bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Sarcopenia Using Muscle Ultrasound in Patients With Cirrhosis and Sarcopenic Obesity (AMUSE STUDY)
Authors: Dhariwal Sukhpal , Roy Akash , Taneja Sunil , Bansal Akash , Gorsi Ujjwal , Singh Surender , De Arka , Verma Nipun , Premkumar Madhumita , Duseja Ajay , Dhiman Radha , Singh Virendra 
Published: August 2022

Background and Aims:
Sarcopenic obesity (SO) marks a confluence of 2 complex entities involving the muscle-liver-adipose tissue axis. Computed tomographic (CT) scan-derived skeletal muscle index (SMI) remains the gold standard for sarcopenia assessment in SO. However, it has intrinsic limitations of cost, radiation, and point of care applicability. We assessed the role of muscle ultrasound (US) in SO.

Methods:
A total of 52 patients with cirrhosis and obesity were assessed for sarcopenia using SMI. US assessment of thigh and forearm muscles was done to record quadriceps muscle thickness (QMT), quadriceps feather index (QMFI), forearm muscle thickness (FMT), and forearm feather index (FFI), respectively. Evaluated US parameters were correlated with SMI and assessed for diagnostic accuracy using the area under the curve.

Results:
A total of 40 (76.9%) males and 12 (23.1%) females [mean age: 50.9 y (43.8 to 53.5 y)] were included. QMT [0.45 cm/m2 (0.42 to 0.48 cm/m2) vs. 0.67 cm/m2 (0.63 to 0.70 cm/m2)], QMFI [0.82 cm/m2 (0.77 to 0.87 cm/m2) vs. 1.12 cm/m2 (1.06 to 1.19 cm/m2)], FMT [0.19 cm/m2 (0.17 to 0.20 cm/m2) vs. 0.25 cm/m2 (0.23 to 0.27 cm/m2)], and FFI [0.38 cm/m2 (0.35 to 0.412 cm/m2) vs. 0.47 cm/m2 (0.44 to 0.50 cm/m2)] were significantly lower in patients with SO (P<0.01). A positive correlation with SMI was seen for all parameters in the entire cohort. The strongest correlation was exhibited by QMT (r=0.70) and QMFI (r=0.70) in males. The area under the curve of QMT, QMFI, FMT, and FFI were 0.98 (95% confidence interval: 0.96-1), 0.95 (0.89-1), 0.85 (0.75-0.96), and 0.80 (0.68-0.93), respectively.

Conclusions:
US-based assessment of sarcopenia has excellent diagnostic accuracy and correlates well with computed tomography-SMI in patients with SO. US may serve as an easy-to-use, point of care tool for assessing sarcopenia in SO with the advantage of repeated sequential assessment.
Reproductive and oncological outcomes of fertility-sparing surgery in patients with stage I epithelial ovarian cancer: A systematic review and meta-analysis
Authors: Zhang Yu-fei , Fan Yu , Mu Yi , Zhang Peng , Wang Meng-yao , Li Jin-ke 
Published: August 2022

Objective:
We meta-analyzed available evidence on fertility, survival, and cancer recurrence in patients with stage I epithelial ovarian cancer (EOC) after fertility-sparing surgery (FSS).

Methods:
We systematically reviewed PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials to identify studies reporting reproductive and oncological outcomes of patients with stage I EOC who underwent FSS. Random-effects models were used to calculate pooled rates of disease outcomes, along with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were conducted to identify sources of heterogeneity in the data.

Results:
We included 23 observational retrospective studies involving 1126 patients. The pooled pregnancy rate was 30% (95% CI, 0.26–0.34), while the pooled natural conception rate was 26% (95% CI, 0.20–0.33). The pooled live birth rate was 27% (95% CI, 0.22–0.32). The pooled rate of EOC recurrence was 12% (95% CI, 0.09–0.14), which did not differ significantly from the rate among patients who underwent radical surgery (odds ratio, 0.77; 95% CI, 0.45–1.33).

Conclusions:
FSS is associated with good oncological outcomes but less than satisfactory reproductive outcomes. All in all, the procedure appears to be a safe alternative to radical surgery for EOC patients who want to preserve fertility.
Ultrasound-guided 5-in-1 trigger point injection for treating tension-type headache: A case report
Authors: Kim Jun Young , Choo Yoo Jin , Chang Min Cheol 
Published: August 2022

Rationale:
Tension-type headache (TTH) is the most common type of primary headache, and trigger point injection (TPI) is frequently used for controlling pain originating from TTHs. In the current report, we introduce a TPI technique involving 4 neck muscles (upper trapezius, splenius capitis, semispinalis capitis, and inferior oblique capitis) and a greater occipital nerve (GON) block within the same sonographic view for the treatment of TTHs.

Patient concerns:
A 44-year-old woman complained with pressing and tightening, nonpulsating, recurrent headaches, mainly in the bilateral occipital area, lasting for approximately 6 months (numeric rating scale: 5). The patient had no nausea, vomiting, photophobia, or phonophobia.

Diagnoses:
The patient was diagnosed as having a TTH.

Interventions:
Under ultrasound (US) guidance, a mixed solution of 2 mL of 2% lidocaine and 5 mL of normal saline was injected layer-by-layer into the 4 target muscles of the neck (upper trapezius, splenius capitis, semispinalis capitis, and inferior oblique capitis) and near the right GON within the same sonographic view bilaterally.

Outcomes:
Two- and 4-week follow-ups after administration of the injections revealed no headache. Our US-guided 5-in-1 TPI technique is viable for treating patients with TTH.

Lessons:
We believe that it can aid in reducing the procedure time and associated pain.
Diagnosis of remnant hyperlipidaemia
Authors: Paquette Martine , Bernard Sophie , Baass Alexis 
Published: August 2022

Purpose of review
In recent years, there has been interest for the development of simplified diagnosis algorithms of dysbetalipoproteinemia (DBL) in order to avoid the complex testing associated with the Fredrickson criteria (reference method). The purpose of this review is to present recent advances in the field of DBL with a focus on screening and diagnosis.

Recent findings
Recently, two different multi-step algorithms for the diagnosis of DBL have been published and their performance has been compared to the Fredrickson criteria. Furthermore, a recent large study demonstrated that only a minority (38%) of DBL patients are carriers of the E2/E2 genotype and that these individuals presented a more severe phenotype.

Summary
The current literature supports the fact that the DBL phenotype is more heterogeneous and complex than previously thought. Indeed, DBL patients can present with either mild or more severe phenotypes that can be distinguished as multifactorial remnant cholesterol disease and genetic apolipoprotein B deficiency. Measurement of apolipoprotein B as well as APOE gene testing are both essential elements in the diagnosis of DBL.
Evaluation of the Safety of a GalaFLEX-AlloDerm Construct in Prepectoral Breast Reconstruction
Authors: Sigalove Steven , O’Rorke Erin , Maxwell G. Patrick , Gabriel Allen 
Published: August 2022

Background:
Prepectoral implant-based breast reconstruction is gaining in popularity. Acellular dermal matrices (ADMs) are an integral part of prepectoral reconstruction. However, large quantities of ADM are required for total implant coverage and the cost of ADMs could be a deterrent to reconstruction. To minimize the cost, the authors have resorted to the use of a bioabsorbable mesh, GalaFLEX, as a partial replacement to ADMs. This study evaluates the comparative safety of using a GalaFLEX-AlloDerm construct versus AlloDerm alone in prepectoral reconstruction.

Methods:
Consecutive patients who underwent immediate, expander-implant, prepectoral breast reconstruction were included in this retrospective study. Patients were stratified into two groups: those who received GalaFLEX-AlloDerm combination versus AlloDerm alone. In GalaFLEX-AlloDerm reconstructions, the lower third of the expander was covered by the AlloDerm while the rest of the expander was covered by GalaFLEX. Complications following reconstruction were compared between the groups.

Results:
AlloDerm alone was utilized in 128 patients (249 breasts) and GalaFLEX-AlloDerm in 135 patients (250 breasts). Rate of any complication was 7.6% in the AlloDerm alone group and 6.4% in the GalaFLEX-AlloDerm group. Rate of infection, major skin necrosis, seroma, capsular contracture, prosthesis exposure/extrusion, and prosthesis loss were ≤3.0% in the GalaFLEX-AlloDerm group and did not differ significantly from those in the AlloDerm only group.

Conclusions:
GalaFLEX bioabsorbable matrix is a less costly alternative to ADMs in two-staged, prepectoral reconstruction with comparable safety outcomes. Further long-term data and clinical experience are needed to better understand the safety of this matrix for use in breast reconstruction.
Siderophores: a potential role as a diagnostic for invasive fungal disease
Authors: Kriegl Lisa , Havlicek Vladimir , Dichtl Karl , Egger Matthias , Hoenigl Martin 
Published: August 2022

Purpose of review
Invasive fungal diseases (IFDs) such as invasive aspergillosis continue to be associated with high morbidity and mortality while presenting significant diagnostic challenges. Siderophores are high-affinity Fe3+ chelators produced by Aspergillus spp. and other fungi capable of causing IFD. Previously evaluated as a treatment target in mucormycosis, siderophores have recently emerged as new diagnostic targets for invasive aspergillosis and scedosporiosis. Here, we review the diagnostic potential of siderophores for diagnosing IFD, with a particular focus on invasive aspergillosis.

Recent findings
The major secreted siderophore of A. fumigatus, triacetylfusarinine C (TAFC), has been successfully detected by mass spectrometry in serum, BALF and urine of patients with invasive aspergillosis, with promising sensitivities and specificities in single-centre studies. Intracellular uptake of siderophores has also been utilized for imaging, wherein fungal siderophores have been conjugated with the easy-to-produce radioactive isotope gallium-68 (68Ga) to visualize infected body sites in PET. For the Scedosporium apiospermum complex, another siderophore N(α)-methyl coprogen B has been shown promising as a marker for airway colonization in early studies.

Summary
Siderophores and particular TAFC have the potential to revolutionize diagnostic pathways for invasive aspergillosis and other mould infections. However, larger multicentre studies are needed to confirm these promising performances. Methods that allow rapid and cost-effective measurements in routine clinical practice need to be developed, particularly when TAFC is used as a biomarker in patient specimens.
Melioidosis and Burkholderia pseudomallei: progress in epidemiology, diagnosis, treatment and vaccination
Authors: Currie Bart J. 
Published: August 2022

Purpose of review
Melioidosis and its causative bacterium Burkholderia pseudomallei are being found in unexpected locations and bacterial genotyping is providing new insights into global spread and where and how individuals are being infected. This review summarizes recent studies covering the epidemiology, diagnosis, treatment, and prevention of melioidosis.

Recent findings
Whole-genome sequencing of B. pseudomallei from patients and environmental sampling is informing the phylogeography of B. pseudomallei at regional, continental, and global levels, while also defining the epidemiology for individual cases. The situation in Africa remains the most unresolved, while the evolving story of B. pseudomallei in the Americas may establish that B. pseudomallei is endemic in parts of southern USA. Guidelines for diagnosis and treatment of melioidosis are well established, and published mortality has decreased from 50% or higher to 10% or lower in some countries but access to laboratory and therapeutic resources are not available or are extremely limited in many melioidosis-endemic regions.

Summary
The enormous clinical diversity of melioidosis and the complexities of laboratory diagnosis and of treatment make it a sentinel disease for highlighting the continuing global disparities in access to and provision of healthcare.
The Effect of a Plastic Barrier Drape on Resuscitation Performance and Provider Contamination
Authors: Young L. Caulette , Lau Jennifer , Buan Joshua , Duty Olivia , Herrera Tanya , Luu Cindy , Rake Alyssa , Chan Margaux , Bragg E. Alexis , Langga Leo , Guerrero Ed , Chang Todd P. 
Published: August 2022

Background
Patient barriers to protect health care workers from COVID-19 exposure have been studied for airway management. Few are tested for cardiopulmonary resuscitation (CPR). We sought to determine whether a plastic drape barrier affects resuscitation performance and contamination risks for a simulated cardiopulmonary arrest scenario.

Methods
This pilot trial randomized in-hospital resuscitation teams of 4 to 6 participants to a plastic drape or without a drape in an in situ cardiopulmonary arrest simulation. The mannequin's airway emanated simulated virus particles (GloGerm, Moab, UT), detectable through UV light. Primary outcomes included airway management and CPR quality measures. Secondary outcomes included visible contamination on personal protective equipment (PPE). We used the Non-Technical Skills (NO-TECHS) instrument to measure perceived team performance and the NASA Task Load Index (NASA-TLX) to measure individual workload. Outcome variables were analyzed using an analysis of covariance (ANCOVA) with participant number as a covariate.

Results
Seven teams were allocated to the intervention (plastic drape) group and 7 to the control. Intubation and ventilation performance (η2 = 0.09, P > 0.3) and chest compression quality (η2 = 0.03–0.19, P > 0.14) were not affected by the plastic drape. However, mean contaminated PPE per person decreased with the drape (2.8 ± 0.3 vs. 3.7 ± 0.3, partial η2 = 0.29, P = 0.05). No differences in perceived workload nor team performance were noted (P > 0.09).

Conclusions
In this pilot study, the use of a plastic drape barrier seems not to affect resuscitation performance on simulated cardiopulmonary arrest but decreases health care worker contamination risk. Further implementation trials could characterize the true risk reduction and any effect on resuscitation outcomes.
Predictive Models for Recurrent Membranous Nephropathy After Kidney Transplantation
Authors: Chung Edmund Y. M. , Blazek Katrina , Teixeira-Pinto Armando , Sharma Ankit , Kim Siah , Lin Yingxin , Keung Karen , Bose Bhadran , Kairaitis Lukas , McCarthy Hugh , Ronco Pierre , Alexander Stephen I. , Wong Germaine 
Published: August 2022

Background.
Recurrent membranous nephropathy (MN) posttransplantation affects 35% to 50% of kidney transplant recipients (KTRs) and accounts for 50% allograft loss 5 y after diagnosis. Predictive factors for recurrent MN may include HLA-D risk alleles, but other factors have not been explored with certainty.

Methods.
The Australian and New Zealand Dialysis and Transplant registry was used to develop 3 prediction models for recurrent MN (Group Least Absolute Shrinkage and Selection Operator [LASSO], penalized Cox regression, and random forest), which were tuned using tenfold cross-validation in a derivation cohort with complete HLA data. KTRs with MN but incomplete HLA data formed the validation cohort. Model performance was evaluated using area under the receiver operating characteristic curve (AUC-ROC).

Results.
One hundred ninety-nine KTRs with MN were included, and 25 (13%) had recurrent MN (median follow-up 5.9 y). The AUC-ROCs for Group LASSO, penalized Cox regression, and random forest models were 0.85 (95% confidence interval, 0.76-0.94), 0.91 (0.85-0.96), and 0.62 (0.57-0.69), respectively, in the derivation cohort, with moderate agreement in selected variables between the models (55%-70%). In their validation cohorts, the AUC-ROCs for Group LASSO and penalized Cox regression were 0.60 (0.49-0.70) and 0.73 (0.59-0.86), respectively. Variables of importance chosen by all models included recipient HLA-A2, donor HLA-DR12, donor-recipient HLA-B65, and HLA-DR12 match.

Conclusions.
A penalized Cox regression performed reasonably for predicting recurrent MN and was superior to Group LASSO and random forest models. These models highlighted the importance of donor-recipient HLA characteristics to recurrent MN, although validation in larger datasets is required.
Inflammatory biomarker signatures in post-surgical drain fluid may detect anastomotic leaks within 48 hours of colorectal resection
Authors: Cuff Simone M. , Reeves Nicola , Lewis Eifion , Jones Eleri , Baker Sarah , Karategos Athanasios , Morris Rachel , Torkington Jared , Eberl Matthias 
Published: August 2022

AbstractBackgroundThe optimal treatment of colorectal cancer is surgical resection and primary anastomosis. Anastomotic leak can affect up to 20% of patients and creates significant morbidity and mortality, a leak is based on clinical suspicion and subsequent radiology. Peritoneal biomarkers have shown diagnostic utility in other medical conditions and could be useful in providing earlier diagnosis. This pilot study was designed to assess the practical utility of peritoneal biomarkers after abdominal surgery utilising an automated immunoassay system in routine use for quantifying cytokines.MethodPatients undergoing an anterior resection for a rectal cancer diagnosis were recruited. A peritoneal drain was placed in the proximity of the anastomosis during surgery, and peritoneal fluid was collected at day 1 and 2 post-operatively, and analysed using the Siemens IMMULITE platform for IL-1β, IL-6, IL-10, CXCL8, TNF-α and CRP.Results42 patients were recruited. Anastomotic leak was detected in 4 patients and a further 5 patients had other intra-abdominal complications. The IMMULITE platform was able to provide robust and reliable results from the analysis of the peritoneal fluid. A metric based on the combination of peritoneal IL-6 and CRP levels was able to accurately diagnose three anastomotic leaks, whilst correctly classifying all negative control patients including those with other complications.ConclusionThis pilot study has demonstrated that a simple immune signature in surgical drain fluid could accurately diagnose an anastomotic leak at 48 hours post-operatively using instrumentation that is already widely available in diagnostic laboratories.
Exposure–response relationships for personal exposure to fine particulate matter (PM2·5), carbon monoxide, and black carbon and birthweight: Results from the multi-country Household Air Pollution Intervention Network (HAPIN) trial
Authors: Balakrishnan Kalpana , Steenland Kyle , Clasen Thomas , Chang Howard , Johnson Michael , Pillarisetti Ajay , Ye Wenlu , Naeher Luke P. , Diaz-Artiga Anaite , McCracken John P. , Thompson Lisa M. , Rosa Ghislaine , Kirby Miles A. , Thangavel Gurusamy , Sambandam Sankar , Mukhopadhyay Krishnendu , Puttaswamy Naveen , Aravindalochanan Vigneswari , Garg Sarada , Ndagijimana Florien , Hartinger Stella , UnderHill Lindsay , Kearns Katherine A , Campbell Devan , Kremer Jacob , Waller Lance , Jabbarzadeh Shirin , Wang Jiantong , Chen Yunyun , Rosenthal Joshua , Quinn Ashlinn , Papageorghiou Aris T. , Ramakrishnan Usha , Howards Penelope P. , Checkley William , Peel Jennifer L. ,   HAPIN Investigators
Published: August 2022

AbstractBackgroundHousehold air pollution (HAP) from solid fuel use is associated with adverse birth outcomes, but data on exposure-response relationships are limited. We examined associations between HAP exposures and birthweight in rural Guatemala, India, Peru, and Rwanda during the Household Air Pollution Intervention Network (HAPIN) trial.MethodsWe recruited 3200 pregnant women between 9 and <20 weeks of gestation. Women randomized to the intervention arm received a liquified petroleum gas (LPG) stove and fuel during pregnancy, while control arm women continued using biomass. We measured 24-hr personal exposures to particulate matter (PM2·5), carbon monoxide (CO), and black carbon (BC) once pre-intervention (baseline), twice post-intervention, and birthweight within 24 hours of birth. We examined the relationship between the average prenatal exposure and birthweight/weight-for-gestational age z-scores using multivariate-regression models.FindingsResults showed an inter-quartile increase in average prenatal exposure to PM2.5 (74·5 μg/m3) and BC (7·3 μg/m3) was associated with a 14·8 (95% confidence interval [CI]: -28·7g, - 0·8g) and 21·9g (95% CI: -37·3g, -6·1g) reduction in birthweight and reduced weight-for-gestational age z-scores of -0·03 (95% CI: -0.06, 0·00) and -0·05 (95%CI: -0·08, -0·01) standard deviations, respectively. We found no associations for birthweight or weight-for-gestational age z-scores with CO exposures.InterpretationResults provide support for continuing efforts to reduce HAP exposure alongside other drivers of low birthweight in low- and middle-income countries.FundingThe study is registered with ClinicalTrials.gov (NCT02944682) and funded by the U.S. National Institutes of Health (1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation (OPP1131279).
A comparison of the effectiveness of biologic therapies for asthma: a systematic review and network meta-analysis
Authors: Pitre Tyler , Jassal Tanvir , Angjeli Albi , Jarabana Vineeth , Nannapaneni Sricherry , Umair Ayesha , Hussain Muizz , Leung Gareth , Kirsh Sarah , Su Johnny , Desai Kairavi , Coyne Jade , Mohan Sindu , Zeraatkar Dena 
Published: August 2022

AbstractBackgroundTrials have not directly compared biologics for the treatment of asthma.ObjectiveTo comparative the relative efficacy of biologics in asthma.MethodsWe searched MEDLINE, EMBASE, CENTRAL, andclinicaltrials.govfrom inception to May 31, 2022, for randomized trials addressing biologic therapies for asthma. Reviewers worked independently and in duplicate to screen references, extract data, and assess risk of bias. We performed a frequentist network meta-analysis and assessed the certainty of evidence using the GRADE approach. We present dichotomous outcomes as absolute risk differences per 1000 patients and relative risk (RR) with 95% confidence intervals (95% CI) and continuous outcomes as mean difference (MD) and 95% CI.ResultsWe identified 64 trials, including 26,630 patients. For patients with eosinophilic asthma, tezepelumab (329 fewer exacerbations per 1000 [95% CI 272.6 to 366.6 fewer]) and dupilumab (319.6 fewer exacerbations per 1000 [95% CI 272.6 to 357.2 fewer]) reduce exacerbations compared to placebo (high certainty). Tezepelumab (MD 0.24 L [95% CI 0.16 to 0.32]) and dupilumab (0.25 L (95% CI 0.21 to 0.29) improve lung function (FEV1) compared to placebo (high certainty). Both tezepelumab (110.97 fewer hospital admissions per 1000 (95% CI 94.53 to 120.56 fewer) and dupilumab (97.27 fewer hospitalizations [4.11 to 124.67 fewer]) probably reduce hospital admissions compared to placebo (moderate certainty). For patients with low eosinophils, biologics probably do not improve asthma outcomes. For these patients, tezepelumab (MD 0.1 L [95% CI 0 to 0.19]) and dupilumab (MD 0.1 L [95% CI 0 to 0.20)] may improve lung function (low certainty).ConclusionTezepelumab and dupilumab are effective at reducing exacerbations. For patients with low eosinophils, however, clinicians should probably be more judicious in use of biologics, including tezepelumab since they probably do not confer substantial benefit.