bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Flow Duration and Outcomes of Extracorporeal Cardiopulmonary Resuscitation in Adults With In-Hospital Cardiac Arrest: A Nationwide Inpatient Database Study*
Authors: Ohbe Hiroyuki , Tagami Takashi , Ogura Takayuki , Matsui Hiroki , Yasunaga Hideo 
Published: October 2022

OBJECTIVES:
Although existing guidelines recommend commencing cannulation for extracorporeal cardiopulmonary resuscitation (ECPR) within 10–20 minutes of failed conventional resuscitation efforts for cardiac arrest, there is little supportive evidence. The present study aimed to determine the association of low-flow duration with survival-to-discharge rate in in-hospital cardiac arrest patients who received ECPR.

DESIGN:
A nationwide retrospective cohort study analyzed a nationwide inpatient database in Japan. Low-flow duration was defined as the time interval from initiation of chest compression to termination of chest compression. We assessed the association between low-flow duration and survival-to-discharge rate by predicting estimates with covariate adjustment stratified by categories of low-flow duration.

SETTING:
More than 1,600 acute-care hospitals in Japan.

PATIENTS:
All in-hospital cardiac arrest patients greater than or equal to 18 years old who received ECPR during hospitalization from July 2010 to March 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Among 303,319 in-hospital cardiac arrest patients, 9,844 (3.2%) received ECPR in 697 hospitals during the study period and 9,433 were eligible in the study. The overall survival-to-discharge rate was 20.5% (1,932/9,433). The median low-flow duration was 26.0 minutes (interquartile range, 12.0–46.0 min) in the overall cohort. The highest and lowest estimated survival-to-discharge rates were 35.1% in the group with low-flow duration 0–5 minutes and 7.9% in the group with low-flow duration greater than 90 minutes. The estimated survival-to-discharge rate dropped sharply by about 20% during the first 35 minutes of low-flow duration (decreasing by about 3% every 5 min), followed by small decreases after the first 35 minutes.

CONCLUSIONS:
The estimated survival-to-discharge rate was markedly decreased by approximately 20% during the first 35 minutes of low-flow duration. Whether we should wait for the first 10–20 minutes of cardiac arrest without preparing for ECPR is questionable.
Contribution of cyclooxygenase-2 overexpression to enhancement in tonically active glutamatergic inputs to the rostral ventrolateral medulla in hypertension
Authors: Fan Jie-Fu , Wang Wen , Tan Xing , Ye Peng , Li Ji-Kui , Niu Lu-Yu , Li Wan-Yang , Wang Wei-Zhong , Wang Yang-Kai 
Published: October 2022

Objective:
Cyclooxygenase (COX) is critical in regulating cardiovascular function, but its role involved in the central control of blood pressure (BP) is uncovered. The tonic glutamatergic inputs to the rostral ventrolateral medulla (RVLM) are enhanced in hypertension. Here, the present study was designed to investigate the effect and mechanism of central COX on tonic glutamatergic inputs to the RVLM and BP regulation.

Methods:
Wistar-Kyoto (WKY) rats and spontaneous hypertensive rats (SHRs) received RVLM microinjection of adeno-associated viral vectors to promote or inhibit the COX2 expression were subjected to subsequent experiments. Glutamate level and glutaminase expression were detected by ELISA and western blot, respectively. The function of tonic glutamatergic inputs was assessed by BP response to microinjection of the glutamate receptor antagonist into the RVLM. PC12 cells were used to detect the underlying signal pathway.

Results:
The RVLM COX2 expression and prostaglandin E2 level were significant higher in SHRs than in WKY rats. Overexpression of COX2 in the RVLM produced an increase in basal BP, RVLM glutamate level, and glutaminase expression in WKY rats, while they were significantly reduced by interfering with COX2 expression in SHRs. Microinjections of the glutamate receptor antagonist into the RVLM produced a significant BP decrease in WKY rats with COX2 overexpression pretreatment. Furthermore, the increased levels of BP, glutamate content, and glutaminase activity in the RVLM evoked by central infusion of angiotensin II were attenuated in COX2 knockout mice. It was also found that prostaglandin E2 increased supernatant glutamate level and phosphorylation of signal transducer and activator of transcription 3 in PC12 cells.

Conclusion:
Our findings suggest that upregulated COX2 expression enhances the tonically active glutamatergic inputs to the RVLM, which is associated with cardiovascular regulation in hypertension.
Fatal Injuries in the Health Care and Social Assistance Industry, Census of Fatal Occupational Injuries, 2011 to 2019
Authors: Hawkins Devan , Chavarria Alma Luana 
Published: October 2022

Objective
This study aimed to describe the characteristics of workers in the health care and social assistance industry who experience fatal occupation injuries and the nature of these injuries.

Methods
Fatal occupational injury rates were calculated for workers in the health and social assistance industry according to age, sex, race ethnicity, industry, and year.

Results
There were 1224 fatalities among workers in the health care and social assistance industry, resulting in a rate of 6.7 fatalities per 1,000,000 worker-years. The rate of fatal injuries was highest among older workers, men, and Black and White workers. The highest number of fatal injuries was transportation and violent incidents. The highest mortality rates were in the vocational rehabilitation services industry.

Conclusions
These findings can be useful for identifying methods for intervening and preventing fatal injuries among workers in the health care and social assistance industry.
Pleural Disease in Acute COVID-19 Pneumonia
Authors: Swenson Kai , Uribe Juan P. , Ayala Alvaro , Parikh Mihir , Zhang Chenchen , Paton Alichia , Trachtenberg Molly , Majid Adnan 
Published: October 2022

Background:
Pleural diseases encompass pleural effusion and pneumothorax (PTX), both of which were uncommon in coronavirus disease of 2019 (COVID-19). We aimed to describe the frequency, characteristics, and main outcomes of these conditions in patients with COVID-19 pneumonia.

Methods:
We performed a retrospective cohort analysis of inpatients with COVID-19 pneumonia between January 1, 2020 and January 1, 2022, at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

Results:
Among 4419 inpatients with COVID-19 pneumonia, 109 (2.5%) had concurrent pleural disease. Ninety-four (2.1%) had pleural effusion (50% seen on admission) and 15 (0.3%) had PTX, both with higher rates of underlying conditions such as heart failure, liver disease, kidney disease, and malignancy. A total of 28 (30%) pleural effusions were drained resulting in 32% being exudative, 43% pseudoexudative, and 25% transudative. Regarding PTX, 5 (33%) were spontaneous and 10 (67%) were due to barotrauma while on mechanical ventilation. We found that the presence of underlying lung disease was not associated with an increased risk of developing PTX. In addition, patients with pleural disease had a higher incidence of severe or critical illness as represented by intensive care unit admission and intubation, longer hospital and intensive care unit stay, and a higher mortality rate as compared with patients without the pleural disease.

Conclusion:
Pleural effusions and pneumothoraces are infrequent findings in patients admitted due to COVID-19 pneumonia, worsened outcomes in these patients likely reflect an interplay between the severity of inflammation and parenchymal injury due to COVID-19 disease and underlying comorbidities.
Evaluation of Insight, Self-Esteem, and Body Satisfaction in Eating Disorders
Authors: Şenay Olcay , Yücel Başak 
Published: October 2022

Abstract
We investigated insight and its relationship with the clinical characteristics in eating disorders (EDs). Thirty anorexia nervosa (AN) and 30 bulimia nervosa (BN) patients, diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, were evaluated with Eating Disorder Examination Questionnaire (EDE-Q), the Body Image Satisfaction Questionnaire (BISQ), Rosenberg Self-Esteem Scale (RSES), and the Brown Assessment of Beliefs Scale (BABS). There was no statistically significant difference between the AN and the BN group in clinical scale scores. Thirty percent of AN and 23.3% of BN patients showed “poor insight” according to BABS. In the whole sample, BABS scores were significantly positively correlated with the EDE-Q eating, shape, weight concern subscales, and global scores, and the RSES scores; and negatively correlated with the BISQ general appearance and trunk subscale scores. Manifestation of “poor insight” is frequent in EDs. Poor insight in EDs is associated with eating, shape and weight concerns, body dissatisfaction, and low self-esteem.
Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South
Authors: Pan Zhongzhe , Dahman Bassam , Bono Rose S. , Sabik Lindsay M. , Belgrave Faye Z. , Yerkes Lauren , Nixon Daniel E. , Kimmel April D. 
Published: October 2022

Background:
Retention in HIV care remains a national challenge. Addressing structural barriers to care may improve retention. We examined the association between physician reimbursement and retention in HIV care, including racial differences.

Methods:
We integrated person-level administrative claims (Medicaid Analytic eXtract, 2008–2012), state Medicaid-to-Medicare physician fee ratios (Urban Institute, 2008, 2012), and county characteristics for 15 Southern states plus District of Columbia. The fee ratio is a standardized measure of physician reimbursement capturing Medicaid relative to Medicare physician reimbursement across states. Generalized estimating equations assessed the association between the fee ratio and retention (≥2 care markers ≥90 days apart in a calendar year). Stratified analyses assessed racial differences. We varied definitions of retention, subsamples, and definitions of the fee ratio, including the fee ratio at parity.

Results:
The sample included 55,237 adult Medicaid enrollees with HIV (179,002 enrollee years). Enrollees were retained in HIV care for 76.6% of their enrollment years, with retention lower among non-Hispanic Black (76.1%) versus non-Hispanic White enrollees (81.3%, P < 0.001). A 10-percentage point increase in physician reimbursement was associated with 4% increased odds of retention (adjusted odds ratio 1.04, 95% confidence interval: 1.01 to 1.07). In stratified analyses, the positive, significant association occurred among non-Hispanic Black (1.08, 1.05–1.12) but not non-Hispanic White enrollees (0.87, 0.74–1.02). Findings were robust across sensitivity analyses. When the fee ratio reached parity, predicted retention increased significantly overall and for non-Hispanic Black enrollees.

Conclusion:
Higher physician reimbursement may improve retention in HIV care, particularly among non-Hispanic Black individuals, and could be a mechanism to promote health equity.
Application of Composite Tissue Flap Pedicled With Superficial Temporal Artery and its Branches in the Repair of Various Maxillofacial Defects
Authors: Lei Bowen , Zhong Yehong , Chen Zhewei , Yang Bin 
Published: October 2022

Objective:
To discuss and study the application of composite tissue flaps pedicled with the superficial temporal artery (STA) and its branches in the repair of various defects, analyze the advantages and disadvantages of such composite tissue flaps, and provide a reference for the personalized design of various maxillofacial defect repairs.

Materials and Methods:
In recent years, 12 cases of various maxillofacial defects were repaired with composite tissue flaps pedicled with the STA and its branches. The application strategies of this type of tissue flaps were summarized by summarizing experience and reviewing literature.

Results:
According to the different defect characteristics of patients and the requirements of patients for surgery, different tissue flaps have been designed, and good results have been obtained. Except for 2 patients who developed dark purple skin flap within 48 hours after operation, the remaining patients were followed up for 6 to 24 months without serious complications.

Conclusion:
The composite tissue flap pedicled with the STA and its branches is a kind of functional tissue flap for facial defect repair. Individualized repair schemes can be designed according to different defect types of patients.
Association Between Malignant Diseases and Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review and Meta-Analysis
Authors: Yao Sheng , Ding Xiaoyong , Rong Gang , Zhou Jie , Zhang Bo 
Published: October 2022

Purpose:
The aim was to identify whether malignant diseases increase the risk of medication-related osteonecrosis of the jaw (MRONJ) occurrence when patients are exposed to bisphosphonate, antiresorptive or antiangiogenic drugs. To analyze related factors.

Methods:
A systematic literature searching was performed in PubMed, Embase, and Google Scholar for studies with information about whether patients have malignant diseases. Patients involved must be treated with MRONJ-related drugs and at high risk of developing MRONJ.

Results:
A total of 6 cohort studies and 3 case-control studies were included. Analysis according 9 studies shows that malignant diseases have significant influence on MRONJ occurrence (risk ratio (RR): 2.62; 95% confidence interval (95% CI): 1.58–4.33; P=0.0002). Subgroup analysis according 6 cohort studies also shows that malignant diseases significantly affect MRONJ occurrence (RR: 3.50; 95% CI: 1.63–7.52; P=0.001). Chemotherapy have no obvious influence on MRONJ occurrence (RR: 1.64; 95% CI: 0.79–3.39; P=0.18). Intravenous drug administration significantly influences MRONJ occurrence (RR: 2.67; 95% CI: 1.27–5.58; P=0.009).

Conclusions:
Patients with malignant diseases have higher risk of MRONJ occurrence when exposed to bisphosphonate, antiresorptive, or antiangiogenic drugs. Cumulative dosages from intravenous drugs administration contribute to MRONJ developing. Prevention of MRONJ in patients with malignancy should be emphasized.
The simultaneous appearance of Kasabach-Merritt syndrome and focal nodular hyperplasia: a rare case with literature review
Authors: Seerwan Karzan , Kaka Ali Hemn H. , Ghalib Omar H. , Ismaeil Deari A. , Hassan Hemin A. , Salih Abdulwahid M. , Kakamad Fahmi H. , Mohammed Shvan H. , Ali Rawa M. , Ahmed Dlshad Hamasaeed 
Published: October 2022

Introduction and importance:
The simultaneous development of Kasabach-Merritt syndrome (KMS) and focal nodular hyperplasia (FNH) in the same individual is rare. This study aims to report the coexistence of KMS and FNH in a 32-year-old female.

Case presentation:
A 32-year-old woman presented to the gastroenterology clinic complaining of heavy menses, fatigue, and hematuria. Physical examination revealed multiple ecchymoses on the skin. Abdominal computed tomography scan revealed a large hepatic lesion with features of atypical hemangioma. Complete blood count showed normochromic, normocytic red blood cells, and thrombocytopenia. Surgery was decided based on a clinical diagnosis of KMS resulting from a giant liver hemangioma. Histopathologic diagnosis of the resected lesion was FNH.

Clinical discussion:
KMS, which refers to a giant hemangioma associated with thrombocytopenia, was initially described by Kasabach and Merritt. It occurs in nearly 1% of hemangiomas and primarily affects infants. KMS is a life-threatening condition that could be fatal if adequate, timely treatment is not administered. FNH is a benign hepatocellular neoplasm with a predilection for females.

Conclusion:
KMS and FNH are 2 distinct conditions that can rarely co-exist in the same patient. Corticosteroids, radiotherapy, and surgical resection are the primary modalities of treatment.
Intraoperative Hypotension and 30-D Mortality After Liver Transplantation
Authors: Wang Libing , Bui Christine Myo , Hofer Ira , Gabel Eilon , Wray Christopher , Xia Victor W. 
Published: October 2022

Background.
Intraoperative hypotension (IOH) is common and associated with mortality in major surgery. Although patients undergoing liver transplantation (LT) have low baseline blood pressure, the relation between blood pressure and mortality in LT is not well studied. We aimed to determine mean arterial pressure (MAP) that was associated with 30-d mortality in LT.

Methods.
We performed a retrospective cohort study. The data included patient demographics, pertinent preoperative and intraoperative variables, and MAP using various metrics and thresholds. The endpoint was 30-d mortality after LT.

Results.
One thousand one hundred seventy-eight patients from 2013 to 2020 were included. A majority of patients were exposed to IOH and many for a long period. Eighty-nine patients (7.6%) died within 30 d after LT. The unadjusted analysis showed that predicted mortality was associated with MAP <45 to 60 mm Hg but not MAP <65 mm Hg. The association between MAP and mortality was further tested using adjustment and various duration cutoffs. After adjustment, the shortest durations for MAPs <45, 50, and 55 mm Hg associated with 30-d mortality were 6, 10, and 25 min (odds ratio, 1.911, 1.812, and 1.772; 95% confidence interval, 1.100-3.320, 1.039-3.158, and 1.008-3.114; P = 0.002, 0.036, and 0.047), respectively. Exposure to MAP <60 mm Hg up to 120 min was not associated with increased mortality.

Conclusion.
In this large retrospective study, we found IOH was common during LT. Intraoperative MAP <55 mm Hg was associated with increased 30-d mortality after LT, and the duration associated with postoperative mortality was shorter with lower MAP than with higher MAP.
Increased SERCA2a sub-cellular heterogeneity in right-ventricular heart failure inhibits excitation-contraction coupling and modulates arrhythmogenic dynamics
Authors: Holmes M. , Hurley M. E. , Sheard T. M. D. , Benson A. P. , Jayasinghe I. , Colman M. A. 
Published: October 2022

The intracellular calcium handling system of cardiomyocytes is responsible for controlling excitation-contraction coupling (ECC) and has been linked to pro-arrhythmogenic cellular phenomena in conditions such as heart failure (HF). SERCA2a, responsible for intracellular uptake, is a primary regulator of calcium homeostasis, and remodelling of its function has been proposed as a causal factor underlying cellular and tissue dysfunction in disease. Whereas adaptations to the global (i.e. whole-cell) expression of SERCA2a have been previously investigated in the context of multiple diseases, the role of its spatial profile in the sub-cellular volume has yet to be elucidated. We present an approach to characterize the sub-cellular heterogeneity of SERCA2a and apply this approach to quantify adaptations to the length-scale of heterogeneity (the distance over which expression is correlated) associated with right-ventricular (RV)-HF. These characterizations informed simulations to predict the functional implications of this heterogeneity, and its remodelling in disease, on ECC, the dynamics of calcium-transient alternans and the emergence of spontaneous triggered activity. Image analysis reveals that RV-HF is associated with an increase in length-scale and its inter-cellular variability; simulations predict that this increase in length-scale can reduce ECC and critically modulate the vulnerability to both alternans and triggered activity.
This article is part of the theme issue ‘The cardiomyocyte: new revelations on the interplay between architecture and function in growth, health, and disease’.
Three-dimensional remodelling of the cellular energy distribution system during postnatal heart development
Authors: Kim Yuho , Ajayi Peter T. , Bleck Christopher K. E. , Glancy Brian 
Published: October 2022

The heart meets the high energy demands of constant muscle contraction and calcium cycling primarily through the conversion of fatty acids into adenosine triphosphate (ATP) by a large volume of mitochondria. As such, the spatial relationships among lipid droplets (LDs), mitochondria, the sarcotubular system and the contractile apparatus are critical to the efficient distribution of energy within the cardiomyocyte. However, the connectivity among components of the cardiac cellular energy distribution system during postnatal development remains unclear. Here, we use volume electron microscopy to demonstrate that the sarcomere branches uniting the myofibrillar network occur more than twice as frequently during early postnatal development as in mature cardiomyocytes. Moreover, we show that the mitochondrial networks arranged in parallel to the contractile apparatus are composed of larger, more compact mitochondria with greater connectivity to adjacent mitochondria in mature as compared with early postnatal cardiomyocytes. Finally, we find that connectivity among mitochondria, LDs and the sarcotubular network is greater in developing than in mature muscles. These data suggest that physical connectivity among cellular structures may facilitate the communication needed to coordinate developmental processes within the cardiac muscle cell.This article is part of the theme issue ‘The cardiomyocyte: new revelations on the interplay between architecture and function in growth, health, and disease’.
Effects of altered cellular ultrastructure on energy metabolism in diabetic cardiomyopathy: an
in silico
study
Authors: Ghosh Shouryadipta , Guglielmi Giovanni , Orfanidis Ioannis , Spill Fabian , Hickey Anthony , Hanssen Eric , Rajagopal Vijay 
Published: October 2022

Diabetic cardiomyopathy is a leading cause of heart failure in diabetes. At the cellular level, diabetic cardiomyopathy leads to altered mitochondrial energy metabolism and cardiomyocyte ultrastructure. We combined electron microscopy (EM) and computational modelling to understand the impact of diabetes-induced ultrastructural changes on cardiac bioenergetics. We collected transverse micrographs of multiple control and type I diabetic rat cardiomyocytes using EM. Micrographs were converted to finite-element meshes, and bioenergetics was simulated over them using a biophysical model. The simulations also incorporated depressed mitochondrial capacity for oxidative phosphorylation (OXPHOS) and creatine kinase (CK) reactions to simulate diabetes-induced mitochondrial dysfunction. Analysis of micrographs revealed a 14% decline in mitochondrial area fraction in diabetic cardiomyocytes, and an irregular arrangement of mitochondria and myofibrils. Simulations predicted that this irregular arrangement, coupled with the depressed activity of mitochondrial CK enzymes, leads to large spatial variation in adenosine diphosphate (ADP)/adenosine triphosphate (ATP) ratio profile of diabetic cardiomyocytes. However, when spatially averaged, myofibrillar ADP/ATP ratios of a cardiomyocyte do not change with diabetes. Instead, average concentration of inorganic phosphate rises by 40% owing to lower mitochondrial area fraction and dysfunction in OXPHOS. These simulations indicate that a disorganized cellular ultrastructure negatively impacts metabolite transport in diabetic cardiomyopathy.
This article is part of the theme issue ‘The cardiomyocyte: new revelations on the interplay between architecture and function in growth, health, and disease’.