bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Hyaluronic Acid Linear Stereoscopic Stack Volume Enhancement Injection Technique in Nasal Reshaping
Authors: Dong Ruiping , Lei Jiaqi , Liu Qingyang 
Published: January 2025

Hyaluronic acid (HA) injection, traditionally used for non-surgical rhinoplasty, is often associated with adverse effects such as increased nasal dorsum width. This study introduces the linear stereoscopic stack volume enhancement (LSSVE) injection technique as a solution for patients with low-profile noses, aiming to improve the nasal dorsum dimension, prevent long-term nasal widening, and address related concerns. A retrospective analysis was conducted on the clinical registry data of patients treated at Shanghai Phiskin Clinic from December 2020 to June 2024, who received HA injections using the LSSVE technique. Each rhinoplasty patient received a personalized injection, with doses ranging from 0.59 to 1.03 mL, adjusted based on specific characteristics of their nose and forehead. The procedure utilized a 25G blunt cannula to administer HA between the nasal bone periosteum and fascial layer using the LSSVE technique. The primary endpoint was patient improvement assessed 6 months post-injection using the Global Aesthetic Improvement Scale (GAIS), evaluated by a blinded assessor. In addition, patient satisfaction and complications were assessed. A total of 189 patients (181 females and 28 males) were included in the study, all of whom received a single HA LSSVE injection. Six months post-injection, the GAIS improvement rate was 82.83%, with a patient satisfaction rate of 84.83%. The injection effect was maintained for 6 months without any nasal dorsum widening, and a significant increase in the nasofrontal angle was observed (P<0.001). No long-term complications were reported post-injection. The LSSVE injection technique demonstrated effectiveness in overcoming the limitations of traditional HA rhinoplasty and preventing long-term nasal dorsum widening.
Long-Term Series of Custom-Bone Hydroxyapatite Cranioplasty: Outcomes and Survival at 15 Years
Authors: Carbonaro Riccardo , Ghiringhelli Gaia , Nataloni Angelo , Amendola Francesco , Catapano Simone , Vaienti Luca , Umana Giuseppe E. , Fricia Marco , Zingaretti Nicola , Zanotti Bruno 
Published: January 2025

Introduction:
Cranioplasty (CP) is a surgical procedure used to repair or reconstruct bone defects in the skull. As CP is not without risk, identifying the safest reconstruction technique is essential to achieve optimal functional recovery. While heterologous prostheses such as HA address issues related to storage and preservation of autograft and help prevent bone resorption, they are associated with a specific spectrum of risks, including infection, dislocation, and fracture. The aim of our article is to evaluate the safety and performance of HA cranioplasty through a retrospective study conducted at 2 centres with extended follow-up of up to 15 years. This study represents one of the most comprehensive and long-term analyses available and provides important insights into the efficacy of this material in clinical practice.

Methods:
Data were collected from patients who underwent CP between December 2001 and December 2008. The authors conducted a retrospective study of a case series of 101 adult and paediatric patients who received custom-made HA implants after craniotomy for various reasons. The primary endpoint was to evaluate prosthesis survival and explantation rates. Secondary endpoints included the incidence of adverse events and the rate of surgical revision.

Results:
Over a period of 7 years (from December 2001 to December 2018), a total of 101 patients who underwent CP with custom-made HA prostheses. Skull reconstruction with CP was performed immediately in 22 cases. All patients were initially evaluated 30 days after CP, with subsequent follow-ups at 6 months, 12 months, 24 months, and then at 3, 4, 5, 10, and 15 years. Major complications requiring explantation were observed in 9 patients: The reasons for explantation were as follows: 3 cases of infection, 2 cases of tumour recurrence, 2 cases of fracture, 1 case of cicatrial retraction, and 1 case of cerebral hemorrhage. Minor complications occurred in 10 cases and resolved without the need for explantation of the HA prosthesis. At the 15-year follow-up, radiographic and clinical evaluations of 41 patients confirmed optimal results, with complete and stable integration of the implant into the surrounding bone and no significant resorption or migration.

Conclusions:
This study provides a comprehensive long-term evaluation of custom HA CP, providing valuable insight into its efficacy and safety over a 15-year follow-up period. Our findings support the viability of HA as a material for cranial reconstruction, demonstrating a high prosthesis survival rate with stable integration in the majority of patients.
Multi-modal image analysis for large scale cancer tissue studies within IMMUcan
Authors: Eling Nils , Dorier Julien , Rusakiewicz Sylvie , Liechti Robin , Devanand Preethi , Daniel Michelle , Windhager Jonas , Fernandez Bruno Palau , Déglise Sophie , Despland Lucie , Benyagoub Abdelkader , Loboda Alexander , Sandkuijl Daaf , Parsotam Nikesh , Hong Henoch S , Morfouace Marie , Guex Nicolas , Coukos George , Bodenmiller Bernd , Tissot Stephanie , Schulz Daniel 
Published: January 2025

MotivationMultiplexed imaging is increasingly used to study tissue architecture in health and disease. To investigate the cancer tumor microenvironment, typically either tissue micro-arrays or small patient cohorts are used to collect and process data. However, studies performed over the course of years, collecting data from thousands of samples are rare and require specialized workflows to ensure sample throughput and reproducibility for data production and processing. Here, we present two such workflows for multiplexed immunofluorescence and imaging mass cytometry of cancer tissues which are applied to a total of roughly 10’000 samples from 2500 patients over six years.SummaryIn cancer research, multiplexed imaging allows detailed characterization of the tumor microenvironment (TME) and its link to patient prognosis. The IMMUcan consortium collects multi-modal imaging data from thousands of cancer patients to perform broad molecular and cellular spatial profiling across five cancer indications. Here, we describe two workflows for multiplexed immunofluorescence (mIF) and imaging mass cytometry (IMC) developed within IMMUcan to enable analysis of thousands of cancer tissues. IFQuant supports web-based, user-friendly, and reproducible analysis of mIF data. High sample throughput for IMC is achieved by optimizing experimental protocols and developing a robotic arm for automated slide loading. We provide a resource of 350’000 manually labelled cells across 180 cancer samples to accurately annotate cell phenotypes in IMC. All major cell phenotypes and tissue structures correlate well between mIF and IMC. These pipelines form the basis for multiplexed image analysis within IMMUcan and provide computational tools for the larger community.
Association Between Age And Endovascular Treatment Outcomes: Binational Registry Of 9941 EVT Cases From Korea And Taiwan
Authors: Kim Beom Joon , Tang Sung-Chun , Hsieh Yi-Chen , Chen Chih-Hao , Kim Yong Soo , Lin Chun-Jen , Park Jong-Moo , Sung Pi-Shan , Kang Kyusik , Chen Yu-Wei , Lee Soo Joo , Lin Kuan-Hung , Cha Jae-Kwan , Tang Chih-Wei , Park Tai Hwan , Chu Hai-Jui , Lee Kyungbok , Fu Chuan-Hsiu , Lee Jun , Chou Chao-Liang , Hong Keun-Sik , Lin Ching-Huang , Yu Kyung-Ho , Wei Cheng-Yu , Kim Dong-Eog , Yen Shang-Yih , Kim Joon-Tae , Chen Po-Lin , Choi Jay Chol , Chan Lung , Kwon Jee Hyun , Shin Dong-Ick , Sohn Sung-Il , Chiou Hung-Yi , Kim Chulho , Park Kwang-Yeol , Kim Chi Kyung , Lien Li-Ming , Heo Sung Hyuk , Lee Jiunn-Tay , Bae Hee-Joon , Jeng Jiann-Shing 
Published: January 2025

AbstractBackground and PurposeAs populations age, there is an increasing need to optimize endovascular treatment (EVT) for acute ischemic stroke. We harmonized prospective stroke registries from Korea and Taiwan to enable direct comparisons of patient characteristics and clinical outcomes, with a particular focus on the impact of advanced age.MethodsProspective stroke registries in South Korea (CRCS-K) and Taiwan (TREAT-AIS) were harmonized to form a unified dataset of patients treated with EVT. EVT outcomes included 3-month modified Rankin Scale (mRS), symptomatic intracranial hemorrhage (SICH), and successful recanalization. We assessed the association between age and outcomes in the overall population and in those aged ≥80 years, adjusting for relevant covariates.ResultsA total of 9941 EVT cases (7835 from Korea and 2106 from Taiwan) were included. Patients had a mean age of 70.1 ± 12.9 years (57.6% male, median NIHSS: 14 [IQR: 9–19]). Compared to Korean patients, Taiwanese patients had a higher prevalence of vascular risk factors and more severe strokes, contributing to lower rates of favorable 3-month outcomes. Increasing age was associated with poorer EVT results; among patients ≥80 years, only 18% achieved mRS 0–2, compared to 47% of younger patients. However, the risk of SICH did not significantly increase with age (adjusted OR per year: 1.00 [0.99–1.01]; adjusted OR ≥80 years: 1.05 [0.85–1.29]). Pre-stroke functional independence and bridging thrombolysis were identified as key modifiers of better outcomes even in the oldest patients.ConclusionTaiwanese EVT patients had more risk factors and worse outcomes than Korean patients. Advanced age is associated with poorer functional recovery, yet selected older patients—particularly those who were functionally independent before the stroke or received bridging thrombolysis—demonstrated meaningful benefit. These results underscore the importance of individualized treatment strategies and careful patient selection, especially as populations continue to age.
Antimicrobial Resistance Pattern among Organisms Isolated from Tertiary Care Hospital in Chennai
Authors: Moses G. F , Subhasri B , Sakthi Abirami R , Kalpana Devi V , Durga shree U , Rithika A , Bannari Amruth G 
Published: January 2025

AbstractBackgroundThe findings will help guide the development of targeted antimicrobial stewardship programs and enhance public health strategies to address resistance.AimThis study aimed to identify common antimicrobial-resistant organisms and their resistance profiles in clinical specimens from a tertiary care hospital.Settings and DesignA cross-sectional study was conducted at ACS Medical College and Hospital, Chennai, from November 2023 to May 2024, involving 346 participants.Materials and MethodsClinical specimens, including urine, blood, sputum, and wound swabs, were collected from patients in various hospital wards. Demographic details of participants were documented, and patients who had received antimicrobial therapy within the previous month or provided tissue samples were excluded. The specimens were analyzed in the central laboratory for microbial growth and antimicrobial resistance profiles. Isolated were tested by Kirby-Bauer disc diffusion method and breakpoint minimum inhibitory concentration for susceptibility against standard antibiotics.ResultsAmong the 346 specimens analyzed, 264 (76.3%) showed microbial growth. The most commonly isolated organisms were Escherichia coli (28.8%), Klebsiella species (26.9%). High level resistance was observed, especially to Polymyxin B (98.7%), Cefoperazone/Sulbactam (97.4%), and Cefotaxime (92.1%).Conclusionantimicrobial resistance requires coordinated action across healthcare, policy, and public sectors. By enforcing stricter regulations, enhancing surveillance, and investing in new treatments, we can slow resistance and preserve the effectiveness of antibiotics, safeguarding public health for future generations.
High magnitude of lung function decline among heroin users attending Medication-Assisted Therapy clinic at Muhimbili National Hospital, Tanzania
Authors: Nkongoki Alex , Balandya Emmanuel , Mamuya Simon , Mbwambo Jessie 
Published: January 2025

AbstractHeroin users have a high burden of respiratory morbidity, including premature lung function decline at age of 41 years. This early decline in lung function has been attributed to exposure to multiple risk factors. Further, methadone treatment has been found to aggravate lung function decline and independently cause asthma. However, the lung function status among heroin users on Medication-Assisted Therapy clinic in Tanzania is yet to be studied. This study aimed to assess the magnitude, pattern, and factors associated with lung function decline among heroin users attending MAT clinic at the Muhimbili National Hospital in Dar-es-salaam, Tanzania. This was a quantitative, analytical cross-sectional study conducted between May, 2022 – July, 2023. Individuals aged 18 years or above with heroin use disorder on the maintenance phase of treatment were recruited into the study. Data were collected using a questionnaire, and lung functions were measured using a portable spirometer. Lung function decline was defined as the percentage of participants with FEV1 <70%. The association between socio-demographic characteristics, substance use history and comorbidities with lung function decline was assessed via binary logistic regression. We enrolled 302 participants into the study (mean age of 42.78±7.56 years), whereby 95.7% were male. Of the study participants, 28.5% had lung function decline with mean age at onset of 44±8 years. Restrictive lung disease was the commonest pattern of lung function decline with a proportion of 13.2%. Independent predictors of lung function decline were being underweight (aOR 4.73, 95% CI 2.61-8.59, p<0.001), living with HIV infection (aOR 2.61, 95% CI 1.20-5.66, p=0.016) and having a history of pulmonary TB (aOR 2.48, 95% CI 1.48-4.17, p=0.001). Heroin users on methadone therapy in Dar-es-salaam have high magnitude of lung function decline compared to the general population. Routine lung function testing is recommended.
Automated Monitoring of Clinical Practice Guideline Adherence Using FHIR and OMOP: A Multi-Center Study in Intensive Care Units
Authors: Lichtner Gregor , Schiefenhövel Fridtjof , Gashi Bora , Martin Ingrid , Jurth Carlo , Vasiljewa Lisa , Kleimeier Dana , Gibb Sebastian , Heim Markus , Brugger Jürgen , Lohr Johannes , Feig Martin A. , Speidel Saya , Bienert Thomas , Abramovich Igor , Kaspar Mathias , Sindel Anja , Mehringer Laurenz , Hinske Ludwig Christian , Simon Philipp , Heller Axel R , Kranke Peter , Meybohm Patrick , Balzer Felix , Spies Claudia , Schneider Gerhard , Hahnenkamp Klaus , Waltemath Dagmar , Boeker Martin , von Dincklage Falk 
Published: January 2025

AbstractBackgroundClinical practice guidelines are important tools for clinical decision support, but monitoring guideline adherence manually is highly resource-intensive. Therefore, we developed an automated system for evaluating guideline adherence based on computer-interpretable representations of guidelines. We implemented the system across multiple university hospitals and assessed its validity and performance by comparing its guideline adherence evaluations to those conducted by medical professionals.MethodsWe selected six representative clinical guideline recommendations from across 41 intensive care guidelines and translated these text-based recommendations into a computer-interpretable, Fast Healthcare Interoperability Resources (FHIR)-based format using an iterative consensus approach. Clinical data from five university hospitals were transformed into the Observational Medical Outcomes Partnership (OMOP) common data model. A decision support system was developed to interpret FHIR-encoded recommendations and apply them to OMOP-formatted patient data. We evaluated the system retrospectively on intensive care data covering 3.5 years and validated its performance by comparing system-generated decisions with human decisions in three hospitals. We created and iteratively refined a user interface for individual and ward-level adherence visualization.FindingsWe expert-reviewed more than 18,000 patient days to assess the applicability of and adherence to the recommendations. The system demonstrated 97.0% accuracy in identifying guideline applicability and adherence, with significantly higher accuracy than human reviewers (accuracy 86.6%, p<0.001, McNemar’s Test). The automated system processed more than 2000 patient days per second for a total of 2,200,000 patient days across 82,000 intensive care episodes, compared to humans’ two patient days per minute.InterpretationWe demonstrate that an automated adherence monitoring system outperforms human reviewers in both accuracy and time efficiency. Using FHIR-encoded recommendations enables flexibility and scalability across hospitals with different data infrastructures. Future work should focus on integrating unstructured patient data and expanding the range of encoded recommendations.FundingFederal Ministry of Education and Research of Germany.
Emergence and Rising Prevalence of Artemisinin Partial Resistance Marker Kelch13 P441L in a Low Malaria Transmission Setting in Southern Zambia
Authors: Martin Anne C. , Sadler Jacob M. , Simkin Alfred , Musonda Michael , Katowa Ben , Matoba Japhet , Schue Jessica , Simulundu Edgar , Bailey Jeffrey A. , Moss William J. , Juliano Jonathan J. , Fola Abebe A. 
Published: January 2025

AbstractIncreasing artemisinin partial resistance (ArtR) due to mutations in the gene encoding Kelch13 (Pfk13) protein in eastern Africa is of urgent concern, and mutations, such asPfk13P441L, continue to emerge. We used an amplicon deep-sequencing panel to estimate the prevalence of ArtRPfk13mutations in samples collected between 2018 and 2023 in southern Zambia.Pfk13P441L was present in 30 of 501 samples (6%), and prevalence increased over time (0% to 7.2%). Further studies of the P441L mutation are needed to document its geographical origin, distribution and impact on treatment outcomes.
Comparison of Machine Learning Models in Predicting Mental Health Sequelae Following Concussion in Youth
Authors: Peng Jin , Chen Jiayuan , Yin Changchang , Zhang Ping , Yang Jingzhen 
Published: January 2025

AbstractYouth who experience concussions may be at greater risk for subsequent mental health challenges, making early detection crucial for timely intervention. This study utilized Bidirectional Long Short-Term Memory (BiLSTM) networks to predict mental health outcomes following concussion in youth and compared its performance to traditional models. We also examined whether incorporating social determinants of health (SDoH) improved predictive power, given the disproportionate impact of concussions and mental health issues on disadvantaged populations. We evaluated the models using accuracy, area under the curve (AUC) of the receiver operating characteristic (ROC), and other performance metrics. Our BiLSTM model with SDoH data achieved the highest accuracy (0.883) and AUC-ROC score (0.892). Unlike traditional models, our approach provided real-time predictions at each visit within 12 months of the index concussion, aiding clinicians in making timely, visit-specific referrals for further treatment and interventions.
PREVALENCE AND FACTORS ASSOCIATED WITH NON-ADHERENCE TO ANTIRETROVIRAL THERAPY IN HIV PATIENTS AT KIBUNGO REFERRAL HOSPITAL, IN RWANDA
Authors: Niyonsenga Phocas Mukezamfura , Habimana Amos , Nsanzabera Charles 
Published: January 2025

AbstractBackgroundIt has been demonstrated that antiretroviral therapy improves health and lengthens the life of HIV positive individuals. For those living with HIV, attaining optimal adherence is turning out to be the largest obstacle. The purpose of this research was to determine how often antiretroviral therapy non-adherence is among HIV patients who visit Rwanda’s Kibungo Referral Hospital.MethodsThis study utilized a quantitative, cross-sectional design. Data collection was conducted from March 25thto April 30, 2024, with a sample size of 396 HIV patients on ART at Kibungo Referral Hospital. Inclusion criteria included patients aged 18 years and older who had been on ART for six months, while exclusion criteria included lack of consent and hospitalized patients. A structured questionnaire was used. The Fisher exact test and logistic regression were employed to analyze associations, with significance set at p < 0.05 and 95% CI.FindingsThe findings showed that the overall non-adherence rate to ART was 13% while the adherence rate was 87%. Also, patients without tertiary education are significantly more likely to be non-adherent to ART compared to those with tertiary education (AoR: 8.232, 95% CI: 4.124-17.217, P-value: <0.001). Patients who experience stigma are more likely to be non-adherent to ART (AoR: 2.148, 95% CI: 1.032-6.689, P-value: 0.015). Patients who perceive ART as ineffective are significantly more likely to be non-adherent (AoR: 9.333, 95% CI: 2.108-20.638, P-value: <0.001. Patients who do not integrate ART into their daily routines are significantly more likely to be non-adherent (AoR: 11.180, 95% CI: 5.879-28.338, P-value: <0.001). There is no significant association between not setting an alarm and non-adherence.In conclusionThe study found a high non-adherence rate to ART among HIV patients at Kibungo Referral Hospital, linked to factors such as younger age, lack of tertiary education, stigma, and perceived ineffectiveness of ART. It recommends implementing structured support systems and targeted interventions to improve adherence and health outcomes for these patients.
Challenges in the medical oxygen ecosystem of Peru: a political economy analysis
Authors: Garcia Patricia J. , Kitutu Freddy Eric , Guzman Jehnette M. , Najarro Lizzette , Ssengooba Freddie , King Carina 
Published: January 2025

AbstractBackgroundMedical oxygen is essential in the management of several human disease conditions including acute respiratory conditions across the life course, and yet access remains unequal in many low- and middle-income countries, including Peru. This study explores Peru’s challenges in ensuring reliable oxygen supplies, with a focus on those laid bare or exacerbated by the COVID-19 pandemic, to inform strategies for improving medical oxygen access.Methodology and Principal FindingsUsing a political economy analysis, we conducted 13 key informant interviews with stakeholders involved in oxygen policy, supply, and health care, supported by reviews of 117 academic and grey literature sources, including policy documents. Before the COVID-19 pandemic, Peru’s requirement for medical oxygen to be >99% pure restricted competition, consolidating control of a few large liquid oxygen suppliers on the oxygen market and blocking smaller, affordable providers due to high compliance costs. Although pre-pandemic oxygen supplies were reportedly adequate, the pandemic exposed severe limitations including market constraints, slow government response, and lack of data management, resulting in an acute oxygen crisis. Civil society and private organizations stepped in, donating medical oxygen generator plants, but many of these are now unused due to insufficient planning for maintenance and operation.Conclusions and SignificanceThis study underscores the urgent need for a National Oxygen System in Peru to oversee supply, distribution, and maintenance, and strengthen resilience for future health emergencies. Solutions include reducing reliance on a small number of external suppliers, infrastructure investments, dedicated funding for maintenance, and training for personnel to ensure continuous oxygen access nationwide. This research highlights systemic vulnerabilities in Peru’s health system and calls for coordinated policies to ensure equitable oxygen access and preparedness for future crises.