bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast-enhanced computed tomography assisted diagnosis of bleeding caused by colonic angiodysplasia: A case report
Authors: Chen Yinze , Liu Xiaomin , Guo Liang , Tang Ying , Meng Xiangwei 
Published: October 2024

Rationale:
Angiodysplasia (AD) in the gastrointestinal tract is a degenerative vascular condition characterized by vascular dilation, tortuosity, and arteriovenous connections within the mucosal and submucosal layers. AD is a significant cause of lower gastrointestinal bleeding in the elderly, often presenting as chronic, intermittent hemorrhage. The research challenge lies in the potential for multiple and minute AD lesions to be missed during endoscopy, which may lead to post-hemostatic rebleeding.

Patient concerns:
An 82-year-old female with a history of coronary artery disease treated with aspirin, presenting with recurrent melena and anemia. The patient exhibited a suboptimal response to blood transfusions and octreotide therapy.

Diagnosis:
After excluding tumorous bleeding in the initial contrast-enhanced computed tomography (CECT), we suspect vascular bleeding as the most probable etiology.

Interventions:
The initial colonoscopy was unsuccessful due to the occurrence of ventricular tachycardia. Considering the patient’s advanced age, cardiac dysfunction, and frailty, a repeat CECT were conducted during episodes of suspected active bleeding. Vascular dilatation within the colonic hepatic flexure wall was visualized during the venous phase, accompanied by contrast agent extravasation into the intestinal lumen. The subsequent urgent colonoscopy and pathological specimens from surgical resection supported the diagnosis of colonic AD.

Outcomes:
After the surgery, the patient did not experience melena thereafter.

lessons:
We highlight that CECT for diagnosing AD-related bleeding offers higher safety and convenience, potentially superior to digital subtraction angiography, particularly in critically ill elderly patients.
Frequency of hepatitis D virus with different hepatitis B virus serological markers and coinfections in hospital patients from Argentina: synchronous testing of anti-HDV antibodies and HDV RNA
Authors: Giorgio Marianela , Ramírez Ladino Kelly Alejandra , López Guido , Sosa Rojas Maricel , Outon Estela , Delfino Cecilia María 
Published: October 2024

Background
Hepatitis D virus (HDV) RNA-positive cases with total anti-HDV antibodies nonreactive were documented. Moreover, HDV infection was observed in subjects with occult hepatitis B virus infection. The prevalence of HDV infection in Argentina is low; however, further research in different populations is needed.

Objective
This study aimed to perform synchronous HDV detection in reactive hepatitis B virus patients treated in a public hospital in the province of Buenos Aires, Argentina, some of whom were coinfected with hepatitis C virus and/or HIV. A total of 189 hepatitis B virus-reactive serum samples with or without hepatitis C virus and/or HIV coinfection were synchronously analyzed for anti-HDV antibodies and HDV RNA.

Results
HDV prevalence was 4.2% with HDV RNA found in 61 samples, most of which were nonreactive to anti-HDV antibodies and hepatitis B surface antigen. Genotype 1 was identified in all HDV sequences. Moreover, triple and quadruple infections were observed, showing a high frequency of HDV infection in hospitalized patients not following the recommended diagnostic algorithm.

Conclusions
This study is evidence that the synchronous testing of anti-HDV antibodies and HDV RNA is necessary for the diagnosis of HDV infection in Argentina. Finally, further research is necessary to identify high-risk populations and improve prevention and control strategies for triple and quadruple infections and their potential consequences.
Nonalcoholic fatty liver disease and colorectal cancer: a two-sample bidirectional Mendelian randomization analysis
Authors: Yang Li 
Published: October 2024

Objective
Observational studies suggest a connection between nonalcoholic fatty liver disease (NAFLD) and colorectal cancer (CRC) risk. It, however, remains unclear whether such a connection is causal. This study aims to examine the association between NAFLD and CRC using a two-sample bidirectional Mendelian randomization (MR) method.

Methods
Summary statistics for NAFLD were obtained from four genome-wide association studies, including 8434 cases and 770 180 controls. Meanwhile, CRC and controls (1803 vs. 174 006) were collected from the FinnGen. The inverse variance weighted (IVW) method was used primarily, while sensitivity analyses were conducted via the weighted median, MR Egger method, simple mode, and weighted mode to enhance result reliability.

Results
We found a positive correlation between NAFLD and CRC by IVW method in the forward MR analysis (odds ratio = 1.270, 95% confidence interval: 1.154–1.398, P = 1.092 × 10−6). Inverse MR analysis, however, suggested that CRC may not have a causal effect on NAFLD. Besides, we observed an absence of horizontal pleiotropy and heterogeneity in this MR analysis.

Conclusion
Our forward MR study found that NAFLD may increase CRC risk. In contrast, CRC may not have a causal relationship with NAFLD. This study provides genetic evidence supporting a cause-and-effect association between NAFLD and CRC.
Community Benefit and Tax-Exemption Levels at Non-Profit Hospitals Across US States
Authors: Oddleifson D. August , Dong Huaying , Wadhera Rishi K. 
Published: October 2024

Objective:
To assess the association between state policies and sociodemographic characteristics and state mean fair share spending at non-profit hospitals. Fair share spending is a hospital’s charity care and community investment less the estimated value of their tax-exempt status.

Background:
Hospitals with non-profit status in the United States are exempt from paying taxes. In return, they are expected to provide community benefits by subsidizing medical care for those who cannot pay and investing in the health and social needs of their community.

Methods:
We used a multivariable linear regression model to determine the association of state-level sociodemographics and policies with state-level mean fair share spending in 2019. Fair share spending data was obtained from the Lown Institute.

Results:
We found no association between the percentage of people living in poverty, in rural areas, or US region and fair share spending. Similarly, there was no association found for state minimum community benefit and reporting requirements. The state percentage of racial/ethnic minorities was associated with higher mean fair share spending [+$1.48 million for every 10% increase (95% CI: 0.01 to 2.96 million)]. Medicaid expansion status was associated with a 6.9-million-dollar decrease (95% CI: -10.4 to -3.3 million).

Conclusions:
State-level community benefit policies have been ineffective at raising community benefit spending to levels comparable to the value of non-profit hospital tax-exempt status.
Community-Level Social Vulnerability and Hip and Knee Joint Replacement Surgery Receipt Among Medicare Enrollees With Arthritis
Authors: Yi Sarah H. , Calanan Renee M. , Reid Michael J.A. , Kazakova Sophia V. , Baggs James , McLees Anita W. 
Published: October 2024

Objectives:
(1) Explore associations between county minority health social vulnerability index (MH-SVI) and total joint replacement (TJR), and (2) assess associations by individual-level race/ethnicity.

Background:
An expanded understanding of relevant social determinants of health is essential to inform policies and practices that promote equitable access to hip and knee TJR.

Methods:
Retrospective cohort study of Medicare enrollees. Centers for Medicare and Medicaid Services claims data were linked with MH-SVI. Multivariable logistic regression models were used to evaluate the odds of TJR according to the MH-SVI quartile in which enrollees resided. A total of 10,471,413 traditional Medicare enrollees in 2018 aged 67 years or older with arthritis. The main outcome was enrollee primary TJR during hospitalization. The main exposure was the MH-SVI (composite and 6 themes) for the county of enrollee residence. Results were stratified by enrollee race/ethnicity.

Results:
Asian American, Native Hawaiian, or Pacific Islander (AANHPI), Black or African American (Black), and Hispanic enrollees comparatively had 26%–41% lower odds of receiving TJR than White enrollees. Residing in counties within the highest quartile of composite and socioeconomic status vulnerability measures were associated with lower TJR overall and by race/ethnicity. Residing in counties with increased medical vulnerability for Black and White enrollees, housing type and transportation vulnerability for AANHPI and Hispanic enrollees, minority status and language theme for AANHPI enrollees, and household composition vulnerability for White enrollees were also associated with lower TJR.

Conclusions:
Higher levels of social vulnerability were associated with lower TJR. However, the association varied by individual race/ethnicity. Implementing multisectoral strategies is crucial for ensuring equitable access to care.
Prospects for gene therapy in polycystic kidney disease
Authors: Chakraborty Anubhav , Yu Alan S.L. 
Published: October 2024

Purpose of review
We aim to provide an updated perspective on the recent advancements in gene therapy for polycystic kidney disease (PKD), a genetic disorder with significant morbidity. Given the rapid evolution of gene therapy technologies and their potential for treating inherited diseases, this review explores the therapeutic prospects and challenges in applying these technologies to PKD.

Recent findings
Significant progress has been made in understanding the genetic underpinnings of PKD, making it a prime candidate for gene therapy. Re-expression of the PKD genes, treatment with the C-terminal tail of polycystin 1 protein and antagomir therapy against miR-17 have shown promise in reducing cyst formation and preserving kidney function. The rapid development of gene-editing tools, antisense oligonucleotide-based strategies, programmable RNA, and advanced gene delivery systems has opened new possibilities for PKD treatment. However, challenges such as off-target effects, delivery efficiency, and long-term safety remain significant barriers to clinical application.

Summary
Current research highlights the transformative potential of gene therapy for PKD. Ongoing studies are crucial to overcoming existing challenges and translating these findings into clinical practice. We highlight the need for multidisciplinary efforts to optimize gene-editing technologies and ensure their safety and efficacy in treating PKD.
A contemporary snapshot of familial hypercholesterolemia registries
Authors: Tamehri Zadeh Seyed Saeed , Pang Jing , Chan Dick C. , Watts Gerald F. 
Published: October 2024

Purpose of review
Familial hypercholesterolemia (FH) registries can capture unique data on FH concerning real-world practice, clinic epidemiology, natural history, cascade testing, cardiovascular consequences of late diagnosis, and use of healthcare resources. Such registries are also valuable for identifying and bridging the gaps between guidelines and clinical practice. We reviewed recent findings from the principal FH registries.

Recent findings
Most adult patients with heterozygous FH (HeFH) are diagnosed late, undertreated, and do not reach guideline-recommended low density lipoprotein-cholesterol (LDL-C) goals. In children and adolescents with HeFH, detection relies principally on genetic testing and measurement of LDL-C levels. Similarly, the majority of patients with homozygous FH (HoFH) receive sub-optimal cholesterol-lowering treatments and do not attain recommended LDL-C goals, gaps being wider in lower income than higher income countries. In HeFH patients, men have a higher risk of atherosclerotic cardiovascular disease than women.

Summary
The evolving data from FH registries provide real-world evidence for developing implementation strategies to address gaps across the continuum of care of FH worldwide.
Establishing an upper extremity transplantation program: lessons learnt over 12 years
Authors: Zuo Kevin J. , Zaccardelli Alessandra , Talbot Simon G. 
Published: October 2024

Purpose of review
As one of the early hand transplant programs in the world, we are often asked to educate other programs on the lessons we have learned and on how to set up a successful hand transplantation program.

Recent findings
Two decades of global experience with vascularized composite allotransplantation (VCA) of the upper limb have demonstrated improved functional outcomes and quality of life for carefully screened patients. Despite initial reticence about VCA, over 30 patients in the USA have benefited from hand transplantation, with around 80% long-term successes. We have experience with four bilateral upper extremity patients who have undergone bilateral upper extremity allotransplants. This review article highlights our personal experience and lessons with respect to VCA team assembly, logistics, patient selection, perioperative planning, the operative procedure, and postoperative management.

Summary
Continual learning and critical evaluation are crucial to maintaining a successful upper extremity VCA program. This will ensure that patients who stand to benefit most from this life-enhancing procedure are identified and are others optimized to achieve the best possible outcomes.
Infant Motor Milestones: Analysis of Content and Variability Among Popular Sources for Parents
Authors: Orlando Julie M. , Cunha Andrea B. , Namit Samantha , Banoub Abram , Alharbi Bashayer M. , Lobo Michele A. 
Published: October 2024

Purpose:
Evaluate the content and variability of infant motor milestone education provided to parents in popular sources.

Methods:
Sources were screened for inclusion, and their motor milestone content was coded. Descriptive and inferential analyses were performed.

Results:
Content from 241 websites, applications, and books was evaluated; 6984 motor milestones were extracted, representing 146 unique milestone codes across 14 categories. Books and applications had more milestone content than websites. There was variability in the milestones mentioned and their associated ages across the sources and relative to the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) content. Several frequently mentioned milestones were behaviors that facilitate early learning.

Conclusions:
There is variability among sources in the motor milestones they provide to parents of infants. The AAP and CDC content likely has some influence on the broader content available, but there is substantial deviation from the information they provide.
Superthin Anterolateral Thigh Flap for Head and Neck Reconstruction
Authors: Kamizono Kenichi , Kadota Hideki , Yoshida Sei 
Published: October 2024

This study was performed to clarify whether the superthin anterolateral thigh (ALT) flap is an appropriate choice for head and neck reconstructions requiring thinner and more pliable flaps. Data of patients who underwent head and neck reconstruction from January 2020 to December 2022 were retrospectively collected. Nine patients (4.2%) underwent reconstruction with a superthin ALT flap. All the flaps survived with no cases of total or partial necrosis. Six patients treated with superthin ALT flaps and 15 patients treated with conventional ALT flaps who underwent oral cavity reconstruction were compared. The mean body mass index was significantly higher in the superthin flap group than in the conventional ALT flap group (25.2 vs 21.2 kg/m2, respectively; P = 0.04). The rate of postoperative complications requiring debridement was 0% and 13% (P = 0.37). The mean postoperative Hirose score was 9.7 and 8.7 (P = 0.17). The mean postoperative Functional Oral Intake Scale score was 6.7 and 5.9 (P = 0.12). Secondary flap refinement surgery after facial skin reconstruction was performed in 0 of 2 patients (0.0%) in the superthin flap group and 4 of 52 patients (7.7%) in the conventional ALT flap group (P = 0.04). Oral cavity reconstruction with superthin ALT flaps did not increase the incidence of postoperative flap necrosis and resulted in comparable postoperative function. In addition, superthin ALT flaps did not require additional flap refinement surgeries after facial skin reconstruction. The superthin ALT flap is a safe and reliable choice for obese patients with thick thigh subcutaneous tissue.
Perioperative Management and Outcomes of Pediatric Craniosynostosis Patients Undergoing Cranioplasty: A Retrospective Analysis
Authors: Battistelli Elisa Zoe , Calabria Orlando , Giani Marco , Moretto Alessandra , Cattaneo Federico , Alberio Giovanni , Trezza Andrea , Ventura Maria Luisa , Mazzoleni Fabio , Biondi Andrea , Citerio Giuseppe , Giussani Carlo , Foti Giuseppe 
Published: October 2024

Cranioplasty is a major surgical procedure typically performed in children under 1 year of age, often associated with significant complications. The scientific literature on perioperative management for children with craniosynostosis undergoing cranioplasty is limited. The authors' objective was to retrospectively evaluate the management, complication rates, and outcomes among children undergoing cranioplasty at our institution. The authors conducted a single-center retrospective analysis of craniosynostosis children who underwent cranioplasty at Fondazione IRCCS San Gerardo dei Tintori between 2009 and 2023. 102 children were studied. Median admission age was 307 days, 30.4% of patients had syndromic disease; 28.4% underwent multi-suture cranioplasty. Median blood loss was 225 ml, and 85% of patients required red blood cell transfusion. There was a significant difference neither in indexed blood loss between the single and the multi-suture groups nor in perioperative transfusion requirement. 93.2% of patients in the single-suture group were extubated upon completion of the procedure against 65.5% of multi-suture group. No deaths were recorded. All patients were admitted to the intensive care unit after surgery. 8.8% patients suffered at least one complication. Airway management was the most common (7.8% of patients), intraoperative blood loss >90% of estimated blood volume occurred in 4 (3.9%) patients, whereas 3 children (2.9%) developed intracranial hypertension. Syndromic patients exhibited a significantly higher incidence of perioperative complications. Managing children’s cranioplasty perioperative care is challenging, especially in multi-suture and syndromic cases. These findings stress the importance of multidisciplinary collaboration, precise intraoperative management, and comprehensive postoperative monitoring.
Psychiatric Sequelae in Adult Open Globe Injury Patients
Authors: Ünal Gonca Ayşe , Özer Ömer 
Published: October 2024

Background:
The aim of this study was to investigate psychiatric sequelae in open globe injury patients and to identify the risk factors associated with these sequelae.

Methods:
After a complete ophthalmologic examination, Davidson Trauma Scale (DTS), State-Trait Anxiety Inventory (STAI), and Zung Depression Scale (ZDS) scores were administered to all patients. Patients were divided into 5 groups according to final best corrected visual acuity (BCVA): group 1 (no perception of light, NPL), group 2 [perception of light (PL) or hand movements (HM)], group 3 (1/200 to 19/200), group 4 (20/200 to 20/50), and group 5 (20/40 or above).

Results:
A total of 113 patients with open globe injuries were included. The mean ZDS scores were 78.5±35.9 in group 1, 66.2±24.5 in group 2, and 27.6±2.1 in group 5. In group 1, 8 patients (66.7%) had moderate depression. In group 2, 20 patients (60.6%) had mild depression. All patients in group 4 and group 5 had ZDS scores in the normal range. There is a statistically significant difference between the groups in terms of ZDS scores. In univariate analysis, depression (ZDS) and trauma (DTS) scores were associated with younger age (P=0.016 and P=0.003, respectively) and lower final visual acuity level (P<0.001, for both). In multivariate analysis adjusted for age and sex, a lower final visual acuity level (P<0.001, for both) was also associated.

Conclusions:
In conclusion, high anxiety and depression scores can be seen in open globe injury patients. Patients with young age and lower final visual acuity should be carefully screened, and the presence of a psychiatric pathology should be investigated. Amelioration of psychiatric pathologies may improve patient compliance with treatment and clinical success.
Speech Outcome Audit for Cleft Lip and Palate Patient Population Correlated With Veau Cleft Type, Surgical Repair Technique, and Patient Age
Authors: Raposo-Amaral Cassio E. , Gil André , Sabbag Anelise , Vincenzi-Lemes Marcela , Raposo-Amaral Cesar A. 
Published: October 2024

Objective:
The objective of this study is to determine speech outcome differences for specific palate repair techniques and correlate these data with patient age at the time of operation.

Methods:
A retrospective study was conducted on a cohort of consecutive nonsyndromic patients who underwent cleft lip and/or palate repair at the authors' hospital between 2010 and 2020. Only those patients who participated in at least 4 years of follow-up accompanied by audio-video recording were included. The patient cohort was divided into 2 age groups, between 1 year and 2 years of age versus older than 2 years of age. Standardized perceptual speech evaluations and nasopharyngoscopy were performed by the authors' team to detect the presence of velopharyngeal insufficiency.

Results:
A total of 481 patients were initially evaluated, and 323 of these patients met all inclusion criteria and were subsequently selected for this study. One hundred seventy-two patients (n = 172) underwent palatal surgery using the Bardach 2-flap palatoplasty technique, 47 patients (n = 47) underwent repair through the von Langenbeck palatoplasty technique, 78 patients (n = 78) underwent repair through Veau-Wardill-Killner palatoplasty technique, and 26 patients (n = 26) underwent repair through double-opposing Z-plasty palatoplasty. The rate of residual velopharyngeal insufficiency was statistically similar among all palatoplasty techniques. A comparison between these two age groups revealed that patients younger than 2 years of age showed higher speech outcome success.

Conclusion:
High rates of speech success are achieved for patients younger than 2 years of age. Speech outcomes success is maximized by proper technique selection in relation to cleft type.