bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Incidence and Prognostic Factors of Two Subtypes of Primary Liver Cancers: A Surveillance, Epidemiology, and End Results-Based Population Study
Authors: Yao Jiping , Liang Xue , Liu Yanning , Li Shuangshuang , Zheng Min 
Published: February 2022

Objectives The objective of our study was to investigate and compare the epidemiologic characteristics, prognostic factors, and survival between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) patients. Methods Age-adjusted incidence rates were evaluated from 1975 to 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was investigated using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox regression analyses were performed to identify the independent prognostic factors for OS. Results In the last 10 years, the incidence rate of ICC increased rapidly by 109% (annual percentage change (APC) = 8.24, 95% CI = 6.64 to 9.86; P < .001), compared with a much more modest 12% increase in the incidence of HCC (APC = 1.59, 95% CI = .56 to 2.62; P < .001). This trend persisted throughout the study across different age groups, sexes, and races. Males older than 70 years and of other races (non-African American and non-Caucasian) showed the highest incidence rates of HCC and ICC. Multivariate Cox regression analysis demonstrated that other race, married status, later year of diagnosis, more examined lymph nodes, and surgery were significant protective factors of OS in HCC patients. In contrast, the race and year of diagnosis were not independent prognostic factors, but radiation and chemotherapy were protective factors of OS in ICC patients. The median OS was 18 months and 12 months in HCC and ICC patients, respectively. Conclusion In the last 10 years, the incidence of HCC had a slow growth in the United States, whereas ICC showed a remarkable increase. The 5-year OS of the former has improved in recent years while that of the latter showed no significant improvement. Therefore, surgery could contribute to superior survival outcomes as compared to other treatments.
Wrist Arthroscopy Using the 2R Portal: Is It Safer Than the 1,2 Portal?
Authors: Hinchcliff Katharine M. , Munaretto Nicholas , Dutton Lauren K. , Ramazanian Taghi , Kakar Sanjeev 
Published: February 2022

Backgroud: The purpose of this study was to compare the 1,2 with a novel 2R portal in terms of proximity to critical structures. Methods: Wrist arthroscopy was performed on 8 fresh frozen cadavers via the 1,2 and 2R portals. External anatomy was then dissected under loupe magnification. The closest distance between the portals and surrounding anatomical structures was measured in millimeters using digital calipers. Results: The 1,2 portal was significantly closer to radial artery and first extensor compartment tendons than the 2R portal. The radial artery was on average 1.32 mm from the 1-2 portal and 14.25 mm from the 2R portal. The 2R portal was significantly closer to the second and third extensor compartment tendons. The closest branch of the superficial branch of the radial nerve (SBRN) was on average 2.04 mm from the 1-2 portal and 7.59 mm from the 2R portal, but this was not statistically significant. Conclusions: We advocate using the 2R portal preferentially to the 1,2 portal when treating radial sided wrist pathology to decrease the risk of iatrogenic radial artery and SBRN injury.
Safety and efficacy of endovascular treatment for tiny ruptured intracranial aneurysms with low-profile visualized intraluminal support stents
Authors: Jin Yazhou , Guo Xinbin , Quan Tao , Chen Zhen , Liu Chao , Guan Sheng 
Published: February 2022

Background Endovascular treatment for tiny ruptured intracranial aneurysms is known to be technically challenging. Thus, we aimed to investigate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stents in the treatment of tiny ruptured intracranial aneurysms. Methods From April 2014 to June 2019, among 90 patients with tiny ruptured aneurysms who were treated at our institution endovascularly, 28 underwent stent-assisted coiling with LVIS stents. The clinical and angiographic results were reviewed. Results In the LVIS group, complete occlusion was achieved in 27 patients (96.4%). Intraprocedural thrombus formation occurred in 3 patients (10.7%). Follow-up angiography in 24 patients at 6–12 months showed complete occlusion in 23 patients (95.8%) and no aneurysm recurrence. In the coiling-only group, complete occlusion was achieved in 58 patients (93.5%). Intraprocedural aneurysm rupture occurred in 2 patients (3.2%), and postprocedural ischemia occurred in 4 patients (6.5%), with a complication rate of 9.7%. Follow-up angiography in 52 patients at 6–12 months showed complete occlusion in 43 patients (82.7%) and aneurysm recurrence in 7 patients (9.2%). No significant (p > 0.05) differences existed between the two groups. Conclusions The LVIS stent is safe and effective in the treatment of tiny ruptured intracranial aneurysms.
Respectful maternity care among laboring women in public hospitals of Benishangul Gumuz Region, Ethiopia: A mixed cross-sectional study with direct observations
Authors: Amsalu Bezabh , Aragaw Amanu , Sintayehu Yitagesu , Sema Alekaw , Belay Yalelet , Tadese Getasew , Kassie Nigus , Guta Alemu , Tibebu Abel , Tiruye Getahun 
Published: February 2022

Objectives: Promoting respectful maternity care is a fundamental strategy for enhancing facility birth, which significantly reduces maternal and newborn mortality and morbidity. Despite these effects, disrespect and abusive childbirth care remain a challenge in Ethiopia. Therefore, this study aimed to determine the prevalence of respectful maternity care and its associated factors among laboring women in public hospitals of Benishangul Gumuz region, Ethiopia. Methods: A facility-based cross-sectional study design was employed, and trained external assessors observed the care provided to 404 laboring women in public hospitals using structured observation checklists. A focus group discussion and two key informant interviews were also conducted. A structured pre-tested questionnaire and a semi-structured guide were used to generate quantitative and qualitative data, respectively. Seven verification criteria were employed, and the mean value and above for each criterion were used to measure respectful maternity care. Results: Of the 404 client–provider interaction observations during childbirth, only 12.6% ( n = 51) participants received respectful maternity care. Being from an urban area (adjusted odds ratio = 3.34, 95% confidence interval: 1.39, 8.08), giving childbirth at daytime (adjusted odds ratio = 2.59, 95% confidence interval: 1.26, 5.33), receiving the service from compassionate and respectful care trained provider (adjusted odds ratio = 4.54, 95% confidence interval: 1.63, 12.66), giving childbirth at general hospital (adjusted odds ratio = 3.03, 95% confidence interval: 1.39, 6.65) were positively associated with respectful maternity care. Staff workload, shortage of supply and equipment, partiality in providing timely care, yelling and insulting at clients and birth companions were also barriers to respectful maternity care. Conclusion: The observed respectful maternity care practices were low in the study area. Therefore, the findings of this study suggest that addressing respectful maternity care would require increased compassionate and respectful care trained providers, and sustained efforts to improve access to basic equipment and supply for maternity care with an emphasis on primary hospitals. Tailored interventions aimed at improving respectful maternity care should also target rural residents and nighttime parturients.
Incidence and predictors of attrition among children on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019: Retrospective follow-up study
Authors: Chanie Ermias Sisay , Tesgera Beshah Debrework , Ayele Amare Demsie 
Published: February 2022

Objectives: Retaining on antiretroviral therapy is essential for reducing HIV-related morbidity and mortality. However, attrition in HIV-positive children remains a critical challenge in resource-limited settings, including Ethiopia. This study aims to determine the incidence and predictors of attrition among children on antiretroviral therapy at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods: An institution-based retrospective follow-up study was conducted among 357 HIV-positive children at the University of Gondar Comprehensive Specialized Hospital from 1 January 2005 to 30 December 2018 (G.C.). Data were collected by chart review using a structured and pre-tested data abstraction checklist. SPSS 22 and STATA 14.0 were used for data entry and analysis, respectively. In the Cox proportional hazard model, bivariables had a 0.25 computed to multivariable, and variables with a p-value of 0.05 at a 95% confidence interval were considered statistically significant predictors of attrition incidence. Results: A total of 344 child records with a completeness rate of 96.4% were reviewed and included in the analysis. The median follow-up period was 4.3 (interquartile range = 4.3 ± 4.7) years, and the median survival time was 132 months. The incidence rate of attrition was 6.6 per 100 person year observation (PYO) (95% confidence interval = 5.5, 8.0). In all, 105 (30.5%) children were recorded as attrition in the follow-up period. Baseline WHO clinical staging 3 and 4 (adjusted hazard ratio = 2.3 (95% confidence interval = 1.3, 4.0)), baseline weight-for-age −2 Z-score (adjusted hazard ratio = 3.1 (95% confidence interval = 1.7, 5.3)), cotrimoxazole non-users (adjusted hazard ratio = 2.5 (95% confidence interval = 1.4, 4.3)), and baseline hemoglobin levels 10 mg/dL (adjusted hazard ratio = 2.7 (95% confidence interval = 1.5, 47)) were found to be a predictor of attrition. Conclusion: The overall incidence of the rate of attrition was high. Baseline WHO clinical staging 3/4, baseline hemoglobin 10 mg/dL, cotrimoxazole (cotrimoxazole preventive therapy) non-user, and underweight at baseline (weight-for-age 2 Z-score) were found to be the main predictors of attrition.
Outbreak of feline infectious peritonitis (FIP) in shelter-housed cats: molecular analysis of the feline coronavirus S1/S2 cleavage site consistent with a ‘circulating virulent–avirulent theory’ of FIP pathogenesis
Authors: Healey Eleni A , Andre Nicole M , Miller Andrew D , Whittaker Gary R , Berliner Elizabeth A 
Published: February 2022

Case series summary This case series describes three shelter-housed cats concurrently diagnosed with feline infectious peritonitis (FIP). The cats were from a cohort of seven surrendered from the site of a house fire. The three cats presented with mild upper respiratory signs. Within 10 days they clinically declined: progressive signs included pyrexia, icterus, lethargy, anorexia and cavitary effusions. Necropsy followed by histopathology and immunohistochemistry confirmed a diagnosis of FIP in all three. Molecular analysis of the causative feline coronavirus (FCoV) revealed varied amino acid alterations in the spike gene both between cats and between sample types in individual cats. A fourth cat from the cohort remained healthy in the shelter but succumbed to FIP 6 weeks post-adoption. Relevance and novel information This case series places FCoV genetic sequences in the context of clinical signs in a small shelter outbreak. Each of the three cats concurrently developed a slightly different clinical presentation. PCR amplification and genetic sequencing revealed that two cats shared an S1/S2 cleavage site mutation (R790S) previously described to be associated with the development of FIP; one of the cats had an additional S1/S2 cleavage site mutation (R793S). The third cat had a single, identical S1/S2 point mutation (R790G) unique from the other two cats; the R790G mutation has not been previously reported. This case series provides interesting data on point mutations associated with the development of FIP and provides support for a ‘circulating virulent–avirulent theory’ of FIP pathogenesis in a small shelter outbreak.
Primary pulmonary diffuse large B-cell lymphoma associated with feline leukaemia virus infection in a young cat
Authors: Ishikawa Kento , Nagashima Tomokazu , Machida Yukino , Yasuda Akiko , Yoshida Karin , Fujita Michio , Ochiai Kazuhiko , Azakami Daigo , Michishita Masaki 
Published: February 2022

Case summary A 4-year-old castrated male domestic shorthair cat with a continuous cough was brought to a private veterinary clinic for detailed examination. Radiography of the thoracic cavity revealed a severe radiopaque region in the caudal lobe of the right lung. At 108 days after the initial visit, CT showed a mass of 27 × 23 × 18 mm in the caudal lobe of the right lung. At that time, no abnormalities in other organs except for the lung were detected on CT and peripheral blood and blood biochemistry tests. The mass in the caudal lobe of the right lung was resected by lobectomy; it had a white surface and was firm. Histopathologically, the mass was non-encapsulated, showing an unclear boundary with surrounding tissues. The mass comprised large, round or polygonal neoplastic cells arranged in a diffuse pattern. Immunohistochemically, neoplastic cells were diffusely positive for CD20, feline leukaemia virus (FeLV) p27 and FeLV glycoprotein 70 but negative for CD3, CD204 and E-cadherin. Based on these findings, diffuse large B-cell lymphoma associated with FeLV infection was diagnosed. Although the cat showed no clinical signs of gastrointestinal or respiratory injury, a routine ultrasonography revealed thickening in the jejunum wall 196 days after lobectomy, and subsequent fine-needle aspiration examination confirmed high-grade lymphoma. Relevance and novel information This is the first report of primary pulmonary diffuse large B-cell lymphoma associated with FeLV infection in a young cat.
Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites
Authors: Reed David E. , Bokhour Barbara G. , Gaj Lauren , Barker Anna M. , Douglas Jamie H. , DeFaccio Rian , Williams Rhonda M. , Engel Charles C. , Zeliadt Steven B. 
Published: February 2022

Objective Veterans Healthcare Administration (VHA) conducted a large demonstration project of a holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns of service use among Veterans with chronic pain, comparing those with and without PTSD. Methods We assessed the use of Whole Health services in a cohort of Veterans with co-occurring chronic pain and PTSD (n = 1698; 28.9%), comparing them to Veterans with chronic musculoskeletal pain only (n = 4170; 71.1%). Data was gathered from VA electronic medical records and survey self-report. Whole Health services were divided into Core Whole Health services (e.g., Whole Health coaching) and CIH services (e.g., yoga). Logistic regression was used to determine whether Veterans with co-occurring chronic pain and PTSD utilized more Whole Health services compared to Veterans with chronic pain but without PTSD. Results A total of 40.1% of Veterans with chronic pain and PTSD utilized Core Whole Health services and 53.2% utilized CIH therapies, compared to 28.3% and 40.0%, respectively, for Veterans with only chronic pain. Adjusting for demographics and additional comorbidities, Veterans with comorbid chronic pain and PTSD were 1.24 ( 95% CI: 1.12, 1.35, P ≤ .001) times more likely than Veterans with chronic pain only to use Core Whole Health services, and 1.23 ( 95% CI: 1.14, 1.31, P ≤ .001) times more likely to use CIH therapies. Survey results also showed high interest levels in Core Whole Health services and CIH therapies among Veterans who were not already using these services. Conclusion Early implementation efforts in VHA led to high rates of use of Core Whole Health and CIH therapy use among Veterans with co-occurring chronic pain and PTSD. Future assessments should examine how well these additional services are meeting the needs of Veterans in both groups.
Shoulder Pathology on Magnetic Resonance Imaging in Asymptomatic Elite-Level Rock Climbers
Authors: Cooper Joseph D. , Seiter Max N. , Ruzbarsky Joseph J. , Poulton Ricky , Dornan Grant J. , Fitzcharles Eric K. , Ho Charles P. , Hackett Thomas R. 
Published: February 2022

Background: The prevalence of findings on shoulder magnetic resonance imaging (MRI) is high in asymptomatic athletes of overhead sports. Purpose/Hypothesis: The purpose of this study was to determine the prevalence of atypical findings on MRI in shoulders of asymptomatic, elite-level climbers and to evaluate the association of these findings with clinical examination results. It was hypothesized that glenoid labrum, long head of the biceps tendon, and articular cartilage pathology would be present in >50% of asymptomatic athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 50 elite climbers (age range, 20-60 years) without any symptoms of shoulder pain underwent bilateral shoulder examinations in addition to dedicated bilateral shoulder 3-T† MRI. Physical examinations were performed by orthopaedic sports medicine surgeons, while MRI scans were interpreted by 2 blinded board-certified radiologists to determine the prevalence of abnormalities of the articular cartilage, glenoid labrum, biceps tendon, rotator cuff, and acromioclavicular joint. Results: MRI evidence of tendinosis of the rotator cuff, subacromial bursitis, and long head of the biceps tendonitis was exceptionally common, at 80%, 79%, and 73%, respectively. Labral pathology was present in 69% of shoulders, with discrete labral tears identified in 56%. Articular cartilage changes were also common, with humeral pathology present in 57% of shoulders and glenoid pathology in 19% of shoulders. Climbers with labral tears identified in this study had significantly increased forward elevation compared with those without labral tears in both active ( P = .026) and passive ( P = .022) motion. Conclusion: The overall prevalence of intra-articular shoulder pathology detected by MRI in asymptomatic climbers was 80%, with 57% demonstrating varying degrees of glenohumeral articular cartilage damage. This high rate of arthritis differs significantly from prior published reports of other overhead sports athletes.
The effect of motor relearning on balance, mobility and performance of activities of daily living among post-stroke patients: Study protocol for a randomised controlled trial
Authors: Ghrouz Amer , Marco Ester , Muñoz-Redondo Elena , Boza Roser , Ramirez-Fuentes Cindry , Duarte Esther 
Published: February 2022

Background Balance and gait impairments are the most common motor deficits due to stroke, limiting the patients' daily life activities and participation in society. Studies investigating effect of task-specific training using biomechanical balance and gait variables (i.e. kinetic and kinematic parameters) as well as posturography after stroke are scarce. Objectives The primary aim of this study is to assess the efficacy and long-term outcome of task-specific training based on motor relearning program (MRP) on balance, mobility and performance of activities of daily living among post-stroke patients. Methods In this two-armed randomised controlled clinical trial, a total of 66 sub-acute stroke patients who meet the trial criteria will be recruited. The patients will randomly receive task-specific training based on MRP or a conventional physical therapy program (CPT). Twenty-four physiotherapy sessions will be conducted, divided into three training sessions per week, 1 h per session, for 8 weeks, followed by an analysis of changes in patient’s balance, gait and performance of activates of daily living at three time periods; baseline, post-intervention and follow-up after 3-months, using clinical outcome measures and instrumental analysis of balance and gait. Discussion The results of this study can guide to better understanding and provide an objective clinical basis for the use of task-specific training in stroke rehabilitation. Also, it intends to help bridge the current knowledge gap in rehabilitation and training recommendations to provide a therapeutic plan in post-stroke rehabilitation. Trial registration ClinicalTrials.gov (NCT05076383). Registered on 13 October 2021 (Protocol version: v2.0).
Comparative safety of inhaled corticosteroids and macrolides in Medicare enrolees with bronchiectasis
Authors: Henkle Emily , Daley Charles L. , Curtis Jeffrey R. , Chan Benjamin , Aksamit Timothy R. , Winthrop Kevin L. 
Published: February 2022

IntroductionBronchiectasis is an increasingly common chronic inflammatory airway disease. We evaluated secondary safety outcomes in a comparative effectiveness study of chronic inhaled corticosteroids (ICS) and macrolide monotherapy in bronchiectasis patients.MethodsWe conducted a retrospective study using US Medicare Parts A, B and D (but not C) 2006–2014 datasets. Among those with a pulmonologist-associated bronchiectasis claim (ICD-9-CM 494.0 or 494.1), without cystic fibrosis, we identified the first new use of either chronic (>28 days) ICS or macrolide monotherapy. For each drug exposure, we calculated crude incidence rates of the secondary safety outcomes: arrhythmia, myocardial infarction, sensorineural hearing loss, hip fracture and opportunistic infections. We calculated a propensity score (PS) for ICS use using demographic, clinical and utilisation characteristics and compared risks of macrolidesversusICS for each outcome using PS decile-adjusted Cox regression models.ResultsOf 285 043 Medicare patients with bronchiectasis, we identified 6500 (2%) macrolide and 83 589 (29%) ICS new users. Key covariates were balanced across exposure groups within decile. Myocardial infarction, hip fracture and opportunistic infection were not significantly associated with treatment. Macrolides were associated with a decreased risk of arrhythmia (adjusted hazard ratio (aHR) 0.87, 95% CI 0.80–0.94) and an increased risk of sensorineural hearing loss (aHR 1.38, 95% CI 1.56–1.22) compared to ICS.ConclusionsMacrolides were not associated with an elevated risk of acute cardiac events compared to ICS. The increased risk of hearing loss in macrolide users compared to ICS users in older bronchiectasis patients should be balanced against known benefits of macrolides.
Determining if T cell antigens are naturally processed and presented on HLA class I molecules
Authors: Friedman Jay , Gunti Sreenivasulu , Lee Maxwell , Bai Ke , Hinrichs Christian , Allen Clint T. 
Published: February 2022

Abstract
Background
Determining T cell responses to naturally processed and presented antigens is a critical immune correlate to determine efficacy of an investigational immunotherapeutic in clinical trials. In most cases, minimal epitopes and HLA restriction elements are unknown.

Results
Here, we detail the experimental use of ex vivo expanded autologous B cells as antigen presenting cells to overcome the limitation of unknown HLA restriction, and the use of electroporated full length mRNA encoding full length parental proteins to ensure that any observed T cell responses are specific for antigens that are naturally processed and presented.

Conclusions
This technique can serve as useful experimental approach to determine the induction or enhancement of specific responses to naturally processed and presented antigens on HLA class I molecules in peripheral blood or tumor infiltrating T cells.