bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiographic Characteristics of Cardiogenic Shock Patients with and Without Cardiac Arrest
Authors: Tabi Meir , Singam Narayana Sarma V. , Wiley Brandon , Anavekar Nandan , Barsness Gregory , Jentzer Jacob C. 
Published: June 2022

Background Cardiac arrest (CA) is associated with worse outcomes in patients with cardiogenic shock (CS). To better understand the contribution of CA on CS, we evaluated transthoracic echocardiography (TTE) parameters in CS patients with and without CA. Methods We retrospectively identified CS patients with a TTE performed near cardiac intensive care unit admission between 2007 to 2018. We compared TTE measurements of left ventricular (LV) and right ventricular (RV) function in patients with and without CA. The primary outcome was all-cause in-hospital mortality, as determined using multivariable logistic regression. Results We included 1085 patients, 35% of whom had CA. Median age was 70 years and 37% were females. CA patients had higher severity of illness, more invasive mechanical ventilation and greater vasopressor/inotrope use. In-hospital mortality was 31% and was higher in CA patients (45% vs. 23%, p <0.001). Although LV ejection fraction (LVEF) was similar (35% vs. 37%, p = 0.05), CA patients had lower cardiac index, mitral valve E wave peak velocity, E/A ratio and E/e' ratio. TTE variables that were associated with hospital mortality varied, among patients with CA, these included measures of RV pressure and function and among patients without CA, these included parameters reflecting LV systolic function. Conclusions Doppler assessments of RV systolic dysfunction were the strongest TTE predictors of hospital mortality in CS patients with CA, unlike CS patients without CA in whom LV systolic function was more important. This emphasizes the importance of RV assessment for mortality risk stratification after CA.
Differences and similarities of proliferative and non-proliferative forms of biopsy-proven lupus nephritis: Single centre, cross-disciplinary experience
Authors: Duran Emine , Yıldırım Tolga , Taghiyeva Arzu , Bilgin Emre , Arıcı Mustafa , Sağlam Emine Arzu , Özen Seza , Üner Meral , Erdem Yunus , Kalyoncu Umut , Ertenli Ali Ihsan 
Published: June 2022

Objective We aimed to compare clinical features, outcomes, treatments, and to define the predictive factors of complete renal response (CRR) in patients with proliferative and non-proliferative lupus nephritis (LN). Methods Patients with systemic lupus erythematosus (SLE) followed between 2014 and 2020 at Hacettepe University Hospitals and who had a kidney biopsy were the subject of the study. One hundered and sixteen patients’ kidney biopsies reported as LN were evaluated retrospectively. Clinical characteristics and laboratory values at the time of kidney biopsy, histopathological forms of LN, and renal response (complete or partial) were recorded. We analyzed the association between CRR rates during the 2-year follow-up after induction therapy and the predictive factors for CRR. Results Of 116 (93 females, 23 males) patients, 95 (81.9%) were in the proliferative group (class III and IV) and 21 (18.1%) were in the non-proliferative group (class II and V). In the proliferative group, the percentage of the patients with elevated basal creatinine levels, median daily proteinuria, anti-double-stranded DNA (dsDNA) positivity, low C3 and C4 levels, the presence of active urinary sediment, and median renal SLE Disease Activity Index (SLEDAI) scores at the time of kidney biopsy were significantly higher than the non-proliferative group. Renal response status during the 2-year follow-up after induction therapy was available for 99 patients. During this time, 70 (70.7%) patients had achieved CRR and time-to-CRR was similar between the proliferative and non-proliferative groups (p = 0.64, log-rank test). The Cox proportional hazards model showed that achievement of CRR was associated with female gender [HR: 2.15 (1.19–3.89 95% CI), p = 0.011], newly diagnosed SLE with renal biopsy [HR: 2.15 (1.26–3.67 95% CI), p = 0.005], hypertension [HR: 0.40 (0.27–0.94 95% CI), p = 0.032], eGFR increase [HR: 1.01 (1.00–1.01 95% CI), p = 0.046], and the presence of active urinary sediment [HR: 0.46 (0.22–0.96 95% CI), p = 0.039]. Conclusions Achieving CRR was similar in proliferative and non-proliferative LN patients, although certain laboratory parameters differed at the onset. Our results indicated the importance of kidney biopsy in the decision-making of treatment of SLE patients with renal involvement and that the defined factors associated with CRR achievement help to predict good renal response.
National Mental Health Performance Framework: Descriptive analysis of state and national data for 2019–2020
Authors: Looi Jeffrey CL , Kisely Stephen R , Allison Stephen , Bastiampillai Tarun 
Published: June 2022

Objective To compare key performance indicators for public state and territory specialist mental health services in Australia. Methods A descriptive analysis of the publicly-available National Mental Health Performance Framework key performance indicators (KPI), hosted by the Australian Institute of Health and Welfare for 2019–2020, at the national level and for states and territories. Results The real-world performance of public mental health services varied across the eight states and territories of Australia. Western Australia had the longest acute hospital stays and the lowest rates of involuntary admissions. Queensland (QLD) had the shortest acute hospital stays at the lowest cost. While the Australian Capital Territory had the highest rates of community treatment at the lowest cost, the Northern Territory had highest hospital and community costs with the most involuntary admissions. Victoria (VIC) had the lowest population percentage receiving specialised mental health services, the highest readmission rates after 28 days, and highest physical and mechanical restraint rates. Conclusions The KPIs indicate that some states and territories show deviations from national benchmarks that may be important for consumers, carers and clinicians. For further improvement in quality and efficiency, more detailed contextual information is required, including detailed mapping of services.
Relationship Between Childhood Abuse and Body Mass Index in Young Adulthood: Mediated by Depression and Anxiety?
Authors: Elsenburg Leonie K. , Liefbroer Aart C. , van Eeden Annelies E. , Hoek Hans W. , Oldehinkel Albertine J. , Smidt Nynke 
Published: June 2022

We examined whether childhood abuse is related to body mass index (BMI) in young adults and whether this relationship is mediated by depression and anxiety. Data are from the Dutch longitudinal cohort study TRAILS (nfemales = 836, nmales = 719). At wave 4, childhood sexual, physical and verbal abuse, and lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD) were assessed. BMI was measured at wave 4 and 5 (mean age = 19.2/22.4 years). Sex-stratified structural equation models were estimated. Females who had experienced sexual abuse had a higher BMI at wave 4 (B = 0.97, 95%CI = [−0.01,1.96]) and a higher increase in BMI between wave 4 and 5 (B = 0.52, 95%CI = [0.04,1.01]) than females who had not experienced sexual abuse. Additionally, MDD and BMI at wave 4 were related in females (B = 1.35, 95%CI = [0.52,2.18]). MDD mediated the relationship between sexual abuse and BMI at wave 4 in females. In addition, sexual abuse moderated the relationship between MDD and BMI at wave 4. The relationship was stronger among females who had experienced sexual abuse than among females who had not. Prevention of BMI changes among females who experienced sexual abuse may thus be warranted, particularly when they developed MDD. MDD treatment, such as abuse-focused psychotherapy, may aid this prevention.
Intraocular lens constant optimization in toric intraocular lens calculation using keratometry and total corneal power
Authors: Liang Jianheng , Liu Hui , Zhou Suowang , Zhou Lijing , Qian Zhuyun , Jiang Lihong , Chen Xu 
Published: June 2022

Purpose To evaluate intraocular lens (IOL) constant optimization in toric IOL calculation with keratometry (K) and total corneal refractive power (TCRP). Methods Predicted spherical equivalent (SE) and residual astigmatism (RA) with K and TCRP were retrospectively calculated using the Haigis, Holladay 1, and SRK/T formulae and optimized IOL constants. The results of the Barrett calculator and the Abulafia–Koch formula with K were also calculated. The median absolute error in SE (MedAE-SE), mean absolute error in RA (MAE-RA), and centroid error (CE) were analyzed. Results Seventy-nine eyes of 71 patients implanted with toric IOLs were included. With K, there were no significant differences between the results before and after constant optimization using all the formulae. With TCRP, constant optimization significantly reduced MedAE-SE; however, significantly increased MAE-RA and CE using the Holladay 1 and SRK/T formulae. MedAE-SE, MAE-RA, and CE using the Haigis formula did not show significant differences. The difference in the predicted RA before and after constant optimization increased with IOL toricity. The MedAE-SE predicted by TCRP was significantly higher than that predicted by K despite constant optimization. The MAE-RA and CE predicted by TCRP were significantly lower than those predicted by K without posterior corneal astigmatism optimization; however, were not significantly different from those predicted by the Barrett and Abulafia-Koch formulae. Conclusions Constant optimization is recommended when using the TCRP in toric IOL calculations, particularly for patients with large astigmatism. However, TCRP did not yield more accurate results than optimized K in toric IOL calculations despite constant optimization.
Clinical efficacy of Fluorometholone versus Loteprednol eye drops after photorefractive keratectomy: A triple-blinded randomized controlled trial
Authors: Razmjoo Hasan , Mikaniki Mohammad , Peyman Alireza , Mikaniki Ebrahim , Abounoori Mahdi , Pourazizi Mohsen 
Published: June 2022

Purpose This study aimed to compare the anti-inflammatory efficacy and safety of 0.1% Fluorometholone (FML) versus (vs.) 0.5% Loteprednol etabonate (LE) following photorefractive keratectomy (PRK). Methods A triple-blinded randomized controlled trial was conducted on both eyes of 100 patients with stable refraction who were candidates for PRK. Both eyes in each subject were randomly allocated to the FML or LE groups. The product to be tested was 0.1% FML eye drops packaged in droppers vs. the 0.5% LE sterile ophthalmic suspension (Lotemax®) packaged in identical droppers. The main clinical outcomes were changes in best-corrected distance visual acuity (BCDVA) and corneal optical density. The second clinical outcomes were a change in intraocular pressure (IOP) after the intervention. Results There was no significant difference regarding mean corneal optical density changes between the two groups, one ( P = 0.55) and three months ( P = 0.98) after the intervention. The mean ± SD BCDVA after one month of the intervention was 0.79 ± 0.11 and 0.84 ± 0.11 in LE and FML groups, retrospectively ( P = 0.02). There was no significant difference regarding mean BCDVA between the two groups three months after intervention ( P = 0.21). The IOP showed no significant difference between the two groups after one ( P = 0.18) and three months ( P = 0.53) of the intervention. Conclusions The results of this clinical trial demonstrate that LE and FML treatment was effective with no clinically meaningful effect on IOP following a short course of treatment.
Effectiveness of telehealth interventions among traumatic brain injury survivors: A systematic review and meta-analysis
Authors: Suarilah Ira , Zulkarnain Hakim , Saragih Ita Daryanti , Lee Bih-O 
Published: June 2022

Introduction Traumatic brain injury (TBI) represents a major cause of death and disability worldwide. Brain damage is associated with physical and psychological difficulties among TBI survivors. Diverse face-to-face and telehealth programs exist to help survivors cope with these burdens. However, the effectiveness of telehealth interventions among TBI survivors remains inconclusive. Methods A systematic review and meta-analysis of randomized control trials were conducted. Relevant full-text articles were retrieved from seven databases, from database inception to January 2022, including Academic Search Complete, CINAHL, EMBASE, Cochrane, MEDLINE, PubMed, and Web of Science. Bias was assessed with the revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis was performed using a random-effects model to calculate the pooled effect size of telehealth interventions for TBI survivors. STATA 16.0 was used for statistical analysis. Results In total, 17 studies ( N = 3158) applying telehealth interventions among TBI survivors were included in the analysis. Telehealth interventions decreased neurobehavioural symptom (standardized mean difference: −0.13; 95% confidence interval [CI]: −0.36 to 0.10), reduce depression (standardized mean difference: −0.32; 95% CI: −0.79 to 0.14), and increase symptom management self-efficacy (standardized mean difference: 0.22; 95% CI: 0.02–0.42). Discussion Telehealth interventions are promising avenues for healthcare delivery due to advances in technology and information. Telehealth programs may represent windows of opportunity, combining traditional treatment with rehabilitation to increase symptom management self-efficacy among TBI patients during recovery. Future telehealth programs can focus on developing the contents of telehealth modules based on evidence from this study.
Glucose variability is associated with an adverse vascular profile but only in the presence of insulin resistance in individuals with type 1 diabetes: An observational study
Authors: Kietsiriroje Noppadol , Pearson Sam M , O’Mahoney Lauren L , West Daniel J , Ariëns Robert AS , Ajjan Ramzi A , Campbell Matthew D 
Published: June 2022

Aims/Hypothesis We hypothesised that the detrimental effect of high glucose variability (GV) in people with type 1 diabetes is mainly evident in those with concomitant insulin resistance. Methods We conducted secondary analyses on continuous glucose monitoring (CGM) using baseline observational data from three randomised controlled trials and assessed the relationship with established vascular markers. We used standard CGM summary statistics and principal component analysis to generate individual glucose variability signatures for each participant. Cluster analysis was then employed to establish three GV clusters (low, intermediate, or high GV, respectively). The relationship with thrombotic biomarkers was then investigated according to insulin resistance, assessed as estimated glucose disposal rate (eGDR). Results Of 107 patients, 45%, 37%, and 18% of patients were assigned into low, intermediate, and high GV clusters, respectively. Thrombosis biomarkers (including fibrinogen, plasminogen activator inhibitor-1, tissue factor activity, and tumour necrosis factor-alpha) increased in a stepwise fashion across all three GV clusters; this increase in thrombosis markers was evident in the presence of low but not high eGDR and at a threshold of eGDR <5.1 mg/kg/min. Conclusion Higher GV is associated with increased thrombotic biomarkers in type 1 diabetes but only in those with concomitant insulin resistance.
Feasibility of the Complete Endovascular Reconstruction of the Trifurcation (CERT) Technique for Revascularisation in Chronic Limb Threatening Ischemia
Authors: Ritter Jens Carsten , Vo Uyen Giao , Moss Jana-Lee 
Published: June 2022

Background Revascularisation of patients with chronic limb threatening ischaemia due to arterial lesions in the below the knee segment can be challenging. This study describes a novel technique that allows a complete endovascular reconstruction of the trifurcation (CERT) utilising stents in the below the knee segment when conventional techniques are exhausted, or have failed to deliver an acceptable result, leading to remaining outflow compromise. Methods: Eight patients with Rutherford 5 chronic limb threatening ischaemia underwent CERT between January 1st, 2018 and January 1st, 2020. All patients underwent ultrasound at 6 weeks post operatively and then at variable intervals until the completion of the follow up period in March 2020. Results: Technical success of the CERT technique was achieved in all patients. Six patients had anterior tibial artery/Tibioperoneal trunk reconstructions, whilst 2 patients were stented directly into posterior tibial and peroneal artery. Five patients (63%) achieved wound healing. All-cause mortality was 25% (2 patients) with 1 patient achieving wound healing prior to death. Two stents were occluded during the follow up period. The first was asymptomatic and had achieved wound healing. The second was symptomatic with stent occlusion and a delayed presentation with Rutherford 3 acute limb ischaemia. Conclusions: Complete endovascular reconstruction of the trifurcation is a feasible option to achieve revascularisation in patients with tissue loss and below the knee arterial lesions allowing a continuous reconstruction of the trifurcation segment keeping the anatomical configuration intact. Clinical outcomes appear acceptable however larger series are needed.
The Prevalence of Depression and PTSD in Adults With Surgically Managed Traumatic Upper-Extremity Amputations
Authors: Cohen-Tanugi Samuel , Reid Risa , Loeffler Bryan J. , Gaston R. Glenn 
Published: June 2022

Background: Upper-extremity limb loss has been associated with serious psychological sequelae. Despite advancements in surgical procedures and prostheses for upper limb amputees, it is critical to recognize the psychosocial component of these patients’ care. Although the role of psychological factors in outcomes is increasingly acknowledged, little is known about the prevalence of depression and post-traumatic stress disorder (PTSD) in the civilian population after traumatic upper-extremity amputation. Methods: In this retrospective observational single-center study, adult patients evaluated for traumatic upper limb amputations from 2016 to 2019 completed the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Visual Analogue Scale, the Center for Epidemiologic Studies Depression Scale, and the Primary Care PTSD Screen during visits. All data underwent descriptive statistical analysis. Results: Thirty-nine adult patients treated for upper-extremity traumatic amputation completed patient-reported outcomes (PROs) questionnaires. The median final follow-up time for our cohort was 17 months from amputation. Twenty patients (51%) screened positive for depression and 27 (69%) for PTSD during follow-up. The median time from amputation to first positive screening was 6.5 months for depression and 10 months for PTSD. The physical component score of Veterans RAND 12-Item Health Survey (VR-12) was significantly worse for patients with depression. The Median DASH and mental component score of VR-12 were significantly worse for patients with PTSD. Conclusion: Upper-extremity limb loss has a significant impact on mental health, which in turn affects PROs. The high prevalence of depression and PTSD in traumatic upper-extremity amputees underscores the necessity for screening and multidisciplinary treatment.
Improving the tolerability of osimertinib by identifying its toxic limit
Authors: Agema Bram C. , Veerman G. D. Marijn , Steendam Christi M. J. , Lanser Daan A. C. , Preijers Tim , van der Leest Cor , Koch Birgit C. P. , Dingemans Anne-Marie C. , Mathijssen Ron H. J. , Koolen Stijn L. W. 
Published: June 2022

Background: Osimertinib is the cornerstone in the treatment of epidermal growth factor receptor-mutated non-small cell lung cancer (NSCLC). Nonetheless, ±25% of patients experience severe treatment-related toxicities. Currently, it is impossible to identify patients at risk of severe toxicity beforehand. Therefore, we aimed to study the relationship between osimertinib exposure and severe toxicity and to identify a safe toxic limit for a preventive dose reduction. Methods: In this real-life prospective cohort study, patients with NSCLC treated with osimertinib were followed for severe toxicity (grade ⩾3 toxicity, dose reduction or discontinuation, hospital admission, or treatment termination). Blood for pharmacokinetic analyses was withdrawn during every out-patient visit. Primary endpoint was the correlation between osimertinib clearance (exposure) and severe toxicity. Secondary endpoint was the exposure–efficacy relationship, defined as progression-free survival (PFS) and overall survival (OS). Results: In total, 819 samples from 159 patients were included in the analysis. Multivariate competing risk analysis showed osimertinib clearance ( c.q. exposure) to be significantly correlated with severe toxicity (hazard ratio 0.93, 95% CI: 0.88–0.99). An relative operating characteristic curve showed the optimal toxic limit to be 259 ng/mL osimertinib. A 50% dose reduction in the high-exposure group, that is 25.8% of the total cohort, would reduce the risk of severe toxicity by 53%. Osimertinib exposure was not associated with PFS nor OS. Conclusion: Osimertinib exposure is highly correlated with the occurrence of severe toxicity. To optimize tolerability, patients above the toxic limit concentration of 259 ng/mL could benefit from a preventive dose reduction, without fear for diminished effectiveness.
Assessments of a novel digital follow-up tool Rehabkompassen® to identify rehabilitation needs among stroke patients in an outpatient setting
Authors: Hu Xiaolei , Jonzén Karolina , Karlsson Marcus , Lindahl Olof A 
Published: June 2022

Introduction It remains a huge challenge to identify individual rehabilitation needs in a time-efficient manner for providing patient-tailored rehabilitation during the continuum of stroke care. We have recently demonstrated the usefulness of a paper-version Rehab-Compass as a follow-up tool. The aim of the current study was to develop a digital version of the Rehab-Compass and evaluate its usability and feasibility. Methods The novel digital tool Rehabkompassen® was developed by an iterative and participatory design process. Patients’ rehabilitation needs were visualized by the tool and used before, during, and after the consultation. The usability and feasibility of the tool was assessed by task completion rate, the System Usability Scale, and satisfaction questionnaires among 2 physicians and 24 adult stroke patients in an outpatient clinical setting. Results Rehabkompassen® identified and graphically visualized a panoramic view of the stroke patients’ multidimensional needs in individual- and group levels. The instrument appeared to be feasible and time efficient in clinical use with a 100% overall task completion rate for both patients and physicians. A majority of the patients reported that it was very easy or fairly easy to answer the digital questionnaires and to understand their own digital Rehab-Compass graph. Two physicians reported a high mean score on the System Usability Scale (95/100) and were positive about using the tool in the future. Conclusions The current results indicated that Rehabkompassen® was a feasible, useful, and time-saving follow-up tool for the identification of rehabilitation needs among stroke survivors in the post-acute continuum of care after stroke. Further research is needed to evaluate the efficacy of the digital instrument among stroke patients.