bluuebunny/crossref_metadata_2025_split huggingface dataset:
Back to the Bottle: Comparison of Palatoplasty Outcomes Before and After Systematic Changes to Postoperative Precaution Protocols
Authors: Lico Margaret M. , Rodrigo Diaz-Siso Jesus , Gayner Sydney , Groysman Leya , Laspro Matteo , Diaz Allison L. , Young Amanda L. , Camison-Bravo Liliana , Flores Roberto L. 
Published: December 2024

Main Objective To analyze postoperative palatoplasty outcomes before and after systemic protocol changes to preferred bottle and arm immobilizer use after surgery. Design Retrospective, cohort study. Setting Urban, academic, tertiary medical center in New York City, NY. Participants Eighty-four patients who underwent primary palatoplasty and met inclusion criteria during 1 of 2 treatment periods, 2016 to 2017 (group A, n = 45) and 2019 to 2020 (group B, n = 39). Interventions Protocols were amended over the 2018 calendar year to allow for utilization of the baby's preferred bottle (vs alternative feeding methods) and hand socks (vs arm immobilizers) in the immediate postoperative period. Data was extrapolated from electronic medical records to compare surgical outcomes. Main Outcome Measures Postoperative wound complications (fistula and dehiscence) that did not resolve within 1 month, length of stay (hours), and 30-day re-admission. Nonparametric Mann-Whitney U tests and Fisher's Exact test were utilized for statistical analysis. Results There were no statistically significant differences between sex, age at surgery, Veau classification, or hard and soft palate surgical repair technique. Group A had a wound complication rate of 8.7% (n = 4) versus a 2.6% rate (n = 1) for group B. No patients were re-admitted to the hospital from either group. There were no statistically significant differences between groups regarding length of stay ( P = .528) or wound complication ( P = .366). Conclusions The findings from this study suggest relaxing postoperative protocols following palatoplasty to allow immediate bottle feedings and unrestricted arm use may be safe without compromise to surgical outcomes.
Earthquake From the Perspectives of Amputee Children and Their Parents/Caregivers: A Phenomenological Study
Authors: Suna Dağ Yeliz , Zengin Mürşide , Yayan Emriye Hilal , Suna Erdoğan 
Published: December 2024

Background Earthquakes cause significant psychological and physical trauma in children, especially when leading to amputations, as they disrupt physical, emotional, and social well-being. Aim This study was conducted phenomenologically to explore the experiences of children amputated in the Kahramanmaraş earthquake and their parents/caregivers. Method This study was conducted as a phenomenological study with children who were amputated in the Kahramanmaraş earthquake and their parents/caregivers between August and October 2023. The sample of the study consisted of seven children and their parents/caregivers who met the inclusion criteria and volunteered to participate in the study through purposive sampling method. Data were collected through in-depth interviews using an introductory information form and a semistructured interview form developed by the researcher. Results It was found that 57.2% of the children who participated in our study were male and their mean age was 11.25 ± 4.02 years. It was found that all the children’s houses were destroyed in the earthquake, they were trapped under the debris, and they experienced losses in their family members and relatives. As a result of data analysis, nine themes were identified as apocalypse, pain, fear, and hopelessness for children and apocalypse, helplessness, pain, anger, and hopelessness for parents/caregivers. Conclusions: This study found that earthquake-affected amputee children perceived the earthquake as an apocalypse, experienced prolonged pain during hospitalization, continued to fear the earthquake, and felt hopeless about the future. The children’s parents/caregivers also reported that they perceived the earthquake as an apocalypse, that they felt helpless and hopeless for themselves and the children, and that the children had angry/irritable behavior with pain after the disaster.
Characteristics of Climbers with High Altitude Pulmonary Edema on Mount Aconcagua
Authors: Park Andrew , Brillhart Aaron , Sethi Sameer , Abramor Bernabé , Duplessis Rodrigo , Pronce Roxana , Seufferheld Javier , Schlein Sarah 
Published: December 2024

Introduction— Mount Aconcagua (6961 m) in Argentina is the highest peak in the Americas, and more than 3000 climbers attempt to summit annually. High altitude pulmonary edema (HAPE) is a leading cause of mortality and evacuation on Aconcagua. Objective— This study sought to describe the characteristics of climbers who developed HAPE on Aconcagua to aid in future prevention efforts. Methods— Climbers diagnosed with HAPE in January 2024 were surveyed regarding demographics, preparation, acclimatization, and illness. Healthy climbers on Aconcagua also were surveyed for the same period, providing a control population. Results— Seventeen climbers were diagnosed with HAPE. These climbers were similar to climbers without HAPE in age, sex, origin, home elevation, hypoxic tent use, staged ascent, recent virus exposure, fitness metrics, and ascent-rate plans. Climbers with HAPE spent fewer nights at the 4300-m base camp (3.6 vs 5.0 nights). Prior to developing HAPE, 71% of patients reported unresolved acute mountain sickness symptoms. HAPE onset median elevation was 5500 m, with a median of 8.0 days over 3000 m and a median lowest SpO2 of 60% at diagnosis. There was a nonsignificant trend between acetazolamide use and increased HAPE. All surveyed HAPE patients descended, required helicopter evacuation, and survived. Conclusion— This study examined climbers who developed HAPE on Mount Aconcagua, yielding implications for high altitude illness prevention efforts and further study. HAPE cases were associated with insufficient nights at the 4300-m base camp and unresolved acute mountain sickness symptoms. The relationship between acetazolamide and HAPE warrants further study on Aconcagua.
COVID-19 Increases the Risk of New Myocardial Infarction in Patients with Old Myocardial Infarction: A Retrospective Observational Study
Authors: El-Menyar Ayman , Ramzee Ahmed Faidh , Asim Mohammad , Shahid Fakhar , Ata Yaser M , El Baba Hamzah , Fino Areen , Nair Arun P , Peralta Ruben , Almaslamani Muna A , Al Suwaidi Jassim , Al-Thani Hassan , Rizoli Sandro 
Published: December 2024

Background: We aimed to investigate the incidence of new acute myocardial infarction (AMI), in patients with Coronavirus disease (COVID-19) who had old MI. We hypothesized that COVID-19 increases the rate of repeated AMI in this population regardless of age and gender. Methods: A retrospective analysis was conducted for adult patients admitted with COVID-19 and developed thromboembolic event (TEE) in 2020. Patients were categorized based on the history of old MI, new MI, age, and gender. Results: Among 16,903 patients with COVID-19 who were admitted, 210 (1.2%) developed TEE (89% were males, 55% were <55 years old, and 80.5% had an old MI). COVID-19 was severe in 32% of cases. AMI occurred in 160 patients (42.5% STEMI and 57.5% NSTEMI). In patients with prior MI, 92.5% developed another AMI. NSTEMI was higher in patients with severe COVID-19 than STEMI (33% vs 21%). Patients with severe COVID-19 had higher mortality (39.4% vs 5.6%), fewer rates of prior MI (74% vs 83%), hypertension (40% vs 60%), and STEMI (31.8% vs 46.5%) than mild COVID-19 patients. On multivariable analysis, COVID-19 severity was an independent predictor of mortality (OR10; 95%CI 1.62-67.19) after adjustment for age, gender, diabetes mellitus, C-reactive protein, serum Ferritin, Procalcitonin, and Fibrinogen values, and prior or new MI. Conclusions: Patients with old MI could develop a new AMI in 80% of COVID-19. However, the mortality was higher in patients without a history of MI due to the severity of COVID-19. Attention should be given to patients who possess thrombotic risk factors in pandemics.
From “invisible” to “audible”: Features extracted during simple speech tasks classify patient-reported fatigue in multiple sclerosis
Authors: Nylander Alyssa , Sisodia Nikki , Henderson Kyra , Wijangco Jaeleene , Koshal Kanishka , Poole Shane , Dias Marcelo , Linz Nicklas , Tröger Johannes , König Alexandra , Hayward-Koennecke Helen , Pedotti Rosetta , Brown Ethan , Halabi Cathra , Staffaroni Adam , Bove Riley 
Published: December 2024

Background: Fatigue is a major “invisible” symptom in people with multiple sclerosis (PwMS), which may affect speech. Automated speech analysis is an objective, rapid tool to capture digital speech biomarkers linked to functional outcomes. Objective: To use automated speech analysis to assess multiple sclerosis (MS) fatigue metrics. Methods: Eighty-four PwMS completed scripted and spontaneous speech tasks; fatigue was assessed with Modified Fatigue Impact Scale (MFIS). Speech was processed using an automated speech analysis pipeline (ki elements: SIGMA speech processing library) to transcribe speech and extract features. Regression models assessed associations between speech features and fatigue and validated in a separate set of 30 participants. Results: Cohort characteristics were as follows: mean age 49.8 (standard deviation ( SD) = 13.6), 71.4% female, 85% relapsing-onset, median Expanded Disability Status Scale (EDSS) 2.5 (range: 0–6.5), mean MFIS 27.6 ( SD = 19.4), and 30% with MFIS > 38. MFIS moderately correlated with pitch ( R = 0.32, p = 0.005), pause duration ( R = 0.33, p = 0.007), and utterance duration ( R = 0.31, p = 0.0111). A logistic model using speech features from multiple tasks accurately classified MFIS in training (area under the curve (AUC) = 0.95, R2 = 0.59, p < 0.001) and test sets (AUC = 0.93, R2 = 0.54, p = 0.0222). Adjusting for EDSS, processing speed, and depression in sensitivity analyses did not impact model accuracy. Conclusion: Fatigue may be assessed using simple, low-burden speech tasks that correlate with gold-standard subjective fatigue measures.
Long-Term Outcomes and Late Complications of Thoracic Endovascular Aortic Repair Using the GORE TAG or Conformable GORE TAG
Authors: Tsushima Shingo , Shibata Tsuyoshi , Iba Yutaka , Sakurada Taku , Muraki Satoshi , Maeda Toshiyuki , Nakajima Tomohiro , Nakazawa Junji , Miura Shuhei , Arihara Ayaka , Nakanishi Keitaro , Mizuno Takakimi , Mukawa Kei , Kawaharada Nobuyoshi 
Published: December 2024

Purpose: Previous clinical studies have reported on the short- and mid-term prognoses of thoracic endovascular aortic repair (TEVAR) using the GORE thoracic aortic graft (TAG) or conformable GORE TAG. We evaluated the long-term prognoses of patients who underwent TEVAR using the GORE TAG or conformable GORE TAG in a real-world setting. Materials and methods: This retrospective observational study analyzed the data of all consecutive patients aged 20 years or older who underwent TEVAR using either the GORE TAG or the conformable GORE TAG at a single center. The surgical criteria did not deviate from global standards. In principle, TEVAR was performed with the TAG or conformable thoracic aortic graft (CTAG) according to the manufacturer’s instructions. The primary outcomes of this study were the 10-year overall survival rate and the rate of freedom from aorta-related deaths at 10 years. Results: Between January 2011 and December 2021, 331 patients underwent TEVAR, of whom 175 consecutive patients treated with TEVAR using either the GORE TAG or the conformable GORE TAG were enrolled. The mean age of the patients was 72.1 ± 9.3 years. In addition, the aneurysm and chronic dissection were 61.7% and 38.3%, respectively. Of all patients, 157 had a proximal landing zone ≥3, and 18 had a zone <3. The mean follow-up time was 46.5 ± 33.1 months. The 30-day mortality rate was 2.86%. The 3-, 5-, 7-, and 10-year overall survival rates were 76.9 ± 3.4%, 63.4 ± 4.1%, 55.9 ± 4.9%, and 42.4 ± 8.4%, respectively. The rate of freedom from aorta-related deaths at 3, 5, 7, and 9 years was 97.4 ± 1.3%, 95.0 ± 2.1%, 95.0 ± 2.1%, and 95.0 ± 2.1%, respectively. Late complications occurred in 23 (13.1%) patients. Endovascular re-intervention was performed because of endoleak, false lumen enlargement, or stent graft-induced new entry tear in 14 patients. Three patients required open conversion, and 6 were observed without re-intervention. Conclusions: Thoracic endovascular aortic repair using the GORE TAG or conformable GORE TAG is a safe and effective procedure for the treatment of thoracic aortic aneurysms and aortic dissection. Clinical Impact Thoracic endovascular aortic repair using the GORE thoracic aortic graft (TAG) or conformable GORE TAG is a safe and effective procedure for the treatment of thoracic aortic aneurysms and aortic dissection. The 30-day mortality rate was 2.86%. During 10 years of follow-up, the overall survival rate was low; however, the risk of aorta-related deaths was also low. No significant differences in freedom from late complications and re-intervention are seen between the TAG and conformable thoracic aortic graft (CTAG) groups. Further investigations into the treatment of late complications are required.
Plasma CircCYP24A1 as a Novel Biomarker of Esophageal Squamous Cell Carcinoma
Authors: Zhang Ruolan , Liu Jianlin , Yang Hang , Tan Jinsong , Xiong Rong , Liu Yun , Feng Gang , Song Guiqin , Liu Kang 
Published: December 2024

Background A clinical challenge in esophageal squamous cell carcinoma (ESCC) remains the lack of applicable plasma biomarkers for screening and diagnosis. Circular RNAs (circRNAs) hold great potential as biomarkers for cancer. The study aims to explore a circRNA as a potential plasma biomarker for screening strategies and diagnostic approaches to ESCC. Methods Upregulated circRNAs were identified through RNA sequencing, with circCYP24A1 being identified as the target circRNA. Fluorescence in situ hybridization was employed to detect the expression of circCYP24A1 in ESCC tissue microarrays, aiming to assess the expression of circCYP24A1 in a large population and its correlation with clinical indicators. Subsequently, qRT-PCR analysis was performed on plasma samples from both ESCC patients and healthy controls to evaluate the expression levels of circCYP24A1, exploring its potential as a biomarker. Finally, the functions of circCYP24A1 were validated through CCK-8 assay, wound healing assay, trans-well assays and western blot assays. Results CircCYP24A1 demonstrated upregulation in both plasma and tissues, exhibiting correlations with lymph node metastasis, TNM staging, and prognosis in ESCC. The circCYP24A1 achieved a perfect area under the curve of 0.94 for the diagnosis of ESCC, and an area under the curve of 0.76 for the prediction of lymph node metastasis. Furthermore, functional loss assays revealed that circCYP24A1 effectively promotes the epithelial-mesenchymal transition and tumor metastasis in vitro. Conclusions CircCYP24A1 emerges as a potential plasma diagnostic biomarker and a predictive factor for LNM for ESCC.
Menstrual hygiene management practices among schoolgirls in resource-limited settings of Bahir Dar City administration, Northwestern Ethiopia
Authors: Adane Yimenu , Ambelu Argaw , Azage Yenesew Muluken , Mekonnen Yalemtsehay 
Published: December 2024

Background: Schoolgirls in resource-limited settings encounter significant challenges in maintaining proper menstrual hygiene management practices. Studies on associated factors in menstrual hygiene management practices among schoolgirls in Bahir Dar City are limited. Objectives: The study aimed to evaluate the menstrual hygiene practices of schoolgirls and identify factors that influence these practices in the limited settings of Bahir Dar City. Design: This study was a school-based, analytical, cross-sectional study conducted among schoolgirls between the ages of 11 and 25. Methods: A total of 701 schoolgirls, selected at random based on their consent, participated in this school-based, analytical, cross-sectional study. The data collection process was comprehensive, involving a self-administered questionnaire and 5 rounds of observations at 10 schools using the Joint Monitoring Program for Water, Sanitation, and Hygiene monitoring tool. The study used a binary logistics regression model to determine the strength of the association between predictor and outcome variables, ensuring a rigorous analysis with a p-value < 0.05. Results: In this study, 375 (53.50%) participants were found to have good menstrual hygiene practices. Factors such as the mothers’ education (diploma and above vs not read and write (AOR = 26.29, 95% CI: 11.69–59.12), fathers’ education (diploma and above vs not read and write (AOR = 19.21, 95% CI: 8.51–43.32), having access to basic water service (AOR = 14.62, 95% CI: 5.12–41.73), having access to basic sanitation services (AOR = 21.02, 95% CI: 7.87–56.15), being older among the schoolgirls (AOR = 19.69, 95% CI: 10.18–38.07), having private work (AOR = 15.58, 95% CI: 6.99–34.73), having open discussions with sisters (AOR = 27.01, 95% CI: 11.45–63.73), having friendly discussions about menstrual hygiene with schoolgirl friends (AOR = 18.67, 95% CI: 8.45–41.24), and residing in urban areas (AOR = 6.43, 95% CI: 3.52–11.73)) were significantly associated with good menstrual hygiene practices. Conclusion: The schoolgirls in the study area had good menstrual hygiene practices. However, uneducated parents, inadequate facilities, limited access to absorbent materials, and lack of support were challenges that affected proper menstrual hygiene management practice. To improve menstrual hygiene practices, it is crucial to address these identified modifiable factors and consider education programs, better facilities, community support, and policy changes that prioritize menstrual hygiene management in schools for schoolgirls to manage menstruation.
Early infarct growth rate is associated with symptomatic intracranial hemorrhage after endovascular thrombectomy
Authors: Wang Wei , Huang Zhihang , Chen Shuaiyu , E Yan , Qi Jingwen , Xie Yi , Su Mouxiao , Zhang Yingdong , Jiang Teng , Zhang Xiaohao 
Published: December 2024

Background: Time elapsed from stroke onset and baseline infarct volume is influential on endovascular thrombectomy (EVT) outcomes. Objectives: This study aimed to explore the utility of early infarct growth rate (EIGR) measured by apparent diffusion coefficient (ADC) in predicting symptomatic intracranial hemorrhage (sICH) of ischemic stroke patients after EVT. Methods: We retrospectively analyzed patients from the prospectively maintained stroke registry admitted between January 2019 and March 2023, presenting with large vessel occlusive stroke in the anterior circulation. EIGR was defined as ischemic core volume on magnetic resonance perfusion imaging (ADC ⩽620 × 10−6 mm2/s) divided by the time from stroke onset to imaging. sICH was diagnosed according to the Heidelberg Bleeding Classification within 72 h after the procedure. Results: A total of 315 patients met the inclusion criteria. We observed sICH in 36 (11.4%) patients. After adjusting for the potential confounders, increased EIGR was confirmed to be independently associated with a higher risk of sICH (adjusted odds ratio, 1.033; 95% confidence interval (CI), 1.018–1.048; p = 0.001). Similar results were also confirmed when EIGR was analyzed as a categorical variable. Using a logistic regression model with restricted cubic splines, we found a linear correlation between EIGR and sICH risk ( p = 0.001 for linearity). Furthermore, adding EIGR to a model containing conventional risk factors significantly improved risk reclassification for sICH (category-free net reclassification index, 0.393; 95% CI, 0.227–0.560; p = 0.001; integrated discrimination improvement, 0.245; 95% CI, 0.146–0.343; p = 0.001). Conclusion: Increased EIGR may predict the sICH in ischemic stroke patients who receiving EVT.
Optimizing Polyphenolic Extraction from Wild Guava Leaves: A Response Surface Methodology Approach to Antioxidant and α-Glucosidase Inhibitory Activities
Authors: Thi Ngoc-Dung Dang , Nguyen Minh-Trung , Bui Thi Bich-Huyen , Mai Quoc-Quan , Nguyen Phuoc-Vinh , Nguyen Quang-Vinh 
Published: December 2024

Objective Elevated concentrations of total phenolic content (TPC) and total flavonoid content (TFC) in extracts from wild Psidium guajava L. leaves are associated with their antioxidant and α-glucosidase inhibitory activities. This study aimed to determine the optimal ultrasound-assisted extraction conditions to maximize TPC, TFC yield, as well as antioxidant and α-glucosidase inhibitory potential. Methods The central composite design (CCD) of Response Surface Methodology (RSM) was employed for empirical model development with three levels of factors, including ethanol concentration (33.18 to 66.82% in distilled water), extraction time (1.59 to 18.41 min) and solvent-to-solid ratio (5.79 to 14.20 mL/g). Results The results indicated that under optimal conditions, the total phenolic content (TPC) and total flavonoid content (TFC) values were 152.954 mg GAE/g DW and 113.871 mg QE/g DW, respectively. These conditions included an ethanol concentration of 51.94%, an extraction time of 9.56 min, and a solvent-to-solid ratio (v/w) of 10.84 mL/g. Furthermore, the maximum values for DPPH and ABTS radical scavenging activities were 124.990 mg TE/g DW and 194.730 mg TE/g DW, respectively and the lowest IC50 for α-glucosidase inhibitory activity recorded at 11.946 µg/mL. The validated models exhibited strong consistency between the predicted and experimental values, with variations of less than 5% under optimal conditions. Additionally, Principal Component Analysis (PCA) also confirmed the appropriate model to predict the extraction yield of total polyphenol and flavonoid content, as well as their biological activities, including DPPH and ABTS radical scavenging and alpha-glucosidase inhibitory activities. Conclusions The enhancement of antioxidant and antidiabetic extraction processes in both the pharmaceutical and food industries through the use of ultrasound-assisted extraction from Wild Guava leaves can increase production to meet high demand. This efficiency is particularly noteworthy, as it demonstrates the advantages of using ultrasound in the extraction process.