bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in shuntflow (Qa), cardiac function and mortality between hemodialysis patients with a lower-arm fistula, an upper-arm fistula, and an arteriovenous graft
Authors: Drouven Johannes W , Wiegersma Janke , Assa Solmaz , Post Adrian , El Moumni Mostafa , Özyilmaz Akin , Zeebregts Clark J , Franssen Casper FM 
Published: April 2022

Background: High-flow vascular accesses may contribute to cardiovascular morbidity and mortality in hemodialysis patients. Since shuntflow (Qa) varies between vascular access types, the current study aims to investigate differences in left ventricular hypertrophy (LVH), systolic and diastolic function parameters, and all-cause mortality between patients with a lower-arm arteriovenous fistula (AVF), an upper-arm AVF, and an arteriovenous graft (AVG). Methods: A post hoc analysis of 100 patients was performed in a single-center, prospective observational study. Echocardiography examinations were performed prior to the dialysis session. Qa measurements were performed using ultrasound dilution. Patient groups were categorized by vascular access type. Cox proportional hazards models were used to investigate the association of shunt type with all-cause mortality with adjustment for potential confounders including, amongst others, age, sex, diabetes, the duration of hemodialysis treatment, shunt vintage, and Qa. Results: Patients with an upper-arm AVF had significantly ( p < 0.001) higher Qa (median 1902, IQR 1223–2508 ml/min) compared to patients with a lower-arm AVF (median 891, IQR 696–1414 ml/min) and patients with an AVG (median 881, IQR 580–1157 ml/min). The proportion of patients with LVH and systolic and diastolic echocardiographic parameters did not differ significantly between groups. Survival analysis showed that an upper-arm AVF was associated with a significantly lower all-cause mortality ( p = 0.04) compared to a lower-arm AVF. Conclusions: Patients with an upper-arm fistula had a higher Qa but similar systolic and diastolic cardiac function. Patients with an upper-arm fistula had a significantly lower risk of all-cause mortality compared with patients with a lower-arm fistula.
The Prevalence of Pharmacogenomics Variants and Their Clinical Relevance Among the Pakistani Population
Authors: Khan Abdul Rafay , Shah Sayed Hajan , Ajaz Sadia , Firasat Sadaf , Abid Aiysha , Raza Ali 
Published: April 2022

Background: Pharmacogenomics (PGx), forming the basis of precision medicine, has revolutionized traditional medical practice. Currently, drug responses such as drug efficacy, drug dosage, and drug adverse reactions can be anticipated based on the genetic makeup of the patients. The pharmacogenomic data of Pakistani populations are limited. This study investigates the frequencies of pharmacogenetic variants and their clinical relevance among ethnic groups in Pakistan. Methods: The Pharmacogenomics Knowledge Base (PharmGKB) database was used to extract pharmacogenetic variants that are involved in medical conditions with high (1A + 1B) to moderate (2A + 2B) clinical evidence. Subsequently, the allele frequencies of these variants were searched among multiethnic groups of Pakistan (Balochi, Brahui, Burusho, Hazara, Kalash, Pashtun, Punjabi, and Sindhi) using the 1000 Genomes Project (1KGP) and ALlele FREquency Database (ALFRED). Furthermore, the published Pharmacogenomics literature on the Pakistani population was reviewed in PubMed and Google Scholar. Results: Our search retrieved (n = 29) pharmacogenetic genes and their (n = 44) variants with high to moderate evidence of clinical association. These pharmacogenetic variants correspond to drug-metabolizing enzymes (n = 22), drug-metabolizing transporters (n = 8), and PGx gene regulators, etc. (n = 14). We found 5 pharmacogenetic variants present at >50% among 8 ethnic groups of Pakistan. These pharmacogenetic variants include CYP2B6 (rs2279345, C; 70%-86%), CYP3A5 (rs776746, C; 64%-88%), FLT3 (rs1933437, T; 54%-74%), CETP (rs1532624, A; 50%-70%), and DPP6 (rs6977820, C; 61%-86%) genes that are involved in drug response for acquired immune deficiency syndrome, transplantation, cancer, heart disease, and mental health therapy, respectively. Conclusions: This study highlights the frequency of important clinical pharmacogenetic variants (1A, 1B, 2A, and 2B) among multi-ethnic Pakistani populations. The high prevalence (>50%) of single nucleotide pharmacogenetic variants may contribute to the drug response/diseases outcome. These PGx data could be used as pharmacogenetic markers in the selection of appropriate therapeutic regimens for specific ethnic groups of Pakistan.
Nutritional Status of Postpartum Mothers and Associated Risk Factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia: A Community Based Cross-Sectional Study
Authors: Sebeta Asresash , Girma Abel , Kidane Rediet , Tekalign Eyob , Tamiru Dessalegn 
Published: April 2022

Background: Malnutrition affects millions of people in developing countries and contributes to poor health outcomes and nutritional status among women in the postpartum period. Lactation increases high nutritional demands and marks a significant life transition that can impact diet quality and subsequently predispose woman to high risk of overweight and undernutrition. Although, studies have been conducted on the nutritional status of lactating women, there is a gap especially on women’s nutritional status during the postpartum period. Therefore, this study aimed to assess the nutritional status of postpartum women and associated factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia, 2020. Method: A community-based cross-sectional study was conducted in Shey-Bench District from March 1 to 30/2020 among 359 postpartum mothers. Bivariate analysis was employed to select candidate variables at P-value <.25 as a cut-off point. Multiple multinomial logistic regression analysis was used to identify variables significantly associated with nutritional status of the mother at P < .05 with 95% CI. Results: The study revealed that 10.3% of women were underweight and 16.7% were overweight. Employed mothers (AOR = 4.467, 95% CI [1.05-19.04]), employed husband (AOR = 0.087, 95% CI [0.021-0.370]), farmer husband (AOR = 0.084, 95% CI [0.024-0.293]), trader husband (AOR = 0.19, 95% CI [0.0614-0.616]), married mother (AOR = 0.222, 95% CI [0.088-0.560]), dietary diversity (AOR = 0.181, 95% CI [0.075-0.436]) were significantly associated with underweight and while being overweight was associated with dietary diversity, maternal age of between 15 to 24 and 25 to 34, exclusive breastfeeding, and frequency of breastfeeding. Conclusion: This study found a lower prevalence of underweight compared with overweight in the study area. Occupational status, marital status, age of the mother, dietary diversity, exclusive and frequency of breastfeeding were significantly associated factors with nutritional status of postpartum mother. We recommend strengthening the provision of nutrition education on modifiable factors with collaboration of other sectors.
Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?
Authors: Taha Sara I , Samaan Sara F , Ibrahim Rehab Ali , Moustafa Nouran M , El-Sehsah Eman M , Youssef Mariam K 
Published: April 2022

Background: In clinical practice, distinguishing disease activity in patients with rheumatological illnesses is challenging. Objectives: We aimed to investigate clinical associations of hemogram-derived indices, namely: red cell distribution width (RDW), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) with disease activity in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS). Methods: In 250 patients with rheumatological disease and 100 healthy age-matched controls, we investigated disease activity scores and indicators and evaluated their association with hemogram-derived indices values. Results: Compared with the control group, RDW, MPV, and PLR significantly increased ( P < .001) in the three studied disorders (RA, SLE, and AS), but LMR dramatically decreased. SII was considerably higher in RA and AS patients compared with controls but not in SLE patients. On the other hand, NLR rose dramatically in SLE patients compared with controls ( P = .043), but did not change much in RA and AS patients ( P > .05). RDW and MPV showed significant changes ( P < .001) in the three studied diseases (RA, SLE, and AS) according to disease activity. They significantly increased across worsening activity scores. Only in the SLE group, PLR was significantly increased with disease activity ( P < .001), while LMR showed a significant decrease ( P = .016). Conclusions: Clinicians must pay close attention to complete blood count (CBC) analysis and its various derived ratios to better characterize the activity of rheumatological disorders and anticipate the disease course and prognosis.
Outcomes of Endurant II Stent Graft According to Anatomic Severity Grade Score
Authors: Omran Safwan , Müller Verena , Schawe Larissa , Bürger Matthias , Kapahnke Sebastian , Bruder Leon , Haidar Haidar , Konietschke Frank , Greiner Andreas 
Published: April 2022

Objectives: This study’s objective was to evaluate Endurant II (Medtronic Inc, Minneapolis, Minnesota) stent graft’s early and midterm outcomes and compare the results according to the anatomic severity grade (ASG) scores. Methods: This was a retrospective study of patients treated with the Endurant II stent graft between January 2013 and May 2021. The patients were divided into 2 independent groups, including those with a low ASG score (score <14) and a high ASG score (score >14). Results: A total of 165 consecutive patients (89% males, age 74±8 years) were included. There were 110 (67%) patients in the low-score group and 55 (33%) patients in the high-score group. Technical success was achieved in all cases. Primary clinical success at 30 days was 100% and at 1 year was 96%. Median operative time was longer in the high-score group with no statistical significance (133 vs 120 minutes, p=0.116). The median dose area product of low-score patients (50.9 Gy·cm2; IQR 22.4–75.5 Gy·cm2) was significantly lower than high-score patients (85.0 Gy·cm2; IQR 46.5–127.9 Gy·cm2) with p=0.025. Median fluoroscopic time was lower in low-score patients (17 minutes; IQR 13–24 minutes) compared with high-score patients (19 minutes; IQR 16–23 minutes) without a significant difference at p=0.148. At a midterm follow-up of 32 months (range 2–63 months), combined complications (29% vs 8%, p<0.001) and implant-related complications (13% vs 4%, p=0.043) were higher in the high-score group. Systemic complications at 30 days were higher in the high-score group without a statistically significant difference (15% vs 11%, p=0.500). The Kaplan-Meier estimate of freedom from reintervention was significantly higher in the low-risk group at 1 (97% vs 90%), 2 (96% vs 88%), and 3 years (96% vs 85%) with (p=0.035). The cumulative survival rate was significantly higher in the low-score group than high-score group (p=0.001) at 1 (99% vs 87%), 2 (98% vs 85%), and 3 years (96% vs 82%). Conclusions: Endurant II endovascular aneurysm repair seems to be safe in both low-score and high-score patients. However, patients in the high-score group showed more implant-related complications and midterm mortalities than those in the low-score group.
Computational Fluid Dynamics for the Prediction of Endograft Thrombosis in the Superficial Femoral Artery
Authors: van de Velde Lennart , Groot Jebbink Erik , Hagmeijer Rob , Versluis Michel , Reijnen Michel M. P. J. 
Published: April 2022

Purpose: Contemporary diagnostic modalities, including contrast-enhanced computed tomography (CTA) and duplex ultrasound, have been insufficiently able to predict endograft thrombosis. This study introduces an implementation of image-based computational fluid dynamics (CFD), by exemplification with 4 patients treated with an endograft for occlusive disease of the superficial femoral artery (SFA). The potential of personalized CFD for predicting endograft thrombosis is investigated. Materials and Methods: Four patients treated with endografts for an occluded SFA were retrospectively included. CFD simulations, based on CTA and duplex ultrasound, were compared for patients with and without endograft thrombosis to investigate potential flow-related causes of endograft thrombosis. Time-averaged wall shear stress (TAWSS) was computed, which highlights areas of prolonged residence times of coagulation factors in the graft. Results: CFD simulations demonstrated normal TAWSS (>0.4 Pa) in the SFA for cases 1 and 2, but low levels of TAWSS (<0.4 Pa) in cases 3 and 4, respectively. Primary patency was achieved in cases 1 and 2 for over 2 year follow-up. Cases 3 and 4 were complicated by recurrent endograft thrombosis. Conclusion: The presence of a low TAWSS was associated with recurrent endograft thrombosis in subjects with otherwise normal anatomic and ultrasound assessment and a good distal run-off.
Revealing the intrinsic dielectric properties of mediterranean green fiber composites for sustainable functional products
Authors: Fares Osama , AL-Oqla Faris , Hayajneh Mohammed 
Published: April 2022

The ability of biodegradable materials to be miniaturized and degrade at specific rates when subjected to certain bacterium types and/or a given range of temperatures has led to a newly emerging technology: organic transient bioelectronics. In this work, the electrical characteristics of new natural composite materials are presented. Four types of natural lignocellulosic fibers were used with polypropylene: black pepper, sumac, pomegranate, and lemon. The composites were prepared as flat smooth sheets with thicknesses ∼1 mm. The dielectric constant and the ac conductivity of the prepared samples were determined for the frequency range of 1 KHz to 4 MH. All measurements were performed at room temperature and humidity utilizing parallel plate capacitor technique associated with high precision Hioki IM3536 LCR meter. The frequency response of the composites under study shows similar behavior to that of the pure sample but with various percentage increments. The dielectric constant shows that the consistent dispersion was highly affected by filler content specially at the low frequency side of the spectrum. The maximum recorded increment was around 55% for 30wt.% sumac samples at 1 KHz. The effect of larger filler loading concentration on the incremental change of the ac conductivity was more obvious at higher frequencies.
Pseudoaneurysm Repair With a Septal Occluder
Authors: Vogel Julia , Räber Lorenz , Makaloski Vladimir 
Published: April 2022

Introduction New treatment options, like endovascular aortic repair, reduced the mortality rate of patients suffering from complications after an acute type A aortic dissection repair. Nevertheless, initial successful treatment of an aortic dissection does not fully eliminate the risk of later adverse aortic events like anastomotic pseudoaneurysm. Pseudoaneurysm of the anastomosis between the ascending and the arch graft could initiate complications like peripheral embolization, dysphagia or compression of mediastinum organs. Re-operation via re-sternotomy bears enormous morbidity and mortality for these patients. There is a high unmet need for percutaneous therapeutic options to treat pseudoaneurysms. Case Presentation A 59-year-old-man treated 15 years ago for type A aortic dissection, was hospitalized due to intermittent abdominal pain. A detailed examination revealed 2 pseudoaneurysms: 1 symptomatic at the level of the reimplanted celiac trunk and 1 asymptomatic at the anastomosis between the brachiocephalic trunk and the aortic arch graft. Due to multiple co-morbidities and previous operations, the risk for surgery was considered too high. Both pseudoaneurysm were treated percutaneously, the symptomatic 1 with covered stent and the asymptomatic with Amplatzer™ septal-occluder. Discussion We present an alternative percutaneous therapy approach for treatment of pseudoaneurysm using a septal-occluder. A follow-up computed tomography 3 months later showed successfully excluded pseudoaneurysm.
Family Support for (Increasingly) Older Adults with Down Syndrome: Factors Affecting Siblings’ Involvement
Authors: Lemoine Lise , Benoît Schneider  
Published: April 2022

Background Life expectancy for people with Down syndrome is increasing, but older adults with Down syndrome are at greater risk of developing certain pathologies associated with ageing. When ageing parents can no longer look after their child with Down syndrome, their other children are often expected to shoulder this responsibility. Method We asked 120 adult siblings of a person with Down syndrome to complete a questionnaire on their current and anticipated relationships. Results Most respondents considered these relationships to be positive, but they expressed concerns about the effects of ageing and about having to organise their sibling with Down syndrome’s future life. We investigated the impact of factors relating to the respondents and to their sibling with Down syndrome (age, gender, social inclusion, protection regime) on these general tendencies. Conclusion Siblings need to be given support, for example, via discussion groups, to facilitate the transition to becoming caregivers.
Efficacy and safety of endoscopic papillectomy: a multicenter, retrospective, cohort study on 227 patients
Authors: Gondran Hannah , Musquer Nicolas , Perez-Cuadrado-Robles Enrique , Deprez Pierre Henri , Buisson François , Berger Arthur , Cesbron-Métivier Elodie , Wallenhorst Timothee , David Nicolas , Cholet Franck , Perrot Bastien , Quénéhervé Lucille , Coron Emmanuel 
Published: April 2022

Background: Endoscopic papillectomy is a minimally invasive treatment for benign tumors of the ampulla of Vater or early ampullary carcinoma. However, reported recurrence rates are significant and risk factors for recurrence are unclear. Objective: The aims of this study were to evaluate the efficacy and safety of endoscopic papillectomy and to identify risk factors for recurrence and adverse events. Methods: All patients who underwent endoscopic papillectomy at five tertiary referral centers between January 2008 and December 2018 were included. Recurrence was defined as the detection of residue on one of the follow-up endoscopies. Treatment success was defined as the absence of tumor residue on the last follow-up endoscopy. Results: A total of 227 patients were included. The resections were en bloc in 64.8% of cases. The mean lesion size was 20 mm (range: 3–80) with lateral extension in 23.3% of cases. R0 resection was achieved in 45.3% of cases. The recurrence rate was 30.6%, and 60.7% of recurrences were successfully treated with additional endoscopic treatment. Finally, treatment success was achieved in 82.8% of patients with a median follow-up time of 22.3 months. R1 resection, intraductal invasion, and tumor size > 2 cm were associated with local recurrence. Adverse events occurred in 36.6% of patients and included pancreatitis (17.6%), post-procedural hemorrhage (11.0%), perforation (5.2%), and biliary stenosis (2.6%). The mortality rate was 0.9%. Conclusion: Endoscopic papillectomy is an effective and relatively well-tolerated treatment for localized ampullary tumors. In this series, R1 resection, intraductal invasion, and lesion size > 2 cm were associated with local recurrence.
Chronic Effects of Pitching on Muscle Thickness and Strength of the Scapular Stabilizers in Professional Baseball Players
Authors: Valle Ohsana , Sheridan Scott S. , Rauch Joseph J. , Sarver Joseph J. , Paul Ryan W. , Thomas Stephen J. 
Published: April 2022

Background: The posterior scapular muscles eccentrically contract to disperse the high forces observed in the deceleration phase of pitching. Muscular adaptations often occur following chronic eccentric loading, however, no study has evaluated the adaptations of the posterior scapular muscles with regard to throwing and their relationship with humeral retroversion (HR) in professional pitchers. Hypothesis: Significant chronic adaptations in muscle thickness (MT) and strength of the trapezius and rhomboids would be observed in healthy professional baseball pitchers, and there would be a significant relationship between humeral adaptations (ie, HR) and posterior scapular muscle adaptations (ie, strength and MT). Study Design: Cross-sectional; Level 3. Methods: A total of 28 healthy male professional baseball pitchers (age, 22 ± 2 years; mass, 95 ± 17 kg; height, 190 ± 7 cm) were included in the study. Bilateral isometric muscle strength of the upper trapezius (UT), middle trapezius, lower trapezius (LT), and rhomboids was measured during a maximum voluntary isometric contraction. Diagnostic ultrasound images of the UT, middle trapezius, LT, rhomboid major, and rhomboid minor muscles were collected bilaterally to measure MT. HR was also quantified bilaterally with ultrasound. Paired sample t tests were used to compare dominant and nondominant strength and MT. Pearson correlation coefficients were used to assess the relationship between HR, isometric strength, and MT. Results: A significantly increased MT of the LT was found on the dominant arm compared with the nondominant arm (5.4 ± 1.1 mm vs 4.4 ± 1.5 mm; P = 0.00). The Pearson correlation coefficient demonstrated a significant weak negative relationship between HR and rhomboid major MT ( P = 0.03; R = −0.36), and a significant weak negative correlation between HR and middle trapezius isometric strength ( P = 0.03; R = −0.37). Conclusion: LT thickness was greater in the throwing arm compared with the nonthrowing arm of pitchers, suggesting a positive adaptation of the LT. Interestingly, there was a weak negative relationship between HR and both rhomboid major MT and middle trapezius isometric strength. This negative relationship suggests that since increased HR leads to decreased internal rotation range of motion during deceleration, the scapula may be forced into anterior tilt and protraction, which can place excessive eccentric load on the rhomboid major and middle trapezius.