bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum lactate is associated with increased illness severity in immunocompromised pediatric hematology oncology patients presenting to the emergency department with fever
Authors: Slatnick Leonora Rose , Miller Kristen , Scott Halden F. , Loi Michele , Esbenshade Adam J. , Franklin Anna , Lee-Sherick Alisa B. 
Published: October 2022

IntroductionDetermining which febrile pediatric hematology/oncology (PHO) patients will decompensate from severe infection is a significant challenge. Serum lactate is a well-established marker of illness severity in general adult and pediatric populations, however its utility in PHO patients is unclear given that chemotherapy, organ dysfunction, and cancer itself can alter lactate metabolism. In this retrospective analysis, we studied the association of initial serum lactate in febrile immunosuppressed PHO patients with illness severity, defined by the incidence of clinical deterioration events (CDE) and invasive bacterial infection (IBI) within 48 hours.MethodsReceiver operating characteristic (ROC) curves were reported using initial lactate within two hours of arrival as the sole predictor for CDE and IBI within 48 hours. Using a generalized estimating equations (GEE) approach, the association of lactate with CDE and IBI within 48 hours was tested in univariate and multivariable analyses including covariates based on Quasi-likelihood under Independence Model Criterion (QIC). Additionally, the association of lactate with secondary outcomes (i.e., hospital length of stay (LOS), intensive care unit (PICU) admission, PICU LOS, non-invasive infection) was assessed.ResultsAmong 897 encounters, 48 encounters had ≥1 CDE (5%), and 96 had ≥1 IBI (11%) within 48 hours. Elevated lactate was associated with increased CDE in univariate (OR 1.77, 95%CI: 1.48-2.12, p&lt;0.001) and multivariable (OR 1.82, 95%CI: 1.43-2.32, p&lt;0.001) analyses, longer hospitalization (OR 1.15, 95%CI: 1.07-1.24, p&lt;0.001), increased PICU admission (OR 1.68, 95%CI: 1.41-2.0, p&lt;0.001), and longer PICU LOS (OR 1.21, 95%CI: 1.04-1.4, p=0.01). Elevated lactate was associated with increased IBI in univariate (OR 1.40, 95%CI: 1.16-1.69, p&lt;0.001) and multivariable (OR 1.49, 95%CI: 1.23-1.79, p&lt;0.001) analyses. Lactate level was not significantly associated with increased odds of non-invasive infection (p=0.09). The QIC of the model was superior with lactate included for both CDE (305 vs. 325) and IBI (563 vs. 579).ConclusionsThese data demonstrated an independent association of elevated initial lactate level and increased illness severity in febrile PHO patients, suggesting that serum lactate could be incorporated into future risk stratification strategies for this population.
Impact of the COVID-19 pandemic on the regular follow-up and outcomes of patients with chronic myeloid leukemia in chronic-phase
Authors: Yılmaz Umut , Küçükyurt Selin , Tunç Sertaç , Eşkazan Ahmet Emre 
Published: October 2022

IntroductionCOVID-19 immediately became a major consideration in the management of chronic myeloid leukemia (CML). The influence of such considerations on viral transmission rates and leukemic control remain to be explored. We conducted this study to identify these alterations and to investigate their clinical consequences.MethodsThis was a cross-sectional study, performed at a single institution on CML patients who were interviewed with a survey. We compared variables concerning new attitudes in the pandemic era between the 12-month periods before and after the pandemic onset. Outcome data were attained from the hospital archives.FindingsThe number of patients receiving regular outpatient care for CML in chronic phase was 210, 91% had achieved at least major molecular responses. We assessed survival, progression, number of clinical visits of all, performed the survey on 89% and evaluated molecular responses on 86.6% of these patients. The frequency of clinical and molecular monitoring was significantly reduced during the pandemic deviating significantly from the guidelines. Frequency of death, progression, loss of molecular response was not significantly increased during the pandemic era despite a few cases where the delay in assessment possibly played a role in the unfavorable outcomes. There were no COVID related deaths or disabilities.ConclusionThe case-based untoward events would have probably been better managed with a more efficient communication web between patients, hematologists, and the laboratory. Therefore, it seems reasonable to consider whether such communicative paths are functional before giving up on the set schedule of CML management at times of uncertainty.
Dietary fiber and probiotics based on gut microbiota targeting for functional constipation in children with cerebral palsy
Authors: Huang Congfu , Lyu Jinli , Chu Chunuo , Ge Lan , Peng Yuanping , Yang Zhenyu , Xiong Shenghua , Wu Bin , Chen Xiao , Zhang Xiaowei 
Published: October 2022

Gastrointestinal (GI) disorders are very common among children with cerebral palsy. Gut microbiota has been confirmed to maintain normal GI physiological function and further contributed to cerebral palsy through the gut-brain axis. Our study was to investigate the effect of dietary fiber combined with probiotics on functional constipated children with cerebral palsy. In total, 35 patient children were enrolled and divided into general diet group (n = 14) and liquid diet group (n = 21). All the participants received Compound Dietary Fiber (CDF) for 1 month and lactic acid-producing and butyric acid-producing probiotics for 6 months. After a 1-month intervention, the frequency of spontaneous and manual defecation, and Bristol score were all significantly improved (P &lt; 0.001). The α-diversity of the gut microbiota was significantly increased after a 1-month intervention (P &lt; 0.05), with a higher abundance of butyric acid-producing bacteria and a lower abundance of opportunistic pathogens (P &lt; 0.05, FDR &lt; 0.05). However, the impersistent effect of the 6-month intervention suggested the insufficient impact of intaking probiotics alone and the short duration of CDF intervention. Moreover, although the intervention had affected the constipation symptoms equally in cerebral palsy children with a general diet and liquid diet, the general diet group showed a greater and more durable change in gut microbiota and clinical phenotypes after intervention than the liquid diet group, which indicated that longer intervention time should be considered for liquid diet children. This study not only illustrated that supplementation of dietary fiber combined with probiotics can improve functional constipation in children with cerebral palsy, but also provides guidance for optimal intervention strategy for future studies, which will further benefit cerebral palsy children.Clinical trial registration:http://www.chictr.org.cn/showproj.aspx?proj=46902, identifier: ChiCTR1900028257.
The combination of Chinese and Western Medicine in the management of rheumatoid arthritis: A real-world cohort study across China
Authors: Zhong Linda LD. , Wang Rongsheng , Lam Wai Ching , Zhu Qi , Du Peipei , Cao Pei Hua , Jiang Ting , Zhang Yuan Yuan , Shen Jie , Su Xiao , Xue Luan , Mao Jianchun , Fang Yong Fei , Gao Ming Li , Hu Chun Rong , Peng Jiang Yun , Gu Ying , Wei Qianghua , Huang Runyue , Lyu Aiping , Liu Hongxia , He Dongyi 
Published: October 2022

Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study.Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM).Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63–0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64–0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73–0.98; p = 0.030) in the per-protocol population.Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.
Influence of dynamic stretching on ankle joint stiffness, vertical stiffness and running economy during treadmill running
Authors: Pamboris George M. , Noorkoiv Marika , Baltzopoulos Vasilios , Powell Douglas W. , Howes Tom , Mohagheghi Amir A. 
Published: October 2022

The purpose of the present study was to investigate whether and how dynamic stretching of the plantarflexors may influence running economy. A crossover design with a minimum of 48 h between experimental (dynamic stretching) and control conditions was used. Twelve recreational runners performed a step-wise incremental protocol to the limit of tolerance on a motorised instrumented treadmill. The initial speed was 2.3 m/s, followed by increments of 0.2 m/s every 3 min. Dynamic joint stiffness, vertical stiffness and running kinematics during the initial stage of the protocol were calculated. Running economy was evaluated using online gas-analysis. For each participant, the minimum number of stages completed before peak O2 uptake (V̇O2peak) common to the two testing conditions was used to calculate the gradient of a linear regression line between V̇O2 (y-axis) and speed (x-axis). The number of stages, which ranged between 4 and 8, was used to construct individual subject regression equations. Non-clinical forms of magnitude-based decision method were used to assess outcomes. The dynamic stretching protocol resulted in a possible decrease in dynamic ankle joint stiffness (−10.7%; 90% confidence limits ±16.1%), a possible decrease in vertical stiffness (−2.3%, ±4.3%), a possibly beneficial effect on running economy (−4.0%, ±8.3%), and very likely decrease in gastrocnemius medialis muscle activation (−27.1%, ±39.2%). The results indicate that dynamic stretching improves running economy, possibly via decreases in dynamic joint and vertical stiffness and muscle activation. Together, these results imply that dynamic stretching should be recommended as part of the warm-up for running training in recreational athletes examined in this study.
Psychological outcomes and associated factors amongst healthcare workers during a single wave, deeper into the COVID-19 pandemic in China
Authors: Tang Jianyong , Wu You , Qi Hongyan , Li Dongjing , Shi Jianfei , Wang Wei , Niu Mengmeng , Liu Liang , Wang Dong , Li Xia 
Published: October 2022

BackgroundTo date, the repeated breakout of the novel coronavirus disease 2019 (COVID-19) pandemic across many regions in China has caused continuous physical and mental harm to health care workers. This study investigates the psychological burden of the pandemic and its associated risk factors among Chinese healthcare workers (HCWs) during a single wave of COVID-19.MethodsFor this cross-sectional web-based survey conducted from January 16, 2022 to February 5, 2022, a total of 412 HCWs from Northwestern China were recruited. Their socio-demographic data and COVID-19 related survey variables were then collected using online self-rating questionnaires. In addition, the Chinese versions of well-validated instruments, including the 12-item General Health Questionnaire for psychiatric morbidity, the Generalized Anxiety Disorder Scale-7 for anxiety, the Patient Health Questionnaire-9 for depression and the Insomnia Severity Index-7 for insomnia, were used to assess the participants' mental health status. Multivariate logistic regression analysis was eventually performed to identify the risk factors associated with the psychological outcomes.ResultsOf the 388 participants who were included in the final study (94.17% response rate), the prevalence of anxiety, depression, and insomnia symptoms were 25.3% (95% CI: 20.9-29.6%), 40.7% (95% CI: 35.8-45.6%), and 30.9% (95% CI: 26.3-35.5%), respectively. Multivariate logistic regression analysis revealed that being a woman and having a perceived need for psychological support were risk factors for all psychological outcomes, while poor disease cognition and perceived susceptibility were risk factors for anxiety. Poor disease cognition and being unvaccinated against COVID-19 were risk factors for depression, with the latter also being an independent risk factor for insomnia.ConclusionThis study has identified a relatively lower prevalence rate of psychological disorders among Chinese HCWs during a single wave, deeper into the COVID-19 pandemic. Female HCWs, and those who had a perceived need for psychological support, had poor disease cognition, were perceived as susceptible to COVID-19 and had not been vaccinated against COVID-19 deserve more attention.
Association between horizontal violence and turnover intention in nurses: A systematic review and meta-analysis
Authors: Zhang Yue , Yin Rulan , Lu Jing , Cai Jianzheng , Wang Haifang , Shi Xiaoqing , Mao Lifen 
Published: October 2022

BackgroundHorizontal violence is common in nurses. Most published studies have focused on horizontal violence and higher turnover rates in nurses; however, it lacks systematic reviews and meta-analyses. The purpose of this review is to quantitatively assess the correlation between horizontal violence and turnover intention in nurses.MethodsSystematic review and meta-analysis were performed in accordance with PRISMA guidelines. The relationship between horizontal violence and turnover intention in nurses was obtained by systematically searching related literature in four English databases (Cochrane, PubMed, Embase, and CINAHL) and three Chinese databases (SinoMed, CNKI, and Wanfang) (up to 6 March 2022). The relationship between horizontal violence and turnover intention was evaluated using Fisher's z-value, which was then converted to r. STATA 16.0 was used to perform statistical analysis. The random-effects model was performed to synthesize data.ResultsA total of 14 studies with 6,472 nurses were included. A low-positive correlation of horizontal violence with turnover intention was found (pooled r=0.32 [0.29–0.34]). Subgroup analysis showed that sample size and quality were not the source of heterogeneity. Measurement tool was the source of heterogeneity. Although geographic region might not be the source of heterogeneity, further subgroup analysis of the country reveals heterogeneity. The funnel plot and Egger's test showed no publication bias.ConclusionHorizontal violence had a low positive correlation with turnover intention in nurses. Nurses who experienced horizontal violence were more likely to leave or change careers than those who did not experience horizontal violence. This finding helps to draw attention to horizontal violence by nursing managers and implement effective interventions for nurses, so as to reduce nurses' turnover.
Muscle mass and physical function in patients with bladder cancer—Data from a prematurely terminated prospective cohort study
Authors: Omland Lise Høj , Ammitzbøll Gunn , Lund Cecilia Margareta , Lindberg Henriette , Dalton Susanne Oksbjerg , Suetta Charlotte , Pappot Helle 
Published: October 2022

BackgroundPatients with bladder cancer (BC) have a high prevalence of comorbidity and low adherence to systemic anticancer treatment but it is unknown whether this is associated with sarcopenia.ObjectiveWe aimed to investigate if the sarcopenia-defining parameters (muscle strength, muscle mass and physical performance) were associated with reduced adherence to systemic anticancer treatment in patients with BC, and if these muscle domains changed during treatment.MethodsPatients &gt;18 years of age with BC referred for chemotherapy or immunotherapy at Department of Oncology, Rigshospitalet, Denmark were eligible for study inclusion. Measurements were performed before treatment initiation and within one week after treatment termination, and consisted of assessments of muscle strength, muscle mass, and physical performance. Data was compared with thresholds outlined by the European Working Group on Sarcopenia in Older Patient's (EWGSOP2) guidelines and a healthy, age-matched Danish cohort.ResultsOver a period of 29 months, we included 14 patients of whom two completed follow-up measurements. The recruitment rate was &lt;50% of planned due to logistics and Covid-19 related limitations. Consequently, a decision to prematurely terminate the study was made. No patients fulfilled EWGSOP2 criteria for sarcopenia, but the majority had reduction in one or more muscle domains compared to healthy, age-matched individuals. The majority of patients had poor treatment tolerance, leading to dose reductions and postponed treatments.ConclusionsIn this prematurely terminated study, no patients fulfilled EWGSOP2 criteria for sarcopenia, yet, most patients were affected in one or more muscle domains and the majority had compromised treatment adherence.
Conventional versus modified nipple sparing mastectomy in immediate breast reconstruction: Complications, aesthetic, and patient-reported outcomes
Authors: Najmiddinov Bakhtiyor , Park Joseph Kyu-hyung , Yoon Kyung-Hwak , Myung Yujin , Koh Hyoung Won , Lee Ok Hee , Hoon Jeong Jae , Shin Hee Chul , Kim Eun-Kyu , Heo Chan Yeong 
Published: October 2022

BackgroundNipple-sparing mastectomy (NSM) followed by immediate breast reconstruction (IBR) is the optimal surgical treatment for breast cancer. However, investigations are ongoing to improve the surgical technique to achieve better results. This study aimed to evaluate the outcomes of modified NSM (m-NSM), which preserves the anterior lamellar fat layer, in patients who underwent IBR.MethodsAll patients who underwent modified NSM (m-NSM) or conventional NSM (c-NSM) followed by IBR using autologous tissue or implants were retrospectively reviewed between January 2014 and January 2021. Two mastectomy types were compared in terms of postoperative complications and aesthetic outcomes using panel assessment scores by physicians and reported outcomes using Breast-Q. In addition, postoperative evaluations of the thickness of mastectomy flap was performed using CT scan images.ResultsA total of 516 patients (580 breasts) with NSM (143 breasts with c-NSM and 437 breasts with m-NSM) followed by IBR were reviewed. The mean ± SD flap thickness was 8.48 ± 1.81 mm in patients who underwent m-NSM, while it was 6.32 ± 1.15 mm in the c-NSM cohort (p = 0.02). The overall major complications rate was lower in the m-NSM group (3.0% vs. 9.0%, p &lt; 0.013). Ischemic complications of the mastectomy flap and nipple-areolar complex (NAC) were more in c-NSM, although the difference was not statistically significant. The mean panel assessment scores were higher in the m-NSM group (3.14 (good) and 2.38 (fair) in the m-NSM and c-NSM groups, respectively; p &lt; 0.001). Moreover, m-NSM was associated with greater improvements in psychosocial (p &lt; 0.001) and sexual (p = 0.007) well-being.ConclusionPreserving the anterior lamellar fat in NSM was associated with thicker mastectomy flap, overall lower rates of complications, including ischemia of the mastectomy flap and nipple-areolar complex, and was associated with better aesthetic outcomes and improved quality of life.
Diabetes Mellitus II como fator de risco à Aterogênese / Diabetes Mellitus II as a risk factor for Atherogenesis
Authors: Oliveira Carolline Damas de Andrade , Ostrowski Renata Batista , Ramos Ellen Cristine Pacheco , Valentini Maria Gabriela Teixeira , Dantas Rebeka Daiany Duarte , Trindade Gabriella Fernandes , Duarte Angélica Souza , Tavares Matheus Cattini Sampaio 
Published: October 2022

Sabe-se que o diabetes mellitus 2 (DMII) está intimamente ligado aos efeitos aterogênicos da dislipidemia relacionada ao diabetes. Níveis elevados de insulina predispõem ao desenvolvimento de doenças arteriais. O mecanismo patológico compartilhado entre a aterosclerose e o diabetes tipo 2 inclui a elevação de citocinas como MCP-1 e interleucina-6 (IL-6), que contribuem para a inflamação, evoluindo para progressão acelerada da aterosclerose pré-existente. O objetivo da revisão de literatura é apresentar a relação do DMII como fator de risco para a aterogênese. Foi realizada uma revisão bibliográfica nos bancos de dados Scielo e LILACS por meio da biblioteca BVS/Bireme. Utillizou-se os descritores: “Diabetes Mellitus II”, “aterogênese” e “risco”. É sabido que a cascata de reações causadas pela hiperglicemia corrobora para distúrbios metabólicos responsáveis pela mudança estrutural e funcional nos vasos sanguíneos, contribuindo para a lesão progressiva do endotélio e aterogênese.
New Genetic Markers of Thyroid Cancer
Authors: Якубовский С.В. , Фридман М.В. , Кондратенко Г.Г. , Лемеш В.А. , Кипень В.Н. 
Published: October 2022

Узловые образования щитовидной железы обнаруживаются с высокой частотой, причем у 7–15% пациентов эти узлы оказываются злокачественными. Стремительный рост заболеваемости высокодифференцированными вариантами рака щитовидной железы, появление значительного количества пациентов с агрессивным клиническим течением этой опухоли, сложности дооперационной ее диагностики требуют выработки персонализированного лечебно-диагностического подхода. В настоящее время тонкоигольная аспирационная биопсия считается «золотым стандартом» диагностики, однако у каждого третьего пациента результат этого исследования не позволяет с достаточной степенью уверенности определить характер процесса и/или спрогнозировать дальнейшее течение заболевания. Успехи молекулярной биологии позволили приблизиться к пониманию молекулярных механизмов особенностей клинического течения рака щитовидной железы и описать ряд соматических мутаций, имеющих как диагностическое, так и прогностическое значение. Аналитический обзор имеющихся в литературе сведений о новых генетических маркерах рака щитовидной железы и возможности их использования для предоперационной диагностики дифференцированных форм этой опухоли, а также с целью прогнозирования течения заболевания и повышения эффективности лечения призван ознакомить широкую врачебную аудиторию с современным состоянием данного вопроса.
Thyroid nodules are a widespread thyroid disorder, and in 7–15% of patients they are malignant. The rapid increase in the incidence of differentiated thyroid cancer, the emergence of a significant number of patients with an aggressive clinical course of these tumors, the complexity of its preoperative diagnosis require the development of a personalized diagnostic and treatment approach. Currently, fine-needle aspiration biopsy is considered the gold standard of diagnosis, however, in every third patient, the result of this study does not allow determining the nature of the lesion and/or predicting the further course of the disease with a sufficient degree of certainty. Advances in molecular biology have allowed to get closer to understanding the molecular mechanisms of the clinical course of thyroid cancer and to describe a number of somatic mutations that have both diagnostic and prognostic significance. An analytical review of the available information on new genetic markers of thyroid cancer and the possibility of their use for preoperative diagnosis of differentiated forms of this tumor, as well as for predicting the course of the disease and improving treatment efficiency, is intended to familiarize a wide medical audience with the current state of the issue.