bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Validation of a Prenatal Cell-Free DNA Screening Test for Fetal RHD in a Large U.S. Cohort
Authors: Gilstrop Thompson Marisa , Xu Wenbo , Moore Bridget , Wang Tina , Sun Nicholas , Pewar Hemant , Avent Neil D. , Vernaza Abelardo , Acosta Felipe , Saben Jessica L. , Souter Vivienne , Parmar Sheetal , Sengupta Urmi , Altug Yucel , EmBree Joshua , Cantos Carlos , Kotwaliwale Chitra , Babiarz Joshua , Zimmermann Bernhard , Swenerton Ryan , Meltzer Jeffrey T. 
Published: November 2024

OBJECTIVE:
To present a large U.S. clinical validation of a next-generation sequencing–based, noninvasive prenatal cell-free DNA test for fetal RHD.

METHODS:
This clinical validation study assessed the performance of a commercially available, next-generation sequencing–based cell-free DNA test for fetal RHD status. Samples that passed quality metrics were included if the patient had a previously reported cell-free DNA result for fetal aneuploidy, maternal RhD-negative serology, newborn RhD serology, and maternal RHD deletion or RHD-CE-D hybrid(r's) genotype. Dizygotic twin pregnancies were excluded. Maternal and fetal RHD genotypes were evaluated with prospective cell-free DNA next-generation sequencing analysis. At the time of analysis, investigators were blinded to fetal RhD status.

RESULTS:
The cohort consisted of 655 pregnant patients with serologic results for RhD antigen. Patient demographics included a representative distribution of race and ethnicities in the RhD-negative U.S. population (74.0% White, 13.7% Hispanic, 7.0% Black, and 2.1% Asian). Cell-free DNA fetal RHD was not reported in two cases. There were zero false-negative cases; 356 of 356 fetuses were correctly identified as fetal RhD positive (sensitivity 100%, 95% CI, 98.9–100%). Of the 297 RhD-negative fetuses, 295 were correctly identified as RhD negative (specificity 99.3%, 95% CI, 97.6–99.8%). Of the fetuses with a negative RhD phenotype, the cell-free DNA test accurately identified three with the fetal RHD pseudogene (RHDΨ) genotype.

CONCLUSION:
Validation of this test in this large U.S. cohort of RhD-negative patients provides data on early and accurate noninvasive prenatal identification of fetal RHD genotype at 9 weeks of gestation or more. This test has the potential to assist patients and clinicians in the prevention and management of RhD alloimmunization.
Effects of prolonged cold stress on vascular function in guinea pigs with atherosclerosis
Authors: Guan Wen-Xiang , Lan Zhuo , Wang Qing-Chun , Wa HaoRi , Muren Huhe , Bai Li-Li , Men SiRi , Liu Guo-Qing , Gao Jing-Xian , Bai Chang-Xi 
Published: November 2024

Research Objective:
This study explored the effects of long-term cold stress on aortic vascular function in guinea pigs. Research Methods: Hartley guinea pigs (n=32) were divided into following groups: atherosclerosis (AS), cold stress (CS), and menthol-stimulated (M) and control (C). On days 1, 15, 30, 45, and 60, guinea pigs in the AS, CS, and M groups were intraperitoneally injected with bovine serum albumin. The C group was provided with maintenance feed and room-temperature water. The AS group was provided with a high-fat diet and room-temperature water. The CS group was maintained in a refrigerator at 4 °C，while providing a high-fat diet and iced water. The M group was administered menthol solution, and provided with a high-fat diet and room-temperature water. The modeling period lasted for 120 days. On day 121, abdominal aortic sera and aortic samples were obtained after intraperitoneal injection of sodium pentobarbital. Blood rheology tests were conducted to assess blood adhesion, biochemical tests to assess lipid levels, and enzyme-linked immunosorbent assays to detect serum nuclear factor-κB, tumor necrosis factor-α, and interleukin-1β, and endothelial nitric oxide (NO) synthase, NO, and endothelin-1(ET-1) in aortic tissue. Hematoxylin and eosin and Oil Red O staining were used to examine pathologic changes in the aorta, western blotting to detect TRPM8 and PKG protein expression, qPCR was used to measure VCAM-1 mRNA expression level. Research findings: Prolonged exposure to cold stress exacerbated lipid-metabolism disorders in guinea pigs fed a high-fat diet, increased aortic vascular cell adhesion, and exacerbated vascular inflammation, leading to endothelial injury, ultimately worsening pathologic changes associated with aortic atherosclerosis.
Subperiosteal Abscess of the Orbit: Long-term Trends in Bacteriology and Clinical Outcomes and Current Management Recommendations
Authors: Boal Nina S. , Ataei Yasaman , Hong Sang H. , Wells Timothy S. , Griepentrog Gregory J. , Esmaili Neda , Chisholm Smith Ann M. , Harris Gerald J. 
Published: November 2024

Purpose:
To evaluate the impact over time of evolving upper respiratory pathogens, modified microbial terminology, and improved laboratory isolation on the bacteriology and management of sinusitis-related subperiosteal abscess of the orbit.

Methods:
Comparative case series of pediatric patients with bacterial sinusitis-related subperiosteal abscess from 2012 to 2022. Outcomes, culture results, age-specific findings, and antibiotic duration were compared with those in 1977 to 1992, 1988 to 1998, 1999 to 2008, and 2002 to 2012 cohorts at the same institution.

Results:
Ninety-one patients met the inclusion criteria. Forty-nine patients (53.8 %) recovered with medical therapy alone; 42 (46.2 %) underwent surgical drainage. There was increased representation in surgical cases of Streptococcus anginosus group (52.4%) and anaerobes (26.2%). Anaerobes were isolated from 2 patients <9 years of age, the youngest age 5; recovery in prior series was limited to patients ≥9 years old. Among 61 of 91 patients <9 years old, 41 (67.2%) were managed medically and 20 (32.8%) underwent surgery. Comparable proportions were 67.5%/32.5%, 85%/15%, and 72%/28% in prior cohorts. Among nonsurgical patients <9 years old, the mean duration of intravenous antibiotics was 4.02 ± 1.2 days. Four patients had multiple admissions. In cases positive for aggressive pathogens, initial findings prompted timely drainage. All patients had favorable visual and systemic outcomes.

Conclusions:
This study extends to 45 years a unique analysis of the bacteriology and clinical course of subperiosteal abscess at a single center with comparatively stable patient demographics and environmental factors, using a relatively uniform treatment algorithm. Despite the increased representation of S. anginosus group and anaerobes, a multifactor protocol with minor modifications remains an effective strategy.
Factor Structure and Measurement Invariance Across Sex of the Sport Concussion Assessment Tool Symptom Inventory
Authors: D'Alonzo Bernadette A. , Barnett Ian J. , Master Christina L. , Hamilton Roy H. , Wiebe Douglas J. , Schneider Andrea L. C. ,   Ivy League-Big Ten Epidemiology of Concussion Study Investigators
Published: November 2024

Objective:
Describe the factor structure of the 22-symptom Sport Concussion Assessment Tool (SCAT), using confirmatory factor analysis (CFA) for a priori hypothesized symptom domains.

Study Design:
Prospective observational study.

Setting/Participants:
Collegiate student-athletes with concussion.

Independent Variables:
Symptoms were collected via the SCAT symptom checklist.

Outcome Measures:
We created symptom domains based on previous literature, guided by clinical expertise. To determine which symptom grouping best represent the data, we used CFA and compared a single-domain model to 3- and 6-domains. We examined fit statistics to assess relative and absolute model fit. Motivated by differences in the prevalence of some individual symptoms by sex in our study, we also examined model invariance by sex to determine if symptoms were being measured as part of the same underlying construct(s).

Results:
Among 1160 concussions (male, n = 667; female, n = 493) between 2015 and 2020, all 3 symptom structures seemed to fit the data well, with 3- and 6-domains fitting better than 1-domain. The 6-domain structure fit the data best with the following domains: headache, vestibulo-ocular, sensory, cognitive, sleep, and affective. All 3 structures showed configural and metric invariance by sex.

Conclusions:
We demonstrate that the SCAT symptom structure is best represented through 6 specific factors; however, the 3-factor model also demonstrated good fit. Key differences between the 3- and 6-domain models may make 1 model more appropriate than the other depending on the research question being addressed. Symptom structures were configurally and metrically invariant by sex, meaning that symptom measures represent symptom domain factors in the same way across sex.
Tracheostomy: update on why, when and how
Authors: Lais Giulia , Piquilloud Lise 
Published: November 2024

Purpose of review
The aim of this review is to summarize available data, including the most recent ones, to help develop the best possible strategy regarding the use of tracheostomy in ICU patients requiring prolonged mechanical ventilation or who experience loss of airway-protecting mechanisms.

Recent findings
Tracheostomy facilitates the weaning process by reducing the patient's work of breathing and increasing comfort. It thus allows for a reduction in sedation levels. It also helps with secretions clearance, facilitates disconnection from the ventilator, and enables earlier phonation, oral intake, and mobilization. Despite these advantages, tracheostomy does not reduce mortality and is associated with both early and late complications, particularly tracheal stenosis. The timing of tracheostomy remains a subject of debate, and only a personalized approach that considers each patient's specific characteristics can help find the best possible compromise between avoiding unnecessary delays and minimizing the risks of performing a needless invasive procedure. In the absence of contraindications, the percutaneous single dilator technique under fibroscopic guidance should be the first choice, but only if the team is properly trained.

Summary
A step-by-step individualized approach based on the available evidence allows identifying the best strategy regarding the use of tracheostomy in ICU patients.
Alcohol-related liver and extrahepatic malignancies: burden of disease and socioeconomic disparities in 2019
Authors: Danpanichkul Pojsakorn , Suparan Kanokphong , Chaiyakunapruk Nathorn , Auttapracha Thanida , Kongarin Siwanart , Wattanachayakul Phuuwadith , Ramadoss Vijay , Suenghataiphorn Thanathip , Sukphutanan Banthoon , Pang Yanfang , Lui Rashid N. , Yang Ju Dong , Noureddin Mazen , Díaz Luis Antonio , Liangpunsakul Suthat , Arab Juan Pablo , Wijarnpreecha Karn 
Published: November 2024

Background
Alcohol is linked to various cancers. While many studies have focused on developed countries, the burden of alcohol-related cancers in developing countries remains underexplored.

Methods
We analyzed data from the Global Burden of Disease Study (2000–2019) to assess mortality and disability-adjusted life years (DALYs) from alcohol-related cancers in low and low-to-middle sociodemographic index (SDI) countries.

Results
In 2019, there were 494 730 mortality from alcohol-related cancer. Low and low-middle SDI countries contributed over 15% of global mortality of alcohol-related cancer. Among multiple types of cancer, other pharyngeal cancers in these countries accounted for over 30% of global mortality of alcohol-related cancer. Primary liver cancer exhibited the highest mortality (n = 16 090) in low and low-middle SDI countries. While deaths and DALYs rates from alcohol-related cancers decreased globally between 2000 and 2019, the related burden increased in low and low-middle SDI countries with a rise in all types of alcohol-related cancers, except for primary liver cancer. The most rapidly growing mortality rates in low SDI were from other pharyngeal cancers (+2.25%), whereas in low-middle SDI countries, colorectal cancer evidenced the highest increase (+2.76%).

Conclusion
The burden from alcohol-related cancer has risen in countries with low and low-to-middle SDI, especially other pharyngeal cancers and colorectal cancer. Policymakers should focus on improving alcohol-related policies as well as screening availability to tackle the associated burden of cancer in resource-constrained countries. However, the difficulty in isolating the impact of alcohol due to limited data on other confounders necessitates caution in interpreting these findings.
Delirium due to any cause is associated with higher resource utilization in patients undergoing liver transplantation: analysis of the National Inpatient Sample
Authors: Singh Carol , Billing Harbir S. , Bhupal Sahiljot Singh , Kohli Isha , Sohal Aalam , Roytman Marina 
Published: November 2024

Objective
The only curative treatment for patients with end-stage liver disease (ESLD) is liver transplantation (LT). Patients with ESLD can develop delirium due to multiple etiologies. In this study, we aimed to assess the prevalence and impact of delirium on outcomes and resource utilization among hospitalized patients undergoing LT.

Methods
We used the National Inpatient Sample Database 2016–2020 to identify adult patients undergoing LT. Patients were stratified into two groups based on the presence of delirium. The outcomes studied were in-hospital mortality, perioperative adverse events, and resource utilization. Multivariate logistic and linear regression analysis was used to identify the relationship between delirium and outcomes.

Results
Of 34 405 included patients, 4930 (14.3%) patients had delirium. Patients with delirium had a higher need for renal replacement therapy (31.7% vs. 17.6%, P < 0.001), vasopressor support (16.8% vs. 11.1%, P < 0.001), and mechanical ventilation (34.1% vs. 15.3%, P < 0.001). They also had higher total perioperative complications (77.3% vs. 60.4%, P < 0.001), longer length of stay (34.8 vs. 17. 7, P < 0.001), and total hospitalization charges ($927 200 vs. $565 486 P < 0.001). After multivariable analysis, patients with delirium had higher odds of perioperative complications (adjusted odds ratio: 1.54, 95% confidence interval: 1.24–1.92, P < 0.001) and resource utilization.

Conclusion
Our finding suggests the need for physicians to identify and reverse delirium as soon as possible.
Analysis of independent risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis combined with diabetes
Authors: Chen Huan , Cai Zihao , Da Binlin , Wang Chunxiang , Yin Qin , Xiao Jiangqiang , Zhang Ming , Zhuge Yuzheng , Zhang Feng 
Published: November 2024

Objective
This study aimed to reveal the independent risk factors for overt hepatic encephalopathy (OHE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with decompensated cirrhosis complicated with diabetes.

Patients and methods
This study retrospectively analyzed 126 consecutive patients with cirrhosis combined with diabetes who underwent TIPS in our department from January 2016 to June 2022. The patients were divided into two groups according to the presence or absence of OHE after TIPS. Data were analyzed using the χ2-tests, unpaired t-tests, logistic regression, receiver operating characteristic curves, and Kaplan–Meier curves.

Results
Age and ascites were independent risk factors for OHE after TIPS in patients with cirrhosis and diabetes. Elder patients had a higher risk of postoperative OHE than younger patients [odds ratio (OR): 1.040; 95% confidence interval (CI): 1.003–1.079]. Compared with patients without ascites, patients with ascites were significantly more likely to develop OHE (OR: 3.757; 95% CI: 1.274–11.080; OR: 4.338; 95% CI: 1.069–17.603).

Conclusion
Age and ascites are independent risk factors of post-TIPS OHE in cirrhotic patients with diabetes.
Proximal Muscle Resistance Training to Improve Walking in People With Multiple Sclerosis: A Pilot Study
Authors: Mañago Mark M. , Forster Jeri E. , Biondi Eliza , Schenkman Margaret , Cameron Michelle H. , Christiansen Cory L. 
Published: November 2024

Background and Purpose:
This pilot study examined the feasibility of a proximal muscle resistance training program to improve walking in people with multiple sclerosis using a combination of in-person, virtual, and independent exercise sessions.

Methods:
People with multiple sclerosis (Expanded Disability Status Scale Score is <6.0) were recruited to a study of resistance training exercises targeting hip abduction and trunk muscles for 10 weeks. Feasibility criteria were: enrolling 40 participants, retaining ≥80%, ≥80% visit adherence, no serious intervention-related adverse events, and ≥80% satisfaction. The 6-Minute Walk Test, Timed 25-Foot Walk Test, muscle performance (hip abduction and lateral trunk flexion strength, and trunk flexion endurance), patient-reported outcomes, daily step count, and pelvis and trunk kinematics were measured before and after intervention. Patient-reported outcomes and step count were measured again 12 weeks after intervention.

Results:
Twenty-eight people (median Expanded Disability Status Scale is 3.5) enrolled and 92.8% were retained. Visit adherence was 86.5% (96% for virtual visits, 74% for in-person visits), and 48% of participants preferred virtual visits, while 20% preferred in-person visits. There were no serious intervention-related adverse events, and there was 100% satisfaction. Following intervention, 6-Minute Walk Test distance increased 29.6 m (95% confidence interval [CI], 12.2-47.0), Timed 25-Foot Walk Test decreased by 0.57 seconds (95% CI, −0.85 to −0.29), and all muscle performance outcomes improved. Patient-reported outcomes also improved immediately following intervention. There were no changes in average daily step count or trunk and pelvis kinematics.

Discussion and Conclusions:
This proximal muscle resistance training program was feasible, with benefits in walking and muscle strength, warranting a future efficacy study.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A499).
Walking as a Mediator Between Strength and Health-Related Quality of Life in Multiple Sclerosis
Authors: Simaitis Laura B. , Gromisch Elizabeth S. , Demeule Alyssa , Murphy Rhiannon , Palumbo Corinne , DelMastro Heather M. 
Published: November 2024

Background and Purpose: Lower limb (LL) weakness and gait impairment are prevalent among persons with multiple sclerosis (PwMS) and can impede functional independence and impact health-related quality of life (HR-QoL). The purpose of this study was to examine the mediation effect of walking speed and perceived walking ability on the relationship between LL weakness and HR-QoL in ambulatory PwMS.

Methods:
Participants (n = 175) were PwMS in this secondary analysis of a cross-sectional study. Demographics, pain (visual analog scale), fatigue (5-item Modified Fatigue Impact Scale), LL strength (hip extensors [HE] and flexors [HF], knee extensors [KE] and flexors [KF], and ankle plantarflexors [APF] and dorsiflexors [ADF]), Timed 25-Foot Walk, 12-item MS Walking Scale, and HR-QoL (MS Impact Scale-Physical [MSIS-29-Phys] and Psychological [MSIS-29-Psych]) were collected. Bivariate and mediation analyses using Hayes’ PROCESS were performed to determine if LL strength had an indirect effect through walking speed or perceived walking ability on physical and psychological HR-QoL while controlling for fatigue and pain.

Results:
There were significant (P < 0.01) correlations for all strength measures with the MSIS-29-Phys and for HF, KE, KF, and APF with the MSIS-29-Psych. In the mediation analyses, LL strength indirectly influenced PwMS’ MSIS-29-Phys through walking speed and perceived walking ability. There was only partial mediation between HE, HF, KF, ADF, and MSIS-29-Phy when walking speed was in the model. LL strength did not influence MSIS-29-Psych.

Discussion and Conclusions:
LL strength impacts physical HR-QoL through walking but does not indirectly affect PwMS’ perceived psychological HR-QoL. These findings may prompt physical therapists to create individualized care plans that address LL weakness and walking impairments with the goal of promoting optimal outcomes and improving HR-QoL.

Video Abstract available
for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A504).
Understanding the Impact of Ergonomic Practices on Musculoskeletal-Related Symptoms and Emotional Wellness in Craniofacial Surgeons
Authors: Scarcella Joshua , Keane Charles A. , Hoque Asef R. , Feczko Robert J. , Janis Jeffrey E. 
Published: November 2024

Background:
A systematic review conducted in 2017 found that Musculoskeletal (MSK) injuries were prevalent among surgeons. Few studies have assessed the role that poor surgical ergonomic practices have had in the development of MSK injuries in plastic and reconstructive surgery (PRS), and fewer specifically in craniofacial surgeons. The impact that MSK injuries have on the emotional well-being of craniofacial surgeons is also not well understood.

Methods:
A branched logic survey with a maximum of 35 questions pertaining to surgical practices, MSK injuries, and emotional well-being was distributed to all active attending physicians who were members of the American Society of Maxillofacial Surgeons (ASMS). The responses were divided into 2 groups, surgeons who reported developing MSK injuries or physical discomfort and those who denied developing MSK injuries or physical discomfort. Data analysis was performed to determine which factors contributed to the incidence of MSK injury and the emotional impact that these injuries had on craniofacial surgeons.

Results:
A total of 82 active craniofacial surgeons completed responses to the survey for an overall response rate of 16.6%. Of these respondents, 65.9% (n=54) suffered MSK injuries or physical discomfort, and 53.7% (29/54) reported difficulty with either falling asleep or staying asleep because of these symptoms within the last year. Both male and female respondents reported experiencing some level of anxiety or depression because of their MSK injuries.

Conclusion:
The impact of a MSK injury may impact both physical and emotional wellness of craniofacial surgeons. This study found that a high percentage of craniofacial surgeons have MSK-injuries whereas some have reported a negative impact on their sleep and emotional well-being.
Assembly of Custom Implant and Ready-Made Distractor for Precise Maxillary Movement Vector Control in Cleft Patient With Midfacial Hypoplasia
Authors: Jeong Ye-Eun , Kim Eun-Young , Lee Ui-Lyong 
Published: November 2024

This study presents a novel approach for maxillary advancement in a patient with cleft lip and palate, utilizing the assembly of a custom titanium implant and a ready-made distractor. The patient exhibited significant maxillary hypoplasia and had concerns regarding the possible deterioration of hypernasality after conventional surgical methods. Distraction osteogenesis was initiated to address these challenges. A custom plate was designed using 3-dimensional printing technology. Integrating the plates with off-the-shelf distractors enables precise control of the distraction vector to optimize surgical precision and outcomes. The treatment plan involved Le Fort I osteotomy, followed by a distraction protocol that achieved a skeletal Class I relationship and total advancement of 7.5 mm and elongation of 2 mm, with no reported complications. This case demonstrates that combining custom implants with standard distractors can provide precise maxillary repositioning at reasonable costs, while mitigating the risks associated with traditional surgical interventions and reducing the need for secondary corrective surgeries.