bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Severe Low‐Flow, Low‐Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
Authors: Bellino Michele , Ferruzzi Germano Junior , Giordano Arturo , Attisano Tiziana , Maiellaro Francesco , Citro Rodolfo , Baldi Cesare , Corcione Nicola , Morello Alberto , Granata Giovanni , Turino Sara , Di Maio Marco , Silverio Angelo , Galasso Gennaro 
Published: November 2024

Background
Whether the presence of right ventricular (RV) dysfunction may influence the clinical outcome of patients with low‐flow, low‐gradient aortic stenosis (LFLG‐AS) undergoing transcatheter aortic valve replacement (TAVR) has not yet been established.

Methods and Results
This study included consecutive patients with LFLG‐AS undergoing TAVR at 2 high‐volume Italian centers. RV dysfunction before TAVR procedure was defined as tricuspid annular plane systolic excursion assessed by transthoracic echocardiography lower than <17 mm. The primary outcome was all‐cause death at 1 year. The propensity score weighting technique was implemented to account for potential selection bias between patients with and without RV dysfunction. A prespecified subgroup analysis was conducted to evaluate the consistency of the results in patients with classical and paradoxical LFLG‐AS forms. This study included 392 patients; of them, 97 (24.7%) patients showed RV dysfunction before TAVR. At propensity score–weighted adjusted Cox regression analysis, RV dysfunction, according to dichotomous definition, was associated with an increased risk for the primary outcome (adjusted hazard ratio [HR], 3.11 [95% CI, 1.58–6.13]), cardiovascular death (adjusted HR, 3.26 [95% CI, 1.58–6.72]), and major adverse cardiovascular and cerebrovascular events (adjusted HR, 3.39 [95% CI, 1.76–6.53]). Conversely, no difference was detected for the risk of stroke and of permanent pacemaker implantation. No significant interaction of the classical and paradoxical LFLG‐AS subgroups was detected for all the outcomes of interest.

Conclusions
This study suggests that RV dysfunction echocardiographically assessed by tricuspid annular plane systolic excursion may improve the prognostic stratification of patients with LFLG‐AS undergoing TAVR.
Tracking of Vascular Measures From Infancy to Early Childhood: A Cohort Study
Authors: Mansell Toby , Nuotio Joel , Vuillermin Peter , Ponsonby Anne‐Louise , Lawlor Deborah A. , McCloskey Kate , Juonala Markus , Burgner David P. ,   the Barwon Infant Study Investigator Group
Published: November 2024

Background
Atherosclerosis develops across the life course, and variation in aortic intima‐media thickness (IMT) is evident from infancy onward, although most early‐life data are cross‐sectional. We investigated whether abdominal aortic IMT at age 6 weeks is associated with vascular measures at 4 years and the relationship of prenatal and perinatal exposures with these measures in early childhood.

Methods and Results

We analyzed data from 518 participants with 6‐week and 4‐year vascular measures from the Barwon Infant Study. Aortic IMT was measured at 6 weeks (mean, 6.1±SD 1.5 weeks) and aortic and carotid IMT, carotid–femoral pulse wave velocity, and blood pressure at 4 years of age (4.3±0.3 years). Associations of early‐life exposures—maternal enteric microbiome, smoking and low‐density lipoprotein cholesterol during pregnancy, birth weight, and gestational age—were also investigated. In the primary model, 6‐week aortic IMT (649±66 μm) was associated with small differences in 4‐year carotid IMT (453±45 μm) (mean difference in carotid IMT per 100 μm higher 6‐week aortic IMT=7.0 μm [95% CI, 0.7–13.3];
P
=0.03), with no evidence for associations with 4‐year aortic IMT, pulse wave velocity, or blood pressure. Higher birth weight was associated with greater 4‐year aortic IMT, and maternal smoking with higher systolic blood pressure.

Conclusions
Vascular measures do not show strong evidence of tracking between infancy and early childhood. Longitudinal studies with repeated assessment beyond age 4 years would inform optimal timing of early prevention and targets for primordial prevention.
From Folklore to Intangible Cultural Heritage
Authors: Bychak Kaciaryna 
Published: November 2024

From Folklore to Intangible Cultural Heritage
This article is a review of the study entitled Ritualising Cultural Heritage and Re-enchanting Rituals in Europe, authored by Alessandro Testa (Durham: Carolina Academic Press, 2023, pp. 253).

Od folkloru do niematerialnego dziedzictwa kulturowego
Recenzja monografii naukowej Ritualising Cultural Heritage and Re-enchanting Rituals in Europe, autorstwa Alessandra Testy (Durham: Carolina Academic Press, 2023, 253 ss.).
Surgery for a giant atherosclerotic left main trifurcation saccular coronary artery aneurysm
Authors: Saricaoglu Mehmet Cahit , Corbacioglu Yusuf , Boga Salih Anil , Deniz Serenay , Dincer Irem , Akar Ahmet Ruchan 
Published: November 2024

Aneurysms of the left main coronary artery are rare clinical entities with an incidence of 0.1%. We herein report a case of left main trifurcation aneurysm in a 57-year-old woman whose coronary angiography demonstrated a giant saccular aneurysm of trifurcation of the left main coronary artery, measuring 32 × 21 mm with tight post-aneurysmal stenosis in the intermediate artery. The patient underwent coronary artery bypass grafting following the resection of CAA and reconstruction with saphenous vein roof-plasty, which ensured the preservation of the native coronary vasculature. At the 6-month follow-up, she remained asymptomatic and preserved preoperative left ventricular function.
Different patterns of longitudinal changes in antinuclear antibodies titers in children with systemic lupus erythematosus and Sjögren's syndrome
Authors: Morán Álvarez Patricia , Bracaglia Claudia , Nicolai Rebecca , Giovannelli Luigi , Caiello Ivan , Boni Alessandra , Matteo Valentina , Moneta Gian Marco , Messia Virginia , De Benedetti Fabrizio , Marasco Emiliano 
Published: November 2024

Objective to investigate the trend of autoantibody titers during a 2-year follow-up in pediatric systemic lupus erythematosus (pSLE) and pediatric Sjögren's syndrome (pSS). Methods Autoantibodies testing was performed every 3-4 months during 2 years from disease onset in a cohort of children with pSLE and pSS. Results We enrolled 21 children with pSLE and 22 children with pSS. All pSLE patients at 2 years showed ANA titers significantly lower compared to disease onset. Eleven patients (73%) were still ANA positive at 2 years, while 4 (26%) became ANA negative. At diagnosis, 12 (80%) patients showed a homogeneous pattern, while 3 (20%) patients showed a speckled pattern. The latter remained ANA positive with the same pattern; only 2 patients with a homogenous pattern converted to speckled, 4 patients with a homogeneous pattern became ANA negative. ANA negative pSLE patients showed lower levels of interferon score compared to ANA positive patients. Anti-dsDNA titers declined equally in the two groups. All patients with pSS, at disease onset, were ANA and anti-Ro positive and 14 (66%) were anti-La positive. After 2 years of follow-up, 100% remained ANA positive but showed significant lower titers. During follow-up anti-Ro and anti-La titers remained stable. Conclusion different patterns in changes of ANA and ENA titers in pSLE and pSS were shown. At 2 years of follow-up, all pSLE patients had a lower ANA titer and 26% became negative; however, all pSS patients remained both ANA and ENA positive. This evidence may be due to different pathogenetic pathways in SLE and pSS.
Imaging Yield and Surgical Outcomes of Nasal, Medial Brow, Forehead, and Scalp Dermoid Cysts
Authors: Meira Pazelli Alexandre , Wang Leda , Gates-Tanzer Lauren , Davis Dawn M.R. , Cofer Shelagh , Mardini Samir , Lehman Julia , Guerin Julie , Ahn Edward S. , Gibreel Waleed 
Published: November 2024

Objective Dermoid cyst (DC) is a congenital cyst with the potential to have intracranial extension (ICE). This study aims to evaluate the imaging yield and surgical outcomes of nasal, medial brow, forehead, and scalp DCs. Design Retrospective review of craniofacial DCs treated at our institution between 1992 and 2024. Results A total of 117 patients (57 females) were included. The median age at cyst detection and removal were 4.8 months (IQR 3.6-9.6) and 1.8 years (IQR 0.9-5.3), respectively. In 42 patients, parents have noticed the presence of the cyst immediately after birth. Cyst wall rupture during surgical removal was reported in 15.4%. The median follow-up time was 1.3 months (IQR 0.5-12.2). Three patients experienced recurrence. No postoperative complication was reported. The regions with the highest prevalence of ICE were the forehead, frontotemporal scalp, and nasal region. The lateral frontal/temporal scalp had a 33.3% rate of ICE. Midline forehead/scalp lesions demonstrated a higher risk of ICE compared to their lateral equivalents (54.5% vs 17.5%, P = .03). The sensitivity and specificity of magnetic resonance imaging (MRI) were 100% and 95.7%, while for computed tomography (CT scans) were 72.7% and 96.5%. The Area Under the Curve for MRI was 0.978, and for CT was 0.846. The sensitivity and specificity of ultrasound were 50% and 100%. Conclusions Midline forehead/scalp DCs are more prone to extend intracranially than lateral DCs. MRI had a higher sensitivity and specificity than CT scans in detecting ICE. Routine screening imaging should be considered in midline forehead/scalp, lateral frontal/temporal, and nasal DCs.
Patient-Reported Esthetic Outcomes Following Secondary Rhinoplasty in Adult Patients with a Cleft lip and Palate
Authors: Homsy Pauliina , Grann Annemari , Lassus Patrik 
Published: November 2024

Objective Secondary rhinoplasty is a frequently requested revision procedure in patients with a history of cleft lip and palate (CLP). The satisfaction of patients with the esthetic outcome of the procedure has been infrequently studied. Design Adult patients with CLP who had undergone a secondary rhinoplasty between 2009 and 2019 were identified in a cross-sectional cohort that had filled the FACE-Q rhinoplasty module. The effect of the cleft type and the number and timing of the nasal revision surgeries were evaluated. Results Forty participants were included, median age of 26 years (range 18-59 years). Nine (23%) participants had a history of bilateral CLP. The median time form the last nasal operation to the study was 4.5 years (range 16 days to 10 years). The participants reported being satisfied with the appearance of the nose (median score 52, interquartile range [IQR] 44-60) but the satisfaction with the appearance of the nostrils (median score 44, IQR 30-64) was below the normative value for the scale. Patients with a history of bilateral CLP reported worse satisfaction across all the aspects of health-related quality of life assessed ( P < .05 for all). No association was observed between the age at the first open rhinoplasty and satisfaction with the appearance of the nose or the nostrils. Conclusions Following secondary rhinoplasty, adults with CLP are, in general, satisfied with their nose but less so with nostrils. Compared to unilateral CLP, bilateral CLP is associated with a worse health-related quality of life.
Clinical Features and Prognosis of Primary Epithelial-Myoepithelial Carcinoma of Salivary Gland: A Surveillance, Epidemiology, and End Results Database-Based Study
Authors: Han Hui , Pan Li-Na 
Published: November 2024

Objective The clinical characteristics and prognosis of primary epithelial-myoepithelial carcinoma of salivary gland (EMC-SG) have not been defined well due to its rarity. The purpose of this study is to assess the proportion of EMC-SG among salivary gland cancers, describe the clinicopathological features and prognosis of this disease, further analyze the factors associated with EMC-SG survival, and establish individual survival-predicting models. Methods Data on patients diagnosed with salivary gland malignancy between 2000 and 2020 were collected from the Surveillance, Epidemiology, and End Results database. The Kaplan-Meier method and log-rank test were employed to estimate survival of EMC-SG patients. Univariable and multivariable Cox proportional hazards models were developed to determine the EMC-SG survival-associated factors. Furthermore, EMC-SG nomograms were constructed. Results A total of 15 212 patients with salivary gland malignancy were identified. Of these, 310 cases were diagnosed with EMC-SG, representing a prevalence of 2.03% (95%CI 1.82%-2.28%). The overall survival (OS) rates for all 310 EMC-SG patients at 2-year, 5-year, and 10-year were 92.43%, 84.85%, and 73.39%, respectively. Age, primary site, and T stage were independent prognostic factors for OS, while pathological grade and the use of surgery were independent prognostic factors for cancer-specific survival (CSS). The concordance index (C-index) for the OS- and CSS-specific nomograms was 0.72 (95%CI 0.64-0.80) and 0.77 (95%CI 0.67-0.87), respectively. The calibration curve and receiver operating characteristic analysis demonstrated that the predicted values aligned well with the actual observations. Decision curve analysis indicated the superiority of the nomograms over the traditional Tumor Node Metastasis staging system. Conclusions This study represents the largest cohort of EMC-SG patients used to investigate the characteristics and prognosis of this disease. EMC-SG patients often have a less aggressive course and favorable prognosis. The established nomograms provide a useful tool for clinicians to predict patient outcomes, and can assist in customizing the counseling approach for this rare disease.
Analysis of the visual function with the continuous transitional focus intraocular lens Precizon Presbyopic
Authors: León-Ibáñez Luis , Piñero David P 
Published: November 2024

Purpose To evaluate the clinical outcomes of a refractive multi-segmented continuous transitional focus intraocular lens (IOL), analyzing the potential influence of patient pupil dynamics on these outcomes. Methods Retrospective consecutive case series study enrolling 40 eyes (20 patients, 47–81 years) implanted with the Precizon Presbyopic IOL (Ophtec BV). The following clinical outcomes were analyzed during a mean follow-up of 12.1 months (2–24 months): visual acuity, refraction, contrast sensitivity (CS) under photopic and mesopic conditions, binocular defocus curve and evaluation of the perception of disturbing visual symptoms with a validated questionnaire. Results Mean binocular uncorrected distance (UDVA), distance-corrected intermediate (DCIVA), uncorrected near (UNVA) and distance-corrected near visual acuities (DCNVA) were −0.09 ± 0.07, 0.04 ± 0.05, 0.17 ± 0.12, and 0.15 ± 0.10 logMAR, respectively. In the binocular defocus curve, mean distance-corrected visual acuity was over 0.20 logMAR for defocus levels from +1.50 to −3.00 D. No significant correlations of photopic pupil diameter with postoperative visual data were found (−0.165 ≤ r ≤ 0.192, p ≥ 0.235). Moderate correlations of mesopic pupil size were found with visual acuities for the defocus levels of −2.50 ( r = 0.454, p = 0.003), −3.00 ( r = 0.609, p < 0.001), −3.50 ( r = 0.519, p < 0.001), and −4.00 D ( r = 0.403, p = 0.010). Only significant differences were found between mesopic and photopic CS for 12 cycles/degree ( p = 0.010). No cases of severe glare or halos were detected. In contrast, 10% of patients referred the severe perception of starbursts postoperatively. Full spectacle independence was referred by almost all patients (90%). Conclusions The IOL demonstrates effective visual restoration at various distances, characterized by high levels of visual quality and minimal dependence on pupil dynamics.
Bone block options for treating glenoid bone loss and glenohumeral instability: A systematic review
Authors: Briggs Damon V , Hurley Eoghan T , Warren Eric , Amanah Alaowei Y , Levin Jay M , Lau Brian C , Dickens Jonathan F , Klifto Christopher S , Anakwenze Oke 
Published: November 2024

Background To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions. Methods Systematic examination of articles in PubMed and EMBASE databases was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies of bone grafts for treating anterior glenohumeral instability. Statistical analyses were conducted via Review Manager, and a p-value of <0.05 was statistically significant. Results Our review included 25 studies evaluating 870 shoulders. Traditional arc Latarjet (TL) had more depth than congruent arc Latarjet (CAL; p = 0.003). The coronal radii of curvature of TL, CAL, distal tibia, and iliac crest bone blocks were similar to native glenoid ( p = 0.400, 0.817, 0.467, 0.216, respectively). CAL coracoid bone blocks restored significantly more glenoid surface area (30.3%) than TL bone blocks ( p = 0.012). The glenoid width and surface area restoration by distal clavicle bone blocks were equivalent to TL ( p = 0.058 and p = 0.103, respectively). Discussion The CAL technique restored higher percentages of glenoid surface area than TL but has less depth, which may increase fracture risk during screw insertion. The distal clavicle bone block is a suitable substitute to TL as it was equivalent regarding glenoid width and surface area restoration.
Determining the optimum dose of remifentanil in combination with propofol for total intravenous anaesthesia in hysteroscopy under Narcotrend and SPI monitoring
Authors: Zhang Xiaoyu , Xu Tao , An Xiaohu , Wang Jianwei , Meng Qiong , Xu Zifeng 
Published: November 2024

Background: Outpatient hysteroscopic surgery requires patients to be anaesthetised and recover quickly, and the drugs used must be safe and effective. Remifentanil is typically co-administered with propofol as total intravenous anaesthesia (TIVA) for hysteroscopy because of its favourable pharmacokinetic and pharmacodynamic properties. However, the optimal dose of remifentanil when co-administered with propofol without neuromuscular blocking agents (NMBAs) has not been established. Objectives: In this sequential dose-finding study, the 90% effective dose (ED90) of remifentanil effect-site concentration (Ce) combined with propofol without NMBAs during outpatient hysteroscopy was calculated to minimise the side effects of using higher doses. Design: This sequential dose-finding study was conducted in August 2022. Methods: Forty patients who underwent outpatient hysteroscopy under TIVA were included in the study. With a biased coin up-and-down design, the initial remifentanil Ce was established at 2 ng/mL, and the subsequent remifentanil dosage was determined based on the reaction of the previous patient. The primary outcome was a remifentanil Ce that resulted in successful TIVA by maintaining a Narcotrend index < 60, surgical pleth index (SPI) < 50, and without patient movement throughout hysteroscopy. Secondary outcomes included rates of hypotension-related symptoms and interventions, drug consumption, post-anaesthesia care unit (PACU)-estimated visual analogue scale (VAS) and Ramsay sedation scores, modified Aldrete scores, and other adverse effects of anaesthesia. The ED90 and 95% confidence intervals (CI) were estimated using isotonic regression methods and bootstrapping. Results: For TIVA without NMBAs during outpatient hysteroscopy, the ED90 Ce of remifentanil combined with propofol was determined to be 2.75 ng/mL (95% CI, 2.50–3.00 ng/mL). The incidence of peri-operative adverse effects of anaesthesia was relatively low. All the patients had satisfactory VAS, Ramsay sedation, and modified Aldrete scores in the PACU. Conclusion: Remifentanil at a Ce of 2.75 ng/mL is recommended for TIVA combined with propofol in outpatient hysteroscopic surgery. Trial registration: http://www.chictr.org.cn (ChiCTR2200062284; 31/7/2022).
An IoT-based cognitive impairment detection device: A newly proposed method in older adults care—choice reaction time-device development and data-driven validation
Authors: Vizitiu Cristian , Stara Vera , Antognoli Luca , Dinculescu Adrian , Mosoi Adrian , Kristaly Dominic M. , Nistorescu Alexandru , Rampioni Margherita , Dominey Kevin , Marin Mihaela , Rossi Lorena , Moraru Sorin-Aurel , Vasile Costin-Emanuel , Dugan Cosmin 
Published: November 2024

Background Research shows that older adults' performance on choice reaction time (CRT) tests can predict cognitive decline. A simple CRT tool could help detect mild cognitive impairment (MCI) and preclinical dementia, allowing for further stratification of cognitive disorders on-site or via telemedicine. Objective The primary objective was to develop a CRT testing device and protocol to differentiate between two cognitive impairment categories: (a) subjective cognitive decline (SCD) and non-amnestic mild cognitive impairment (na-MCI), and (b) amnestic mild cognitive impairment (a-MCI) and multiple-domain a-MCI (a-MCI-MD). Methods A pilot study in Italy and Romania with 35 older adults (ages 61–85) assessed cognitive function using the Mini-Mental State Examination (MMSE) and a CRT color response task. Reaction time, accuracy, and demographics were recorded, and machine learning classifiers analyzed performance differences to predict preclinical dementia and screen for mild cognitive deficits. Results Moderate correlations were found between the MMSE score and both mean reaction time and mean accuracy rate. There was a significant difference between the two groups’ reaction time for blue light, but not for any other colors or for mean accuracy rate. SVM and RUSBoosted trees were found to have the best preclinical dementia prediction capabilities among the tested classifier algorithms, both presenting an accuracy rate of 77.1%. Conclusions CRT testing with machine learning effectively differentiates cognitive capacities in older adults, facilitating early diagnosis and stratification of neurocognitive diseases and can also identify impairments from stressors like dehydration and sleep deprivation. This study highlights the potential of portable CRT devices for monitoring cognitive function, including SCD and MCI.
Telerehabilitation solutions in patient pathways: An overview of systematic reviews
Authors: Nicolas Benoit , Leblong Emilie , Fraudet Bastien , Gallien Philippe , Piette Patrice 
Published: November 2024

Background Telerehabilitation (TR), a branch of telemedicine, provides remote therapeutic rehabilitation through telecommunication. Driven by technological advances and benefits like remote monitoring and patient education, it has grown since 1998. The Coronavirus Disease 2019 (COVID-19) pandemic highlighted its importance in maintaining healthcare access. Research question What is the efficacy of TR compared to in-person rehabilitation? Are the assessment tools effective? Is TR well-accepted, and are costs reduced? Methods A bibliographic search on Medline, Cochrane and Google Scholar focused on systematic reviews (SRs) from 2014 to Mai 2024, comparing TR or home-based rehabilitation with in person treatments for various conditions. Independent reviewers conducted initial screenings, resolving disagreements by a third reviewer. Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the quality of review. The data was synthesised narratively. Results The search identified 665 SRs. After selection, 228 SR were included. TR models include synchronous (real-time video interactions), asynchronous (independent sessions through digital platforms) and mixed methods. Regardless of the medical fields, the conclusions of the SRs consistently point to the equivalence of TR compared to in-person rehabilitation. Remote evaluations via digital tools were reliable and valid for various assessments. TR is cost effectiveness and well accepted. Conclusions TR is a viable alternative or complement to traditional rehabilitation, offering enhanced accessibility, reduced costs and improved results. Barriers include technical issues, training and concerns about lack of physical contact. Mixed methods could address these challenges.