bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Octogenarians at Higher Risk of Complications After Elective Lumbar Spinal Fusion Surgery? Analysis of a Cohort of 7,880 patients from the Kaiser Permanente Spine Registry
Authors: Kuo Calvin C. , Royse Kathryn E. , Prentice Heather A. , Harris Jessica E. , Guppy Kern H. 
Published: August 2022

Study Design.
A retrospective cohort study with chart review

Objective.
To determine if there is a difference in risk of adverse outcomes following elective posterior instrumented lumbar spinal fusions for patients aged ≥80 compared to patients aged 50-79.

Summary of Background Data.
Patients aged ≥80 years are undergoing elective lumbar spinal fusion surgery in increasing numbers. There are conflicting data on the risks of intraoperative and postoperative complications in these patients.

Methods.
Patients aged ≥80 were compared to 50-79 (reference group) using time-dependent multivariable Cox-Proportional Hazards regression with a competing risk of death for longitudinal outcomes and multivariable logistic regression for binary outcomes. Outcome measures used were 1) intraoperative complications (durotomy), 2) postoperative complications: 30-day outcomes (pneumonia); 90-day outcomes (deep vein thrombosis [DVT], pulmonary embolism [PE], emergency room [ER] visits, readmission, reoperations, and mortality); and 2-year outcomes (reoperations and mortality).

Results.
The cohort consisted of 7,880 patients who underwent primary elective posterior instrumented lumbar spinal fusion (L1-S1) for degenerative disc disease or spondylolisthesis. This was subdivided into 596 patients were aged ≥80 and 7284 patients aged 50-79. After adjustment, patients aged ≥80 had a higher likelihood of durotomy (odds ratio [OR]=1.43, 95% confidence interval [CI]=1.02-2.02) and 30-day pneumonia (OR=1.81, 95% CI=1.01-3.23). However, there was a lower risk of reoperation within 2-years of the index procedure (hazard ratio [HR]=0.69, 95% CI=0.48-0.99). No differences were observed for mortality, readmissions, ER visits, PE, or DVT.

Conclusions.
In a cohort of 7,880 elective posterior instrumented lumbar fusion patients for degenerative disc disease or spondylolisthesis, we did not observe any significant risks of adverse events between patients aged ≥80 and those aged 50-79 except higher durotomies and 30-day pneumonia in the former. We believe octogenarians can safely undergo lumbar fusions, but proper preoperative screening is necessary to reduce the risks of 30-day pneumonia.
Sex-specific association between coffee consumption and incident chronic kidney disease: a population-based analysis of 359,906 participants from the UK Biobank
Authors: Tang Lei , Yang Lina , Chen Wenwen , Li Chunyang , Zeng Yu , Yang Huazhen , Hu Yao , Qu Yuanyuan , Song Huan , Zeng Xiaoxi , Fu Ping 
Published: August 2022

Abstract

Background:
The risk for chronic kidney disease (CKD) is influenced by genetic predisposition, sex, and lifestyle. Previous research indicates that coffee is a potentially protective factor in CKD. The current study aims to investigate whether sex disparity exists in the coffee–CKD association, and whether genetic risk of CKD or genetic polymorphisms of caffeine metabolism affect this association.

Methods:
A total of 359,906 participants from the UK Biobank who were enrolled between 2006 and 2010 were included in this prospective cohort study, which aimed to estimate the hazard ratios for coffee intake and incident CKD using a Cox proportional hazard model. Allele scores of CKD and caffeine metabolism were additionally adjusted for in a subsample with qualified genetic data (n = 255,343). Analyses stratified by genetic predisposition, comorbidities, and sex hormones were performed. Tests based on Bayesian model averaging were conducted to ascertain the robustness of the results.

Results:
Coffee was inversely associated with CKD in a dose-dependent manner. The effects of coffee did not differ across different strata of genetic risk for CKD, but were more evident among slower genetically predicted caffeine metabolizers. Significant sex disparity was observed (P value for interaction = 0.013), in that coffee drinking was only associated with the risk reduction of CKD in females. Subgroup analysis revealed that testosterone and sex hormone-binding globulin (SHBG), but not estradiol, modified the coffee–CKD association.

Conclusions:
In addition to the overall inverse coffee–CKD association that was observed in the general population, we could also establish that a sex disparity existed, in that females were more likely to experience the benefit of the association. Testosterone and SHBG may partly account for the sex disparity.
Bile reflux and bile acids in the progression of gastric intestinal metaplasia
Authors: Qu Xiaodong , Shi Yongquan 
Published: August 2022

Abstract
Gastric intestinal metaplasia (GIM) is a precancerous lesion of gastric cancer (GC) and is considered an irreversible point of progression for GC. Helicobacter pylori infection can cause GIM, but its eradication still does not reverse it. Bile reflux is also a pathogenic factor in GIM and can continuously irritate the gastric mucosa, and bile acids in refluxed fluid have been widely reported to be associated with GIM. This paper reviews in detail the relationship between bile reflux and GIM and the mechanisms by which bile acids induce GIM.
Patient blood management in the ICU
Authors: Neef Vanessa , Blum Lea , Hof Lotta , Choorapoikayil Suma , Kieserling Kira , Meybohm Patrick , Steinbicker Andrea U. , Zacharowski Kai , Piekarski Florian 
Published: August 2022

The majority of ICU patients are anaemic. Anaemia is associated with worse outcomes and a necessity for red blood cell transfusions. ICU patients are a heterogeneous patient group with a broad spectrum of main diagnoses and comorbidities. Evidence-based transfusion trigger guidelines have been established that are dependent on comorbidities. Special attention has been given to blood saving measures and point-of-care diagnosis of coagulation disorders in ICU patients. The administration of intravenous iron and erythropoiesis-stimulating agents can provide useful and individualised alternatives to the administration of red blood cell concentrates in treatment of iron deficiency anaemia. In presence of inflammation and infection, it is challenging to identify the cause of anaemia. The hepcidin-ferroportin pathway may facilitate the diagnosis of anaemia in ICU patients and indicate novel targets in anaemia treatment.
This review article presents patient blood management measures and summarises the current literature on transfusion thresholds and alternative therapeutic options using intravenous iron and erythropoiesis-stimulating agents with a key focus on the ICU.
Ventriculo-arterial coupling: from physiological concept to clinical application in peri-operative care and ICUs
Authors: Guinot Pierre-Grégoire , Andrei Stefan , Longrois Dan 
Published: August 2022

As an extension of the traditional heart-centred pressure-flow model, the ventriculo-arterial coupling concept is based on the pressure–volume relationship of the left ventricle and the vascular system. Even though ventriculo-arterial coupling has been studied in cardiology for more than 30 years, its value in clinical practice in anaesthesia and ICU remains poorly known and used.
The clinical interest in ventriculo-arterial coupling is derived from its strong connection with cardiac energetics and efficiency. An alteration of ventriculo-arterial coupling is a marker of disease severity and is associated with outcome. The main categories of cardio-circulatory failures observed in ICU patients commonly exhibit alterations in ventriculo-arterial coupling with typical patterns. Furthermore, the effectiveness of usual haemodynamic treatments and interventions correlates with ventriculo-arterial coupling improvements in ICU patients. Consequently, treatment and management bundles may be proposed to specifically target the correction of ventriculo-arterial uncoupling to optimise the patients’ haemodynamic status and outcome. Restoring ventriculo-arterial coupling with treatments improves outcomes in subgroups of ICU patients.
Even though ventriculo-arterial coupling evaluation cannot be considered as a part of the basic core curriculum of anaesthesiologists and ICU residents, anaesthesia and ICU practitioners must be familiarised with the clinical significance of ventriculo-arterial (un)coupling and availability of its bedside noninvasive evaluation. The understanding of ventriculo-arterial coupling may be particularly important in complex haemodynamic clinical situations.
Partial Identification of the Average Causal Effect in Multiple Study Populations: The Challenge of Combining Mendelian Randomization Studies
Authors: Diemer Elizabeth W. , Zuccolo Luisa , Swanson Sonja A. 
Published: August 2022

Background:
Researchers often use random-effects or fixed-effects meta-analysis to combine findings from multiple study populations. However, the causal interpretation of these models is not always clear, and they do not easily translate to settings where bounds, rather than point estimates, are computed.

Methods:
If bounds on an average causal effect of interest in a well-defined population are computed in multiple study populations under specified identifiability assumptions, then under those assumptions the average causal effect would lie within all study-specific bounds and thus the intersection of the study-specific bounds. We demonstrate this by pooling bounds on the average causal effect of prenatal alcohol exposure on attention deficit-hyperactivity disorder symptoms, computed in two European cohorts and under multiple sets of assumptions in Mendelian randomization (MR) analyses.

Results:
For all assumption sets considered, pooled bounds were wide and did not identify the direction of effect. The narrowest pooled bound computed implied the risk difference was between −4 and 34 percentage points.

Conclusions:
All pooled bounds computed in our application covered the null, illustrating how strongly point estimates from prior MR studies of this effect rely on within-study homogeneity assumptions. We discuss how the interpretation of both pooled bounds and point estimation in MR is complicated by possible heterogeneity of effects across populations.
Long-term Traffic-related Air Pollutant Exposure and Amyotrophic Lateral Sclerosis Diagnosis in Denmark: A Bayesian Hierarchical Analysis
Authors: Parks Robbie M. , Nunez Yanelli , Balalian Arin A. , Gibson Elizabeth A. , Hansen Johnni , Raaschou-Nielsen Ole , Ketzel Matthias , Khan Jibran , Brandt Jørgen , Vermeulen Roel , Peters Susan , Goldsmith Jeff , Re Diane B. , Weisskopf Marc G. , Kioumourtzoglou Marianthi-Anna 
Published: August 2022

Background:
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Limited evidence suggests ALS diagnosis may be associated with air pollution exposure and specifically traffic-related pollutants.

Methods:
In this population-based case–control study, we used 3,937 ALS cases from the Danish National Patient Register diagnosed during 1989–2013 and matched on age, sex, year of birth, and vital status to 19,333 population-based controls free of ALS at index date. We used validated predictions of elemental carbon (EC), nitrogen oxides (NOx), carbon monoxide (CO), and fine particles (PM2.5) to assign 1-, 5-, and 10-year average exposures pre-ALS diagnosis at study participants’ present and historical residential addresses. We used an adjusted Bayesian hierarchical conditional logistic model to estimate individual pollutant associations and joint and average associations for traffic-related pollutants (EC, NOx, CO).

Results:
For a standard deviation (SD) increase in 5-year average concentrations, EC (SD = 0.42 µg/m3) had a high probability of individual association with increased odds of ALS (11.5%; 95% credible interval [CrI] = –1.0%, 25.6%; 96.3% posterior probability of positive association), with negative associations for NOx (SD = 20 µg/m3) (–4.6%; 95% CrI = 18.1%, 8.9%; 27.8% posterior probability of positive association), CO (SD = 106 µg/m3) (–3.2%; 95% CrI = 14.4%, 10.0%; 26.7% posterior probability of positive association), and a null association for nonelemental carbon fine particles (non-EC PM2.5) (SD = 2.37 µg/m3) (0.7%; 95% CrI = 9.2%, 12.4%). We found no association between ALS and joint or average traffic pollution concentrations.

Conclusions:
This study found high probability of a positive association between ALS diagnosis and EC concentration. Further work is needed to understand the role of traffic-related air pollution in ALS pathogenesis.
Case Findings: Sodium Ferric Gluconate Complex and Fetal Bradycardia
Authors: Droney Madeline , Scovell Samuel , Hatfield Joanne , Pender Erin 
Published: August 2022

Abstract
Anemia in pregnancy is a significant event that often requires treatment to prevent long term effects in the mother and the fetus. Many factors determine which iron preparation to use, including route and ease of administration, patient tolerability, safety, and cost. This case report summarizes two separate patient cases where sodium ferric gluconate complex was administered intravenously to pregnant women, resulting in fetal bradycardia and emergent cesarean procedures.
The Association Between a Second Course of Cardiac Rehabilitation and Cardiovascular Outcomes Following Repeat Percutaneous Coronary Intervention Events
Authors: Zhang Wenliang , Supervia Marta , Dun Yaoshan , Lennon Ryan J. , Ding Rongjing , Sandhu Gurpreet , Tilbury Thomas , Squires Ray W. , Vardar Ufuk , Tabatabaei Niloufar , Thomas Randal J. 
Published: August 2022

Purpose:
Survivors of coronary artery disease (CAD) events are at risk for repeat events. Although evidence supports cardiac rehabilitation (CR) after an initial CAD event, it is unclear whether a repeat course of CR (CR × 2) is beneficial after a recurrent CAD event. The purpose of this study was to determine the association of CR × 2 with clinical outcomes in persons undergoing repeat percutaneous coronary intervention (PCI).

Methods:
We assessed the prevalence of CR × 2 and its impact on cardiovascular outcomes in individuals who experienced a repeat PCI at the Mayo Clinic hospitals between January 1, 1998, and December 31, 2013. Landmark analyses were used to calculate unadjusted and propensity score adjusted mortality rates and cardiovascular (CV) events rates for patients who underwent CR × 2 compared with those who did not.

Results:
Among 240 individuals who had a repeat PCI and who had participated in CR after their first PCI, 97 (40%) participated in CR × 2. Outcomes were assessed for a mean follow-up time of 7.8 yr (IQR 7.1-9.0 yr). Propensity score-based inverse probability weighting analysis revealed that CR × 2 was associated with significantly lower target lesion revascularization (HR = 0.47: 95% CI, 0.26-0.86; P = .014), lower combined end point of CV death, myocardial infarction, and target lesion revascularization (HR = 0.57: 95% CI, 0.36-0.89; P = .014), and lower CV hospitalization (HR = 0.60; 95% CI, 0.43-0.84; P = .003).

Conclusion:
A second course of CR following repeat PCI is associated with a lower risk of adverse clinical outcomes. These findings support current policies that allow for repeat courses of CR following recurrent CV events.
Arterial stiffness and atrial fibrillation: shared mechanisms, clinical implications and therapeutic options
Authors: Vio Riccardo , Giordani Andrea S. , Stefil Maria , Madine Jillian , Fairbairn Timothy , Themistoclakis Sakis , Salvi Paolo , Caforio Alida L.P. , Shantsila Alena , Shantsila Eduard , Akhtar Riaz , Field Mark , Lip Gregory Y.H. , Proietti Riccardo 
Published: August 2022

Arterial stiffness (AS) and atrial fibrillation (AF) share commonalities in molecular and pathophysiological mechanisms and numerous studies have analyzed their reciprocal influence. The gold standard for AS diagnosis is represented by aortic pulse wave velocity, whose measurement can be affected by arrhythmias characterized by irregularities in heart rhythm, such as AF. Growing evidence show that patients with AS are at high risk of AF development. Moreover, the subset of AF patients with AS seems to be more symptomatic and rhythm control strategies are less effective in this population. Reducing AS through de-stiffening interventions may be beneficial for patients with AF and can be a new appealing target for the holistic approach of AF management.
In this review, we discuss the association between AS and AF, with particular interest in shared mechanisms, clinical implications and therapeutic options.
Forkhead box O3 longevity genotype may attenuate the impact of hypertension on risk of intracerebral haemorrhage
Authors: Nakagawa Kazuma , Chen Randi , Greenberg Steven M. , Ross G. Webster , Willcox Bradley J. , Donlon Timothy A. , Allsopp Richard C. , Willcox D. Craig , Morris Brian J. , Masaki Kamal H. 
Published: August 2022

Objective:
Since the G allele of forkhead box O3 (FOXO3) single nucleotide polymorphism (SNP) rs2802292 is associated with resilience and longevity, ostensibly by mitigating the adverse effects of chronic cardiometabolic stress on mortality, our aim was to determine the association between the FOXO3 SNP rs2802292 genotype and risk of hypertension-mediated intracerebral haemorrhage (ICH).

Methods:
From a prospective population-based cohort of Japanese American men from the Kuakini Honolulu Heart Program (KHHP), age-adjusted prevalence of ICH by hypertension was assessed for the whole cohort after stratifying by FOXO3 genotype. Cox regression models, adjusted for age, cardiovascular risk factors and, FOXO3 and APOE genotypes, were utilized to determine relative risk of hypertension's effect on ICH. All models were created for the whole cohort and stratified by FOXO3 G-allele carriage vs. TT genotype.

Results:
Among 6469 men free of baseline stroke, FOXO3 G-allele carriage was seen in 3009 (46.5%) participants. Overall, 183 participants developed ICH over the 34-year follow-up period. Age-adjusted ICH incidence was 0.90 vs. 1.32 per 1000 person-years follow-up in those without and with hypertension, respectively (P = 0.002). After stratifying by FOXO3 genotype, this association was no longer significant in G allele carriers. In the whole cohort, hypertension was an independent predictor of ICH (relative risk [RR] = 1.70, 95% confidence interval [CI] 1.25, 2.32; P = 0.0007). In stratified analyses, hypertension remained an independent predictor of ICH among the FOXO3 TT-genotype group (RR = 2.02, 95% CI 1.33, 3.07; P = 0.001), but not in FOXO3 G-allele carriers (RR = 1.39, 95% CI 0.88, 2.19; P = 0.15).

Conclusions:
The longevity-associated FOXO3
G allele may attenuate the impact of hypertension on ICH risk.
Trends in the Microbiological Spectrum of Nonviral Keratitis at a Single Tertiary Care Ophthalmic Hospital in India: A Review of 30 years
Authors: Joseph Joveeta , Karoliya Roshini , Sheba Esther , Sharma Savitri , Bagga Bhupesh , Garg Prashant 
Published: August 2022

Purpose:
The aims of this study were to assess the trends in microorganisms from patients with infectious keratitis and to assess their antibiogram patterns at a tertiary eye care center in India.

Methods:
In this retrospective observational case series, microbiological records of all corneal ulcers were reviewed from 1991 to 2020 and assessed for trends in keratitis and antibiotic susceptibility using the χ2 test.

Results:
Of the total of 51,747 patients, 51.13% were culture positive. A decrease in bacteria was noted from 56% to 38%, with a parallel increase in fungal isolates from 24% to 51%. Gram-positive bacteria accounted for 70.8% of the total bacteria, a trend in rise of Streptococcus pneumoniae (31%) and a decreasing trend in prevalence of Staphylococcus epidermidis was observed over 30 years. Pseudomonas aeruginosa (55.5%) was the most prevalent gram-negative pathogen, whereas Fusarium spp. (33.1%) and Aspergillus spp. (32.4%) were the most common fungal isolates. The susceptibility of gram-positive organisms to cefazolin decreased from 95.5% to 66% (P = 0.0001), amikacin from 88% to 55% (P= 0.0001), and vancomycin from 98.9% to 90.7% (P < 0.05). A similar decrease in susceptibility was also significant for gram-negative organisms with piperacillin/tazobactam and chloramphenicol (P < 0.05). A significant trend toward increasing resistance against fluoroquinolones was also observed for ciprofloxacin (gram-positive organisms: 16% to 50%; gram-negative organisms: 11.5% to 18.7%), gatifloxacin (38% to 47%), and moxifloxacin (9.4% to 29%).

Conclusions:
The spectrum of keratitis has changed, and fungus is now the predominant etiology. An increasing trend in resistance to all antibiotics studied would affect the empiric treatment, also suggesting regular surveillance.
Paliperidone-Associated Sialorrhea
Authors: Burk Bradley G. , Donaldson Victoria , Jackson Cherry W. , Cates Marshall E. , Birur Badari 
Published: August 2022

Abstract

Purpose/Background
Antipsychotic-associated sialorrhea is a problematic adverse effect with potentially negative consequences on quality of life and medication adherence. While clozapine is the antipsychotic that is most associated with sialorrhea, there have been published reports of other second-generation antipsychotics associated with sialorrhea, including aripiprazole, olanzapine, quetiapine, and risperidone. Although drooling is mentioned within the package insert for paliperidone, to date there have been minimal published reports in which paliperidone is implicated as the offending agent.

Methods/Procedures
Here, we present a case of sialorrhea in a 56-year-old man with schizoaffective disorder who had a supratherapeutic paliperidone level after both oral and intramuscular paliperidone use.

Findings/Results
Paliperidone was ultimately cross tapered to aripiprazole, and the patient was given atropine drops and benztropine with resolution of the sialorrhea. We provide a review of the literature regarding the other available reports of paliperidone-associated sialorrhea, possible mechanisms behind pathophysiology, as well as reports from the World Health Organization and Food and Drug Administration adverse event reporting systems.

Implications/Conclusions
Clinicians should be aware of the potential for paliperidone and other nonclozapine second-generation antipsychotics to be associated with sialorrhea, especially given the increased frequency of their use for a variety of psychiatric disorders.
Working From Home During the COVID-19 Pandemic
Authors: Zhang Wei , Sun Huiying , Gelfand Aaron , Sawatzky Richard , Pearce Alison , Anis Aslam H. , Prescott Katrina , Lee Christine 
Published: August 2022

Objective
The aim of this study was to measure the association of working from home (WFH) with work productivity loss due to caregiving responsibilities or health problems during the COVID-19 pandemic.

Methods
We conducted an online survey of family/friend caregivers (n = 150 WFH/75 non-WFH) and patients (n = 95/91) who worked during the past 7 days in May and July 2020, respectively. Absenteeism and presenteeism were measured using the Valuation of Lost Productivity questionnaire.

Results
Working from home was associated with higher odds of absenteeism (odds ratio, 2.53; 95% confidence interval, 1.11 to 5.77) and presenteeism (2.79; 1.26 to 6.18) among caregivers and higher odds of presenteeism among patients (2.78; 1.13 to 6.84). However, among caregivers with absenteeism more than 0 days, WFH was significantly associated with fewer absent workdays.

Conclusions
Working from home was not associated with overall absenteeism and presenteeism in caregivers or patients. Working from home allows a more flexible and inclusive workplace without impacting productivity, although further research is needed.