bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intensive care unit requirements in patients treated with immune checkpoint inhibitors
Authors: Cooksley Tim , Weaver Jamie M J , Haji-Michael Phil 
Published: November 2022

Summary

Objective
To determine the proportion of emergency patients treated with immune checkpoint inhibitors (ICIs) that require critical care admission and their requirements.

Design
Prospective case series.

Methods
Analysis of acutely unwell patients treated with ICIs attending a tertiary UK cancer hospital between May 2018 and May 2022. The primary outcome measure was the percentage of patients treated with ICI therapy requiring ICU admission. The secondary outcome measure was whether this need was driven by an immune-mediated toxicity.

Results
Eighteen (1.2%) patients of the 1561 acutely admitted patients treated with ICI therapy required an admission to ICU. Ten (55.5%) patients were admitted due to an immune-mediated toxicity; four due to pneumonitis and four due to myasthenia gravis. Seven of 10 survived their ICU admission with 6 surviving at least 6-month post-ICU discharge.

Conclusions
Only a small minority of emergency admissions in patients treated with ICIs require admission to ICU. This series adds further evidence that patients with organ failure due to immune-mediated toxicity may achieve good outcomes from ICU admission.
ESTIMATION OF FETAL AND PEDIATRIC DOSES FROM CHEST CT EXAMINATIONS USING VIRTUALDOSE SOFTWARE
Authors: Ye Zirui , Qi Miao , Zhao Yingming , Wei Wei , Xu X George 
Published: November 2022

Abstract
Pregnant women and children sometimes had to undergo chest computed tomography (CT) scans during the Corona Virus Disease 2019 (COVID-19) pandemic. This study estimated the fetal and pediatric doses from chest CT scans. Organ doses and effective doses were calculated using the VirtualDose-CT software. Two groups of computational human phantoms, pregnant females and pediatric patients were used in this study. The results of doses normalized to volumetric CT Dose Index (CTDIvol) can be used universally for other dosimetry studies. Based on our calculations and international survey data of CTDIvol, fetal absorbed doses from COVID-19-related chest CT were found to be 0.04–0.36, 0.05–0.44 and 0.07–0.61 mGy for 3, 6 and 9 months of pregnancy, respectively. When the scan range is extended to the abdominal region, fetal doses increase by almost 4-fold. Effective doses for COVID-19-related chest CT were 1.62–13.77, 1.58–13.46, 1.57–13.33 and 1.29–10.98 mSv for the newborn, 1-, 5- and 10-y-old children, respectively. In addition, the effects of specific axial scan ranges exceeding the thorax region were evaluated. Although doses from chest CT scans are small, such data allow radiologists and patients to be informed of the dose levels and ways to avoid unnecessary radiation.
Biological properties of different extracts of the Kalanchoe daigremontiana (‘Mother of thousands’): a review
Authors: Carreiro Faustino Denise , das Chagas Lima Naiara Nascimento , James Allahdadi Kyan , Cedraz Pinto Laise 
Published: November 2022

AbstractObjectivesKalanchoe daigremontiana (KD) is a succulent plant with widespread popular use as an anticancer and for the treatment of a variety of other diseases. The presence of bufadienolides (BFD), a cardiotoxic compound and other substances may justify some of its biological properties, however, clinical studies and toxicity and safety data are still scarce. The objective of this systematic review was to describe KD’s biological properties and mechanisms, as well as its toxicity. Searches were performed in four databases with the descriptors: ‘kalanchoe daigremontiana’ AND ‘cytotoxicity’, ‘antioxidant’ OR ‘anti-inflammatory’ OR ‘toxicity’. In total, 11 studies were included according to the PRISMA 2020 protocol.Key findingsThe aqueous and ethanolic extracts of KD showed important antioxidant and anti-inflammatory activity, associated with the presence of flavonoids and phenols in the extracts. The extracts from fractions that were rich in BFD or dichloromethane showed anticancer (related to inhibition of mitochondrial dehydrogenase activity and reduction of glutathione level) and anticoagulant actions (due to reduced fibrin clot formation and increased degradation).SummaryMore studies are still needed to demonstrate the concentration limits for beneficial effects and the toxic limitations of this species, until then, cautious use and consumption of KD is recommended.
The case for standalone micro-invasive glaucoma surgery: rethinking the role of surgery in the glaucoma treatment paradigm
Authors: Radcliffe Nathan 
Published: November 2022

Purpose of review
To highlight progress in glaucoma therapy challenging the traditional medication-first approach and present evidence supporting early standalone surgery in the era of micro-invasive glaucoma surgery (MIGS).

Recent findings
Medical therapy is limited by well documented poor adherence that compromises the quality of intraocular pressure reduction. Results from modern clinical trials demonstrate advantages of selective laser trabeculoplasty and MIGS procedures in terms of both IOP control and progression risk.

Summary
The MIGS options for pseudophakic or precataractous patients are limited by regulatory rules that require the performance of some procedures only at the time of cataract surgery. These include the iStent/iStent Inject and the Hydrus implants. Nonbleb-forming procedures currently available for standalone use in eyes with mild–moderate primary open-angle glaucoma include gonioscopy-assisted transluminal trabeculotomy (which lowers IOP by 28-61% and medication use by 38–73% in various studies), trabecular ablation with the Trabectome (23–39% and 21–43%, respectively), excisional goniotomy with the Kahook Dual Blade (15–36% and 15–40%, respectively), ab interno canaloplasty (35% and 57%, respectively), and combined canaloplasty and trabeculotomy using the OMNI system (39–40% and 64–73%, respectively). For patients who would benefit from early standalone surgery, these procedures offer meaningful reductions in both IOP and medication burden.
Risk Factors for 30-Day Mortality in Neonates With Carbapenem-resistant A. baumannii Sepsis
Authors: Phatigomet Manapat , Thatrimontrichai Anucha , Maneenil Gunlawadee , Dissaneevate Supaporn , Janjindamai Waricha 
Published: November 2022

Background:
Carbapenem-resistant Acinetobacter baumannii (CRAB) sepsis is becoming an extreme threat caused by high-case fatality rates and poor prevention and control in ICUs worldwide. However, the risk of mortality among neonatal CRAB sepsis is still unclear.

Methods:
A retrospective medical records review study, which aimed to identify the risk factors of mortality in neonates with CRAB sepsis (including both bacteremia and/or meningitis) in Thailand from 1996 to 2019. All cases featuring positive blood and cerebrospinal fluid cultures for CRAB were reviewed. A multivariable logistic regression model was analyzed for nonsurvivors and survivors of neonatal CRAB sepsis.

Results:
In a 24-year period, 47 of these were identified with CRAB sepsis. The median (interquartile range) gestational age and birth weight were 30 (28–35) weeks and 1500 (933–2482) g, respectively. The 30-day case fatality rate was 55% (26/47). In multivariable analysis, nonsurvivors of neonatal CRAB sepsis were associated with congenital heart disease (adjusted odds ratio [OR] = 1.33; 95% CI 1.06–1.66, P = 0.02), CRIB II score ≥9 (adjusted OR = 1.65; 95% CI: 1.20–2.27, P = 0.004), severe thrombocytopenia (adjusted OR = 1.45; 95% CI: 1.09–1.94, P = 0.02), and septic shock (adjusted OR = 1.62; 95% CI: 1.33–1.99, P <0.001).

Conclusion:
The risk factors of mortality in neonates with CRAB sepsis are associated with congenital heart disease, CRIB II score ≥9, shock, and severe thrombocytopenia.
Tolerability and efficacy of duloxetine for the prevention of persistent musculoskeletal pain after trauma and injury: a pilot three-group randomized controlled trial
Authors: Beaudoin Francesca L. , Gaither Rachel , DeLomba Weston C. , McLean Samuel A. 
Published: November 2022

Abstract
This study investigated the tolerability and preliminary efficacy of duloxetine as an alternative nonopioid therapeutic option for the prevention of persistent musculoskeletal pain (MSP) among adults presenting to the emergency department with acute MSP after trauma or injury. In this randomized, double-blind, placebo-controlled study, eligible participants (n = 78) were randomized to 2 weeks of a daily dose of one of the following: placebo (n = 27), 30 mg duloxetine (n = 24), or 60 mg duloxetine (n = 27). Tolerability, the primary outcome, was measured by dropout rate and adverse effects. Secondary outcomes assessed drug efficacy as measured by (1) the proportion of participants with moderate to severe pain (numerical rating scale ≥ 4) at 6 weeks (pain persistence); and (2) average pain by group over the six-week study period. We also explored treatment effects by type of trauma (motor vehicle collision [MVC] vs non-MVC). In both intervention groups, duloxetine was well tolerated and there were no serious adverse events. There was a statistically significant difference in pain over time for the 60 mg vs placebo group (P = 0.03) but not for the 30 mg vs placebo group (P = 0.51). In both types of analyses, the size of the effect of duloxetine was larger in MVC vs non-MVC injury. Consistent with the role of stress systems in the development of chronic pain after traumatic stress, our data indicate duloxetine may be a treatment option for reducing the transition from acute to persistent MSP. Larger randomized controlled trials are needed to confirm these promising results.
Association of female sex with increased risk of sleep disturbance in adult patients with moderate to severe psoriasis: a Chinese cross-sectional study
Authors: Tan Min-Jia , Luo Yan , Hu Jing-Jin , Wang Mi , Wang Qiao-Lin , Xu Li-Cong , Hu Kun , Li Xing-Yu , Yang Jing , Chen Jun-Chen , Kuang Ye-Hong , Zhu Wu 
Published: November 2022

Objective:
Up to 85.3% of patients with psoriasis experience sleep disturbance (SD). However, SD has not been characterized in Chinese patients with psoriasis, and the factors that affect SD among adult patients with psoriasis remain unclear. This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis.

Methods:
This was a cross-sectional, questionnaire-based, case-control study involving 142 adult participants with psoriasis and 142 healthy controls. The Pittsburgh Sleep Quality Index (PSQI) was administered to assess SD. Mild psoriasis was defined by Psoriasis Area and Severity Index (PASI) and body surface area (BSA) cut-offs of <10, and mild to severe psoriasis was determined by PASI and BSA cut-offs of ≥10.

Results:
The prevalence of SD (PSQI score of ≥6) was 47.9% in adult patients with psoriasis. The mean PSQI score in patients with psoriasis was 6.1 ± 3.7, which was higher than that in the control group (4.9 ± 2.5, P < 0.001). The risk of SD in the psoriasis group was 1.669 times higher (adjusted odds ratio, 1.669; 95% confidence interval, 1.008–2.761; P = 0.046) than that in the healthy group. Female sex (adjusted odds ratio, 4.130; 95% confidence interval, 1.306–13.058; P = 0.016) was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis, whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis.

Conclusions:
Patients with psoriasis were more likely than healthy controls to develop SD. In patients with moderate to severe psoriasis, but not in those with mild psoriasis, female sex was associated with a higher likelihood of SD.
Updates in percutaneous tracheostomy and gastrostomy: should we strive for combined placement during one procedure?
Authors: DeMaio Andrew , Yarmus Lonny 
Published: November 2022

Purpose of review
Percutaneous tracheostomy and gastrostomy are minimally invasive procedures among the most common performed in intensive care units. Practices across centres vary considerably, and questions remain about the optimal timing, performance and postoperative care related to these procedures.

Recent findings
The COVID-19 pandemic has triggered a reevaluation of the practice of percutaneous tracheostomy and gastrostomy in the ICU. Combined percutaneous tracheostomy and gastrostomy at the bedside has potential benefits, including improved nutrition, decreased exposure to anaesthetics, decreased patient transport and decreased hospital costs. Percutaneous ultrasound gastrostomy is a novel technique that eliminates the need for an endoscope that may allow intensivists to perform gastrostomy at the bedside.

Summary
Multidisciplinary care is essential to the follow up of critically ill patients receiving tracheostomy and gastrostomy. Combined tracheostomy and gastrostomy has numerous potential benefits to patients and hospital systems. Interventional pulmonologists are uniquely qualified to perform both procedures and serve on a tracheostomy and gastrostomy team.
The feedback cycles between glucose, amino acids and lipids and alpha cell secretion and their role in metabolic fatty liver disease
Authors: Winther-Sørensen Marie , Holst Jens J. , Wewer Albrechtsen Nicolai J. 
Published: November 2022

Purpose of review
Glucagon increases hepatic glucose production and in patients with metabolic diseases, glucagon secretion is increased contributing to diabetic hyperglycemia. This review explores the role of amino acids and lipids in the regulation of glucagon secretion and how it may be disturbed in metabolic diseases such as obesity and metabolic associated fatty liver disease (MAFLD).

Recent findings
Human and animal studies have shown that MAFLD is associated with glucagon resistance towards amino acid catabolism, resulting in elevated plasma levels of amino acids. A recent clinical study showed that MAFLD is also associated with glucagon resistance towards lipid metabolism. In contrast, MAFLD may not decrease hepatic sensitivity to the stimulatory effects of glucagon on glucose production.

Summary
Elevated plasma levels of amino acids and lipids associated with MAFLD may cause diabetogenic hyperglucagonemia. MAFLD and glucagon resistance may therefore be causally linked to hyperglycemia and the development of type 2 diabetes.
Parental Childhood Adversity and Pediatric Emergency Department Utilization
Authors: Weigert Rachel M. , McMichael Brianna S. , VanderVelden Heidi A. , Lee Daniel B. , Cutler Gretchen J. , Troy Mike F. , Bergmann Kelly R. 
Published: November 2022

Objectives
Adverse childhood experiences (ACEs) including physical, emotional, or sexual abuse; neglect; and/or exposure to household instability have been associated with adult emergency department utilization, but the impact of parental ACEs on pediatric emergency department (PED) utilization has not been studied. The primary aim was to determine if parental ACEs impact resource utilization as measured by (1) frequency of PED utilization, (2) acuity of PED visits, and (3) 72-hour PED return rates. The secondary aim was to determine if resilience interacts with the impact of parental ACEs on PED utilization.

Methods
This study is a cross-sectional survey using previously validated measures of ACEs, resiliency, and social determinants of health screening. Surveys were administered from October 17, 2019, to November 27, 2019, via iPad by research assistants in our institution's PEDs. Survey responses were linked to data abstracted from the electronic health record. Descriptive statistics were used to characterize our study population. Pearson correlation was used to identify correlation between ACEs, social determinants of health, and PED utilization measures.

Results
A total of 251 parents had complete data. Parental ACEs were positively associated with frequency of PED visits (incidence rate ratio, 1.013). In addition, high levels of parental resilience attenuated the association between parental ACEs and the number of severe acuity visits and were associated with fewer 72-hour return visits (incidence rate ratio, 0.49).

Conclusions
Parental ACEs appear to be positively associated with frequency of PED utilization and inversely associated with higher-acuity PED visits and parental resiliency.
Perioperative Hormone Management in Gender-Affirming Mastectomy: Is Stopping Testosterone Before Top Surgery Really Necessary?
Authors: Robinson Isabel S. , Rifkin William J. , Kloer Carmen , Parker Augustus , Blasdel Gaines , Shaker Nabeel , Zhao Lee C. , Bluebond-Langner Rachel 
Published: November 2022

BACKGROUND:
Gender-affirming mastectomy, or “top surgery,” has become one of the most frequently performed procedures for transgender and nonbinary patients. However, management of perioperative testosterone therapy remains controversial. Despite a lack of supporting evidence, many surgeons require cessation of testosterone prior to top surgery. This represents the first study to compare complication rates in patients undergoing gender-affirming mastectomy with and without discontinuation of perioperative testosterone.

METHODS:
Retrospective review identified patients undergoing top surgery by the senior author between 2017 and 2020. Reflecting a change in the senior author’s practice, prior to May 2019, all patients were required to discontinue testosterone prior to surgery, while all patients treated after this point continued their testosterone regimens throughout the perioperative period. Patients were stratified according to testosterone regimen and perioperative hormone management, with demographics and postoperative outcomes compared between groups.

RESULTS:
490 patients undergoing gender-affirming mastectomy during the study period were included. Testosterone was held perioperatively in 175 patients and continued in 211 patients, while 104 patients never received testosterone therapy. Demographics were similar between groups, and there was no difference in rates of hematoma (2.9% vs. 2.8% vs 2.9% respectively, p=0.99), seroma (1.1% vs. 0% vs 1%, p=0.31), venous thromboembolism (0% vs. 0.5% vs 0%, p=0.99), or overall complications (6.9% vs. 4.3% vs 5.8%, p=0.54).

CONCLUSIONS:
Our results demonstrate no difference in postoperative complication rates between groups. While further investigation is warranted, our data suggest that routine cessation of testosterone in the perioperative period is not necessary for patients undergoing gender-affirming mastectomy.
Delayed Cerebrospinal Fluid Leaks Complicating Endoscopic Orbital Surgeries
Authors: Yang Muyue , Ma Liang , Zhuang Ai 
Published: November 2022

Objective:
To report cerebrospinal fluid leak as an uncommon but noteworthy delayed complication after endoscopic orbital surgeries and to describe its incidence, mechanism, prevention, diagnosis, and management.

Methods:
Case series of 3 patients who underwent endoscopic orbital surgery in the Department of Ophthalmology, Shanghai Ninth People’s Hospital affiliated to Shanghai JiaoTong University School of Medicine from January 2003 to December 2020. A review of the literature was also conducted.

Results:
Three cases of delayed cerebrospinal fluid leaks occurred 10 years, 3 months, and 4 months after endoscopic orbital surgeries, respectively, were reviewed and reported. Two patients developed cerebrospinal fluid leaks after surgical repair of orbital blowout fractures with titanium mesh and porous polyethylene (Medpor), respectively, and 1 patient developed cerebrospinal fluid leak after transantral optic canal decompression. In the first case, head computed tomography (CT) cisternography and magnetic resonance imaging confirmed the site of the leak that required surgical repair. In the second case, a coronal CT showed that the implanted titanium mesh was tightly against the cribriform plate, which might cause defect of skull base and dura. In the third case, orbital CT identified a dehiscence on the sphenoidal wall as the leak site, which was repaired in a secondary endoscopic surgery.

Conclusions:
A cerebrospinal fluid leak, as an uncommon but noteworthy complication, can occur as delayed as 10 more years after surgery. For patients with specific anatomic characteristics, such as Kero type III, surgeons should perform meticulous preoperative evaluation and intraoperative procedures to prevent this complication.
Hepatitis E Virus Infection, a Risk for Liver Transplant Recipients in Sweden
Authors: Frankal Miriam , Skoglund Catarina , Castedal Maria , Lagging Martin , Norder Heléne 
Published: November 2022

Background.
Following exposure to hepatitis E virus (HEV), liver transplant (LT) recipients have an increased risk of developing chronic infection, which may rapidly progress to severe liver damage if not treated. The prevalence of HEV infection after LT is unclear and likely varies geographically. The aim of this study was to investigate the prevalence of acute and chronic HEV infection among LT recipients in an HEV endemic region.

Methods.
During 2013 to 2015, 109 of 152 prospectively enrolled patients listed for LT received a liver graft and completed the study protocol. They were evaluated for anti-HEV IgM, HEV IgG, and HEV RNA at the time of LT assessment and 3 and 12 mo post-LT. Medical records were reviewed.

Results.
Twelve (11%) LT recipients acquired markers of HEV infection during the study period. Seven patients (6%) had detectable HEV RNA, 1 before LT and 3 at the 3-mo and another 3 at the 12-mo follow-up post-LT. All resolved their infections without treatment and had undetectable HEV RNA at the succeeding follow-up. Another 5 (5%) patients developed anti-HEV antibodies without detectable HEV RNA as an indication of HEV infection during follow-up. Signs and symptoms of HEV infection were subtle‚ and none were diagnosed in routine clinical care.

Conclusion.
A substantial proportion of LT recipients in Sweden are at risk of acquiring HEV infection, both before and after LT. The results highlight the frequency of silent, spontaneously resolving HEV infections and do not support universal screening of LT recipients in Sweden, despite HEV being a potentially treatable infection.