bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival and Causes of Death among Patients with Intrahepatic Cholangiocarcinoma in the United States from 2000 to 2018
Authors: Elgenidy Anas , Afifi Ahmed M. , Jalal Prasun K. 
Published: September 2022

Abstract

Background:
Intrahepatic cholangiocarcinoma (iCCA) has shown a substantial increase in mortality globally. On the contrary, perihilar cholangiocarcinoma and distal cholangiocarcinoma have been decreasing. We aim to evaluate the causes of death after iCCA diagnosis.

Methods:
We studied 8,962 patients with iCCA diagnosed between 2000 and 2018 in the United States. The standardized mortality ratio for each cause of death was calculated. We used R software version 3.5 to perform Kaplan–Meier survival tests and covariate-adjusted Cox models.

Results:
Of the 8,962 patients diagnosed with iCCA, 7,335 (81.8%) died during the follow-up period with a mean age of death of 67.88 years. The highest number of deaths (4,786; 65.2%) occurred within the first year following iCCA diagnosis. 4,832 (66%) were from iCCA, 2,063 (28%) were from other cancers, and 440 (6%) were from non-cancer causes mainly cardiovascular disease. The overall mean survival after 1 year of diagnosis was 40.8% (39.8–41.9); however, the overall mean survival was 9.8% (9–10.5) after 5 years of diagnosis. The multivariable analysis showed that age, sex, stage, and management of iCCA have a statistically significant impact on survival.

Conclusions:
Following iCCA diagnosis, about 34% died from non-iCCA causes. The most common non-iCCA cancer cause was liver cancer, and cardiovascular disease represents a substantial percentage of non-cancer deaths. Our findings provide insights into how iCCA survivors should be followed up regarding future risks.

Impact:
The management and follow-up should be tailored to the needs of each patient with iCCA.
Alchemical Waters Run Deep
Authors: Raggetti Lucia 
Published: September 2022

Abstract
In the course of the 9th and 10th centuries, the Arabo-Islamic world acquired a massive amount of knowledge from the antique and late antique traditions. In order to reconstruct the historical circumstances in which this transfer of knowledge took place, we are often forced to rely on the narratives that frequently accompany technical texts. The frame tale attached to The Treasure of Alexander (Ḏaḫīrat al-Iskandar) is a complex narrative that glues together an anthology of technical texts in ten chapters. Its alchemical section contains, among other things, instructions for preparing four different ‘sharp waters’, characterized by an increasing degree of intensity. Such ‘waters’—possibly acid and corrosive substances—were supposed to be used in the treatment and dyeing of different minerals and metals. This paper offers a critical edition and English translation of the passages dealing with the four ‘waters’ and their role in different alchemical procedures in The Treasure of Alexander. Special attention is paid to those textual clues that may link the contents of The Treasure to the Graeco-Egyptian alchemical tradition of ‘divine water’.
Quality control of total carbon dioxide (CO2) in serum or plasma using the Abbott Architect is affected by environmental pCO2 concentrations
Authors: Cuykx Matthias , Develter Mieke , Verschaeren Jan , Leenaerts Dorien , Willemse Johan , Boes Juul 
Published: September 2022

Introduction: Total CO2, or bicarbonate, is a parameter in clinical chemistry often applied to assess the metabolic status of a patient. This article discusses the observations and interventions during an episode of assay instability on an Abbott Architect routine chemistry analyser. Results: The Levey–Jennings plot of QC data showed a circadian pattern, having an overestimation of total CO2 during periods of high personnel attendance. A qualitative analysis revealed a correlation between atmospheric CO2 in the lab environment and the acquired total CO2 value in a quality control sample. Assessment of total CO2 is hence influenced by the equilibrium between atmospheric CO2, dissolved CO2 and bicarbonate. The effect is more pronounced on samples containing low concentrations of total CO2. The bias related to environmental CO2 is also noticeable on patient samples, patient means between periods with high and low atmospheric CO2 levels differed by 2 mmol/L. Discussion: Passive ventilation of the laboratory environment is proven insufficient during weather conditions in which the lab is not exposed to wind. Consistent reduction of atmospheric CO2 could only be guaranteed with an active ventilation infrastructure. Systematic closure of analyser lids also reduced analyser variance. Conclusion: The lab environment is an important source of parameter variance. Both environmental and infrastructural aspects must be considered when assessing the potential cause of the instability.
Narrative modelling: A comparison of high and low mass dwelling solutions in Afghanistan and Peru
Authors: Eltaweel Ahmad , Kuchai Noorullah , Albadra Dima , Coley David , Hart Jason , Acevedo-De-los-Ríos Alejandra , Rondinel-Oviedo Daniel R 
Published: September 2022

Displaced populations are housed in various constructions, including lightweight predesigned structures. Theoretically, self-built heavyweight structures should ensure better temperatures and be closer to cultural norms. To examine this directly for the first time, lightweight pre-designed solutions are compared with high-mass self-built alternatives in Afghanistan and Peru, via monitoring, dynamic simulation, occupant surveys, the Shelter Assessment Matrix (SAM) and ShelTherm. Lightweight solutions increase peak summer temperatures, but only by 2°C, but reduce minimum temperatures by up to 5°C. Simulations only provided a qualitatively similar time series to the monitoring, because identical homes showed a large variance in temperatures. This questions the benefit of simulation compared to approaches which concentrate on whether shelters exacerbate or ameliorate external temperatures. In addition, a dwelling provides more than comfort, it supports family life, which is best addressed by tools like SAM, not thermal simulation. Hence it might be ideal to recommend high-mass self-build if possible, and to focus modelling efforts on qualitative aspects of simulation time-series, such as whether the building suppresses or exacerbates external conditions, and equally on psycho-cultural aspects. The term narrative modelling is introduced to describe this new approach which will be of direct benefit to the humanitarian community. Building simulation engineers have much to offer the humanitarian shelter sector, however they are not often brought into play in a disaster. Hence, we suggest a practical role they can take is in examining strategies before disasters and in creating knowledge or analysis methods that aid agency staff can apply on the ground. Here we showcase this approach. It is clear that although dynamic thermal simulation is highly useful, psycho-social aspects are equally important, thus engineers are likely to need to use tools that consider such aspects in order to maximize the usefulness of their conclusions.
Video-assisted thoracoscopic versus open sleeve lobectomy for non-small cell lung cancer: A systematic review and meta-analysis from six comparative studies
Authors: Geropoulos Georgios , Esagian Stepan M , Skarentzos Konstantinos , Ziogas Ioannis A , Katsaros Ioannis , Kosmidis Dimitrios , Tsoulfas Georgios , Lawrence David , Panagiotopoulos Nikolaos 
Published: September 2022

Background Lung sleeve resection is indicated for centrally located lung tumors, especially for patients who cannot tolerate pneumonectomy. With video-assisted thoracoscopic surgery (VATS) being increasingly implemented for a wide variety of thoracic pathologies, this study aims to compare the intraoperative, postoperative, and long-term outcomes of VATS and open bronchial sleeve lobectomy for non-small cell lung cancer (NSCLC). Methods The MEDLINE (via PubMed), Cochrane Library, and Scopus databases were searched. Original clinical studies, comparing VATS and open sleeve lobectomy for NSCLC were included. Evidence was synthesized as odds ratios for categorical and weighted mean difference (WMD) for continuous variables. Results Our analysis included six studies with non-overlapping populations reporting on 655 patients undergoing bronchial sleeve lobectomy for NSCLC (229 VATS and 426 open). VATS sleeve lobectomy was associated with significantly longer operative time ((WMD): 45.85 min, 95% confidence interval (CI): 12.06 to 79.65, p  =  0.01) but less intraoperative blood loss ((WMD): −34.57 mL, 95%CI: −58.35 to −10.78, p < 0.001). No significant difference was found between VATS and open bronchial sleeve lobectomy in margin-negative resection rate, number of lymph nodes resected, postoperative outcomes (drainage duration, length of hospital stay, 30-day mortality), postoperative complications (pneumonia, bronchopleural fistula/empyema, prolonged air leakage, chylothorax, pulmonary embolism, and arrhythmia), and long-term outcomes (overall survival, recurrence-free survival). Conclusions The limitation of our study arises mainly due to the heterogeneity of the included studies. Nevertheless, VATS bronchial sleeve lung resection constitutes a feasible and safe alternative to the open sleeve lung resection surgery for the management of centrally located lung tumors.
A hybrid approach to comparing parallel-group and stepped-wedge cluster-randomized trials with a continuous primary outcome when there is uncertainty in the intra-cluster correlation
Authors: Sarkodie Samuel K , Wason James MS , Grayling Michael J 
Published: September 2022

Background/Aims: To evaluate how uncertainty in the intra-cluster correlation impacts whether a parallel-group or stepped-wedge cluster-randomized trial design is more efficient in terms of the required sample size, in the case of cross-sectional stepped-wedge cluster-randomized trials and continuous outcome data. Methods: We motivate our work by reviewing how the intra-cluster correlation and standard deviation were justified in 54 health technology assessment reports on cluster-randomized trials. To enable uncertainty at the design stage to be incorporated into the design specification, we then describe how sample size calculation can be performed for cluster- randomized trials in the ‘hybrid’ framework, which places priors on design parameters and controls the expected power in place of the conventional frequentist power. Comparison of the parallel-group and stepped-wedge cluster-randomized trial designs is conducted by placing Beta and truncated Normal priors on the intra-cluster correlation, and a Gamma prior on the standard deviation. Results: Many Health Technology Assessment reports did not adhere to the Consolidated Standards of Reporting Trials guideline of indicating the uncertainty around the assumed intra-cluster correlation, while others did not justify the assumed intra-cluster correlation or standard deviation. Even for a prior intra-cluster correlation distribution with a small mode, moderate prior densities on high intra-cluster correlation values can lead to a stepped-wedge cluster-randomized trial being more efficient because of the degree to which a stepped-wedge cluster-randomized trial is more efficient for high intra-cluster correlations. With careful specification of the priors, the designs in the hybrid framework can become more robust to, for example, an unexpectedly large value of the outcome variance. Conclusion: When there is difficulty obtaining a reliable value for the intra-cluster correlation to assume at the design stage, the proposed methodology offers an appealing approach to sample size calculation. Often, uncertainty in the intra-cluster correlation will mean a stepped-wedge cluster-randomized trial is more efficient than a parallel-group cluster-randomized trial design.
Treatment of filum terminale pial arteriovenous fistulas in the sacral region: A case report and systematic review
Authors: Guo Yunbao , Yu Jinlu 
Published: September 2022

Spinal filum terminale pial arteriovenous fistulas (FT PAVFs) are uncommon. Most FT PAVFs are located in the lumbar region; far fewer are located in the sacral region. Due to the rarity of sacral FT PAVFs, the precise surgical dissection and removal of these lesions are challenging. Here, we report an FT PAVF in the sacral region. The patient was a 45-year-old male who suffered from progressive weakness and numbness of the bilateral lower limbs; his symptoms gradually worsened. Digital subtraction angiography (DSA) showed an AVF at the sacral canal at the S3-4 level. Microsurgical treatment with intraoperative DSA was performed, and the FT PAVF was resected. After the operation, the patient gradually recovered. Follow-up magnetic resonance imaging revealed a recession in the dilation of the spinal cord venous plexuses. A literature review was also performed, and a total of 14 FT PAVFs of the sacral region were identified. The patients identified in the literature review had an average age of 58.9 ± 12.9 years, and 92.9% of the patients were male. Spinal cord edema was present in 85.7% of the FT PAVF patients. Regarding treatment, 64.3% of the FT PAVF patients underwent microsurgical resection, 28.6% patients underwent endovascular treatment, and 7.1% patients underwent a hybrid operation; good outcomes were achieved with all three methods. Therefore, FT PAVF of the sacral region is a unique lesion whose angioarchitecture needs to be identified carefully; prompt treatment is necessary, and microsurgery can yield good outcomes.
Efficacy and safety of ruxolitinib in patients with myelofibrosis and low platelet count (50 × 109/L to <100 × 109/L) at baseline: the final analysis of EXPAND
Authors: Guglielmelli Paola , Kiladjian Jean-Jacques , Vannucchi Alessandro M. , Duan Minghui , Meng Haitao , Pan Ling , He Guangsheng , Verstovsek Srdan , Boyer Françoise , Barraco Fiorenza , Niederwieser Dietger , Pungolino Ester , Liberati Anna Marina , Harrison Claire , Roussou Pantelia , Wroclawska Monika , Karumanchi Divyadeep , Sinclair Karen , te Boekhorst Peter A.W. , Gisslinger Heinz 
Published: September 2022

Background: Thrombocytopenia is a common feature of myelofibrosis (MF), a myeloproliferative neoplasm driven by dysregulated JAK/STAT signaling; however, pivotal trials assessing the efficacy of ruxolitinib (a JAK1/2 inhibitor) excluded MF patients with low platelet counts (<100 × 109/L). Objectives: Determination of the maximum safe starting dose (MSSD) of ruxolitinib was the primary endpoint, with long-term safety and efficacy as secondary and exploratory endpoints, respectively. Design: EXPAND (NCT01317875) was a phase 1b, open-label, ruxolitinib dose-finding study in patients with MF and low platelet counts (50 to <100 × 109/L). Methods: Patients were stratified according to baseline platelet count into stratum 1 (S1, 75 to <100 × 109/L) or stratum 2 (S2, 50 to <75 × 109/L). Previous analyses established the MSSD at 10 mg twice daily (bid); long-term results are reported here. Results: Of 69 enrolled patients, 38 received ruxolitinib at the MSSD (S1, n = 20; S2, n = 18) and are the focus of this analysis. The incidence of adverse events was consistent with the known safety profile of ruxolitinib, with thrombocytopenia (S1, 50%; S2, 78%) and anemia (S1, 55%; S2, 44%) the most frequently reported adverse events and no new or unexpected safety signals. Substantial clinical benefits were observed for patients in both strata: 50% (10/20) and 67% (12/18) of patients in S1 and S2, respectively, achieved a spleen response (defined as ⩾50% reduction in spleen length from baseline) at any time during the study. Conclusion: The final safety and efficacy results from EXPAND support the use of a 10 mg bid starting dose of ruxolitinib in patients with MF and platelet counts 50 to <100 × 109/L. Registration: ClinicalTrials.gov NCT01317875.
Development of a nomogram for predicting lymph node metastasis in patients with urothelial carcinoma of the bladder
Authors: Abdelatif Ahmed , Ali Ahmed Issam , Kattan Michael , Small Robert P , Gabr Ahmed H 
Published: September 2022

Background and Objectives: Multiple nomograms have previously been described to predict recurrence, overall, and cancer-specific survival following radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB).Our aim was to develop a nomogram for the preoperative prediction of lymph node (LN) metastasis in UCB. Methods: We prospectively collected data from 483 patients which were used in construction of the statistical model. The variables considered as predictors in the model were demographic, histopathological and radiological factors. Results: The full model containing all 12 covariates produced an AIC (Akaike information criterion) value of 448.9. After model selection T-stage, grade, CIS (carcinoma in situ), pathology, LV (lymphovascular) invasion and CT (computed tomography) were included as the most parsimonious model while retaining predictive accuracy. Ta in 82 (17%), T1 in 214 (445) and T2 in 187 (38%) patients. This model had an AIC of 436.4, indicating a significant improvement in model fit after the removal of unimportant predictors. The C-indices were 0.821 and 0.808 for the reduced model and the full model, respectively, indicating greater discrimination ability for the reduced model.The nomogram further emphasises the effect of CT and LV invasion on the risk of LN positivity. Specifically, regardless of all other variables, a patient with a CT will have 100 points more than a patient without a CT, corresponding to a difference in risk of approximately 40%. The odds of LN positivity for patients with a CT are 7.45 times that of patients without a CT, regardless of all other covariates. LV invasion, pathology, CIS and T-stage are also statistically significant ( p = 0.05). Conclusion: This nomogram is a preoperative prediction tool that uses different preoperative variables with acceptable predictive accuracy for LN metastasis in patients with BC.
The nurse anesthetist’s perception of the role of case manager in four provinces of Indonesia
Authors: Lusiana Devi Ni Luh Putu , Swarjana I Ketut , Sastamidhyani Ni Putu Ayu J. , Wicaksana I Gusti Agung Tresna 
Published: September 2022

Introduction Integrated and patient-focused healthcare is urgently needed, and there is an important role for case managers in implementing them. However, the understanding of healthcare providers, especially nurse anesthetists, about the role of case managers is still varied and is often considered only as a complement to hospital accreditation. This study aimed to determine the factors that influence the nurse anesthetist’s perception of the role of the case manager. Methods This cross-sectional study involved 369 nurse anesthetists who were selected using cluster sampling. Data collection was done using Google Forms. Furthermore, the data were analyzed using multiple logistic regression to identify the factors that influence the nurse anesthetists’ perception of the role of the case manager. Results From a total of 369 respondents, most (60%) have a positive perception of case managers. Marital status (AOR = 2.3; 95% CI: 1.27–4.15) and knowledge (AOR = 3.2; 95% CI: 2.03–5.07) were significant predictors of the nurse anesthetist’s perception of the role of the case manager. Discussion Even though the majority of nurse anesthetists have positive perceptions, socialization to increase knowledge about case managers is needed to reduce misperceptions about the role of case managers.
Lessons for sleep medicine learned from the COVID-19 pandemic
Authors: Grote Ludger 
Published: September 2022

During the coronavirus disease 2019 (COVID-19) pandemic, sleep medicine services were dramatically reduced worldwide. Implementation of mitigation strategies was suggested by expert organisations and helped to restart sleep medicine services. Distance communication and monitoring during diagnosis, treatment initiation, and treatment follow-up have been used widely, in particular for patients with sleep apnoea. Follow-up studies demonstrate both advantages and potential disadvantages with the use of these new technologies.Emerging epidemiological evidence suggests that obstructive sleep apnoea may be an independent risk factor for adverse outcome in COVID-19, including an increased risk for hospitalisation and elevated mortality. Experimental studies explaining the underlying mechanisms behind these findings are warranted.
Diversification of PAR signaling through receptor crosstalk
Authors: Lee-Rivera Irene , López Edith , López-Colomé Ana María 
Published: September 2022

AbstractProtease activated receptors (PARs) are among the first receptors shown to transactivate other receptors: noticeably, these interactions are not limited to members of the same family, but involve receptors as diverse as receptor kinases, prostanoid receptors, purinergic receptors and ionic channels among others. In this review, we will focus on the evidence for PAR interactions with members of their own family, as well as with other types of receptors. We will discuss recent evidence as well as what we consider as emerging areas to explore; from the signalling pathways triggered, to the physiological and pathological relevance of these interactions, since this additional level of molecular cross-talk between receptors and signaling pathways is only beginning to be explored and represents a novel mechanism providing diversity to receptor function and play important roles in physiology and disease.