Coelho Júlio Cezar Uili 
Published: March 2022

Abstract
Pneumatosis cystoides intestinalis (PCI) is a rare condition, characterized by gas-filled cysts in the intestinal wall. The mesentery and intra-abdominal ligaments can be affected. PCI is classified as primary or secondary and associated with multiple predisposing factors. An asymptomatic 87-year-old man underwent an abdominal tomography for follow-up of bladder carcinoma. The examination revealed intestinal and mesenteric pneumatosis associated with pneumoperitoneum. At laparoscopy, intestinal and mesenteric pneumatosis without intestinal infarction was identified. He was discharged on the fifth postoperative day. PCI is a benign condition that can be confused with mesenteric ischemia. Treatment is conservative, with periodic clinical evaluations. Surgical procedure is unnecessary for its diagnosis or management.
Financial Status and Well-being in Recently Separated Military Veterans
Authors: Elbogen Eric B , Zeber John E , Vogt Dawne , Perkins Daniel F , Finley Erin P , Copeland Laurel A 
Published: March 2022

ABSTRACT

Introduction
Veterans transitioning from military service to civilian life manage numerous changes simultaneously, in health, employment, social relationships, and finances. Financial problems may impact financial well-being as well as adjustment to civilian life in general; yet, research on Veterans’ financial challenges remains limited. This study examined six indicators of perceived financial status among newly transitioned Veterans over a period of 3 years and then examined perceived financial well-being measured in two domains—satisfaction and functioning—and difficulty adjusting to civilian life as functions of financial status.

Materials and Methods
A sample representing 48,965 Veterans who separated from active duty/activated status in fall 2016 provided informed consent and survey data over their first 33 post-military months; data were analyzed in weighted regression models that included demographics, military characteristics, social support, resilience, life stress, and indicators of financial status.

Results
Financial status immediately post-separation included having stable housing (88%), being able to pay for necessities (83%), keeping up with creditors (88%), having insurance for catastrophic events such as disability (79%), saving for retirement (62%), and setting aside 3 months of salary (50%). Thirteen percent of Veterans disclosed troubled financial status, having achieved no more than two of these financial goals; 38% had moderate and 49% excellent financial status. Troubled or moderate financial status, Black race, enlisted, and higher levels of stress predicted lower financial functioning. Older age, college degree at baseline, employment, and social support predicted better financial satisfaction. Veterans with troubled financial status reported greater difficulty adjusting to civilian life (odds ratio 1.34); women were less likely to report difficulty adjusting to civilian life (odds ratio 0.85).

Conclusions
Findings indicate that financial satisfaction and functioning may be sensitive to psychosocial factors (social support and stress). Findings also underscore the value of assessing Veterans’ financial status (poor debt management and lack of future planning), providing encouragement and assistance to pursue a college degree, and improving household financial management, thus increasing the likelihood that Veterans will have the necessary tools to manage their finances after separation and achieve whole health well-being.
Graves’ Disease Combined With Orthostatic Hypotension: A Two-Case Report
Authors: Han Ya-Juan , Yu Zhao-Ying , Miao Run , Chen Shuo , Wang Yu-Bing 
Published: March 2022

ABSTRACTGraves’ disease (GD) is the most common cause of hyperthyroidism in the clinic, accounting for about 85% of all hyperthyroidisms. However, hyperthyroidism combined with OH has been rarely reported in the international community. We analyzed the clinical characteristics and pathogenesis of GD combined with orthostatic hypotension. We conducted a retrospective analysis of 2 GD combined with orthostatic hypotension cases diagnosed by Chinese and Western Medical Association Hospital of Southern Medical University from July to August 2018 and discussed their clinical characteristics, treatment methods, and pathogenesis. The main clinical manifestations of both two patients with hyperthyroidism were vertigo during postural changes or activities and relief from supine position and blood volume supplementation. Considering the lack of blood volume, the symptoms were alleviated after symptomatic treatment. The possibility of hyperthyroidism combined with orthostatic hypotension should be taken into consideration in clinical diagnosis and treatment.
Part I: Background and Clinical Considerations for Stress Fractures in Female Military Recruits
Authors: Abbott Alexandra , Wang Cindy , Stamm Michaela , Mulcahey Mary K 
Published: March 2022

ABSTRACT

Introduction
Stress fractures (SFx) represent a significant proportion of musculoskeletal injuries in military recruits internationally. Incidence rates as high as 40% have been reported, varying by country and branch of military cohorts. Tibial SFx are the most common, followed by other lower extremity sites, and are related to the emphasis on running during training. SFx disproportionately affect female recruits, similarly to a disparity demonstrated in female athletes.

Methods
A literature review of articles relevant to our review was conducted using PubMed, utilizing keywords stress fracture, military, recruits, diagnosis, management, treatment, prevention, epidemiology, background, and/or female. Articles older than 10 years old (prior to 2010) were not considered. Review articles were considered, but if a research article was cited by a review, the research was included directly. Articles with primary military data, members of the military as subjects, especially when female recruits were included, were strongly considered for inclusion in this review.

Results
SFx can cause medical morbidity and financial burden and can require discharge from military service. SFx management in the military has cost the United States approximately $100 million annually, which may be underestimated due to lost duty hours or medical discharge with resulting compensation. However, SFx incidence rates have been demonstrated to be reducible with concerted efforts in military cohorts.

Conclusion
This review, Part I of a two-part series, provides updated information for multidisciplinary management of SFx in female military recruits. There are many similarities to management in athletes, but unique nuances of the military recruit require specific knowledge to reduce the high incidence rates of injury.
An Examination of Factors That Influence Receipt of Reproductive Health Screenings Among Female Veterans
Authors: Ferras Madisen , Dye Judy , Ayala Guadalupe X , Schmied Emily 
Published: March 2022

ABSTRACT

Introduction
As the number of women veterans grows, so does the need to ensure they receive timely health care, including preventive reproductive health screenings such as cervical cancer screenings and mammograms. However, little is known about the rates of reproductive health screenings among veterans and what factors may be related to screening. The objectives of this cross-sectional study were to (1) understand healthcare treatment-seeking experiences among women veterans, (2) determine the rate of adherence to screening guidelines for cervical and breast cancers, and (3) examine potential correlates of adherence to clinical reproductive health screening guidelines.

Materials and Methods
Women veterans completed an electronically administered survey, which assessed personal characteristics, psychological health symptoms, military service history, health insurance status, healthcare-seeking experiences (e.g., barriers to and satisfaction with care), and receipt of cervical and breast cancer screenings. Multivariable logistic regression identified factors associated with adherence to clinical guidelines for cervical and breast cancer screening.

Results
Of the 90 women (mean age = 38.78; SD = 12.19) who participated, 64 (71.10%) reported meeting all age-applicable screening guidelines. The most common barriers to obtaining women’s healthcare were availability of convenient appointment times, finding time in your schedule to make and go to an appointment, and long wait times for appointments. Multivariable logistic regression revealed veterans without a regular women’s health provider were less likely to adhere to guidelines than those with a regular provider (OR = 0.16; 95% CI, 0.04-0.57).

Discussion
Many women veterans are unable to receive reproductive health screenings; continued efforts are needed to determine how to increase adherence in this unique population.
A national survey of skin health in nursing personnel
Authors: Parsons V , Oxley G , Hines J , Gallagher R , Sunley K , Fellows Caroline , Hodgkinson M , Ormandy K , Gould D 
Published: March 2022

Abstract

Background
Hand dermatitis is a well-established occupational risk in nursing staff.

Aims
To explore skin health in nursing staff and to develop resources and recommendations to promote good skincare at work.

Methods
Cross-sectional survey.

Results
We analysed data from 1,545 surveys. Forty-six percent reported ‘poor’ skin health and the majority (93%) experienced at least one skin problem over the previous 12 months, with only 22% seeking help from their employer. Only 2% took time off work due to skin problems, with many expressing concerns that taking sick leave would be viewed negatively by others. Over half (53%) had reduced or stopped using antibacterial rubs and soap, and 18% had reduced the use of gloves. Most respondents used hand cream and over half used products they had purchased themselves. Only 42% received skin health care information from employers, with fewer (26%) receiving training on how to identify early signs of skin disease. Only 16% had access to skin surveillance in line with regulatory requirements. Only 26% of respondents were aware of the support offered by their professional nursing association. Suggestions for improving skin health included increasing publicity concerning the importance of skin health in healthcare settings, improving access to hand creams, better quality products, enhanced education and training and more involvement from Occupational Health (OH).

Conclusions
Results confirm that poor skin health remains a persistent problem for nurses. Employers could do more to promote skin health and nurses need to be made more aware of the support and guidance offered by professional bodies.
Effect of booster vaccination against Delta and Omicron variants in Iceland
Authors: Norddahl Gudmundur L , Melsted Pall , Gunnarsdottir Kristbjorg , Halldorsson Gisli H , Olafsdottir Thorunn A , Gylfason Arnaldur , Kristjansson Mar , Magnusson Olafur T , Sulem Patrick , Gudbjartsson Daniel F , Thorsteinsdottir Unnur , Jonsdottir Ingileif , Stefansson Kari 
Published: March 2022

AbstractBy the end of July 2021, the majority of the Icelandic population had received vaccination against COVID-19. In mid-July a wave of SARS-CoV-2 infections, dominated by the delta variant, spread through the population, followed by an omicron wave in December. A booster vaccination campaign was initiated to curb the spread of the virus. We estimated the risk of infection for different vaccine combinations using vaccination data from 276,028 persons and 963,557 qPCR tests for 277,687 persons. We measured anti-Spike-RBD antibody levels and ACE2-Spike binding inhibitory activity in 371 persons who received one of four recommended vaccination schedules with or without an mRNA vaccine booster. Overall, we found different antibody levels and inhibitory activity between recommended vaccination schedules, which was reflected in the observed risk of SARS-CoV-2 infections. We observed an increased protection following mRNA boosters, against both omicron and delta variant infections, although BNT162b2 boosters provided greater protection against omicron than mRNA-1273 boosters.