bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency of phacoemulsification handpieces with high and low intraocular pressure settings
Authors: Spaulding Justin , Hall Brad 
Published: November 2024

Purpose:
To compare the efficiencies of the Active Sentry handpiece at low intraocular pressure (IOP) (20 mm Hg) with the Ozil handpiece at high IOP (50 mm Hg).

Setting:
Private practice (Medford, Oregon).

Design:
Single-site, prospective, double-arm, randomized, contralateral eye study.

Methods:
The first operated eye was randomized to receive phacoemulsification with either the Active Sentry handpiece at 20 mm Hg (Active Sentry group) or the Ozil handpiece at 50 mm Hg (Ozil group). The second operated eye was assigned to the other group. Outcome measures included phacoemulsification time, total aspiration time, aspiration time during phacoemulsification, fluid use, cumulative dissipated energy, total torsional time, total longitudinal time, and central corneal thickness.

Results:
36 participants (72 eyes) completed the study. Mean total aspiration time was 90.1 ± 16.4 seconds in the Active Sentry group and 85.1 ± 17.0 seconds in the Ozil group (P > .05). Mean aspiration time during phacoemulsification was 40.9 ± 8.5 seconds in the Active Sentry group and 40.4 ± 8.8 seconds in the Ozil group (P > .05). Mean total phacoemulsification time was 29.5 ± 7.3 seconds in the Active Sentry group and 31.0 ± 7.4 seconds in the Ozil group (P > .05). Mean total fluid volume was 32.8 ± 4.6 mL in the Active Sentry group and 33.8 ± 6.0 mL in the Ozil group (P > .05).

Conclusions:
The results of this study suggest that the efficiencies of the Active Sentry handpiece at low IOP settings and the Ozil handpiece at high IOP are similar.
Assessment of measurement variability across automated biometry devices
Authors: Micheletti J. Morgan , Hall Brad 
Published: November 2024

Purpose:
To evaluate measurement variability between different readily available automated biometric devices for the purposes of improving surgeon decision-making for phakic intraocular lens (IOL) sizing.

Setting:
Private practice (Houston, Texas).

Design:
Prospective, single-center, bilateral, nonrandomized, open-label, observational study.

Methods:
This study included healthy eyes, with no prior eye surgery, and with a spherical equivalent of at least −1.00 diopter. Orbscan II was compared with Argos, Atlas 9000, caliper, IOLMaster 500, IOLMaster 700, iTrace, Lenstar LS900, Pentacam HR, and Pentacam AXL Wave. Preoperative measurements included white-to-white (WTW), anterior chamber depth (ACD), and central corneal thickness (CCT). Linear mixed-effect models were created to determine adjustment factor between the Orbscan II and other devices for WTW, ACD, and CCT measurements.

Results:
204 participants (408 eyes) completed the study. All mean WTW measurements were significantly different compared with the Orbscan II (P < .01), except for Pentacam AXL Wave. All mean ACD and CCT measurements were significantly different compared with the Orbscan II (P < .01). Adjustment factors for WTW ranged from −0.65 to 0.24 mm. Adjustment factors for ACD ranged from −0.21 to −0.16 mm. Adjustment factors for CCT ranged from 19.9 to −36.0 μm.

Conclusions:
The biometers tested were not interchangeable with the Orbscan II. Adjustment factors for WTW and ACD may compensate for differences between devices and adapt ICL sizing recommendations.
Citrate in autosomal dominant polycystic kidney disease: biomarker or therapeutic agent?
Authors: Rocha Daniel Ribeiro , Matos Ana Cristina Carvalho , Heilberg Ita Pfeferman 
Published: November 2024

Purpose of review
This review highlights the latest findings regarding hypocitraturia in autosomal dominant polycystic kidney disease (ADPKD), from both experimental and clinical studies, exploring the underlying pathophysiology and potential therapeutic approach.

Recent findings
Experimental studies have shown that the lodging of microcrystals in the tubules can trigger cyst formation and growth in polycystic kidney disease (PKD). ADPKD patients are prone to developing hypocitraturia in early stages, which could predispose to calcium microcrystal formation. Low urinary citrate excretion has been associated with a more rapid decline in eGFR and poorer renal survival in ADPKD patients. Animal studies employing citrate supplementation have shown promising effects on preserving the decline in estimated glomerular filtration rate (eGFR) and cyst growth.

Summary
Current knowledge suggests that urinary citrate could be incorporated into existing prognostic markers for disease progression and potential adjuvant therapy in ADPKD, but further clinical studies to support such hypothesis must be undertaken.
Combined coronary artery bypass grafting and orthopedic fixation in a patient with multiple comorbidities: a case report
Authors: Natsha Noor , Najjar Roua , Warasna Haya Jebreen Mohammad , Awad Mohammad Yaser Hasan , Alhadad Baha , Marzouqa Bisher , Qabaja Murad 
Published: November 2024

Background:
Coronary artery disease is a prevalent cardiovascular condition and the leading cause of morbidity and mortality worldwide. The management of orthopedic injuries requiring surgical fixation is particularly complex in patients with comorbidities such as diabetes mellitus and hypertension (HTN). Coordinating the sequence, timing, and execution of coronary artery bypass grafting (CABG) and orthopedic fixation requires careful consideration of the patient’s overall health, surgical risks, and recovery potential.

Case presentation:
A 55-year-old male presented with a right distal tibial fracture following a fall. His medical history included HTN, type 2 diabetes mellitus, and Kyrle’s skin disease. During his hospital stay, he was diagnosed with non-ST-segment elevation myocardial infarction. Severe multivessel Coronary artery disease was confirmed by catheterization. After interdisciplinary consultation, simultaneous CABG and open reduction and internal fixation of the tibial fracture were performed. He was discharged in good condition and showed positive recovery during a 1-month follow-up.

Discussion:
This case highlights the complexities of managing patients with multiple comorbidities who require both cardiac and orthopedic surgeries. This simultaneous approach allows for efficient treatment, leading to a shorter hospital stay and recovery period. This report supports the feasibility and benefits of simultaneous surgery in complex clinical scenarios, although further studies are required to establish broader guidelines.

Conclusion:
Our case emphasizes the importance of a multidisciplinary approach for managing patients with multiple comorbidities who require concurrent surgical intervention. Preoperative planning and speciality coordination ensured optimal outcomes. Further research is needed to develop standardized guidelines for intraoperative care of patients undergoing simultaneous procedures.
Protein-losing enteropathy as the first presentation of systemic lupus erythematosus the first case reported in Palestine with systemic review
Authors: Abu Jheasha Amal , Alsharif Tasneem , Alwahsh Raghad , Abumunshar Ahmad , Al-Ardah Rawand , Abuturki Abdelwadod 
Published: November 2024

Introduction:
Systemic lupus erythematosus is a chronic inflammatory disease affecting women, causing gastrointestinal issues like acute pancreatitis, esophagitis, and protein-losing enteropathy. Protein loss is uncommon, but a case study shows protein-losing enteropathy as a first sign.

Importance:
Protein-losing enteropathy (PLE) is a rare gastrointestinal manifestation of SLE, often seen years before diagnosis. Suspecting hypoalbuminemia without protein loss is crucial, but diagnosis is challenging due to imaging and histological findings.

Case presentation:
A 22-year-old woman with epigastric pain experienced sudden abdominal pain, vomiting, and arthralgia. An abdominal CT scan revealed moderate bilateral hydronephrosis, pelvic free fluid, a kidney stone, and a cyst. Laboratory tests showed normal hemoglobin levels, platelets, white blood cells, C-reactive protein, and ESR. Diagnosis of SLE was confirmed, and pulse steroid therapy and hydroxychloroquine were initiated. Severe ascites required pigtail insertion, and ceftazidime was added. The patient’s condition improved, and she was discharged with regular follow-ups.

Clinical discussion:
A 22-year-old female was diagnosed with protein-losing enteropathy, a rare gastrointestinal manifestation of systemic lupus erythematosus (SLE). The disease is divided into mesenteric vasculitis, pseudo-obstruction, and protein loss enteropathy. The patient also had severe enteritis, abdominal pain, nausea, and diarrhea. The study found that the main complaint was abdominal pain with dysphagia, mainly due to active SLE inflammation. The patient responded well to treatment, with a 62.5% rapid improvement in pulse steroids and a cure for underlying causes through DMARDS or immunosuppressant drugs.

Conclusions:
The case presents a rare SLE diagnosis with gastrointestinal involvement, pleural effusion, and progressive swelling. Despite correct diagnosis and aggressive treatment, clinical improvement occurred, requiring high clinical suspicion.
The Association Between Change in Symptom Severity and Personal Recovery in Patients With Severe Mental Illness
Authors: Van Eck Robin Michael , Jelsma Auke , Blondeel Jelle , Burger Thijs Jan , Vellinga Astrid , de Koning Mariken Beatrijs , Schirmbeck Frederike , Kikkert Martijn , Boyette Lindy-Lou , de Haan Lieuwe 
Published: November 2024

Abstract
This study examined the relationship between change in symptom severity and personal recovery in patients with severe mental illness (SMI). Forty-nine outpatients at Mentrum/Arkin, Amsterdam, the Netherlands, were assessed at baseline and 3 years later, using the Brief Psychiatric Rating Scale and the Mental Health Recovery Measure. Correlation coefficients and linear regression analyses were used. Further, the impact of severity of symptoms at baseline on change in personal recovery was evaluated. Results show that change in symptom severity explained 31.8% of the variance of change in personal recovery. Change in depression/anxiety explained 27.3% of the variance of change in personal recovery. Higher affective symptom severity at baseline significantly predicted positive change in personal recovery. In conclusion, besides change in symptom severity, other potential determinants of personal recovery should be addressed in treatment of patients with SMI, for example, self-esteem and social functioning. Treatment of depression/anxiety symptoms may increase personal recovery.
Visibility, Physical Work Environment, and Stress in ICU Nurses
Authors: Keys Yolanda , Fineout-Overholt Ellen 
Published: November 2024

OBJECTIVE
Relationships among coworker and patient visibility, reactions to physical work environment, and work stress in ICU nurses are explored.

BACKGROUND
Millions of dollars are invested annually in the building or remodeling of ICUs, yet there is a gap in understanding relationships between the physical layout of nursing units and work stress.

METHODS
Using a cross-sectional, correlational, exploratory, predictive design, relationships among variables were studied in a diverse sample of ICU nurses.

RESULTS
Visibility had a direct effect on work stress (P < 0.01). The ViPES (Visibility, Physical Environment and Stress) model can help explain relationships among study variables. The findings from this study support the notion that high visibility is a job resource and low visibility is a job demand.

CONCLUSIONS
Design features supporting a sense of connection may be especially important to less experienced ICU nurses. Elements of the built environment that allow nurses to see not only patients, but also their coworkers, may help mitigate work stress.
L-Serovar Rectal Chlamydia trachomatis in Patients Who Were Male-Assigned at Birth Attending Two Sexual Health Clinics, Baltimore, Maryland 2009–2016
Authors: Hamill Matthew M. , Deng Zhongyue , Hardick Justin , Tobias Susan , Page Kathleen R. , Quinn Thomas C. , Gaydos Charlotte A. , Hsieh Yu-Hsiang 
Published: November 2024

Introduction
Lymphogranuloma venereum (LGV) caused by L-serovars of Chlamydia trachomatis (CT) is a sexually transmitted infection (STI) causing asymptomatic infection, and anogenital disease. Epidemiologically, LGV has been strongly associated with human immunodeficiency virus (HIV) infection.

Methods
Using a retrospective longitudinal study design, we first described unadjusted and adjusted associations between demographic and sociobehavioral characteristics and rectal (r) CT (rCT) and rLGV in sexual health clinic attendees in Baltimore, MD, between 2009 and 2016 at baseline visits. Rectal samples that tested positive for CT with the Aptima AC2 assay underwent DNA extraction and in-house L-serovar PCR analysis. Then, patients were followed over 24 months and incident STIs were described using multivariable Cox-proportional hazard regression models.

Results
In 292/391 (73.4%) patients who were male-assigned at birth (MAB), LGV prevalence was 20/292 (6.8% (95% confidence interval, 4.2%–10.4%)). In the final multivariable regression model, LGV was significantly associated with age greater than 25 years, transgender identity, and a history of syphilis. Baseline LGV was not associated with incident HIV or gonorrhea, but after adjusting for age, race, HIV status, and history of syphilis, LGV was marginally associated with a new syphilis diagnosis (hazard ratio 2.35 (95% confidence interval, 0.96–5.73), P = 0.06) over 24 months follow-up.

Conclusion
Lymphogranuloma venereum accounted for almost 7% of rCT in patients MAB attending sexual health clinics in Baltimore between 2009 and 2016. Lymphogranuloma venereum was not associated with prevalent or incident HIV as in other studies. FDA-cleared tests and better surveillance measures are required to understand changes in the epidemiology of LGV in the United States.
Computer-assisted Cognitive Behavior Therapy and Mobile Apps for Depression and Anxiety: Evidence-based Digital Tools for Clinical Practice
Authors: Rajeshkumar Lavanya , Mishkind Matthew , Coleman Jeremy J. , Pahwa Mehak , LaPreze Dani , Solenske Shaelyn , Wright Jesse H. 
Published: November 2024

Purpose of Review:
Provider shortages and other barriers to traditional mental health care have led to the development of technology-based services designed to enhance access and improve the efficiency and convenience of treatment. We reviewed research on computer-assisted cognitive behavior therapy (CCBT) and mobile mental health applications to assess the effectiveness of these methods of delivering or augmenting treatment, evaluating patient and provider uptake, and making recommendations on the clinical use of these tools in the treatment of depression and anxiety.

Results:
Research on CCBT has found solid evidence for efficacy when the use of a therapeutic computer program is supported by a clinician or other helping professional. Lower levels of efficacy have been found when CCBT is used as a stand-alone treatment. Current CCBT programs have many desirable features; however, few of the current programs incorporate services such as artificial intelligence that have the potential to help improve communication with patients. An increasing number of mobile apps have been created that claim to be useful for depression and/or anxiety, yet caution is warranted before using most due to limited research on effectiveness, low retention rates, and other issues like safety concerns.

Summary:
Growth in the development of CCBT and mental health applications for depression/anxiety has provided several tools that could enhance treatment delivery. A large number of randomized, controlled trials have documented the effectiveness of CCBT, while research on mobile apps has been much less robust. The advantages and disadvantages of these digital technologies are identified, and recommendations are made for clinical use.
Exploring sex differences in the needs and priorities of people with lower limb amputations: An adaptation of the Prosthesis Evaluation Questionnaire
Authors: Carswell Tess M. R. , Monkman Helen , Giles Joshua W. 
Published: November 2024

Background:Females with lower limb amputations have different risk factors and lower success with their prostheses overall. Studying priorities of this population, specifically in how they differ between sexes, through survey methods may improve understanding of female-specific needs and inform sex-specific prosthetic design.Objectives:To adapt the Prosthesis Evaluation Questionnaire and use this to assess sex differences in needs and priorities of people with lower limb amputations (pLLAs).Study design:Cross-sectional questionnaire study.Methods:A committee was formed to modify the Prosthesis Evaluation Questionnaire. The modified questionnaire was completed online by 26 pLLAs (13 females, 13 males). Sex differences in subscale and individual closed-question responses were analyzed using Mann-Whitney U tests. Sex differences in open-ended question responses were analyzed using affinity diagramming.Results:Significant sex differences were found in subscale scores and separate closed questions, with resulting qualitative themes further suggesting sex-specific priorities and perspectives. Females reported lower satisfaction with prosthetic appearance, poorer overall ambulation abilities, and greater perception of social burden than males. Sex differences were also found in themes related to prosthesis satisfaction and other psychosocial factors including social adjustment.Conclusions:Findings demonstrated all-encompassing sex differences in the priorities and needs of pLLAs. This work can be used to better understand and target female's unique priorities through sex-specific considerations in research and prosthetic design.
Sonographic and Disease Activity Findings Related With Medication Change in JIA
Authors: Esteban Ysabella , Avar-Aydin Pinar Ozge , Ting Tracy V. , Cassedy Amy , Vega-Fernandez Patricia 
Published: November 2024

Background
Musculoskeletal ultrasound (MSUS) is increasingly used to evaluate pediatric inflammatory arthritis. This study aimed to explore the relationship between MSUS findings with medication modifications in patients with juvenile idiopathic arthritis (JIA) and clinical disease activity measurements (clinical Juvenile Arthritis Disease Activity Score [cJADAS-10], active joint count [AJC], patient/parent global assessment [PPGA], and physician global assessment [PGA]).

Methods
Data from patients with JIA who underwent a 12-joint (bilateral second and third metacarpophalangeal, wrist, elbow, knee, and ankle) MSUS examination during a 57-month period were collected. Patients were categorized into 2 groups: a medication change group and a control group (patients without medication change). A pediatric-specific MSUS scoring system was used to assess MSUS findings. The association between clinical and MSUS findings was examined for the study groups.

Results
A total of 38 patients, 23 in the medication change group and 15 in the control group were included. The medication change group had higher AJC, PGA, and cJADAS-10. These patients also had a statistically significant presence of abnormal knee MSUS findings. For other joints, the frequency of abnormal MSUS findings was slightly higher in patients with a medication change, but the difference was not statistically significant. No strong correlation was observed between MSUS findings and clinical disease activity measurements.

Conclusions
Abnormal MSUS findings were not observed to be higher in patients with a change in medication except for the involvement of the knee joint. Further longitudinal studies are needed to understand the role of MSUS in the medical decision-making process in JIA.
Voxel-Based Dosimetry Predicts Local Tumor Progression Post 90Y Radiation Segmentectomy of Colorectal Liver Metastases
Authors: Dimopoulos Platon M. , Sotirchos Vlasios S. , Dunne-Jaffe Cynthia , Petre Elena N. , Gonen Mithat , Zhao Ken , Kirov Assen S. , Crane Christopher , D’Angelica Michael , Connell Louise C. , Sofocleous Constantinos T. 
Published: November 2024

Background
Radiation segmentectomy (RS) is an alternative potential local curative treatment for selected colorectal liver metastases (CLMs) not amenable to ablation or limited resection.

Purpose
The aim of this study was to evaluate the dosimetric response of low volume CLMs to RS in heavily pretreated patients who are not candidates for resection or percutaneous ablation.

Patients and Methods
This single-center retrospective study evaluated CLMs patients treated with RS (prescribed tumor dose >190 Gy) from 2015 to 2023. RS doses to tumor(s) and margins were calculated from SPECT/CT and PET/CT images. Response and local tumor progression (LTP) were assessed using anatomic (RECIST 1.1) and metabolic (PERCIST) criteria. LTP-free survival (LTPFS) and overall survival were estimated with Kaplan-Meier methodology. Variables were assessed as predictors of LTPFS using the Cox proportional hazards model.

Results
Thirty-six patients underwent 38 RS procedures to treat 57 tumors. Median time from initial diagnosis to detection of liver metastases and RS were 16.4 (interquartile range: 6.5–32.2) and 26.8 (interquartile range: 12.5–40.0) months, respectively. Median overall survival after RS was 14.3 (95% confidence interval [CI]: 10.8–30.7) months. Predictors of LTPFS included tumor number(s), mean tumor dose (MTD), and margin mean absorbed dose (MMAD). Complete radiographic (hazards ratio [HR]: 1.29e-16, 95% CI: 4.06e–17-4.07e-16, P < 0.001) and metabolic response (HR: 0.38, 95% CI: 0.15–0.95, P = 0.038) correlated with prolonged LTPFS. One-year LTPFS rate was 83.3% for tumors receiving MTD ≥400 Gy and a 5-mm surrounding MMAD ≥350 Gy (P = 0.006). No instances of LTP were observed when tumors received stereotactic irradiation over 300 Gy (at least 95% of the tumor volume received ≥300 Gy). One-year LTPFS rate for tumors receiving MTD ≥400 Gy was 68.6% versus 14.3% for those that did not reach this threshold (P = 0.013). In multivariate analysis, MTD ≥400 Gy and 5-mm MMAD ≥350 Gy were independent predictors of LTPFS (HR: 0.11; 95% CI: 0.01–0.81; P = 0.03).

Conclusions
MTD ≥400 Gy, MMAD ≥350 Gy, and stereotactic tumor irradiation ≥300 Gy are associated with prolonged LTPFS after RS for CLMs.
Has the Time Come to Switch From Extensive Lymph Node Dissection to Sentinel Lymph Node Biopsy in Prostate Cancer Patients Treated With Radical Laparoscopic Prostatectomy?
Authors: Delgado Bolton Roberto C. , Calapaquí Terán Adriana K. , Giammarile Francesco 
Published: November 2024

Abstract
The efficacy of the available procedures currently recommended for staging and prognostic evaluation of prostate cancer patients treated with radical laparoscopic prostatectomy is discussed, taking into account the available evidence and potential implications in patient management.