bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simplified ischemia-free liver transplantation by providing alternating flow of the portal vein and hepatic artery: Applicability, efficiency, and safety
Authors: Li Jiahao , Qin Meiting , Tang Yunhua , Dan Jia , Chen Honghui , Chen Huadi , Huang Jinbo , Yang Yongqi , Wang Tielong , Li Yefu , Chen Maogen , Ju Weiqiang , Wang Dongping , Guo Zhiyong , Tan Haidong , He Xiaoshun , Zhao Qiang 
Published: December 2024

Conventional ischemia-free liver transplantation (CIFLT) represents a pioneering procedure that circumvents ischemia-reperfusion injury to livers throughout the transplant procedure. However, its complexity has limited its widespread adoption. This study introduced a simplified ischemia-free liver transplantation (SIFLT) technique by providing an alternating flow of the portal vein and hepatic artery, demonstrating its efficacy and safety. In this retrospective study, 32 patients who received SIFLT and 32 who received CIFLT were included between January 2021 and January 2024. The intraoperative and postoperative outcomes were collected and elevated. Patients who underwent SIFLT had a shorter anhepatic phase (44.0±2.4 vs. 51.6±2.4 min, p=0.03), along with a comparatively reduced intraoperative blood loss compared to those who underwent CIFLT. Furthermore, the SIFLT group exhibited significantly lower peak AST levels within postoperative 7 days (413.1±62.6 vs. 707.5±110.7 U/L, p=0.02). The incidence of early allograft dysfunction, primary nonfunction, and transplant-related complications were similar across both groups. There were no significant differences in the number of Clavien-Dindo classification of surgical complications and comprehensive complication index at 3 months after transplantation. Kaplan-Meier analysis confirmed similar patient and graft survival rates. The subgroup analysis of extended criteria donor demonstrated that SIFLT can effectively reduce anhepatic phase and intraoperative blood loss and can achieve a clinical prognosis similar to CIFLT. Additionally, histological analysis revealed that both groups demonstrated well-preserved livers and bile ducts. The SIFLT simplifies the intricate surgical procedure while ensuring the protection of livers from ischemia-reperfusion injury. This technique holds promise for enabling patients to achieve clinical outcomes comparable to those of CIFLT.
Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights
Authors: James Matthew D. , Berton Danilo C. , Neder J. Alberto 
Published: December 2024

Purpose of review
Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity.

Recent findings
Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions.

Summary
Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.
Effect of the allelic background on the phenotype of primary hyperoxaluria type I
Authors: Mandrile Giorgia , Cellini Barbara , Ferraro Pietro Manuel 
Published: December 2024

Purpose of review
Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disorder of hepatic glyoxylate metabolism leading to nephrolithiasis and kidney failure. PH1 is caused by mutations on the AGXT gene encoding alanine:glyoxylate aminotransferase (AGT). The AGXT gene has two haplotypes, the major (Ma) and the minor (mi) alleles. This review summarizes the role of the minor allele on the molecular pathogenesis and the clinical manifestations of PH1.

Recent findings
PH1 shows high genetic variability and significant interindividual variability. Although the minor haplotype is not pathogenic on its own, it may be crucial for the pathogenicity of some mutations or amplify the effect of others, thus affecting both symptoms and responsiveness to Vitamin B6, the only pharmacological treatment effective in a selected group of PH1 patients.

Summary
In the last years, new drugs based on RNA-interference are available for patients nonresponsive to Vitamin B6, but no specific biomarkers are available to predict disease course and severity. Therefore, a clinical assessment of PH1 taking into account molecular analysis of the mutations and the allelic background and the possible synergism among polymorphic and pathogenic variants should be encouraged to promote approaches of personalized medicine that improve the management of available resources.
Virtual Reality as Active Distraction in Laceration Repair
Authors: McEvoy Anne O. , Vincent Olivia B. , Vazifedan Turaj , Chang Todd P. , Clingenpeel Joel M. , Kapoor Rupa 
Published: December 2024

Objectives:
We conducted an unblinded, randomized control trial to determine if immersive virtual reality (VR) goggles decrease pain and fear scores in children undergoing laceration repair in the pediatric emergency department (PED) compared to the standard of care. Secondary outcomes included duration of procedure, physical holding, anxiolytic usage, and desire to use VR goggles again.

Methods:
Ninety-one patients aged 6-17 years in a PED with simple lacerations sutured by PED staff completed surveys. Eligible patients were randomized to receive either VR or standard of care. Guardians and providers also completed surveys. Self-reported pain scores were assessed by the Wong-Baker Faces Pain Scale and fear scores by Children's Fear Scale.

Results:
There were significant reductions in pain and fear scores for VR goggles compared to standard of care. Patients rated their mean pain score as 3.7 in controls and 2.3 in the VR group, and mean fear score of 3.0 and 2.2. The likelihood of physical holding was significantly lower among those who used VR goggles (adjusted odds ratio = 0.34, 95% confidence interval [0.13–0.92], P = 0.033). The likelihood of receiving anxiolytics was lower among the 12- to 17-year-olds (adjusted odds ratio = 0.27, 95% confidence interval [0.11–0.69], P = 0.006). There was no significant difference in the procedure duration (P = 0.06). A total of 97.9% of parents, 93.6% of patients, and 95.7% of providers would use VR again.

Conclusion:
Virtual reality goggles are an effective tool for distraction for simple laceration repairs. Their use leads to decreased pain and fear. Children who used VR goggles did not require to be held as often for sutures. There was no significant difference in anxiolytics or duration of procedure.
The impact of stroke impairment and phases in daily steps of stroke survivors living in community: a systematic review with meta-analysis
Authors: Guediri Amine , Mandigout Stéphane , Agbohessou Kokouvi Geovani , Daviet Jean-Christophe , Compagnat Maxence 
Published: December 2024

Abstract

Objectives
to provide detailed information about the number of steps taken by stroke survivors based on their level of impairment in order to guide recommendations for PA.

Design
A meta-analysis was conducted, including studies that assessed daily steps and stroke impairment in community-dwelling stroke patients. Participants were categorized into three groups based on stroke impairment severity (minor, minor and moderate, moderate and severe) and into two groups based on stroke phase (subacute and chronic).

Results
A total of 47 studies were included, encompassing 1749 participants. There were 494 in the minor stroke group, 1097 in the minor and moderate group, and 158 in the moderate and severe group. A significant difference in daily steps was observed across these groups (P < 0.01), with the first group averaging 4645 steps/day, the second 3610 steps/day, and the third 1990 steps/day. No significant difference was found between the subacute and chronic groups in terms of daily steps (3839 vs 3783 steps/day).

Conclusion
The study highlights the significant impact of stroke impairment on daily step count. We recommend implementing targeted interventions, particularly during the chronic phase, to increase PA levels in stroke survivors, tailored to the specific impairments of each patient.
Risk factors for cognitive decline in persons with HIV
Authors: Henderson Merle , Winston Alan 
Published: December 2024

Purpose of review
Cognitive disorders persist in persons with HIV, despite virologically suppressive antiretroviral therapy. We summarize the current evidence on risk factors for cognitive decline in persons with HIV in the modern antiretroviral therapy-era.

Recent findings
Recent consensus recommendations have proposed a new approach for defining cognitive impairment in persons with HIV, which distinguishes true cognitive impairment from low cognitive performance alone and considers both HIV and non-HIV-associated causes of brain injury. Adverse mental health, risks associated with substance misuse, and an increasing burden of age-related comorbidities have been highlighted as important contributors toward cognitive decline in this population. Aging may potentiate these risk factors through polypharmacy and drug-drug interactions.

Summary
Cognitive decline in persons with HIV is likely multifactorial, with contributions from both HIV and non-HIV-associated mechanisms, particularly age-related comorbidities. With an aging community of persons with HIV, screening for risk factors associated with cognitive decline may be crucial to implement appropriate risk reduction strategies.
Early Detection of Basal Cell Carcinoma of Skin From Medical History
Authors: Lin Yili 
Published: December 2024

Background and Objectives:
Basal cell carcinoma (BCC) is the most common form of skin cancer, originating from basal cells in the skin’s outer layer. It frequently arises from prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. Although BCC rarely metastasizes, it can cause significant local tissue damage if left untreated. Early detection is essential to prevent extensive damage and potential disfigurement. The United States Preventive Services Task Force (USPSTF) currently remains uncertain about the benefits and potential harms of routine skin cancer screenings in asymptomatic individuals. This paper evaluates the accuracy of predicting BCC using patients’ medical histories to address this uncertainty and support early detection efforts.

Methods:
We analyzed the medical histories of 405,608 patients, including 7733 with BCC. We categorized 25,154 diagnoses into 16 body systems based on the hierarchy in the Systematized Nomenclature of Medicine (SNOMED) ontology. For each body system, we identified the most severe condition present. Logistic Least Absolute Shrinkage and Selection Operator (LASSO) regression was then employed to predict BCC, using demographic information, body systems, and pairwise and triple combinations of body systems, as well as missing value indicators. The dataset was split into 90% for training and 10% for validation. Model performance was evaluated using McFadden’s R2, Percentage Deviance Explained (PDE), and cross-validated with the area under the receiver operating characteristic curve (AUC).

Results:
Diagnoses related to the Integument system showed an 8-fold higher likelihood of being associated with BCC compared to diagnoses related to other systems. Older (age from 60 to 69) white individuals were more likely to receive a BCC diagnosis. After training the model, it achieved a McFadden’s R2 of 0.286, an AUC of 0.912, and a PDE of 28.390%, reflecting a high level of explained variance and prediction accuracy.

Conclusions:
This study underscores the potential of LASSO Regression models to enhance early identification of BCC. Extant medical history of patients, available in electronic health records, can accurately predict the risk of BCC. Integrating such predictive models into clinical practice could significantly improve early detection and intervention.
A Study Analysing the Distribution and Determinants of Diabetic Macular Edema in a Tertiary Care Center
Authors: Priethikka M. S. , Chandrasekaran B. , Subha L , Chellakumar Vikram , Balakrishnan M , Solasa Deepthi 
Published: December 2024

ABSTRACTAIMThis study aims to examine the correlation between the specific type of diabetic macular edema (DME) identified using Optical Coherence Tomography (OCT) and various factors, including patient age, gender, diabetic profile (fasting blood sugars, postprandial blood sugars, and HbA1c), duration of Type 2 Diabetes Mellitus, and central macular thickness on OCT.OBJECTIVEThe study intends to investigate the relationships between the age of patients and DME type, gender prevalence in DME, duration of Type 2 Diabetes Mellitus and DME type, diabetic profiles and DME type, central macular thickness and DME type, and severity of diabetic retinopathy and DME type.IntroductionDiabetic maculopathy is a major cause of vision impairment in diabetic retinopathy. This study explores the relationship between DME types as determined by OCT and factors such as age, gender, diabetic profile, and diabetes duration.Materials and MethodsConducted over one year at a tertiary health care center, the study evaluated 95 patients with diabetic maculopathy through comprehensive clinical assessments including OCT classification of DME types.ResultsThe findings indicated a higher prevalence of DME among males, predominantly in the 61- 70 age group. A significant association was found between diabetes duration and mixed-type DME. However, no significant correlations were observed between glycemic control measures (FBS, PPBS, HbA1c) and DME types.ConclusionThe study underscores the importance of demographic and clinical factors in understanding variations in DME types, highlighting the need for tailored management strategies to reduce vision loss risk in diabetic patients.
Caregiver’s Decision to Report Adverse Drug Reactions among Children Receiving Seasonal Malaria Chemoprevention in Ghana
Authors: Mohammed Abdul Gafaru , Dadzie Dora , Asumah George Adu , Adomako Isaac , Idun-Acquah Joel Jeffrey , Boateng Paul , Peprah Nana Yaw , Malm Keziah L. 
Published: December 2024

AbstractIntroductionThe antimalarial medicines used in Seasonal Malaria Chemoprevention (SMC) campaigns are generally well-tolerated but adverse drug reactions (ADRs) can occur. Monitoring, reporting, and prompt management of ADRs is essential to build and maintain trust in SMC campaigns in the implementing communities. The caregiver’s decision to report ADRs represents a critical issue at the intersection of public health, child welfare, and pharmacovigilance. As SMC campaigns continue to expand, it is imperative to understand and address the factors influencing caregivers’ decisions to report ADRs.MethodsA mixed methods cross-sectional study involving questionnaire administration, focus group discussions, and review of children’s health records was employed to collect data from caregivers of children aged 3-59 months in the Northern, North-East, and Savanna regions of Ghana. A systematic random sample of 679 caregivers was recruited for the study across three regions. Data including ADR occurrence, maternal and child characteristics was collected from selected caregivers in their homes. Logistic regression was performed for associations between caregiver’s reports of ADRs and caregiver characteristics.ResultsAbout 49.5% (336/679) of caregivers mentioned the occurrence of ADRs in children after receiving SMC medication. The commonly cited ADR was diarrhea (34.7%, 116/336). Only 16.9% (57/336) of caregivers reported ADRs to the health workers at the time of occurrence. After adjusting for confounders, increasing age of child (aOR=1.04, 95%CI:1.008-1.065), receiving education on ADR reporting (aOR=4.03, 95%CI:4.366-6.119), education on management of mild ADRs (aOR=4.43, 95%CI:2.094-9.808) and having a means of reaching health personnel (aOR=1.56, 95%CI:1.202-2.037) increased the odds of ADR reporting while increasing age of caregivers (aOR=0.92, 95%CI:0.883-0.966) and being married (aOR=0.17, 95%CI:0.149-0.183) decreased the odds of reporting ADRs among the caregivers studied.ConclusionLess than 20% of caregivers whose children experienced ADRs after receiving SMC medication reported the incident. Caregiver education on ADRs and it’s management and means of reaching the health team were modifiable factors that influenced caregiver ADR reporting.
Risk stratification in hip and knee replacement using Artificial Intelligence: a dual centre study to support the utility of high-volume low-complexity hubs and ambulatory surgery centres
Authors: Woodward Christopher , Green Justin , Reed MR , Beard David J , Williams Paul R 
Published: December 2024

ABSTRACTThe COVID-19 pandemic has resulted in a significant backlog of hip and knee replacement surgeries in the United Kingdom (UK).1,2To address this, surgical hubs have been proposed to enhance efficiency, particularly for high-volume, low-complexity cases.3,4These hubs and Ambulatory Surgery Centres often lack higher level care support such as intensive care facilities and are thus suited to patients with less co-morbidity and systemic illness. Pre-operative risk assessment is required to enable correct patient allocation to the appropriate site and reduce unwarranted risk.This study explores the use of artificial intelligence (AI) for risk stratification in hip and knee arthroplasty. A polynomial regression model was developed using patient demographics, blood results, and comorbidities to assign risk scores for postoperative complications. The model was generated from 29,658 patient records from two UK National Health Service (NHS) healthcare organisations. It demonstrated an area under the receiver operating characteristic curve (AUROC) as the evaluation metric and was capable of categorising patients into high and low risk. Validation was performed using a retrospective analysis of 445 patients. Predicted versus actual complications and need for further care were used to examine agreement. The model’s sensitivity was 70% for identifying high-risk patients and had a negative predictive value of 96%. This AI risk prediction was comparable to consultant-led care in risk stratification.These findings suggest that AI can support more streamlined and efficient preoperative risk stratification, potentially reducing the burden on preoperative assessment teams and optimising resource allocation. While not without limitations, the AI model offers a sophisticated adjunct to clinical decision-making around determining risk. This can support facilities like hubs in the UK NHS or Ambulatory Surgery Centres in the United States.
Native trees within plantations and surrounding forest cover are essential for bird conservation in cashew-dominated landscapes within a biodiversity hotspot
Authors: Madhu Nandita , Sadekar Vishal , Biswas Nayantara , Jayapal Rajah , Rege Anushka , Naniwadekar Rohit 
Published: December 2024

ABSTRACTAnnually, agriculture is responsible for about 60% of tropical forest loss globally.strategies in agricultural landscapes range from enhancing farm-level habitat diversity to retaining forest cover within landscapes. A critical question is determining the relative influence of native trees within farms and forest cover around them on avian diversity, trait responses and species persistence in tree-based systems in landscapes where protected areas are often absent, often the case in lowland tropical forest ecosystems.By sampling birds across gradients of cashew plantation intensification and varying levels of surrounding cashew and forest cover, we examined the relative influence of site- and landscape-level factors on species composition, taxonomic, functional, and phylogenetic diversity, as well as species- and trait-specific responses, and whether phylogenetic relationships among bird species influenced these responses.At the community level, forests, cashew agroforests, and cashew monocultures hosted compositionally different bird communities. Site-level variables, specifically the proportion of native trees, influenced taxonomic and phylogenetic diversity, while landscape-level variables had no effect. None of the predictor variables accounted for the variation in functional diversity.At the species level, site-level variables, specifically the proportion of native trees, and landscape-level variables, particularly cashew cover around plantations, had positive and negative impacts on species responses, respectively. At the trait level, evergreen forest specialists were associated positively with the proportion of native trees and negatively associated with cashew cover. Resident species had a positive association with forest cover. We found a phylogenetic signal in species responses to predictor variables, indicating that closely-related species responded similarly to predictor variables.Synthesis and applications: To retain taxonomic and phylogenetic diversity and ensure persistence of evergreen forest specialists, it is essential to retain native trees within cashew plantations and maintain surrounding forest cover. Future policies should incentivise the retention and restoration of forest patches and restrict the felling of native trees within cashew plantations.