bluuebunny/crossref_metadata_2025 huggingface dataset:
DIFFERENCES BETWEEN PROFILE OF OFFICE, HOME AND 24H AMBULATORY BLOOD PRESSURE MONITORING IN PREECLAMPSIA AND UNCOMPLICATED HYPERTENSION IN PREGNANCY
Authors: Szczepaniak-chichel Ludwina , Lipski Dawid , Uruski Pawel , Tykarski Andrzej
Published: May 2024

Objective:

Definition of arterial hypertension and management decision making in guidelines is still based on office blood pressure measurement (OBPM), both in general and pregnant population, although in clinical practice 24h ambulatory monitoring (ABPM) seems to be more accurate, which if not available often replaced with home BP (HBPM). Information on differences between values of BP depending on method in course of pregnancy are scarce. Aim of the study was to assess profile and compare results of three methods of BP measurement used simultaneously – HBPM, OBPM and 24 ABPM in pregnancy in real clinical setting with regard to hypertensive status, development of preeclampsia (PE) and time of pregnancy.

Design and method:

In a prospective longitudinal study 241 pregnant women admitted between 2017 and 2023 to outpatient clinic had their BP examined - monthly throughout pregnancy and 6-8 weeks, 6 months and 1 year postpartum. On each occasion data on HBPM (from 7 days prior) were collected, compared with OBPM in standardized conditions (OMRON®-705I) as well as with result of 24h ABPM (AND®TM-2430). Pharmacotherapy in hypertensive patients was managed in accordance with ESH/ESC guidelines.

Results:

We have recruited 40 normotensive controls and 201 women with hypertension (145 chronic; 56 pregnancy induced). Preeclampsia developed in 49 of hypertensives (HT+PE) (18,6% of chronic HT, 39,3% of PIH) – on average in 32,8 w.g. (20-39). SBP/DBP as median are presented in table 1. BP of controls differed significantly from both complicated (HT+PE) and uncomplicated hypertensive patients (HT) in all three methods at all stages of pregnancy and postpartum (p< 0.05). Significant differences between HT+PE and HT are marked in table 2 in gray.

Conclusions:

Regardless of method of BP assessment and good BP control with antihypertensives achieved values in HT pregnancies differed significantly from normotensive pregnancies. Preeclamptic patients were characterized with significantly higher BP values in HBPM, OBPM and – most strongly expressed - in night-ABPM than uncomplicated hypertensives already 2 months before average time of PE recognition. The night-time BP values from ABPM seems to have the strongest predictive and diagnostic value for early recognition of preeclampsia.
Stillbirth Risk and Smallness for Gestational Age According to Hadlock, INTERGROWTH-21st, WHO, and GROW Fetal Weight Standards: Analysis by Maternal Ethnicity and Body Mass Index
Authors: Gardosi Jason , Hugh Oliver
Published: May 2024

(Abstracted from Am J Obstet Gynecol 2023;229:547.e1–13

Fetal growth during pregnancy is an important marker of fetal health, and fetal growth restriction (FGR) is highly correlated with stillbirth. To mitigate this risk, fetal growth must be assessed accurately and appropriately to recognize risk factors that point to FGR versus a normally developing fetus.
Antibiotic Treatment of Women With Isolated Intrapartum Fever vs Clinical Chorioamnionitis: Maternal and Neonatal Outcomes
Authors: Shqara Raneen Abu , Glikman Daniel , Jad Saher , Rechnitzer Hagai , Lowenstein Lior , Wolf Maya Frank
Published: May 2024

(Abstracted from Am J Obstet Gynecol. 2023;229:540.e1–540.e9

Clinical chorioamnionitis affects up to 13% of all term pregnancies and up to 70% of spontaneous preterm premature rupture of the membrane. It is a syndrome defined by the presence of intrapartum maternal fever ≥38°C accompanied by at least 2 of the following clinical signs: maternal tachycardia (>100 bpm), fetal tachycardia (>160 bpm), maternal leukocytosis >15,000/mm2, purulent cervical discharge, or uterine tenderness.
The Womb Cancer Awareness Measure (WCAM): Development of an Instrument to Assess Public Awareness of Endometrial Cancer
Authors: Jones Olivia , Young Hannah , Clarke Helen , Crosbie Emma J , Sivalingam Vanitha N
Published: May 2024

(Abstracted from Int J Gynecol Cancer 2023;34:73–79

This survey study describes the development of the Womb Cancer Awareness Measure (WCAM), an instrument to assess public awareness of endometrial cancer, consisting of items related to knowledge of red flag symptoms and risk factors. The 36-item questionnaire was developed with the input of a panel of scientists, gynecologic oncologists, and patient representatives and aimed to evaluate confidence levels in detecting a red flag symptom and the rapidity of seeking medical care.
Serum Progesterone Is Lower in Ovarian Stimulation With Highly Purified HMG Compared to Recombinant FSH Owing to a Different Regulation of Follicular Steroidogenesis: A Randomized Controlled Trial
Authors: Bosch Ernesto , Alama Pilar , Romero Josep Lluis , Marı Marta , Labarta Elena , Pellicer Antonio
Published: May 2024

(Abstracted from Hum Reprod 2024;39:393–402

Serum progesterone levels following ovarian stimulation (OS) are associated with the cycle result in terms of ongoing pregnancy and live birth rate, with levels above a certain threshold associated with poorer results. An increase in progesterone is positively associated with the ovarian response and the FSH dose administered during OS; however, this mechanism is not well understood.
Performance Evaluation of a Supervised Machine Learning Pain Classification Model Developed by Neonatal Nurses
Authors: Manworren Renee C. B. , Horner Susan , Joseph Ralph , Dadar Priyansh , Kaduwela Naomi
Published: May 2024

Background:

Early-life pain is associated with adverse neurodevelopmental consequences; and current pain assessment practices are discontinuous, inconsistent, and highly dependent on nurses’ availability. Furthermore, facial expressions in commonly used pain assessment tools are not associated with brain-based evidence of pain.

Purpose:

To develop and validate a machine learning (ML) model to classify pain.

Methods:

In this retrospective validation study, using a human-centered design for Embedded Machine Learning Solutions approach and the Neonatal Facial Coding System (NFCS), 6 experienced neonatal intensive care unit (NICU) nurses labeled data from randomly assigned iCOPEvid (infant Classification Of Pain Expression video) sequences of 49 neonates undergoing heel lance. NFCS is the only observational pain assessment tool associated with brain-based evidence of pain. A standard 70% training and 30% testing split of the data was used to train and test several ML models. NICU nurses’ interrater reliability was evaluated, and NICU nurses’ area under the receiver operating characteristic curve (AUC) was compared with the ML models’ AUC.

Results:

Nurses weighted mean interrater reliability was 68% (63%-79%) for NFCS tasks, 77.7% (74%-83%) for pain intensity, and 48.6% (15%-59%) for frame and 78.4% (64%-100%) for video pain classification, with AUC of 0.68. The best performing ML model had 97.7% precision, 98% accuracy, 98.5% recall, and AUC of 0.98.

Implications for Practice and Research:

The pain classification ML model AUC far exceeded that of NICU nurses for identifying neonatal pain. These findings will inform the development of a continuous, unbiased, brain-based, nurse-in-the-loop Pain Recognition Automated Monitoring System (PRAMS) for neonates and infants.
Novel therapies in juvenile idiopathic arthritis
Authors: Sage Anne M. , Clarke Sarah L.N. , Ramanan Athimalaipet V.
Published: May 2024

Purpose of review

This review summarises the major novel treatment options for children with juvenile idiopathic arthritis (JIA) since the pandemic, reflecting not only on advancements in therapeutics but also approach to management and research.

Recent findings

Several recent international paediatric trials have been important in advancing understanding of JIA and furthering available treatment options. Biologic and small molecule agents were demonstrated to be effective and safe in recalcitrant or severe JIA (including extra-articular complications), mirroring the adult equivalent diseases.

Although joint and overall health have vastly improved for young people with JIA, ongoing international collaboration, critical review of treatment strategies and high quality research are essential to optimize outcomes.
INTEREST OF REGULAR ASSAYS OF AQUEOUS HUMOR INTERLEUKIN-10 LEVELS IN MONITORING OF VITREORETINAL LYMPHOMA
Authors: Metayer Charline , Kodjikian Laurent , Nguyen Anh-Minh , Loria Olivier , Chaperon Mayeul , Ghesquieres Hervé , Mathis Thibaud
Published: May 2024

Purpose:

To investigate the variation of interleukin-10 (IL-10) levels in the aqueous humor (AH) of patients with vitreoretinal lymphoma (VRL) throughout therapy and follow-up and analyze the relation of these variations with VRL clinical course and relapse.

Methods:

This study retrospectively included consecutive patients diagnosed with VRL in a single center. AH IL-10 samples and patient clinical course were evaluated. The response to treatment was evaluated according to the criteria set by the International Primary Central Nervous System Lymphoma Collaborative Group.

Results:

A total of 59 eyes of 34 patients were included. Interleukin-10 levels decreased significantly at first AH sample after therapy induction (median [IQR] 3.0 [2.8–3.6] months) among patients in complete clinical remission (P < 0.001). Among patients in complete clinical remission with residual detectable IL-10 in AH after therapy induction (85.3% systemic chemotherapy, 11.8% intravitreal methotrexate, 2.9% palliative care), 87.5% experienced ocular relapse within 5 years. The detection of IL-10 in AH at the first visit after induction for complete clinical remission obtained a sensitivity of 77.8% (95% CI 0.45–0.96) and a specificity of 96.4% (95% CI 0.82–0.99) to predict ocular relapse. For relapsing eyes (N = 26), IL-10 significantly increased between the last IL-10 measurement and the time of the first ocular relapse (P < 0.001). In 76.0% of cases, an increase in IL-10 was detected earlier than clinical relapse with a mean (SD) of 4.0 (2.4) months.

Conclusion:

The present study suggested the usefulness of IL-10 in the prognosis of VRL. This study showed a relation between IL-10 in AH and tumoral activity, and for the first time with disease relapse.
MIXED PATHOPHYSIOLOGIES OF LAMELLAR MACULAR HOLES AND RELATED DISEASES
Authors: Matoba Ryo , Kanzaki Yuki , Morita Tetsuro , Masuda Yuki , Kimura Shuhei , Hosokawa Mio M. , Shiode Yusuke , Morizane Yuki
Published: May 2024

Purpose:

To investigate the characteristics of mixed pathophysiologies in lamellar macular holes (LMHs) and related diseases using multimodal optical coherence tomography.

Methods:

Overall, 126 eyes diagnosed with LMH, epiretinal membrane foveoschisis, or macular pseudohole using the horizontal B-scan image according to the definition proposed by Hubschman et al in 2020 were analyzed using multimodal optical coherence tomography imaging including horizontal and vertical 5-line B-scan, radial scan, and macular three-dimensional volume scan images. If at least two diagnostic criteria for LMH, epiretinal membrane foveoschisis, or macular pseudohole were satisfied in these scans, the patient was diagnosed as having a “mixed type.” Retinal traction force was quantitatively evaluated by measuring the maximum depth of the retinal folds using en-face images.

Results:

Mixed types constituted 34.1% of the cases. The LMH-related mixed group demonstrated intermediate characteristics between the epiretinal membrane foveoschisis/macular pseudohole and true LMH groups in terms of retinal traction and LMH-specific features and had a significant positive correlation between the maximum depth of the retinal folds and mean M-CHARTS scores (P = 0.034).

Conclusion:

A thorough optical coherence tomography analysis is necessary to accurately diagnose LMH and related diseases. A significant positive correlation was observed between the maximum depth of the retinal folds and the degree of metamorphopsia in the LMH-related mixed group.
Engaging Community Health Workers in Primary Care Practices
Authors: Rohan Elizabeth A. , Townsend Julie S. , Bermudez Andrea Torres , Thompson Hope L. , Holman Dawn M. , Reza Avid , Tharpe Felicia Solomon , Wennerstrom Ashley
Published: May 2024

Community health workers (CHWs) are increasingly addressing health disparities in primary care settings; however, there is little information about how primary care practitioners (PCPs) interact with CHWs or perceive CHW roles. We examined PCP engagement with CHWs in adult primary care settings. Overall, 55% of 1504 PCPs reported working with CHWs; involvement with CHWs differed by some PCP demographic and practice-related factors. While PCPs perceived CHWs as engaging in most nationally endorsed CHW roles, they identified several barriers to integrating CHWs into care teams. Findings can inform ongoing efforts to advance health equity through integrating CHWs into primary care practices.
An international, multicenter, survey-based analysis of practice and management of acute liver failure
Authors: Gurakar Ahmet , Conde Amiel Isabel , Ozturk N. Begum , Artru Florent , Selzner Nazia , Psoter Kevin J. , Dionne Joanna C. , Karvellas Constantine , Rajakumar Akila , Saner Fuat , Subramanian Ram M. , Sun Li-Ying , Dhawan Anil , Coilly Audrey
Published: May 2024

Acute liver failure (ALF) is an acute liver dysfunction with coagulopathy and HE in a patient with no known liver disease. As ALF is rare and large clinical trials are lacking, the level of evidence regarding its management is low-moderate, favoring heterogeneous clinical practice. In this international multicenter survey study, we aimed to investigate the current practice and management of patients with ALF. An online survey targeting physicians who care for patients with ALF was developed by the International Liver Transplantation Society ALF Special-Interest Group. The survey focused on the management and liver transplantation (LT) practices of ALF. Survey questions were summarized overall and by geographic region. A total of 267 physicians completed the survey, with a survey response rate of 21.36%. Centers from all continents were represented. More than 90% of physicians specialized in either transplant hepatology/surgery or anesthesiology/critical care. Two hundred fifty-two (94.4%) respondents’ institutions offered LT. A total of 76.8% of respondents’ centers had a dedicated liver-intensive or transplant-intensive care unit (p < 0.001). The median time to LT was within 48 hours in 12.7% of respondents’ centers, 72 hours in 35.6%, 1 week in 37.6%, and more than 1 week in 9.6% (p < 0.001). Deceased donor liver graft (49.6%) was the most common type of graft offered. For consideration of LT, 84.8% of physicians used King’s College Criteria, and 41.6% used Clichy Criteria. Significant differences were observed between Asia, Europe, and North America for offering LT, number of LTs performed, volume of patients with ALF, admission to a dedicated intensive care unit, median time to LT, type of liver graft, monitoring HE and intracranial pressure, management of coagulopathy, and utilization of different criteria for LT. In our study, we observed significant geographic differences in the practice and management of ALF. As ALF is rare, multicenter studies are valuable for identifying global practice.
Ceftazidime Poloxamer Gel: Expanding the Therapeutic Armamentarium for Ciprofloxacin-Resistant Pseudomonas Mastoid Cavity Otorrhea
Authors: Roy Catherine F. , Cohen-Tenoudji Bertrand , Mijovic Tamara
Published: May 2024

Objective

To present and evaluate the treatment of ciprofloxacin-resistant Pseudomonas mastoid cavity otorrhea with a ceftazidime thermosensitive poloxamer gel.

Study design

A retrospective clinical capsule report.

Patients

Three patients diagnosed with ciprofloxacin-resistant Pseudomonas otorrhea in the setting of a previous canal-wall-down mastoidectomy between March 2019 and June 2023 visiting our tertiary care institution were retrospectively reviewed.

Intervention

Application of a 2% ceftazidime thermosensitive poloxamer gel to mastoid cavity.

Main Outcome Measures

No evidence of disease during microscopic inspection of the ear within a month of initial treatment or bacterial eradication on subsequent culture.

Results

Two patients had complete resolution of symptoms and achieved a safe and dry ear after topical application of the hydrogel. The second patient had pseudomonal eradication on culture, but persistent otorrhea due to other multidrug-resistant bacteria and an anatomically unfavorable mastoid cavity, which ultimately resolved after revision surgery.

Conclusions

This small case series suggests that topical treatment of mastoid cavity otorrhea with a 2% ceftazidime poloxomer gel is a potential therapeutic avenue in patients with ciprofloxacin-resistant Pseudomonas.
Accuracy of the OMRON HEM-7361T blood pressure monitor in the differentiation between atrial fibrillation and sinus rhythm
Authors: Zhou Yi , Xia Jia-Hui , Zhang Wei , Li Yan , Wang Ji-Guang
Published: May 2024

Objective

We investigated the accuracy of the OMRON HEM-7361T automated oscillometric blood pressure (BP) monitor in the differentiation between atrial fibrillation and sinus rhythm.

Methods

An approximately equal number of patients with persistent atrial fibrillation and individuals with sinus rhythm were recruited from outpatients and inpatients of Ruijin Hospital, Shanghai, China. BP was measured three times consecutively with a 30-s interval with the OMRON HEM-7361T automatic electronic BP monitor for atrial fibrillation detection. A hand-held single lead electrocardiogram device was used for simultaneous electrocardiogram recordings.

Results

The device accurately identified atrial fibrillation in 100 (99.0%) of the 101 patients, with only 1 patient incorrectly classified as non-atrial fibrillation. The device correctly identified 99 (95.2%) of the 104 participants with sinus rhythm as non-atrial fibrillation, with five participants incorrectly classified as atrial fibrillation. The device had a positive predictive value of 95.2%, negative predictive value of 99.0%, and overall accuracy of 97.1%. Among the six misclassified participants, one with atrial fibrillation had a heart rate of 65 beats/min, and four of the five participants with sinus rhythm had cardiac arrhythmias (atrial or ventricular premature beat in one participants, sinus tachycardia in one participant, and both arrhythmias in one participant).

Conclusion

The OMRON HEM-7361T BP monitor is accurate in the differentiation between atrial fibrillation and sinus rhythm. Whether the device is sufficiently accurate in the differentiation between atrial fibrillation and other cardiac arrhythmias remains under investigation.
Validating the accuracy of Omron HEM-7372T1-AZAZ (BP5460) in monitoring blood pressure according to the ISO 81060-2:2018+Amd 1:2020 protocol in the general population
Authors: Takahashi Hakuo , Yamashita Shingo , Yakura Nobuki
Published: May 2024

Purpose

The performance of the Omron HEM-7372T1-AZAZ (BP5460) in monitoring blood pressure (BP) in the upper arm was validated in accordance with the International Organization for Standardization (ISO) 81060-2:2018 (E) and amendment (Amd)1:2020 protocol.

Methods

The device was used to assess 98 participants who fulfilled the inclusion criteria, including the range of arm circumference and systolic and diastolic BP, in accordance with the protocol. Data validation and analysis were performed according to the manufacturer’s instructions.

Results

In the ISO validation procedure (criterion 1), the mean ± SD of the differences between test device readings and reference BP was 0.3 ± 6.17/3.6 ± 5.26 mmHg (systolic/diastolic). These data fulfilled the ISO requirements of ≤5±≤8 mmHg. The mean differences between the observer measurements and Omron HEM-7372T1-AZAZ (BP5460) readings were 0.3 ± 4.82 mmHg for systolic BP and 3.6 ± 4.78 mmHg for diastolic BP, fulfilling criterion 2 with SD values of ≤6.95 for SBP and ≤5.89 for DBP. Therefore, two ISO criteria were fulfilled.

Conclusion

The Omron HEM-7372T1-AZAZ BP monitor fulfilled the requirements of the ISO validation standard. This device can be recommended for home BP measurements in the general population.
Associations of Homelessness With Primary Care and Acute Care Utilization Among Medicaid-Enrolled Youth
Authors: Yue Dahai , Chuang Emmeline , Zhou Weihao , Essien Elsie A. , Lee Youngeun , O’Masta Brenna , Pourat Nadereh
Published: May 2024

Background:

Youth comprise one-third of the US homeless population. However, little is known about how homelessness affects health care utilization.

Objective:

Examine associations of homelessness with hospitalization, primary care, and ED visits, varying by race/ethnicity, among Medicaid-enrolled youth.

Research Design:

A cross-sectional analysis was conducted using California Medicaid claims data on youth beneficiaries with complex needs. We examined the number of hospitalizations, preventable and nonpreventable ED, and primary care visits using a multivariate regression. We further explored the differential associations by race/ethnicity.

Results:

Approximately 17% of our sampled youth experienced homelessness in 2018 (N=90,202). Compared with their housed counterparts, youth experiencing homelessness had a 1.9 percentage point (pp) higher likelihood of frequent ED visits (95% CI: 1.7–2.2) but a 2.9 pp lower probability of any primary care visits (95% CI: -3.9 to -1.9). Homelessness was associated with 221 more ED visits (95% CI: 182–260), 100 more preventable ED visits (95% CI: 84–116), 19.9 more hospitalizations (95% CI: 12–27), but 56 fewer primary care visits (95% CI: -104 to -7), per 1000 youth. The associations of homelessness with total ED visits, preventable ED visits, and needed and nonpreventable ED visits were all higher among Whites and, particularly, Blacks than for Hispanics and Asians.

Conclusions:

Medicaid-enrolled youth who experienced homelessness had more overall ED, preventable ED, and hospital visits, but fewer primary care visits than their housed peers. Our results suggest promoting primary care use should be considered among strategies to improve health and reduce costs.
Discussions of Cancer Survivorship Care Needs
Authors: Borders Tyrone F. , Hammerslag Lindsey
Published: May 2024

Background:

Rural cancer survivors may face greater challenges receiving survivorship care than urban cancer survivors.

Purpose:

To test for rural versus urban inequities and identify other correlates of discussions about cancer survivorship care with healthcare professionals.

Methods:

Data are from the 2017 Medical Expenditure Panel Survey (MEPS), which included a cancer survivorship supplement. Adult survivors were asked if they discussed with a healthcare professional 5 components of survivorship care: need for follow-up services, lifestyle/health recommendations, emotional/social needs, long-term side effects, and a summary of treatments received. The Behavioral Model of Health Services guided the inclusion of predisposing, enabling, and need factors in ordered logit regression models of each survivorship care variable.

Results:

A significantly lower proportion of rural than urban survivors (42% rural, 52% urban) discussed in detail the treatments they received, but this difference did not persist in the multivariable model. Although 69% of rural and 70% of urban ssurvivors discussed in detail their follow-up care needs, less than 50% of both rural and urban survivors discussed in detail other dimensions of survivorship care. Non-Hispanic Black race/ethnicity and time since treatment were associated with lower odds of discussing 3 or more dimensions of survivorship care.

Conclusions:

This study found only a single rural/urban difference in discussions about survivorship care. With the exception of discussions about the need for follow-up care, rates of discussing in detail other dimensions of survivorship care were low among rural and urban survivors alike.
Attitudes, Beliefs, and Intention to Receive a COVID-19 Vaccine for Pediatric Patients With Sickle Cell Disease
Authors: Shook Lisa M. , Rosen Brittany L. , Mara Constance A. , Mosley Cami , Thompson Alexis A. , Smith-Whitley Kim , Schwartz Lisa , Barriteau Christina , King Allison , Oke Eniola , Jallow Fatoumatou , Murphy Bridget , Crosby Lori
Published: May 2024

Sickle cell disease (SCD), which occurs primarily in individuals of African descent, has been identified as a preexisting health condition for COVID-19 with higher rates of hospitalization, intensive care unit admissions, and death. National data indicate Black individuals have higher rates of vaccine hesitancy and lower COVID-19 vaccination rates. Understanding the key predictors of intention to receive a COVID-19 vaccine is essential as intention is strongly associated with vaccination behavior. This multisite study examined attitudes, beliefs, intentions to receive COVID-19 vaccines, and educational preferences among adolescents, young adults, and caregivers of children living with SCD. Participants completed an online survey between July 2021 and March 2022. Multivariate logistic regression was used to examine the association between participant age and COVID-19 vaccine attitudes, beliefs, and vaccine intentions. Of the 200 participants, 65.1% of adolescents, 62.5% of young adults, and 48.4% of caregivers intended to receive a COVID-19 vaccine for themselves or their child. Perception that the vaccine was safe was statistically significant and associated with patient and caregiver intention to receive the COVID-19 vaccine for themselves or their child. Participant age was also statistically significant and associated with the intent to get a booster for patients. Study findings highlight key concerns and influencers identified by patients with SCD and their caregivers that are essential for framing COVID-19 vaccine education during clinical encounters. Study results can also inform the design of messaging campaigns for the broader pediatric SCD population and targeted interventions for SCD subpopulations (eg, adolescents, caregivers).
Fluorescence in neurosurgery: its therapeutic and diagnostic significance – a comprehensive review
Authors: Rauf Sameer A. , Ahmed Rubayyi , Hussain Tooba , Saad Muhammad , Shah Hussain H. , Jamalvi Syed A. , Yogeeta Fnu , Devi Muskan , Subash Arun , Gul Maryam , Ahmed Shaheer , Haque Md Ariful
Published: May 2024

This review provides a comprehensive overview of the therapeutic and diagnostic implications of fluorescence imaging in neurosurgery. Fluorescence imaging has become a valuable intraoperative visualization and guidance tool, facilitating precise surgical interventions. The therapeutic role of fluorescence is examined, including its application in photodynamic therapy and tumor-targeted therapy. It also explores its diagnostic capabilities in tumor detection, margin assessment, and blood–brain barrier evaluation. Drawing from clinical and preclinical studies, the review underscores the growing evidence supporting the efficacy of fluorescence imaging in neurosurgical practice. Furthermore, it discusses current limitations and future directions, emphasizing the potential for emerging technologies to enhance the utility and accessibility of fluorescence imaging, ultimately improving patient outcomes in neurosurgery.
Inequities Along the Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis Services Continuum for Black Women in the United States, 2015–2020
Authors: Townes Ashley , Tanner Mary R. , Yu Lei , Johnson Wayne D. , Zhu Weiming , Iqbal Kashif , Dominguez Kenneth L. , Henny Kirk D. , Drezner Kate , Schumacher Christina , Bickham Jacquelyn , Elopre Latesha , Edelstein Zoe R. , Hoover Karen W. ,   On Behalf of the Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) Project Team
Published: May 2024

(Abstracted from Obstet Gynecol 2024;143:294–301

Throughout the United States, racial disparities in sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) diagnoses persist. Disproportionately higher rates of diagnosed STIs and HIV infections occur among Black individuals (people who identified as Black or African American were combined into this group).
Effect of Pelvic Floor Muscle Training With Smartphone Reminders on Women in the Postpartum Period: A Randomized Controlled Trial
Authors: Chu Lei , Jin Xia , Wu Siyu , Tong Xiaowen , Li Huaifang , Chen Xinliang
Published: May 2024

(Abstracted from Urogynecology (Phila) 2024;30:138–146

Long-term pelvic floor dysfunction may be caused by pregnancy and childbirth, with urinary incontinence (UI) prevalence rates of 30% in the first 3 postpartum months and persisting in half of those women 20 years after delivery. Combatting pelvic floor dysfunction is possible through pelvic floor muscle training (PFMT), which may improve overall quality of life, as well as prevent UI, sexual dysfunction, and postpartum pelvic muscle impairment.
Outcomes in Women With Pelvic Organ Prolapse Presenting With Pessary-Related Complications
Authors: Omosigho Ukpebo , Propst Katie , Ferrando Cecile A.
Published: May 2024

(Abstracted from Urogynecology 2024;30:147–152

Pessaries are an effective first-line treatment for pelvic organ prolapse (POP) and urinary incontinence (UI) symptoms and are associated with significant quality-of-life improvement. In patients willing to consider both pessary and surgery, effectiveness of pessary can rival that of surgical interventions.
Variables Associated With Resolution and Persistence of Ovarian Cysts
Authors: Lasher Anne , Harris Lauren E. , Solomon Angelica L. , Harbin Laura M. , Raby Lauren , Dietrich Charles S. , Kryscio Richard J. , van Nagell John R. , Pavlik Edward J.
Published: May 2024

(Abstracted from Obstet Gynecol 2023;142:1293–1301

Approximately 15%–20% of women develop ovarian cysts, and roughly 85% resolve within 5 years. However, ovarian cysts do carry a very low potential for malignancy and can be distressing.
Adverse Events in Patients Aged 90 Days or Younger Receiving Ketamine in the Emergency Department
Authors: Mills Lauren A. , Kuntz Heather M.
Published: May 2024

Objectives

The aim of this study was to identify the incidence of adverse events of ketamine administration in the pediatric emergency department in patients aged 90 days or younger in order to demonstrate the safety and efficacy of administration in this patient population.

Methods

An 8-year retrospective chart review of patients aged 90 days or younger who received ketamine in the pediatric emergency department was conducted. All patients who met the age criteria were included in this study. Identified routes of ketamine administration included oral, intramuscular, and intravenous.

Results

Fourteen patients were identified who met the inclusion criteria and were included in the final analysis. The median age was 45 days old. Indications for ketamine administration included 7 cases for procedural sedation, 5 cases for RSI, and 2 cases for postintubation sedation. The average dose amount (mg/kg) of ketamine administered was 10, 4.43, and 1.59 for oral, intramuscular, and intravenous routes, respectively. Of the 14 patients, 1 patient was identified to have an adverse event to ketamine administration. A transient desaturation and bradycardic event due to laryngospasm was observed during laryngoscopy performed for RSI that was resolved with administration of anticholinergics and paralytics as well as successful intubation and ventilation.

Conclusions

In this study, 1 patient suffered an adverse event due to laryngospasm during intubation. In the pediatric population, the incidence of adverse events of ketamine administration has been found to be variable in the current literature, ranging from 0.71% to 7.26%. In our study, an adverse event occurred in 1 out of 14 administrations (7.1%). The incidence of adverse events associated with ketamine administration in our patients aged 90 days or less appeared to be similar to that reported in the general pediatric population.
Diffuse Intense 18F-PSMA-1007 Uptake of the Breasts in a Woman With TFE3-Rearranged Renal Cell Carcinoma
Authors: Zhao Qian , Dong Aisheng , Zuo Changjing
Published: May 2024

A 23-year-old woman presenting with gross hematuria was found to have a left renal mass suspicious for renal cell carcinoma on abdominal contrast-enhanced CT. An 18F-PSMA-1007 PET/CT scan was performed for evaluating the renal mass. 18F-PSMA-1007 PET/CT showed focal activity of the renal mass, which was a transcription factor E3-rearranged renal cell carcinoma proved after nephrectomy. Surprisingly, diffuse heterogeneous intense activity of the bilateral breasts and moderate activity of the right accessory breast was observed. There was no morphological abnormality of the bilateral breasts and right accessory breast on CT images, indicating physiological PSMA uptake.
Between Pathological Prostate Cancer Lymph Nodes and Sentinel Nodes
Authors: Morel Agnès , Rousseau Thierry , Ferrer Ludovic , Lacoste Jacques , Nevoux Pierre , Picot-Dilly Elise , Le Thiec Maelle , Rusu Daniela , Campion Loic , Rousseau Caroline
Published: May 2024

Purpose

On the basis of the concept of sentinel lymph node biopsy (SLNB), SLNs should contain decisive information for clinical outcomes. In localized prostate cancer patients, this study assessed retrospectively clinical outcome after radical laparoscopic prostatectomy associated with SLNB and extensive pelvic lymph node dissection.

Methods

A total of 231 consecutive patients of intermediate to high risk were analyzed. Recurrence-free survival (RFS) was assessed with Kaplan-Meier curves. Various pathological parameters were analyzed using univariable and multivariable analyses through Cox regression analysis. The study was approved and registered under 2007-R41.

Results

The median follow-up was 7.1 years (95% confidence interval, 6.6–7.5). In total, 38/231 (16.5%) patients were pN1. Of these 38 patients, 27 had only SLN involvement (SLNI), 10 patients had both SLN and non-SLNI, and 1 patient had isolated non-SLNI, indicating a false-negative (FN). If the updated Briganti nomogram threshold set at >7% for recommending extensive pelvic lymph node dissection had been applied to these patients, we would have missed 44% (12/27) of patients with SLNI and 50% (5/10) of patients with SLNI and non-SLNI, as well as the FN patient. At the time of final follow-up, 84/231 (36.5%) patients had recurrence. In multivariable analysis, and regarding node status, the most significant prognostic factor was SLN with macrometastases and/or micrometastases, respectively, P = 10−3 and P < 10−3. No more information was obtained with non-SLN status. Probabilities of RFS between negative and positive SLN patients presented a major significant difference (P < 10−15) with a risk of event 8.75 times more frequent if SLN was involved than if it was metastasis-free.

Conclusions

SLNB seems to contain decisive information for the clinical outcome of patients with localized intermediate- and high-risk prostate cancer patients. The question raised is thus whether immediate additional postoperative treatment should be offered to patients with metastatic SLN.
Scapholunate Ligament Reconstruction With Internal Brace Augmentation Techniques for Chronic Scapholunate Dissociation
Authors: An Young Sun , Lee Sang Ki , Choy Won Sik
Published: May 2024

Introduction

The scapholunate ligament is the most important stabilizer of the scapholunate articulation. The management of chronic irreversible injuries of this ligament in the absence of preexisting arthritis of the wrist joint remains controversial. Recently, surgeons introduced a novel surgical technique using an internal brace (IB). Several biomechanical studies on this technique have been conducted using cadavers; however, very few studies have discussed the results in detail in actual clinical practice. Therefore, herein, we investigated the radiological and functional results of patients who underwent IB augmentation as a treatment for chronic scapholunate dissociation.

Methods

This retrospective study was conducted from April 2018 to May 2022. Twenty-two patients with chronic scapholunate dissociation were treated using the IB augmentation technique, of whom 17 were followed-up for at least 1 year. Radiological results, including scapholunate distance, scapholunate angle, and radioscaphoid angle, were collected. Furthermore, clinical parameters, such as the visual analog scale (preoperative and at final follow-up), the Disabilities of the Arm, Shoulder, and Hand scores (preoperatively and at 3, 6, and 12 months postoperatively), and Mayo wrist scores (preoperative and at final follow-up), were measured.

Results

The scapholunate distance increased significantly in the affected wrist compared to the unaffected wrist, which improved after reconstruction in all wrist positions (P < 0.05). Compared to the unaffected wrist, the scapholunate angle increased significantly in all positions (P < 0.05) except for extension (P = 0.535) and improved after reconstruction in all wrist positions. The radioscaphoid angle significantly increased compared to the angle of the unaffected wrist in all positions (P < 0.05) except for extension (P = 0.602) and clenched fist (P = 0.556). This angle improved after reconstruction in all wrist positions except for extension (P = 0.900). The visual analog scale score (7–2, preoperatively and at final follow-up) and Mayo wrist score (53–82, preoperatively and at final follow-up) improved after surgery. The Disabilities of the Arm, Shoulder, and Hand scores also improved after surgery (68, 53, 30, 7, preoperatively and at 3, 6, and 12 months postoperatively).

Conclusions

This study revealed that scapholunate ligament reconstruction using an autologous tendon and suture tape is a good reconstruction technique that can improve clinical symptoms and radiographic parameters with a shorter operation time and fewer complications than other reconstruction methods.
Major Pancreatic Resection Increases Bone Mineral Density Loss, Osteoporosis, and Fractures
Authors: Khalilieh Saed , Iyer Amrita , Hammelef Emma , Zohar Nitzan , Gorgov Eliyahu , Yeo Theresa P. , Lavu Harish , Bowne Wilbur , Yeo Charles J. , Nevler Avinoam
Published: May 2024

Objective:

To assess whether long-term survivors of pancreatic surgery show increased risk to develop impaired bone mineral density, osteoporosis, and vitamin D deficiency.

Background:

Pancreatic resection poses a risk for malabsorption of fat-soluble vitamins and other micronutrients essential for bone mineralization. Here, we evaluated the long-term effects of pancreatic resection on bone mineral density (BMD) and its clinical sequelae.

Methods:

This was a two-pronged analysis of post-pancreatectomy patients with a follow-up period greater than 3 years comprising (1) a large, propensity score-matched, cohort study based on a multinational federated research network (FRN) and (2) a retrospective single institution review of clinical and radiographic patient data. In the FRN analysis, an initial cohort of 8,423 post-pancreatectomy patients were identified and propensity score-matched with normal controls. The primary endpoint was the 10-year risk of developing osteoporotic pathological fractures and secondary endpoints included diagnosis of osteoporosis, vitamin-D deficiency, and related therapies. The single institution retrospective analysis identified 224 patients who underwent pancreatic resection between 2005 and 2019. BMD was quantified in CT images acquired before and after surgery. BMD trends and related factors were assessed in a time-series mixed effect linear regression model.

Results:

A total of 8,080 propensity score-matched pairs were included in the FRN analysis. The analysis revealed a 2.4-fold increase in pathological fractures (P<0.0001) and 1.4-1.5 fold increase in osteoporosis/osteomalacia (P<0.0001) and vitamin-D deficiency (P<0.0001) in post-pancreatectomy patients. Vitamin-D supplements were more common in the pancreatectomy group (OR 1.4, 95% CI 1.28-1.53, P<0.0001), as were specific osteoporosis/osteomalacia treatments such as calcitonin, denosumab, romosozumab, abaloparatide, and teriparatide (OR 2.24, 95%CI 1.69-2.95, P<0.0001). Retrospective analysis of CT imaging revealed that BMD declined more rapidly following pancreatic resection compared to normal historical controls (P=0.015). Older age, pancreatic cancer, and pancreaticoduodenectomy were associated with increased rates of BMD loss (P<0.05, each).

Conclusions:

After pancreatic resection, patients are at higher risk for BMD loss and subsequent fractures. As the cohort of pancreatic resection survivorship grows, attention will need to be paid to focused prevention efforts to reduce BMD loss, osteoporosis, and fractures in these vulnerable patients, with specific attention to the pancreatic cancer population.
The Potential Utilization of Machine Perfusion to Increase Transplantation of Macrosteatotic Livers
Authors: Cywes Claire , Banker Amay , Muñoz Nicolas , Levine Matthew , Abu-Gazala Samir , Bittermann Therese , Abt Peter
Published: May 2024

Background.

The demand for liver transplantation has led to the utilization of marginal grafts including moderately macrosteatotic livers (macrosteatosis ≥30% [Mas30]), which are associated with an elevated risk of graft failure. Machine perfusion (MP) has emerged as a technique for organ preservation and viability testing; however, little is known about MP in Mas30 livers. This study evaluates the utilization and outcomes of Mas30 livers in the era of MP.

Methods.

The Organ Procurement and Transplantation Network database was queried to identify biopsy-proven Mas30 deceased donor liver grafts between June 1, 2016, and June 23, 2023. Univariable and multivariable models were constructed to study the association between MP and graft utilization and survival.

Results.

The final cohort with 3317 Mas30 livers was identified, of which 72 underwent MP and were compared with 3245 non-MP livers. Among Mas30 livers, 62 (MP) and 1832 (non-MP) were transplanted (utilization of 86.1% versus 56.4%, P < 0.001). Donor and recipient characteristics were comparable between MP and non-MP groups. In adjusted analyses, MP was associated with significantly increased Mas30 graft utilization (odds ratio, 7.89; 95% confidence interval [CI], 3.76-16.58; P < 0.001). In log-rank tests, MP was not associated with 1- and 3-y graft failure (hazard ratio, 0.49; 95% CI, 0.12-1.99; P = 0.319 and hazard ratio 0.43; 95% CI, 0.11-1.73; P = 0.235, respectively).

Conclusions.

The utilization rate of Mas30 grafts increases with MP without detriment to graft survival. This early experience may have implications for increasing the available donor pool of Mas30 livers.
Graft Survival of En Bloc Deceased Donor Kidneys Transplants Compared With Single Kidney Transplants
Authors: White Molly H. , Ross Lainie , Gallo Amy , Parker William F.
Published: May 2024

Background.

The US Kidney Allocation System allocates en bloc deceased donor kidney grafts from donors <18 kg in sequence A along with single kidney transplants (SKTs) from kidney donor profile index (KDPI) top 20% donors. Although en bloc grafts outperform SKT grafts holding donor weight constant, it is unclear if en bloc grafts from the smallest pediatric donors perform the same as top 20% KDPI SKTs.

Methods.

Using the Scientific Registry of Transplant Recipients, we compared the donor characteristics and graft survival of en bloc grafts from the smallest donors (<8 kg) and from larger donors (≥8 kg) with SKTs by KDPI sequence for transplants performed in 2021.

Results.

Larger donor en blocs had similar 1-y survival to sequence A SKTs estimated by the Kaplan–Meier method (96% versus 96%, P = 0.9), but the smallest donor en blocs had significantly shorter 1-y survival than those SKTs (80% versus 96%, P < 0.01). Using transplants from 2010 to 2012, the smallest donor en blocs had similar 10-y survival to sequence A SKTs (69% versus 64%, P = 0.3).

Conclusions.

These findings suggest that future updates of the Kidney Allocation System should include a score specific to pediatric donors to account for these differences in en bloc graft survival.
Access to and Health Outcomes of Pediatric Solid Organ Transplantation for Indigenous Children in 4 Settler-colonial Countries: A Scoping Review
Authors: Lin Jia , Selkirk Enid K. , Siqueira Izabelle , Beaucage Mary , Carriere Carmen , Dart Allison , De Angelis Maria , Erickson Robin L. , Ghent Emily , Goldberg Aviva , Hartell David , Henderson Randi , Matsuda-Abedini Mina , McKay Ashlene , Prestidge Chanel , Toulouse Crystal , Urschel Simon , Weiss Matthew J. , Anthony Samantha J.
Published: May 2024

Solid organ transplantation (SOT) is considered the optimal treatment for children with end-stage organ failure; however, increased efforts are needed to understand the gap surrounding equitable access to and health outcomes of SOT for Indigenous children. This scoping review summarizes the literature on the characteristics of access to and health outcomes of pediatric SOT among Indigenous children in the settler-colonial states of Canada, Aotearoa New Zealand, Australia, and the United States. A search was performed on MEDLINE, EMBASE, PsycINFO, and CINAHL for studies matching preestablished eligibility criteria from inception to November 2021. A preliminary gray literature search was also conducted. Twenty-four studies published between 1996 and 2021 were included. Studies addressed Indigenous pediatric populations within the United States (n = 7), Canada (n = 6), Aotearoa New Zealand (n = 5), Australia (n = 5), and Aotearoa New Zealand and Australia combined (n = 1). Findings showed that Indigenous children experienced longer time on dialysis, lower rates of preemptive and living donor kidney transplantation, and disparities in patient and graft outcomes after kidney transplantation. There were mixed findings about access to liver transplantation for Indigenous children and comparable findings for graft and patient outcomes after liver transplantation. Social determinants of health, such as geographic remoteness, lack of living donors, and traditional spiritual beliefs, may affect SOT access and outcomes for Indigenous children. Evidence gaps emphasize the need for action-based initiatives within SOT that prioritize research with and for Indigenous pediatric populations. Future research should include community-engaged methodologies, situated within local community contexts, to inform culturally safe care for Indigenous children.
Preserved appendages in a Silurian binodicope: implications for the evolutionary history of ostracod crustaceans
Authors: Siveter David J. , Briggs Derek E. G. , Siveter Derek J. , Sutton Mark D.
Published: May 2024

Ostracod crustaceans originated at least 500 Ma ago. Their tiny bivalved shells represent the most species-abundant fossil arthropods, and ostracods are omnipresent in a wide array of freshwater and marine environments today and in the past.
Derima paparme
gen. et sp. nov. from the Herefordshire Silurian Lagerstätte (~430 Ma) in the Welsh Borderland, UK, is one of only a handful of exceptionally preserved ostracods (with soft parts as well as the shell) known from the Palaeozoic. A male specimen provides the first evidence of the appendages of Binodicopina, a major group of Palaeozoic ostracods comprising some 135 Ordovician to Permian genera. The appendage morphology of
D. paparme
, but not its shell, indicates that binodicopes belong to Podocopa. The discovery that the soft-part morphology of binodicopes allies them with podocopes affirms that using the shell alone is an unreliable basis for classifying certain fossil ostracods, and knowledge of soft-part morphology is critical for the task. Current assignment of many fossil ostracods to higher taxa, and therefore the evolutionary history of the group, may require reconsideration.