bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular epidemiology, evolution, and transmission dynamics of raccoon rabies virus in Connecticut
Authors: Veytsel Gabriella , Desiato Julia , Chung Hyunjung , Tan Swan , Risatti Guillermo R , Helal Zeinab H , Jang Sungmin , Lee Dong-Hun , Bahl Justin 
Published: December 2024

Abstract
In North America, raccoon rabies virus (RRV) is a public health concern due to its potential for rapid spread, maintenance in wildlife, and impact on human and domesticated animal health. RRV is an endemic zoonotic pathogen throughout the eastern USA. In 1991, an outbreak of RRV in Fairfield County, Connecticut, spread through the state and eventually throughout the Northeast and into Canada. Factors that contribute to, or curb, RRV transmission should be explored and quantified to guide targeted rabies control efforts, including the size and location of buffer zones of vaccinated animals. However, population dynamics and potential underlying determinants of rabies virus diversity and circulation in Connecticut have not been fully studied. In this study, we aim to (i) investigate RRV source–sink dynamics between Connecticut and surrounding states and provinces, (ii) explore the impact of the Connecticut River as a natural barrier to transmission, and (iii) characterize the genomic diversity and transmission dynamics in Connecticut. Using RRV whole-genome sequences collected from various host species between 1990 and 2020, we performed comparative genetic and Bayesian phylodynamic analyses at multiple spatial scales. We analyzed 71 whole-genome sequences from Connecticut, including 21 recent RRV specimens collected at the Connecticut Veterinary Medical Diagnostic Laboratory that we sequenced for this study. Our analyses revealed evidence of RRV incursions over the US–Canada border, including bidirectional spread between Quebec and Vermont. Additionally, we highlighted the importance of Connecticut and New York in seeding RRV transmission in eastern North America, including two introduction events from New York to Connecticut that resulted in sustained local transmission. While RRV transmission does occur across the Housatonic and Connecticut Rivers, we demonstrated the distinct presence of spatial structuring in the phylogenetic trees and characterized the directionality of RRV migration. The significantly higher mean transition rates from locations east to west of the Connecticut River, compared to west to east, may be leveraged in directing interventions to fortify these natural barriers. Ultimately, the findings of these international, regional, and state analyses can inform targeted control programs, vaccination efforts, and enhanced surveillance at borders of key viral sources and sinks.
Follow-up Adherence After Teleretinal Screening for Diabetic Retinopathy
Authors: Chamberlain Paul D. , Date Rishabh C. , Shen Kevin L. , Campagna Giovanni A. , Piller Linda B. , Chu Yvonne I. , Weng Christina Y. 
Published: December 2024

Aim:
Determine the follow-up rate for patients referred following an abnormal teleretinal imaging (TRI) screening and examine patient characteristics predictive of follow-up nonadherence.

Materials and Methods:
A cross-sectional study of patients screened between August 2014 and July 2016 in the Harris Health System (HHS) in Houston, TX. All diabetic patients referred for in-person examination, who had data for all study variables, and who did not have established ophthalmic care in the HHS within the previous 2 years were included. Data collected included TRI findings, clinic location, age, race, gender, hemoglobin A1C (HbA1c), and insulin use. The primary outcome was whether or not a patient attended an in-person follow-up visit. Attendance was the dependent variable in a multivariable logistic regression with the aforementioned exposures used as independent variables.

Results:
There were 1695 patients included in the study. The follow-up rate (ie, the percentage of patients who went for an in-person examination with an ophthalmologist following a positive screening test and referral) was 54.9%. TRI findings of proliferative diabetic retinopathy (PDR) + referable diabetic macular edema (DME) predicted poorer compliance with follow-up recommendations compared to patients with PDR alone (OR 0.64, 95% CI 0.42-0.99; P=0.046). Age, race, gender, glycemic control, and insulin use did not predict compliance.

Conclusion:
Age, race, gender, glycemic control, and insulin use were not found to be predictive of follow-up compliance rates; the most severe disease (PDR + DME) predicted noncompliance. Diabetic retinopathy screening programs may consider more aggressive measures in emphasizing compliance in patients with the worst disease as these patients are more likely to miss follow-up appointments. More studies are needed to characterize risk factors for noncompliance.
The Safety of Recently Approved Therapeutics in Age-Related Macular Degeneration
Authors: Khanani Ibrahim , Aziz Aamir A. , Khanani Zoha A. , Khan Hannah , Mojumder Ohidul , Sulahria Humza , Ali Haaziq , Khan Huma , Rahimzadeh Tyler S. , Vannavong Jordyn , Gahn Greggory M. , Khanani Arshad M. 
Published: December 2024

Recent developments in treatments for both forms of advanced age-related macular degeneration (AMD) have led to the approval of multiple agents and modalities within the last few years. Five new medications for both neovascular AMD (nAMD) and geographic atrophy (GA) secondary to nonexudative AMD (neAMD) have been FDA-approved within the last 5 years, along with a new device designed for sustained drug delivery for nAMD. In nAMD, the newest agents approved by the FDA are brolucizumab (Novartis Pharmaceuticals, Basel, Switzerland), faricimab (F. Hoffman-La Roche, Basel, Switzerland), aflibercept 8 mg (Regeneron Pharmaceuticals, Tarrytown, NY, USA), and a new device in the port delivery system with ranibizumab (Genentech, San Francisco, CA, USA). The first agents FDA-approved for GA secondary to neAMD are pegcetacoplan (Apellis Pharmaceuticals, Waltham, MA, USA) and avacincaptad pegol (Iveric Bio, Parsippany, NJ, USA). Evaluation of safety in both clinical trials and the real-world has been of paramount importance after the approval of these newest agents to understand their effects in real patients. Real-world data, as demonstrated in both registrational studies along with retrospective chart review studies, has shown to be an important factor in the implementation of newer drugs, along with the treatment decisions that physicians choose to make regarding their dosing and follow-up. This review article discusses the safety of the most recently approved FDA as seen in both clinical trials and real-world studies.
Retropupillary Iris Clip Intraocular Lenses: A Case Series of 57 Eyes
Authors: Mallick Pauline , Fung Adrian T. 
Published: December 2024

Purpose:
To report visual and refractive outcomes and intraoperative and postoperative complications after pars plana vitrectomy (PPV) with retropupillary implantation of an iris clip intraocular lens (IOL).

Methods:
This is a retrospective case series of patients who underwent secondary retropupillary intraocular lens insertion combined with pars plana vitrectomy to treat aphakia secondary to a dislocated nucleus lens (group A); or IOL dislocation (group B). Patient demographics, preoperative visual and refractive outcomes, intraoperative factors, postoperative visual and refractive outcomes, and complications within the follow-up period ranging from 6 months up to 3 years postoperative, were recorded.

Results:
In total, 57 eyes of 50 patients were included with a follow-up range of 6 months to 3 years. The overall mean age was 77.0 years (range 28 to 99 years), with 26/50 (52%) of patients being male. There were 13/57 (22.8%) patients in group A and 44/57 (77.2%) patients in group B. The single most common identifiable cause for lens dislocation was pseudoexfoliation, which was seen in 13/57 (22.8%) of eyes. The mean improvement in visual acuity (baseline and final follow) was 0.72 logMAR (1.09 logMAR to 0.37 logMAR) in all patients, 1.12 logMAR (1.64 logMAR to 0.52 logMAR) in group A, and 0.60 logMAR (0.91 logMAR to 0.31 logMAR) in group B. In 46 eyes (80.7%), postoperative refractive errors were within ±1.00 dioptres (D) of the target refraction, with a mean difference of 0.36D from target refraction. Complications included corneal edema (35.1%), hyphema (26.3%), anterior chamber inflammation (26.3%), vitreous hemorrhage (14%), elevated intraocular pressure (IOP, 12.3%) and cystoid macular edema (CME, 5.3%). All these complications were managed with topical medical therapy and did not require further surgical intervention. One eye from group A was the only eye that developed retinal detachment (RD) or endophthalmitis. No patients had IOL dislocation in the postoperative follow-up period, which ranged from 6 months to 3 years.

Conclusions:
Retropupillary implantation of an iris clip IOL with pars plana vitrectomy is an efficient, predictable, and stable surgical option for aphakic eyes without capsular support. Postoperative corneal edema, hyphema, and anterior chamber inflammation are common but usually resolve without the need for further surgical intervention.
Reprogramming patient-induced pluripotent stem cell-specific retinal organoids for deciphering epigenetic modifications of RNA methylation
Authors: Chien Yueh , Yang Yi-Ping , Lin Tai-Chi , Chiou Guang-Yuh , Yarmishyn Aliaksandr A. , Wang Chia-Hao , Ching Lo-Jei , Lin Yi-Ying , Chen Shih-Jen , Hwang De-Kuang , Hsu Chih-Chien 
Published: December 2024

Background:
Induced pluripotent stem cell (iPSC) technology has emerged as a powerful tool for disease modeling, providing an innovative platform for investigating disease mechanisms. iPSC-derived organoids, including retinal organoids, offer patient-specific models that closely replicate in vivo cellular environments, making them ideal for studying retinal neurodegenerative diseases where retinal ganglion cells (RGCs) are impacted. N6-methyladenosine (m6A), a prevalent internal modification in eukaryotic mRNAs, plays a critical role in RNA metabolic processes such as splicing, stability, translation, and transport. Given the high energy demands of RGCs, mitochondrial dysfunction, which leads to impaired adenosine triphosphate (ATP) production and increased reactive oxygen species (ROS) levels, is often central to the progression of retinal neurodegenerative disorders. However, the epigenetic mechanisms underlying m6A modification and their contributions to these conditions remain unclear.

Methods:
Patient-specific iPSCs were generated from individuals with Leber hereditary optic neuropathy (LHON) and differentiated into RGCs within retinal organoids. To analyze m6A methylation, we used quantitative polymerase chain reaction (PCR) and focused on differential expression of key m6A-modifying enzymes.

Results:
iPSC-derived retinal organoids are adaptable for studying and investigating the epigenetic mechanisms of retinal neurodegenerative diseases. Our data demonstrated the profiling of global m6A-related gene expression levels in LHON patient-derived iPSC-RGCs compared with controls, highlighting specific disruptions in m6A modification pathways.

Conclusion:
These findings suggest that differential m6A modifications may play pivotal roles in the pathogenesis of retinal neurodegenerative diseases and affect the progression of the disease in affected individuals.
Long-term results of laparoscopic Heller-Dor for esophageal-gastric junction outflow obstruction: a prospective comparative study
Authors: Salvador Renato , Forattini Francesca , Provenzano Luca , Costantini Andrea , Vittori Arianna , Santangelo Matteo , Capovilla Giovanni , Costantini Mario , Moletta Lucia , Nezi Giulia , Nicoletti Loredana , Valmasoni Michele 
Published: December 2024

Background:
The aim of this prospective, controlled study was to assess the 5-year follow-up of laparoscopic Heller-Dor (LHD) in patients with esophago-gastric junction outflow obstruction (EGJOO), compared with achalasia patients (ACH). The management of EGJOO reflects the experience gained with esophageal achalasia, for which LHD has been proven to be an effective long-term treatment. Prospective long-term results of LHD in EGJOO patients are still lacking.

Materials and methods:
Patients with diagnosis of idiopathic EGJOO referred for dysphagia or food-regurgitation, treated with LHD, were enrolled and then followed prospectively for 5 years. During the follow-up, patients were evaluated with Eckardt score (ES), Barium-swallow X-ray, high-resolution manometry (HRM), 24-hour pH-monitoring and endoscopy. Primary outcome was therapeutic success (ES ≤ 3 or no additional treatment).

Results:
The study involved 150 patients: 25 in the EGJOO group and 125 in the ACH group. After 5 years, there was no significant difference in success rate: 90.5% in the EGJOO group, 87.5% in ACH stage I – pattern I, 91.6% in ACH stage I – pattern II and pattern III (P = 0.94). The ES and all the HRM parameters were similar in all groups. Moreover, the screening endoscopy and the 24-hour pH-monitoring showed a similar postoperative acid exposure in all groups.

Conclusion:
This is the first study based on prospective data to assess the long-term outcome of LHD in patients with EGJOO. After at least 5 years of follow-up, LHD has a comparable success rate in both EGJOO and achalasia patients and can be proposed as a safe and effective treatment for EGJOO patients.
Invasive or non-invasive vagus nerve stimulation modulation of brain function and remodeling after stroke: a review
Authors: Zhang Jun , Zhou Fengyuan , Roberts Neil , Yuan Qiang , Wang Meihua , Wu Gang , Yang Weijian , Fu Pengfei , Wang Meiyun , Hu Jin 
Published: December 2024

Background:
The main reason restricting stroke patients from reintegrating into society is neurological deficits. Of particular interest is the potential vagus nerve stimulation (VNS) potentially offers for sustaining improvement in neurological deficits. The goal of the present study is to provide a summary of the findings from research that has been carried out to elucidate the mechanisms and demonstrate the efficacy and safety of the clinical application of VNS, as well as to identify research gaps in the field, in order to offer references for subsequent further research and application.

Methods:
A systematic search was conducted in the PubMed, Web of Science, Embase, and Ovid MEDLINE databases (1866 publications). An initial screening of abstracts and titles was performed, followed by a thorough review and assessment of the full texts of 253 relevant papers.

Results:
Ultimately, 62 studies that met the eligibility criteria were included. VNS may be performed either invasively or non-invasively. The modulation of brain function that is produced by VNS may improve cerebral function by one or more of the following means, namely stimulating the pathway that regulates synaptic plasticity, inhibiting inflammatory response, promoting vascular regeneration or protecting the blood–brain barrier. Application of invasive VNS has produced promising results in the treatment of moderate/severe upper limb dyskinesia in patients with ischemic stroke and has gradually entered clinical practice. Furthermore, transcutaneous auricular VNS has also demonstrated potential therapeutic effects (standardized mean differences 1.16, 95% CI = 0.02–2.30). However, further developments are required in many aspects, including preventing indications of dysfunction, optimization of parameters, timing and duration of stimulation and site of application.

Conclusions:
The VNS as a promising therapeutic approach for stroke rehabilitation. The application of VNS in the treatment of hemorrhagic stroke is still unexplored and warrants attention in future studies.
Alterations of oscillatory activity and cognitive function after aneurysmal subarachnoid hemorrhage
Authors: Liu Peng , Han Chuanliang , Zhang Tongyu , Xu Yueqiao , Yang Kun , Li Yuxia , Ye Zhennan , Wang Changming , Zhang Hongqi 
Published: December 2024

Background:
Aneurysmal subarachnoid hemorrhage (aSAH) can lead to cognitive impairment (CI), but underlying neural mechanisms remain to be elucidated.

Materials and methods:
To predict long-term CI after aSAH, resting electroencephalography (EEG) was measured in 112 patients hospitalized with a diagnosis of aSAH (n = 66) or unruptured intracranial aneurysms (controls) (n = 46). A neuropsychological battery was administered 8–24 months after discharge.

Results:
Power spectrum analysis in the parietal-occipital lobe showed significantly higher power theta vs. alpha oscillations in patients with CI after aSAH. The power of theta and alpha oscillations were significantly correlated with multiple cognitive scale scores on the neuropsychological battery. A neural model was established, which showed that connectivity between inhibitory and excitatory neurons in neural circuits contributed to changes in theta and alpha oscillations and CI in aSAH.

Conclusion:
The data collection, analysis, and computational model established in this study can serve as a new paradigm for other clinical studies investigating CI.
ChatGPT Can Often Respond Adequately to Common Patient Questions Regarding Femoroacetabular Impingement
Authors: Adelstein Jeremy M. , Sinkler Margaret A. , Li Lambert T. , Fortier Luc M. , Vakharia Ajit M. , Salata Michael J. 
Published: December 2024

Objective:
This study aims to analyze the ability of ChatGPT to answer frequently asked questions (FAQs) regarding FAI. We hypothesize that ChatGPT can provide accurate and thorough responses when presented with FAQs regarding FAI.

Design:
Ten FAQs regarding FAI were presented to ChatGPT 3.5 and initial responses were recorded and analyzed against evidence-based literature. Responses were rated as “excellent response requiring no further clarification,” “satisfactory response requiring minimal clarification,” “satisfactory response requiring moderate clarification,” or “unsatisfactory response requiring substantial clarification.”

Setting:
Institutional.

Independent Variables:
Frequently asked questions regarding femoroacetabular impingement.

Main Outcome Measures:
Accuracy and thoroughness of ChatGPT responses to FAQs. Hypothesis was formulated before data collection.

Results:
Most responses from ChatGPT were rated as satisfactory and required only minimal clarification. Two responses received an excellent rating and required no further clarification, while only 1 response from ChatGPT was rated unsatisfactory and required substantial clarification.

Conclusions:
ChatGPT provided largely accurate and thorough responses to FAQs regarding FAI while appropriately reiterating the importance of always consulting a medical professional.
Respiratory syncytial virus pulmonary infections in adults – disease burden and prevention
Authors: Waterer Grant W. , Metersky Mark 
Published: December 2024

Purpose of review
We highlight the evolving understanding of the burden of respiratory syncytial virus (RSV) in older adults and recent data on the three new vaccines.

Recent findings
As well as a greater recognition of the amount of RSV infection in adults, and especially over 60 years of age, there has been a significant amount of study detailing the postacute burden including excess cardiovascular disease and loss of physical and cognitive functioning. Three new RSV vaccines now have published data for two seasons, and while direct comparison is not possible due to differences in the timing, methodology and populations studies, all show good efficacy with no serious side effects of concern.

Summary
RSV causes a substantial amount of morbidity and mortality in older adults with both acute and longer term impacts. With effective vaccines now available clinicians should be advocating with their patients to prevent RSV infection.
Congenital diaphragmatic hernia presenting as tension hydropneumothorax: surgical dilemma
Authors: Aihole Jayalaxmi Shripati 
Published: December 2024

Introduction:
Congenital diaphragmatic hernia (CDH) most commonly seen on the left side, presenting usually in neonates and infants with respiratory distress.

Importance:
CDH presenting as tension hydropneumothorax requiring urgent intercostal chest tube drainage (ICD) and subsequently inducing the injury to the herniated bowel and lung, is not an uncommon event, rarely reported in toddlers as well as its management.

Case presentation:
Two such rare cases of CDH presenting with tension hydropneumothorax requiring ICD insertion and their consequences have been discussed here.

Clinical discussion:
CDH can present later in life due to consequent recurrent bronchopneumonia and failure to thrive.

Conclusion:
Clinical history and clinical judgement can only aid the surgeon in avoiding such confusing clinical scenarios.
The Impact of a Couple-Based Intervention on One-Year Viral Suppression Among Pregnant Women Living With HIV and Their Male Partners in Malawi: A Randomized Controlled Trial
Authors: Rosenberg Nora E. , Graybill Lauren A. , Mtande Tiwonge , McGrath Nuala , Maman Suzanne , Nthani Tiyamike , Krysiak Robert , Thengolose Isaac , Hoffman Irving F. , Miller William C. , Hosseinipour Mina 
Published: December 2024

Introduction:
Couple-based behavioral interventions (CBIs) have been associated with improved HIV virological outcomes for pregnant women and their male partners living with HIV in observational settings, but have never been tested in a randomized controlled trial (RCT).

Setting:
Bwaila District Hospital Antenatal Clinic (Lilongwe, Malawi).

Methods:
An RCT was conducted among 500 pregnant women living with HIV (index clients) randomized 1:1 to the standard of care (SOC) or CBI and followed for 1 year. The CBI offered an initial session for index clients, HIV-assisted partner notification, 2 enhanced couple counseling and testing sessions, illustrated materials, and antiretroviral therapy pickup for either couple member at the antenatal clinic. At 12 months, viral load among index clients and male partners with HIV was measured. Risk differences (RD) and 95% confidence intervals (CIs) compared viral suppression (<1000 copies/mL) between arms.

Results:
The mean index client age was 26.6 years; most were married or cohabiting (93.3%). Index client viral suppression was 6.5% higher in the CBI arm (88.0%) than in the SOC arm (81.6%). Male partner viral suppression was 16.2% higher in the CBI arm (73.6%) than the SOC arm (57.4%). Overall, couple viral suppression was 7.8% higher (CI: 0.5% to 15.1%, P = 0.04) in the CBI arm (84%) than in the SOC arm (76.0%). Social harms were rare (3.6%) and comparable between arms (P = 0.8).

Conclusions:
This CBI had a positive impact on couple viral suppression. Scaling this CBI to antenatal clients with HIV and their male partners could improve HIV outcomes among expecting families.
Fumarate Hydratase–Deficient Renal Cell Carcinoma With Paraganglioma Detected on 18F-FDG PET/CT
Authors: Deng Yan , He Limeng , Wu Ji , Zhang Wei 
Published: December 2024

Abstract
We report FDG PET/CT findings of fumarate hydratase–deficient renal cell carcinoma coincidence with para-aortic paraganglioma in a 27-year-old man. He presented with painless gross hematuria for 3 days. CT identified an enhancing lesion in the left kidney, suggestive of a tumor. 18F-FDG PET/CT imaging showed the mass with high FDG uptake. An adjacent FDG-avid nodule was also noted. Postoperative pathology supported a diagnosis of fumarate hydratase–deficient renal cell carcinoma of the left kidney mass, and the adjacent nodule was paraganglioma.