bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early subclinical macular disease in asymptomatic patients with primary antiphospholipid syndrome: A quantitative multimodal retinal evaluation
Authors: Zacharias Leandro Cabral , Neto Taurino dos Santos Rodrigues , Dias da Silva Neto Epitácio , Monteiro Mário Luiz Ribeiro , Balbi Gustavo Guimarães Moreira , Signorelli Flávio , Higashi Alex Haruo , Bonfá Eloisa , de Andrade Danieli Castro Oliveira 
Published: December 2024

Purpose To perform a quantitative multimodal evaluation in 25 patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with 25 healthy individuals. Methods A structural and functional ophthalmological evaluation using optical coherence tomography angiography (OCTA) and microperimetry (MP) exam in 25 patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were documented and subsequent statistical analysis was performed for comparative purposes, with significance set at p < 0.05. Results We included 100 eyes of 50 subjects (25 patients with PAPS without ocular complaints and 25 healthy individuals). Quantitative OCTA assessment revealed significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) using high-speed protocol, as well as in the SVC in the high-resolution protocol. Analysis of the foveal avascular zone (FAZ) parameters showed a larger area of FAZ in the DVC in PAPS patients using the high-speed method compared to the control group ( p = 0.047). In MP quantitative analysis, the PAPS group exhibited lower central ( p = 0.041) and global ( p < 0.001) retinal sensitivity compared to the control group, along with sectoral differences, except in the inferior sector. Conclusions PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without paracentral acute middle maculopathy (PAMM). Our findings underscore the significance of ocular evaluation beyond symptomatic assessment in these patients.
Ultrasound measurement of abdominal and low back muscle symmetry in adult degenerative lumbar scoliosis: A case-control study
Authors: Dawu Wang , Kaiting Li , Weiwei Yi , Yuzhang Tao , Xiaohong Li , Yong Zhang 
Published: December 2024

Background Individuals with adult degenerative lumbar scoliosis (ADLS) have underlying biomechanical alterations along the trunk muscles. However, few studies have evaluated trunk muscles in ADLS. Objective To quantify and evaluate the symmetry, thickness, and stiffness (shear modulus) of the abdominal and back muscles in ADLS participants. Methods This was a case-control study with participants aged 60–79 years with ADLS (n = 37) and without ADLS (n = 37). Radiographic examination data were collected from the participants. Ultrasound thickness and shear modulus measurements were performed to compare differences in the rectus abdominis, external oblique, internal oblique, transversus abdominis (TrA), multifidus, erector spinae, and quadratus lumborum muscles in the supine, prone and standing positions in the ADLS (n = 37) and control groups (n = 37). Thicknesses and shear modulus were compared. Results The absolute thickness of the TrA in ADLS group was significantly greater on the convex side than on the concave side in both the supine (2.978 ± 0.552 vs. 2.556 ± 0.513, p = 0.041) and standing positions (2.671 ± 0.475 vs. 2.054 ± 0.401, p = 0.034). The percentage changes in both sides of the shear modulus of the TrA were significantly greater in the ADLS group than in the control group for the supine position ( p = 0.019), and standing position ( p = 0.039). Conclusions Compared with those in the control group, only the absolute muscle thicknesses and percent change in the shear modulus of the TrA in the ADLS participants were more asymmetric.
Back to the Anatomy Lab to Redefine the Pulley System of the Thumb: Is There an A0 Pulley?
Authors: Sullivan John M. , Edwards Shelley , Waetjen Eric , Dogar Shireen , Walker Marc E. 
Published: December 2024

Background: There are various anatomical descriptions of the pulley system of the fingers and thumb. The A0 pulley, often referred to as palmar aponeurosis of the fingers, is of keen interest, especially regarding surgical release of the A1 pulley for trigger finger; however, there has been no anatomical description of the A0 pulley in the thumb. Methods: Twenty-four cadaveric thumbs were dissected to expose the entire pulley system. Each structure, including the A2, Aob, Av, A1 pulleys, and any proximal transverse elements, were cataloged. Results: Three distinct transverse elements were identified proximal to the A1 pulley including: (1) the named ligament of Grapow; (2) the proximal commissural ligament and associated transverse fascial tissues; and (3) a definable A0, identified in 10/12 (83.3%) cadavers and 15/24 (62.5%) thumbs. Ten A0 pulleys occurred bilaterally, while 5 occurred unilaterally. Conclusions: The presence of an A0 pulley in greater than 80% of the studied thumbs serves as an important anatomic finding that should be considered in surgical treatment. An additional finding of importance is that the pulley system anatomy demonstrated variability in laterality. Based on these anatomic findings, not only can the A0 pulley be defined as a unique anatomic structure of the thumb, but its repair also has implications for successful surgical treatment of thumb pulley system pathologies.
The Psychological Impact of Adult Traumatic Brachial Plexus Injury
Authors: Emani Sivaram , Garg Rohit , Elhassan Bassem , Winograd Jonathan , Zhang Dafang 
Published: December 2024

Background: Adult traumatic brachial plexus injuries (BPIs) present a significant medical challenge, potentially leading to life-altering consequences for patients’ upper extremity pain and function. However, the psychological impact on patients has not been extensively studied. Methods: Adult patients with traumatic BPIs treated at 2 tertiary referral centers in the United States from 2015 to 2019 were retrospectively identified. This cohort of 84 patients was targeted for prospective interviews, and 44 patients (52%) responded. Validated measures including the posttrumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (PCL-5), Decision Regret Scale, Patient-Reported Outcome Measurement Information System (PROMIS) Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) were obtained through telephone-based interviews. Additional data were collected through electronic medical record review. Results: On average, patients experience low post-traumatic stress (median score 6, interquartile range [IQR] 3-20) and decision regret (median score 5, IQR 0-22.5). However, a notable fraction (18%) of patients met the clinical threshold for PTSD. Significant correlations were observed between PCL-5 scores and worse PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and QuickDASH. Decision regret scores correlated with worse PROMIS Upper Extremity and QuickDASH. Conclusions: While the overall incidence of PTSD and treatment decision regret after adult traumatic BPI is low, clinical PTSD was found in a significant percentage of patients associated with pain and functional impairment. This study highlights the importance of understanding and addressing the psychological burden of traumatic BPI.
Can simultaneous coronary and peripheral angiography alter the treatment planning in Fontaine stage IV peripheral arterial disease?
Authors: Vaezzadeh Kosar , Tayebi Pouya , Jalali Seyed Farzad , Hedayati Goudarzi Mohammad Taghi , Jafaripour Iraj , Ziaie Naghmeh , Bijani Ali 
Published: December 2024

Objectives Peripheral arterial disease (PAD) and coronary artery disease (CAD) are major contributors to global morbidity and mortality. Many PAD patients remain asymptomatic for CAD, which often leads to undetected coronary artery involvement. This hidden coronary disease poses significant risks, particularly following peripheral revascularization, as increased cardiac demand can precipitate complications. Methods This cross-sectional descriptive study assessed the prevalence of coronary artery stenosis in patients with Fontaine Stage IV peripheral arterial disease. Simultaneous angiography of both the coronary and lower extremity arteries was performed, and the severity of arterial stenosis was rigorously evaluated. The correlation between the extent of peripheral and coronary artery disease was analyzed. Results A total of 60 patients (63.3% male, 36.7% female; mean age 65.23 ± 9.86 years) were included. Comorbidities were common, with 90% having diabetes, 50% hypertension, 23.3% hyperlipidemia, and 30% smoking history. Severe peripheral artery stenosis was frequently observed, particularly in the posterior tibial artery (total occlusion in 26.6% and 20% of the right and left arteries, respectively). Significant coronary involvement was also prevalent, with 51.7% exhibiting three-vessel disease. Coronary revascularization was required in the majority of cases (CABG: 40%, PCI: 35%), with a higher proportion among women (77.2%) and men (73.7%). Conclusion This study highlights the necessity of comprehensive coronary evaluation in patients with advanced lower limb ischemia. A substantial proportion of these patients have silent but critical coronary disease, which, if left unaddressed, could result in serious post-revascularization complications.
Interstitial lung disease with antibody–drug conjugates: a real-world pharmacovigilance study based on the FAERS database during the period 2014–2023
Authors: Shi Jing , Liu Xinya , Wu Li , Jiang Yun , Zhang Yuanming , Wang Yanfeng 
Published: December 2024

Background: Antibody–drug conjugates (ADCs) combine the targeted nature of monoclonal antibodies with the potent efficacy of small-molecule cytotoxic drugs. However, they also carry unique safety risks, including lung toxicity. Objective: To conduct a systematic review and analysis of ADC-related interstitial lung disease (ILD) incidence, characteristics, and risk factors to optimize safe and effective clinical use. Design: ADC-related ILD reports from the FDA Adverse Event Reporting System (FAERS) database between January 2014 and March 2023 were analyzed. Methods: ADC-related ILD reports were retrieved from the FAERS database. Statistical analyses were conducted using reporting odds ratio (ROR) and information components (ICs). The lower limit of the 95% confidence interval (CI) was set for ROR (ROR025) >1 or IC (IC025) >0, and statistical significance was determined based on a minimum of three reports. Results: The study analyzed the statistical data on ADC-induced ILDs (1277 cases). Trastuzumab deruxtecan was reported to be the most frequent (38.4%). Among the 33 preferred terms (PTs) in standardized MedDRA queries (SMQ) = “Interstitial lung disease,” the three most common were as follows: ILD (40.6%), pneumonitis (27.9%), and acute respiratory distress syndrome (ARDS) (7.6%). Trastuzumab deruxtecan showed the strongest association with ILD (PT) and pneumonitis, whereas ARDS was associated with four different drugs. The median time to onset of ADC-related ILDs was 51 days (interquartile range (IQR), 16–196), with ARDS having the earliest median time to onset at 15 days (IQR, 6–52). The onsets of pneumonitis, ILD, lung infiltration, and pulmonary toxicity were similar. More than 26% of ADC-related ILD cases result in death, with ARDS having the highest mortality rate of 65.0%. Conclusion: ADCs are associated with an increased risk of pulmonary adverse events, such as ILDs, with significant differences between drugs and varying mortality rates for different adverse events, necessitating distinct monitoring and appropriate management.
Bioimpedance analysis (extracellular mass to body cell mass ratio) as complementary assessment for malnutrition in hemodialysis patients
Authors: Papalini Sandra , Londrino Francesco , De Rocchis Daniela , Criscione Alessia , Soldo Manuela , Espinosa Emma 
Published: December 2024

Background: Protein energy wasting (PEW) is a frequent condition in haemodialysis patients but often goes missed. The diagnosis of PEW is complex even though composite nutritional indices seem to show strong correlations with mortality and cardiovascular events. Bioimpedance analysis in dialysis centres is used to study patient's degree of water load but not to assess nutritional status. Recently, the extracellular mass/body cell mass ratio (ECM/BCM) ≥ 1.2 has also been considered as a parameter of malnutrition in the haemodialysis patients. Objective: To assess the nutritional reliability of ECM/BCM ≥ 1.2 in patients referred to the Dialysis Centre of the “S. Spirito Hospital” Rome. Methods: 16 Patients were enrolled and than evaluated anthropometrically, for nutritional and inflammatory parameters, subjected to the Malnutrition Inflammation Score (MIS) and monitored with impedance measurements before, after and 30 min after the haemodialysis session. Results: ECM/BCM ≥ 1.2 demonstrates a statistically significant direct correlation ( p < 0.001) with MIS. Albumin and pre-albumin were inversely correlated with ECM/BCM ≥ 1.2, cholesterolaemia was directly correlated. Conclusions: ECM/BCM ≥ 1.2 appears to be a simple and reliable indicator for the diagnosis of malnutrition in the chronic haemodialysis patient. Given the small sample size, further studies are needed to support this thesis.
The Role of Emergency and Primary Care in Combating the Rise of Gonorrhea: Another Purview Paradox?
Authors: Allan-Blitz Lao-Tzu , Chan Karly , Adamson Paul , Klausner Jeffrey D. , Hsu Katherine 
Published: December 2024

Introduction: Drug-resistant Neisseria gonorrhoeae is an urgent threat to public health. Novel prevention and treatment strategies are emerging, including immunizations, pharmacologic post-exposure prophylaxis, rapid molecular resistance assays, and novel antibiotics. However, where and how such strategies are optimally implemented remains unclear. Methods: We conducted a retrospective interrupted time series analysis of gonorrhea cases reported to the Massachusetts Department of Public Health. We collected names of treating providers from 2011 (n = 100) and 2022 (n = 108), and cross-referenced provider names with publicly available records from the Massachusetts Boards of Registration in Medicine and Nursing to identify provider type, specialty, year of terminal degree or licensure, and clinic type. Results: Of 208 providers, 111 (53.4%) were advanced care practitioners. Providers treated cases predominantly in community health centers (n = 65, 31.3%) and emergency departments or urgent care centers (n = 60, 28.8%). Only 11 (12.4%) of 89 physicians were trained in either adult or pediatric infectious diseases. Conclusion: Our results indicate that the majority of gonorrhea cases in the Massachusetts are treated in non-specialty settings. The time is now to plan for implementation of the emerging strategies to avoid underutilization and assure uptake of interventions in settings positioned to reach persons diagnosed with gonorrhea who will benefit most.
Risk Factors for de Novo Postoperative Urinary Retention in Posterior Lumbar Spine Surgery
Authors: Nakajima Hideaki , Honjoh Kazuya , Watanabe Shuji , Takeura Naoto , Kubota Arisa , Matsumine Akihiko 
Published: December 2024

Study Design Retrospective cohort study. Objective De novo postoperative urinary retention (POUR) after lumbar posterior decompression surgery for lumbar spinal canal stenosis (LSCS) is a statistically known but uncommon complication for both patients and spine surgeons. The aim of this study is to review clinical data and imaging findings and identify preoperative predictors of de novo POUR. Methods The subjects were 738 surgically treated patients with LSCS, without preoperative bladder dysfunction or perioperative complications. Univariate and multivariate analyses using propensity score matching were performed to identify prognostic factors for POUR lasting for at least 1 week after postoperative urinary catheter removal. Results POUR occurred in 23 patients (3.1%). The median recovery time was 41 days and only 12 patients (52.2%) showed improvement within 3 months. Patients with POUR were significantly older, and the lumbar Cobb angle, location of compressed dura mater (ventral or dorsal), and type of cauda equina redundancy (curve-type) were identified as independent prognostic factors. POUR had no association with sex, comorbidities, surgical procedures, number of decompressed segments, or degree of dura mater compression. Conclusions This study suggests that older age and curve-type stenosis with ventral or dorsal compression of the dura mater are risk factors for development of de novo POUR. Such preoperative imaging findings may indicate a higher risk of intraoperative thermal and nerve injuries, and possible uneven cauda equina flow improvement after decompression.
Achieving tuberculosis elimination in Canada and the USA: giving equal weight to domestic and international efforts
Authors: Rana Namrata , Johnston James C. , Schwartzman Kevin , Oxlade Olivia , Suarez Pedro G. , Gasana Michel , Murray Megan , Brigden Grania , Campbell Jonathon R. 
Published: December 2024

Abstract
A major contributor to the tuberculosis burden in the United States (US) and Canada is the progression of tuberculosis infection acquired before immigration among persons born outside the US and Canada. Domestic interventions against tuberculosis, such as those associated with tuberculosis infection testing and treatment, while critical, are alone insufficient to address tuberculosis and achieve elimination. To hasten tuberculosis elimination in North America, coupling domestic efforts with consistent funding and multifaceted support for tuberculosis detection, treatment, and prevention worldwide is necessary. These efforts will reduce tuberculosis transmission and the prevalence of tuberculosis infection in an increasingly globalized world. We discuss the epidemiologic and economic rationale for this approach, as well as current efforts and potential strategies. We further place in context benchmark tuberculosis programs that have used international funding to achieve a sustained decline in tuberculosis incidence, as exemplars for the importance of such funding to international progress towards elimination. We conclude by providing suggestions for future pathways toward sustainable programs. Following the substantial global and local response to COVID-19, we call for the same intensity to eliminate this millennia-old disease.
Body Weight Gain Associated With Alectinib in Patients With ALK+ Non–Small Cell Lung Cancer: Pooled Analysis of Individual Patient Data From Four Prospective Clinical Trials
Authors: Sikkema Barend J. , Baart Sara J. , Paats Marthe S. , Smit Egbert F. , Schols Annemie M.W.J. , Mathijssen Ron H.J. , van Rossum Elisabeth F.C. , Dingemans Anne-Marie C. 
Published: December 2024

PURPOSE
Weight gain is a known adverse event (AE) of alectinib. This study evaluates the progression of actual weight gain over time and explores its association with baseline characteristics.

METHODS
A pooled analysis of individual patient data from four clinical trials (ALEX, J-ALEX, ALUR, and ML29453) was conducted. Actual weight gain was calculated as the percent change from baseline. A linear mixed model estimated weight change over time and associations between clinical characteristics and weight change.

RESULTS

Follow-up weights were available for three trials (J-ALEX, ALUR, and ML29453) and missing for ALEX. In total, 2,622 weights were recorded in the first year (N = 302). At baseline, 13.6% of the Japanese population were underweight and 5.0% in the Western population. Actual weight gain of any grade was substantially higher than reported AE rates (49%
v
5%), with 18% experiencing ≥10% weight gain (from median 55.6 kg to 64.1 kg). Time on alectinib was positively associated with weight change (β = .37; 95% CI, 0.24 to 0.51;
P
< .001), corresponding to an average increase of 4.4% over 1 year. Baseline BMI was not associated with weight change in J-ALEX (β = –.090 [95% CI, –0.19 to 0.012];
P
= .092) and ALUR/ML29453 (β = –.016 [95% CI, –0.077 to 0.044];
P
= .59). Baseline albumin was positively associated with weight change in ALUR/ML29453 (β = .084 [95% CI, 0.027 to 0.14];
P
= .0045), although not considered a clinically meaningful predictor.

CONCLUSION
Weight gain is under-reported as AE in trials. Actual weights showed ≥10% weight gain in 18% of patients. Clinicians should be aware of this AE, emphasizing the importance of timely identification and monitoring weight. Identifying predictors for weight gain remains challenging.
Associations of Cumulative Adulthood, Childhood and Lifelong Insulin With Adulthood Retinal Microvasculature
Authors: Repo Oskari , Juonala Markus , Rovio Suvi P , Mykkänen Juha , Nevalainen Jaakko , Kähönen Mika , Lehtimäki Terho , Laitinen Tomi P , Viikari Jorma , Raitakari Olli , Tapp Robyn , Pahkala Katja 
Published: December 2024

Abstract

Context
Exogenous insulin is reported to have both vasodilatory and vasoconstrictive effects on microvasculature. Little is known about the associations of long-term endogenous insulin exposure with microvasculature.

Objective
To test the hypothesis that long-term exposure to high insulin levels in childhood and adulthood is associated with adverse changes in retinal microvasculature in adulthood in a population without diabetes.

Methods
We analyzed data derived from the longitudinal Cardiovascular Risk in Young Finns Study. The first cross-sectional study was conducted in 1980, and participants were followed for 31 years from childhood to adulthood with frequent follow-up visits. Fundus photos were taken in 2011, and microvascular outcome measures were derived in participants at the age of 34 to 49 years (n = 1684). After exclusion of individuals with diabetes or missing insulin measures, 1166 participants formed the population of the present study. Cumulative exposure as the area under the curve (AUC) for adulthood (10-year exposure between 2001 and 2011) and childhood (exposure between ages 6-18 years) insulin and other cardiovascular risk factors were determined. Additionally, adulthood and childhood cumulative AUCs were summarized to construct lifelong AUCs.

Results
Higher adulthood, childhood, and lifelong exposure for cumulative insulin was associated with decreased retinal arteriolar diameter when adjusted for age and sex and further for cumulative conventional cardiovascular risk factors.

Conclusion
Cumulative childhood, adulthood, and lifelong insulin are associated with decreased retinal arteriolar diameter in adulthood in a population of participants without diabetes, independently of conventional cardiovascular risk factors.
Percepções de estudantes e preceptores sobre a interdisciplinaridade no processo de formação em fisioterapia
Authors: Cavalcanti de siqueira Nayara bezerra , Silveira Braglia Cesar Vieira Juliany , Menezes Thalita 
Published: December 2024

Mudanças curriculares vêm acontecendo dentro das IES com o objetivo de promover a formação de profissionais aptos a realizar ações integrais de saúde. Essa pesquisa investigou a compreensão de preceptores e estagiários de fisioterapia acerca da vivência da interdisciplinaridade no contexto do estágio curricular. O estudo de abordagem qualitativa foi realizado em uma instituição de ensino superior do interior de Caruaru-PE, nos meses de Outubro e Novembro de 2018. Um grupo focal foi realizado e os dados obtidos foram analisados através da análise de Bardin apresentando as seguintes categorias: Percepção de Interdisciplinaridade, Estágio Interdisciplinar: motivação e desafios e Desenvolvimento pessoal e profissional. Os resultados encontrados demonstram que a vivência interdisciplinar estimula uma formação pautada no atendimento integral, desenvolvendo uma postura profissional mais humanizada. Sugere-se a continuidade de estudos sobre a interdisciplinaridade, devido à escassez de trabalhos que investigam a temática.