bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phrenic Nerve Palsy After Posterior Cervical Fusion
Authors: Falconiero Thomas , Viola Anthony , LaGreca Mark , Yeung Caleb M. , Rihn Jeffrey 
Published: November 2024

Introduction:
Cervical nerve palsies, most commonly C5, are relatively common following posterior cervical decompression and fusion (PCDF) for the management of cervical myelopathy. However, phrenic nerve palsy following PCDF is a rare complication documented in only one previous case report. The authors present a case of phrenic nerve palsy following PCDF.

Methods and Material:
The patient is a 51-year-old male who presented with cervical myelopathy and radiculopathy as well as cervicalgia of 1 year’s duration. The patient underwent C3–C6 posterior cervical decompression and fusion (PCDF). On postoperative day 5, he was found to have a right C5 nerve palsy, which improved with steroid use and physical therapy. When he returned at 7 weeks postoperatively, the patient had progressive dyspnea. A fluoroscopic exam by pulmonology revealed a right-sided phrenic nerve palsy was the cause of the dyspnea.

Results and Discussion:
Phrenic nerve palsy causing hemi-diaphragmatic paralysis is a rare complication of cervical spine surgery that requires a high degree of suspicion due to the nonspecific signs and symptoms. Our clinical case suggests that surgeons should bear in mind phrenic nerve palsy as a potential complication in patients with respiratory distress following cervical laminectomy.
Performance of the Healthy Aging Brain Care Monitor Self Report in Monitoring Post-Intensive Care Syndrome Among Acute Respiratory Failure Survivors
Authors: Savsani Parth K. , Khan Sikandar H. , Perkins Anthony J. , Wang Sophia , Jawaid Samreen , Moiz Salwa , Monahan Patrick O. , Kroenke Kurt , Gao Sujuan , Khan Babar A. 
Published: November 2024

OBJECTIVES:
To describe the performance of the Healthy Aging Brain Care Monitor Self Report (HABC-M SR) in assessment of post-intensive care syndrome (PICS) among Acute Respiratory Failure ICU survivors.

DESIGN:
Secondary data analysis of a randomized controlled trial.

SETTING:
Patients evaluated by a nurse care coordinator in an out-of-hospital setting.

PATIENTS:
English-speaking adults 18 years old or older who were admitted to the ICU with acute respiratory failure requiring invasive or noninvasive mechanical ventilation for greater than or equal to 24 hours.

INTERVENTIONS:
Patients randomized to the intervention arm of the mobile critical care recovery program, a negative trial testing multidisciplinary care to improve quality of life.

MEASUREMENTS AND MAIN RESULTS:
HABC-M SR scale was used to assess PICS in the intervention group at ICU discharge, 3, and 6 months post-discharge. Hospital Anxiety and Depression Scale; Pain, Enjoyment of Life, and General Activity Scale; Timed Up and Go; and Patient-Reported Outcomes Measurement Information System sleep scores were obtained at the same time. Mini-Mental State Examination (MMSE) was administered at baseline and 6 months. ICU survivors reported mild PICS symptoms, which improved over 6 months (mean HABC-M SR scores: baseline [8.5, sd 7.6], 3 mo [5.3 mo, sd 6.6 mo], and 6 mo [5.2 mo, sd 6.9 mo; p < 0.001]). HABC-M SR total score had moderate internal consistency that improved over time (Cronbach’s alpha = 0.78 at baseline and 0.84 at 6 mo). The psychological subscale of HABC-M SR was moderately correlated with standardized scales for mood, pain, and sleep. The cognitive subscale was not significantly correlated with MMSE.

CONCLUSIONS:
While HABC-M SR correlated with mood, physical, and sleep symptoms, the cognitive subscale was less sensitive compared with standardized scales.
Novel immunotherapeutic approaches in lung cancer: driving beyond programmed death-1/programmed death ligand-1 and cytotoxic T-lymphocyte-associated Protein-4
Authors: Resuli Blerina , Kauffmann-Guerrero Diego 
Published: November 2024

Purpose of review
In this review, our aim is to highlight the latest novel immunotherapeutic approaches for advanced nonsmall cell lung cancer (NSCLC) beyond anti-programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) and anti- cytotoxic T-lymphocyte-associated Protein-4 (CTLA4).

Recent findings
Immune checkpoint inhibitors (ICIs) revolutionized the treatment of advanced NSCLC. Despite that, patients develop primary or acquired resistance to ICIs. The discovery of novel approaches represents both an unmet need and an opportunity to improve outcomes in these patients.

Summary
We summarized the most relevant novel immune checkpoints, many of them in their early phase of testing, to provide a comprehensive overview of the state of the art of immunotherapy in NSCLC beyond PD-1/PD-L1 and CTL-4 inhibitors.
Immune checkpoint inhibitors in driver mutation-positive nonsmall cell lung cancer
Authors: Huber Rudolf M. , Kauffmann-Guerrero Diego 
Published: November 2024

Purpose of review
Immune checkpoint inhibitors (ICIs) and targeted therapies have changed the landscape of management of nonsmall cell lung cancer (NSCLC) dramatically. Whereas ICIs in NSCLC without specific driver mutations are well established it is unclear what the place of ICIs in driver mutation-positive NSCLC is. This review summarizes the current view on the use of ICIs in driver mutation-positive NSCLC.

Recent findings
Immune checkpoint inhibition in combination with chemotherapy (and antiangiogenesis) in recurrent driver mutation-positive NSCLC after tyrosine kinase inhibitor therapy may be effective

Summary
Currently the role of immune checkpoint inhibitors in driver mutation-positive NSCLC is limited. They can in combination be applied in second and later line settings if no specific therapy is available.
The comparison of clinicopathological characteristics of two distinct manifestations of gastric signet ring cell carcinoma under EUS
Authors: Liu Shanshan , Han Chaoqun , He Qi , Shang Guochen , Jin Yu , Liu Jun , Ding Zhen , Lin Rong 
Published: November 2024

ABSTRACT

Background and Objectives
There are two different endoscopic ultrasonographic manifestations of gastric signet ring cell carcinoma (GSRCC). No studies have been reported on the differences in the clinical profiles of patients based on EUS examination. We aim to study the variations in clinicopathological characteristics between two distinct endoscopic ultrasonographic manifestations of GSRCC.

Methods
A total of 302 patients with GSRCC confirmed by pathological examination who underwent EUS were enrolled in the study. Based on the endoscopic ultrasonographic features, patients were categorized into two groups: type 1, where the entire layer structure disappeared, and type 2, where the layer structure was still present and appeared lymphomatoid. Clinicopathologic features were collected retrospectively and analyzed.

Results
Compared with type 2 patients, type 1 patients tended to develop GSRCC at an older age (P = 0.033) and had higher serum levels of tumor markers and were more likely to experience anemia (P < 0.001) and weight loss (P < 0.001) during the disease progression. Significant increases in the tumor size (P < 0.001), thickness of the affected gastric wall (P < 0.001), and depth of tumor invasion (P < 0.001) were observed in type 1 patients. Furthermore, type 1 patients had higher prevalence of affected blood vessels (P < 0.001), nerves (P < 0.001), lymph nodes (P < 0.001), and peritoneal metastasis (P < 0.001). However, no difference was found in the duration of disease between the two groups, and all deficient mismatch repairs were observed in type 1 patients.

Conclusions
The two distinct endoscopic ultrasonographic manifestations of GSRCC exhibited different clinicopathological characteristics, suggesting that they may represent different subtypes of the disease that require special attention in management strategies.
Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
Authors: Hirsiger Stefanie , Lese Ioana , Arenas Hoyos Isabel , Zubler Cédric , Haberthür David , Hlushchuk Ruslan , Djonov Valentin , Banz Yara , Macek Ana , von Tengg-Kobligk Hendrik , Casoni Daniela , Rieben Robert , Olariu Radu 
Published: November 2024

Background:
Representative translational animal models play a key role in vascularized composite allotransplantation (VCA) research. A composite porcine hindlimb flap, previously described, is a relevant preclinical model. However, its bulkiness and the absence of critical immunologic tissues make it less suitable for investigating the unique immunologic features of VCA. We aimed to further develop this model by reducing its bulkiness and by including donor-draining lymph nodes.

Methods:
We conducted an anatomic study by harvesting 11 porcine osteomyocutaneous flaps (4 conventional and 7 modified techniques), which were characterized by computed tomography. Furthermore, 8 allotransplantations were performed in Swiss landrace pigs. After the procedure, animals were assigned to a model development and control group (N = 4 per group). No immunosuppression was given, and animals were followed up until grade 3 rejection.

Results:
With the modified technique, the flap weight was significantly reduced with a mean weight of 831 g, corresponding to 1.8% total body weight versus 1710 g in the conventional technique, representing 4.2% of total body weight (P < 0.0001). The muscle/bone ratio was reduced from 8.24 (conventional) to 2.92 (modified), (P = 0.03). Histologically, graft-draining lymph nodes showed typical changes related to rejection and no signs of ischemia after in vivo transplantation.

Conclusions:
By modifying the surgical technique, the bulkiness of the flap was markedly reduced, without impairing its vascularization and reliably including vascularized graft-draining lymph nodes. Our modified VCA model in the pig presents distinct advantages for surgery as well as immunologic analysis, warranting a large-scale use for experimental reconstructive transplantation studies.
Adherence to antihypertensive medications in Omani patients: a comparison of drug biochemical analysis and the Morisky Medication Adherence Scale
Authors: Al-Ani Abdullah , Al Suleimani Yousuf , Ritscher Sabrina , Toennes Stefan W. , Al-Hashar Amna , Al-Zakwani Ibrahim , Al Za’abi Mohammed , Al Hashmi Khamis 
Published: November 2024

Background:
Medication nonadherence is a major risk factor for suboptimal or failed hypertension pharmacologic therapy.

Objective:
To determine the nonadherence rate to antihypertensive medications using high-performance liquid chromatography–tandem mass spectrometry (LC–MS/MS) and the self-reported Morisky Medication Adherence Scale (MMAS).

Methods:
This study used a prospective cross-sectional cohort design. Patients with hypertension aged ≥18 years and prescribed at least one antihypertensive medication were recruited from an outpatient hypertensive clinic at a tertiary healthcare institution in Oman. Adherence was assessed using LC–MS/MS urine analysis and the MMAS.

Results:
In total, 162 patients completed the MMAS questionnaire and provided urine samples for LC–MS/MS analysis. The overall mean age of the cohort was 55 ± 13 years, and 57% of the patients were men. The mean systolic and diastolic blood pressures were 146 ± 18 mmHg and 79 ± 10 mmHg, respectively. Using the MMAS method, 65% of the patients reported nonadherence. However, LC–MS/MS analysis revealed that only 27% of the patients were nonadherent. The adherent group by LC–MS/MS had significantly lower systolic (P = 0.026) and diastolic blood pressures (P < 0.001) than the nonadherent group, whereas no differences were observed using the MMAS method. There was weak or no agreement between the MMAS and LC–MS/MS results (P = 0.142).

Conclusion:
Almost one-fourth of our patients with hypertension were nonadherent to their medications. There was a weak concordance between the MMAS and LC–MS/MS methods in detecting medication nonadherence. Further research into noninvasive convenient adherence scales or methods and their correlations with LC–MS/MS analysis is warranted.
Relationship between blood pressure variability and blood pressure phenotypes: a home blood pressure monitoring study
Authors: Alves Marco A.M. , Bezerra Rodrigo , Dal Pont Christian S. , Mota-Gomes Marco A. , Paiva Annelise M.G. , Barroso Weimar S. , Miranda Roberto D. , Barbosa Eduardo C.D. , Brandão Andréa A. , Lima-Filho José L. , Coca Antonio , Sposito Andrei C. , Feitosa Audes D.M. , Nadruz Wilson 
Published: November 2024

Objective:
Home blood pressure (BP) variability (BPV) and BP phenotypes such as white-coat hypertension (WCH), white-coat uncontrolled hypertension (WUCH), masked hypertension (MH) and masked uncontrolled hypertension (MUCH) are predictors of adverse cardiovascular events. This study compared home BPV across BP phenotypes built from abnormal office BP (OBP) and home BP monitoring (HBPM) thresholds defined by three distinct societies [European Society of Hypertension (ESH): OBP ≥ 140/90 mmHg and HBPM ≥ 135/85 mmHg; American College of Cardiology/American Heart Association (ACC/AHA): OBP and HBPM ≥ 130/80 mmHg and Brazilian Society of Cardiology (BSC): OBP ≥ 140/90 mmHg and HBPM ≥ 130/80 mmHg].

Methods:
This cross-sectional study evaluated 51 194 treated (37% men, age = 61 ± 15 years) and 56 100 untreated (41% men, age = 54 ± 16 years) individuals from 1045 Brazilian centers who underwent OBP and HBPM measurements. Systolic and diastolic home BPV were estimated as the: standard deviation, coefficient of variation, and the variability independent of the mean of HBPM.

Results:
Results of adjusted analysis showed that home BPV parameters were significantly greater in individuals with WCH/WUCH according to the BSC criteria, in those with MH/MUCH defined by the ACC/AHA criteria, and tended to be greater in individuals with either MH/MUCH or WCH/WUCH defined by the ESH criteria.
Furthermore, restricted cubic spline analysis showed a U-shaped association between BPV and the difference between OBP and HBPM in treated and untreated individuals.

Conclusion:
Home BPV was greater in WCH/WUCH and/or MH/MUCH depending on the criteria used to define abnormal OBP and HBPM thresholds. These findings underscore the need to standardize abnormal BP criteria in clinical practice.
NEURORETINITIS ASSOCIATED WITH COVID-19 INFECTION AND VARICELLA-ZOSTER VIRUS REACTIVATION
Authors: Gavrić Ana Uršula , Mylemans Evelien Margareta , Valentinčič Nataša Vidovič 
Published: November 2024

Purpose:
To report a case of neuroretinitis as the presenting manifestation of COVID-19 infection alongside VZV reactivation, in the absence of other systemic symptoms.

Methods:
A case report.

Results:
A previously healthy 15-year-old male presented with a one-week history of acute unilateral visual loss and clinical findings consistent with neuroretinitis. Diagnostic work-up revealed a positive nasopharyngeal swab PCR for COVID-19 and serology showed the presence of IgM and IgG antibodies for VZV. Following a comprehensive treatment regimen involving intravenous acyclovir, high-dose intravenous steroids and oral doxycycline, rapid and remarkable improvements were observed. The macular star and optic disc swelling regressed, and visual acuity improved from 20/200 to 20/20.

Conclusion:
This case offers valuable insights into the neuroretinitis associated with COVID-19 infection and VZV reactivation.
Risk of zonular dialysis in fellow eye cataract surgeries: multicenter comparative study
Authors: Elhusseiny Abdelrahman M. , Ibrahim S. Nazem , Toma Joseph , Yang Yit C. , Sallam Ahmed B. 
Published: November 2024

Purpose:
To evaluate the risk of zonular dialysis (ZD) in fellow eye phacoemulsification cataract surgery and to identify risk factors, including prior first eye ZD.

Setting:
8 United Kingdom National Health Service clinical centers.

Design:
Retrospective database study.

Methods:
Overall risk of ZD in the fellow eye was calculated and the odds ratio (OR) for the various risk factors was reported, including first eye ZD. The main outcome measures were the risk and the predictors of intraoperative ZD in the fellow eye.

Results:
There was a total of 66 288 patients. At the time of the first surgery, the mean age of patients was 75.3 ± 10.2 years and 39.2% were male. Intraoperative ZD occurred during the first eye surgery in 333 patients (0.5%) and the fellow eye in 349 patients (0.5%). The risk of fellow eye developing ZD in patients with first eye ZD was higher than in patients without first eye ZD: 23 of 333 patients (6.9%) vs 326 of 65 955 patients (0.5%) (unadjusted OR 14.9, P < .001). In the adjusted logistic regression model, first eye ZD was the most significant risk factor (OR 13.3, 95% confidence interval [CI] 8.2-21.7). Other significant covariates of ZD in the fellow eye were pseudoexfoliation (OR 6, 95% CI 3.8-9.7), previous pars plana vitrectomy (OR 4.5, 95% CI 1.1-18.5), and poor pupillary dilation (OR 2.2, 95% CI 1.4-3.3).

Conclusions:
The most important risk factor for the development of ZD in the fellow eye during cataract surgery was the occurrence of ZD in the first eye. These findings have implications for patient counseling and surgery allocation.
Ocular shape of cataract with retinitis pigmentosa: case-control study
Authors: Iida Masanobu , Masuda Yoichiro , Ohira Ryo , Ichihara Kosuke , Komatsu Koji , Shiba Takuya , Iwaki Hisaharu , Oki Kotaro , Nakano Tadashi 
Published: November 2024

Purpose:
To investigate the anterior segment morphology in cataracts with retinitis pigmentosa (RP).

Setting:
The Jikei University Hospital.

Design:
Retrospective matched case-control study.

Methods:
The analysis included 28 eyes of 28 patients with cataracts and RP and 28 eyes of 28 patients with cataracts but without RP, matched for age and sex. Lens thickness, anterior lens curvature (Front R), posterior lens curvature, anterior chamber depth (ACD), anterior chamber width, central corneal thickness (CCT), white-to-white (WTW) distance, corneal curvature, and axial length (AL) were compared between the groups. Data were obtained from preoperative evaluations conducted before cataract surgery. The same set of comparisons was also conducted for 18 eyes of 18 patients with cataracts and RP and 18 eyes of 18 patients with cataracts but without RP, matched for age, sex, and AL. Cases with missing data, categorized as Emery-Little classification grade 4 or above, or those with a history of acute angle closure were excluded.

Results:
In the age and sex-matched analysis, cataracts with RP showed a significantly thicker lens, steeper Front R, shallower ACD, thinner CCT, and shorter AL. In the analysis matched by age, sex, and AL, cataracts with RP had a thicker lens, steeper Front R, and larger WTW distance.

Conclusions:
Cataracts with RP demonstrated centripetal swelling of the lens, centrifugal corneal thinning, and AL shortening. A decrease in tension between the lens and eyeball wall because of zonular weakness in the RP may lead to swelling of the lens and horizontal flattening of the eyeball.
Effects of Procedural Information, Buzzy, and Multiple Interventions on Pain in Children Undergoing Venipuncture: A Randomized Controlled Trial
Authors: KAHRIMAN Ilknur , MERAL Buket , COLAK Bahar , BEKTAS Meral , KIRBAS Zila Özlem , ARICI Yeliz Kasko 
Published: November 2024

ABSTRACT

Background
Needle-related procedures are commonly performed in childhood and lead to considerable pain.

Purpose
This randomized controlled study was conducted to compare the effects on venipuncture pain of the Buzzy, an informational animated video, multiple interventions, and standard care in children aged 6–12 years.

Methods
One hundred eighty children were assigned to the groups using a computerized randomization program. Pain level was evaluated by the children, parents, and their nurses using the Wong–Baker Faces Pain Scale. The level of agreement among the nurse, parents, and children's pain reports was evaluated. Multivariable regression analysis was performed to identify the factors significantly associated with pain score.

Results
The participants in the Buzzy, video watching, and multiple intervention groups reported lower mean pain scores (child: KW = 28.24, p < .001; parent: KW = 18.51, p < .001; nurse: KW = 44.4, p < .001) than their peers in the control group. Moreover, age was identified as a risk factor affecting pain level (OR = 1.375, 95% CI [1.086, 1.740]; p = .008).

Conclusions
Buzzy and informational videos are potentially effective methods to facilitate venipuncture-related pain management in children. The use of pain management methods during venipuncture is recommended, especially in children younger than 10 years old.
Clinical efficacy and outcomes of calcitriol combined with bisphosphonates in the treatment of postmenopausal osteoporosis: A quasi-experimental study
Authors: Han Kui , Wang Xiaoyan 
Published: November 2024

Background:
A quasi-experimental study was conducted to investigate the clinical efficacy and outcomes of calcitriol combined with bisphosphonates in the treatment of postmenopausal osteoporosis (OP).

Methods:
A total of 152 patients with postmenopausal OP from March 2019 to June 2021 were enrolled. The patients who received calcitriol treatment were adopted as the control group, and the patients treated with calcitriol combined with bisphosphonates were considered as the intervention group. The treatment effects of patients were compared, and the pain degree of the joints of the patients was evaluated by Visual Analogue Scale/Score (VAS), the Barthel Index score was used to evaluate the daily living ability of patients, the hand and Oswestry Disability Index (ODI) were used to evaluate the dysfunction before and after treatment, and the bone metabolism indexes, immune cytokines and bone mineral density were detected before and after treatment, and the incidence of adverse reactions was calculated.

Results:
Regarding the therapeutic effects, the intervention group indicated an effective rate of 96.05% while the effective rate was 84.21% in the control group. The total effective rate of treatment in the intervention group was higher than the control group. The VAS, ODI scores, and bone metabolism indexes of the intervention group were significantly lower than the control group at 1, 2, and 3 months after treatment. The Barthel Index scores and bone mineral density of the intervention group were higher than the control group at 1, 2, and 3 months after treatment. The improvement of immune cytokines in the intervention group was significantly better than the control group (P < .05). One patient in the intervention group developed dizziness and 1 patient developed chills, with an adverse reaction rate of 2.63%, while in the control group, 2 patients had fever, and 2 patients developed chills, with an adverse reaction rate of 5.26% (P > .05).

Conclusion:
Calcitriol combined with bisphosphonates has a significant clinical effect in the treatment of postmenopausal OP, which can significantly relieve bone pain in postmenopausal OP patients, enhance abnormal bone metabolism and immune function, and promote bone mineral density and daily living ability.