bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complete androgen blockade vs. medical castration alone as adjuvant androgen deprivation therapy for prostate cancer patients following radical prostatectomy: a retrospective cohort study
Authors: Jin Di , Jin Kun , Chen Bo , Zhou Xianghong , Yuan Qiming , Zhang Zilong , Wei Qiang , Qiu Shi 
Published: March 2022

Abstract

Background:
Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).

Methods:
Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.

Results:
A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR] = 1.07, 95% confidence intervals [95% CI] = 0.60–1.90, P = 0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction = 0.0247, HR = 0.37, 95% CI = 0.14–1.00, P = 0.0497).

Conclusion:
Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.
CD5+ Gamma Delta T-Cell Lymphoproliferative Disorder/Lymphoma Without Cytotoxic Granules in the Skin
Authors: Ju Jennifer Y. , Sorensen Eric P. , Walsh John S. , Shinohara Michi M. , Naresh Kikkeri N. 
Published: March 2022

Abstract:
We report a case of an unusual and aggressive gamma delta T-cell lymphoproliferative disorder/lymphoma presenting in the skin that lacked the expected cytotoxic markers and had increased expression of CD5, CD20, CD79a, CD30, and PD-1 without CD56. Monoclonal TCR-γ gene rearrangement was identified. A computed tomography scan of the chest, abdomen, and pelvis revealed a 7.7-cm soft-tissue inguinal mass and prominent retroperitoneal and pelvic lymphadenopathy, without hepatosplenomegaly. Flow cytometry finding on peripheral blood was normal. The clinical, morphologic, and immunophenotypic features of this case defy the current World Health Organization and European Organization for Research and Treatment of Cancer classifications, and a similar case has not been reported previously.
Effects of Supervised Exercise Training on Atrial Fibrillation
Authors: Oesterle Adam , Giancaterino Shaun , Van Noord Megan G. , Pellegrini Cara N. , Fan Dali , Srivatsa Uma N. , Amsterdam Ezra A. 
Published: March 2022

Purpose:
Atrial fibrillation (AF) is associated with the comorbidities of a sedentary lifestyle. Endurance athletes also show an increased incidence of AF. The role of exercise in the treatment of AF is unknown so this study aimed to examine the effects of supervised exercise on AF.

Methods:
A meta-analysis of randomized controlled trials (RCTs) examining supervised exercise training in participants with AF was performed. The primary outcome was AF recurrence and burden. Secondary outcomes included AF symptoms, quality of life, and cardiorespiratory fitness (CRF).

Results:
Thirteen RCTs, involving 1155 participants, were included. Paroxysmal AF was present in 34% and persistent AF in 64%. The types of exercise were diverse and included cardiac rehabilitation (64%), aerobic training (7%), Qi Gong (4%), interval training (11%), and yoga (15%). Exercise training reduced AF recurrence (relative risk = 0.77: 95% CI, 0.60–0.99), improved quality of life in 5 of the 10 components of the Short Form 36 survey, and improved CRF (standardized mean difference [SMD] = 0.56: 95% CI, 0.27–0.85). The AF burden was reduced only in studies that included continuous ambulatory monitoring (SMD =−0.49: 95% CI, −0.96 to −0.01) but not when all studies were included (SMD =−0.12: 95% CI, −0.61 to 0.38). There was no difference in adverse events between exercise and control.

Conclusions:
Supervised exercise training is safe, reduces AF recurrence, and improves quality of life and CRF in participants with AF. Further large RCTs with ambulatory monitoring and robust exercise regimens are needed to assess the effects of exercise training on AF burden and AF symptoms.
Very Low Risk for In-hospital Adverse Outcome Such as ST-elevation or Non-ST-elevation Myocardial Infarction in Patients Undergoing Knee Surgery
Authors: Talle Armin , Hashemzadeh Mehrtash , Movahed Mohammad Reza 
Published: March 2022

Background:
Knee surgery is a very common surgery. The risk of cardiac events is thought to be low. The goal of this study was to evaluate inpatients adverse outcomes such as ST-elevation myocardial infarction (STEMI) or Non-ST-elevation myocardial infarction in patients undergoing knee surgery.

Method:
Using the nation inpatient sample database, we evaluated the occurrence of STEMI and Non-STEMI in a very large population.

Results:
Using 2 random samples from 2005 to 2014, 10 years apart involving 7444 knee surgeries, the occurrence of STEMI and Non-STEMI were very low. In 2005, only 1 STEMI (0.0%) and 4 non-STEMI (0.1%) events occurred in inpatient knee-surgery patients. In the 2014 group, 0 STEMI (0.0%) and 5 non-STEMI (0.16%) events occurred in inpatient knee-surgery patients. Overall, STEMI or non-STEMI events occurred in 0.13% of inpatient knee-surgery procedures.

Conclusions:
Inpatients’ adverse outcome of patients undergoing knee surgery is very low suggesting that extensive cardiac workup for knee surgery may not be warranted.
CLINICAL FEATURES OF RETINAL METASTASES
Authors: Gascon Pierre , Matet Alexandre , Gualino Vincent , Denis Danièle , Nguyen Anh-Minh , Papegaey Maxence , Levy Natanael , Arnould Thomas , Kodjikian Laurent , Mathis Thibaud 
Published: March 2022

Purpose:
To report a cohort of patients diagnosed with retinal metastases (RM), and to integrate these new cases in a systematic review of the literature, analyzing the clinical features and prognosis factors of patients with RM.

Methods:
We conducted a retrospective multicenter study including patients with RM. We also performed a full literature review of all published cases with a diagnosis of RM.

Results:
A total of six new cases were described on multimodal imaging. By combining the data from the literature and from our patients, we report the characteristics of a total of 69 patients. The most frequent primary tumor sites were cutaneous melanoma (36%), lung (23%), gastrointestinal tract (17%), and breast (12%). Multimodal imaging highlighted specific characteristics of RM. Fluorescein and indocyanine green angiography revealed early hypofluorescence followed by progressive filling of intrinsic dilated vessels. Optical coherence tomography demonstrated a hyperreflective intraretinal mass in all cases with or without subretinal fluid, hyperreflective intraretinal dots, or intraretinal fluid. Ultrasonography revealed a medium-high reflective dome-shaped tumor. Fifty-nine percent of the patients died during the follow-up with a mean survival time of 8.8 ± 8.7 months.

Conclusion:
We described here the clinical spectrum of RM and highlighted specific features of the disease.
Development and Validity Testing of an Assessment Tool for Oncofertility Barriers in Multidisciplinary Healthcare Providers on the Breast Cancer Team
Authors: HUANG Sheng-Miauh , LAI Jerry Cheng-Yen , LI Chin-Ching , CHEN Ping-Ho , LIEN Pei-Ju , LIEN Ching-Ting 
Published: March 2022

ABSTRACT

Background
Multidisciplinary healthcare providers, especially clinical nurses, lack a valid tool to assess the comprehensive barriers affecting oncofertility care in breast cancer treatment.

Purpose
The aims of the research were to develop a self-assessment scale on oncofertility barriers and test its validity and reliability.

Methods
This was a methodological study. The initial 36 items of the developed Oncofertility Barrier Scale (OBS) were generated through qualitative study and a review of the literature. This scale was further refined using expert validity (n = 10), face validity (n = 10), and item analysis (n = 184). Exploratory factor analysis with principal axis factoring and direct oblimin rotation was used to determine the construct validity. The reliability of the OBS was evaluated using internal consistency and test–retest analyses.

Results
The mean item-level and scale-level content validity indices of the initial OBS were higher than .96. The data were shown to be feasible for the factor analysis, and a six-factor solution was chosen that accounted for approximately 57.6% of the total variance. These factors included (a) lack of information and education, (b) rigid thinking toward oncofertility care, (c) cancer patient stereotypes, (d) fertility risk, (e) insufficient support, and (f) interrupted oncofertility care. The Cronbach’s alpha of the 27-item OBS was .91, and the test–retest reliability coefficient was .55.

Conclusions/Implications for Practice
The final version of the developed OBS has acceptable reliability, content validity, and construct validity. This scale is appropriate for use in research and clinical practice settings to identify the barriers to fertility cancer care that should be resolved by the breast cancer care team.
Health-Related Quality of Life Trajectories Among Older Adults With Diabetes Mellitus: A Group-Based Modeling Approach
Authors: PARK Sunhee , PARK Chang Gi , LEE Taewha 
Published: March 2022

ABSTRACT

Background
Health-related quality of life (HR-QoL) is an important issue among older adults with diabetes mellitus. However, information on longitudinal changes in HR-QoL over time using the illness trajectory model is limited.

Purpose
The purpose of this study was to identify patterns of temporal change in HR-QoL and their predictors using longitudinal data and a group-based modeling approach.

Methods
European Quality of Life–5 Dimensions data for 440 older adults with diabetes mellitus were drawn from the nationwide Korea Health Panel Survey conducted from 2009 to 2013. Latent class growth analysis and multinomial logistic regression models were used to identify the predictors of HR-QoL trajectories.

Results
Four distinct classes of HR-QoL trajectory were identified: high decrease (n = 46, 10.5%), high stable (n = 232, 52.7%), medium stable (n = 157, 35.7%), and low increase (n = 5, 1.1%). Participants in ``high decrease” and ``high-stable” classes tended to be men who were highly educated, physically active, and adherent to their medication regimen. High economic status, few chronic diseases, independence in activities of daily living, and high self-rated health status were also identified as indicators of being in the ``high-decrease” and ``high-stable” class group.

Conclusions/Implications for Practice
A salient finding of this study is that HR-QoL trajectories in older adults with diabetes mellitus are not homogeneous but instead diverge into four distinct classes. Most participants showed no major changes in HR-QoL across the 5-year period, regardless of HR-QoL level. To prevent patients with diabetes from experiencing chronically low levels of HR-QoL, comprehensive assessment and individualized care based on HR-QoL are necessary.
Evaluation of an Intensive Care Outreach Nurse Program in 4 UAE Hospitals
Authors: Williams Ged , Du Plessis Jean , Rotering Loralee , Samuel Asha , Abdel Khaleq Maher Husni , Sweeny Amy 
Published: March 2022

Background:
Intensive care outreach nurses (ICONs) can reduce deterioration and death of patients in hospitals.

Purpose:
Evaluate outcomes associated with implementation of the ICON role across 4 UAE hospitals.

Methods:
Trend analyses and χ2 tests were used to measure changes before ICON program, during ICON year 1, ICON year 2, when the service coverage extended 24/7, and until the end of 2019.

Results:
From year 1 to year 2, failures to escalate decreased from a rate of 14.8 to 5.6 episodes per 1000 admissions for all sites combined (P < .001). The cardiac arrest rate went from 4.04 to 1.42 per 1000 admissions in year 2 and continued downward to 0.72 per 1000 (P < .001). Transfer from ward or readmission to intensive care unit/high dependency unit varied by site, although there was a statistically significant trend for all hospitals combined.

Conclusion:
The ICON role contributed to fewer failure to escalate incidents and lower cardiac arrest rates.
Variation in Prehospital Protocols for Pediatric Respiratory Distress Management in the United States
Authors: McCans Kerry , Varma Selina , Ramgopal Sriram , Martin-Gill Christian , Owusu-Ansah Sylvia 
Published: March 2022

Objective
This study aimed to compare statewide emergency medical services protocols for the management of pediatric respiratory distress.

Methods
We performed a descriptive study of emergency medical services protocols for the management of pediatric respiratory distress in the United States, excluding those without model or mandatory protocols. We compared medication recommendations for specific disease processes, including asthma, croup, epiglottitis, anaphylaxis, generalized respiratory distress, intubation, and drug assisted intubation.

Results
Thirty-four state protocols were included. All had protocols to address the management of pediatric respiratory distress. There was high agreement in albuterol use for bronchospasm and epinephrine use in anaphylaxis. Epinephrine was recommended in all anaphylaxis protocols, 27 croup protocols (79%), and 3 epiglottitis protocols (9%). Six states (18%) called for albuterol in patients with generalized respiratory distress. Steroid recommendations and indications had variance among states; 26 states (76%) allowed steroid use in patients with asthma, 19 states (56%) recommended steroid use in anaphylaxis, and 11 (32%) recommended steroid use in croup protocols. The route for steroid administration also varied among protocols. Five states (15%) allowed continuous positive airway pressure application in pediatric patients, whereas endotracheal intubation and rapid sequence intubations had varying requirements as well as recommendations for use. Twelve (35%) listed impending or current respiratory failure as an indication, whereas other states had specific markers, such as Glasgow Coma Scale or oxygen saturation, as indications.

Conclusions
All included states had specific recommendations for the management of pediatric respiratory distress. There was consistency in recommendations for albuterol use for wheezing and epinephrine use for anaphylaxis. However, there was wide variability in other uses for epinephrine, steroid administration, continuous positive airway pressure use, and specific treatments for croup and epiglottitis. The findings of this study provide a base for important future evidence-based protocol developments and changes in prehospital pediatric respiratory distress treatment.
Assault-Related Concussion in a Pediatric Population
Authors: Means Margaret J. , Myers Rachel K. , Master Christina L. , Arbogast Kristy B. , Fein Joel A. , Corwin Daniel J. 
Published: March 2022

ObjectivesThe aim of this study was to compare demographic characteristics, medical care, and outcomes among patients with assault-related concussion (ARC) versus sports and recreation–related concussion (SRC).MethodsWe conducted a retrospective chart review of 124 patients (62 ARC, 62 SRC) aged 8 to 17 years presenting to the care network of a large tertiary care pediatric hospital between July 1, 2012, and June 30, 2014 with a concussion diagnosis at time of presentation. We abstracted patient demographics, initial medical care visit characteristics, and outcome data, and compared proportions using χ2testing and Fisher exact test and medians using Wilcoxon rank sum test.ResultsPatients with ARC were more likely to be Black, publicly insured, and present first for care to the emergency department. Significantly fewer patients with ARC received visio-vestibular testing at initial visit (27% vs 74%,P< 0.001). During recovery, the total number of reported physical, cognitive, emotional, and sleep symptoms did not differ between groups; however, more than twice as many patients with ARC reported decline in grades postinjury compared with patients with SRC (47% vs 20%,P= 0.012). There were trends toward prolonged symptom recovery and time to physician clearance for full return to activities among patients with ARC compared with SRC.ConclusionsThis study highlights potential disparities in the initial evaluation and outcomes of pediatric concussion patients based on mechanism of injury. Patients with ARC were less likely to receive a concussion-specific diagnostic evaluation and reported a greater impact on educational outcomes, suggesting differences in concussion diagnosis and management among assault-injured patients. Further examination in larger populations with prospective studies is needed to address potential inequities in concussion care and outcomes among patients with ARC.
Accumulation of 99mTc-DTPA in Lumbar Tuberculosis
Authors: Yin Hongyan , Yu Haojun , Shi Dai , Lv Jing , Shi Hongcheng 
Published: March 2022

Abstract
A 70-year-old woman with lumbar and renal tuberculosis underwent 99mTc-DTPA renal scintigraphy to evaluate renal function before lumbar lesion resection and nephrectomy. The images incidentally identified a focus of abnormal DTPA activity in the midline of the abdomen, which corresponded to lumbar tuberculosis revealed by CT images. Subsequent pathology after the resection of the lesions was consistent with lumbar and renal tuberculosis.
Dimethyl malonate slows succinate accumulation and preserves cardiac function in a swine model of hemorrhagic shock
Authors: Taghavi Sharven , Abdullah Sarah , Toraih Eman , Packer Jacob , Drury Robert H. , Aras Oguz A.Z. , Kosowski Emma M. , Cotton-Betteridge Aaron , Karim Mardeen , Bitonti Nicholas , Shaheen Farhana , Duchesne Juan , Jackson-Weaver Olan 
Published: March 2022

BACKGROUND
Succinate (SI) is a citric acid cycle metabolite that accumulates in tissues during hemorrhagic shock (HS) due to electron transport chain uncoupling. Dimethyl malonate (DMM) is a competitive inhibitor of SI dehydrogenase, which has been shown to reduce SI accumulation and protect against reperfusion injury. Whether DMM can be therapeutic after severe HS is unknown. We hypothesized that DMM would prevent SI buildup during resuscitation (RES) in a swine model of HS, leading to better physiological recovery after RES.

METHODS
The carotid arteries of Yorkshire pigs were cannulated with a 5-Fr catheter. After placement of a Swan-Ganz catheter and femoral arterial line, the carotid catheters were opened and the animals were exsanguinated to a mean arterial pressure (MAP) of 45 mm. After 30 minutes in the shock state, the animals were resuscitated to a MAP of 60 mm using lactated ringers. A MAP above 60 mm was maintained throughout RES. One group received 10 mg/kg of DMM (n = 6), while the control received sham injections (n = 6). The primary end-point was SI levels. Secondary end-points included cardiac function and lactate.

RESULTS
Succinate levels increased from baseline to the 20-minute RES point in control, while the DMM cohort remained unchanged. The DMM group required less intravenous fluid to maintain a MAP above 60 (450.0 vs. 229.0 mL; p = 0.01). The DMM group had higher pulmonary capillary wedge pressure at the 20-minute and 40-minute RES points. The DMM group had better recovery of cardiac output and index during RES, while the control had no improvement. While lactate levels were similar, DMM may lead to increased ionized calcium levels.

DISCUSSION
Dimethyl malonate slows SI accumulation during HS and helps preserve cardiac filling pressures and function during RES. In addition, DMM may protect against depletion of ionized calcium. Dimethyl malonate may have therapeutic potential during HS.
When and where to count? Implications of migratory connectivity and non-breeding distribution to population censuses in a migratory bird population
Authors: Piironen Antti , Fox Anthony D. , Kampe-Persson Hakon , Skyllberg Ulf , Therkildsen Ole Roland , Laaksonen Toni 
Published: March 2022

AbstractMigratory connectivity is a metric of the co-occurrence of migratory animals originating from different breeding sites, and like their spatio-temporal distributions, can vary substantially during the annual cycle. Together, both these properties affect the optimal times and sites of population censusing.We tracked taiga bean geese(Anser fabalis fabalis)during 2014–2021 to study their migratory connectivity and non-breeding movements, and determine optimal periods to assess the size of their main flyway population. We also compared available census data with tracking data, to examine how well two existing censuses covered the population.Daily Mantel’s correlation between breeding and non-breeding sites lay between 0 and 0.5 during most of the non-breeding season, implying birds from different breeding areas were not strongly separated other times in the annual cycle. However, the connectivity was higher among birds from the westernmost breeding areas compared to the birds breeding elsewhere. Daily Minimum Convex Polygons showed tracked birds were highly aggregated at census times, confirming their utility. The number of tracked birds absent at count sites during the censuses however exceeded numbers double-counted at several sites, indicating that censuses might have underestimated the true population size.Our results show that connectivity can vary in different times during the non-breeding period, and should be studied throughout the annual cycle. Our results also confirm previous studies, which have found that estimates using marked individuals usually produce higher population size estimates than total counts. This should be considered when using total counts to assess population sizes in the future.
Identification of protein aggregates in the aging vertebrate brain with prion-like and phase separation properties
Authors: Harel Itamar , Chen Yiwen R. , Ziv Inbal , Singh Param Priya , Negredo Paloma Navarro , Goshtchevsky Uri , Wang Wei , Astre Gwendoline , Moses Eitan , McKay Andrew , Machado Ben E. , Hebestreit Katja , Yin Sifei , Alvarado Alejandro Sánchez , Jarosz Daniel F. , Brunet Anne 
Published: March 2022

SUMMARYProtein aggregation, which can sometimes spread in a prion-like manner, is a hallmark of neurodegenerative diseases. However, whether prion-like aggregates form during normal brain aging remains unknown. Here we use quantitative proteomics in the African turquoise killifish to identify protein aggregates that accumulate in old vertebrate brains. These aggregates are enriched for prion-like RNA binding proteins, notably the ATP-dependent RNA helicase DDX5. We validate that DDX5 forms mislocalized cytoplasmic aggregates in the brains of old killifish and mice. Interestingly, DDX5’s prion-like domain allows these aggregates to propagate across many generations in yeast. In vitro, DDX5 phase separates into condensates. Mutations that abolish DDX5 prion propagation also impair the protein’s ability to phase separate. DDX5 condensates exhibit enhanced enzymatic activity, but they can mature into inactive, solid aggregates. Our findings suggest that protein aggregates with prion-like properties form during normal brain aging, which could have implications for the age-dependency of cognitive decline.