bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhinosporidiosis Presenting as a Large Oral Cavity Mass: A Case Report
Authors: Swain Santosh Kumar 
Published: October 2024

Background: Rhinosporidiosis (RS) is a chronic granulomatous infection that primarily impacts the mucous membranes of the nose and nasopharynx. The diagnosis of RS is usually done by the clinical presentations and confirmed by histopathological study. The diagnosis of RS may be delayed when the extra-nasal sites are involved. Wide and complete excision of the lesion by thorough electro-cautery is usually recommended. Case Report: A 25-year-old male patient attended the outpatient department of otorhinolaryngology with a chief complaint of swallowing difficulty and sensation of foreign body in the oral cavity and oropharynx for 3 months. Conclusion: Rhinosporidiosis (RS) is an enigmatic disorder with a debatable mode of infection and the nature of the etiological agent. Atypical and extra-nasal cases of RS should be carefully diagnosed, managed, and monitored throughout their clinical course.
Exploring Denosumab’s potential in aneurysmal bone cyst treatment: A scoping review
Authors: Sandhu Vinesh , Ajit Singh Vivek , Puri Ajay 
Published: October 2024

Background: Denosumab effectively treats RANKL-mediated bone disorders by inhibiting osteoclast activity. While approved for giant cell tumours, its role in aneurysmal bone cysts (ABC) remains unclear. This review explores denosumab’s application in ABCs, focusing on its role, outcomes, and adverse effects. Methods: A scoping review adhering to PRISMA Extension for Scoping Reviews guidelines was conducted. The search involved five databases from inception until 31 December 2023. Results: From an initial 390 studies, 29 were selected post-screening involving 67 patients. The most common ABC sites were the spine ( n = 42) and pelvis ( n = 7). Denosumab served as primary treatment in 25 patients (37.3%), neoadjuvant in 11 (16.4%), second-line therapies after inadequate initial therapies in 24 (35.8%), and adjunct therapy in seven cases. All patients demonstrated favourable clinical and radiological responses post-denosumab. 10 patients (15%) experienced tumour recurrences: six after denosumab discontinuation (3-17 months post-cessation), three post-surgery following neoadjuvant denosumab, and one during ongoing treatment. Adverse effects reported were hypocalcaemia ( n = 10), hypercalcemia ( n = 14), and sclerotic metaphyseal bands ( n = 2), all in the paediatric age group. While hypocalcaemia surfaced early in denosumab therapy, hypercalcaemia manifested 2.5-6 months post-discontinuation, mainly managed with bisphosphonates. Fewer than half of the studies had follow-ups that exceeded 2 years. Conclusion: Denosumab may be an effective therapy for ABC, especially for high-risk cases like spinal and pelvic tumours. It can also be utilized as a second-line for recurrence/failed initial intervention or as neoadjuvant therapy. Concerns exist about tumour recurrence and rebound hypercalcemia, necessitating careful monitoring, longer follow-up, and prophylactic measures. Prospective clinical trials are warranted for deeper insights.
Geographic atrophy progression secondary to age-related macular degeneration: Five years of follow-up
Authors: Sadeghi Elham , Valsecchi Nicola , Vupparaboina Sharat Chandra , Mehrotra Kunaal , Vupparaboina Kiran Kumar , Bollepalli Sandeep Chandra , Sahel Jose-Alain , Eller Andrew W , Chhablani Jay 
Published: October 2024

Purpose To study the progression of geographic atrophy (GA) secondary to age-related macular degeneration over a five-year follow-up. Methods Eyes with GA included to assess demographic data, yearly optical coherence tomography (OCT) findings and the GA growth rate on infra-red (IR) images. Results A total of 41 eyes of 29 patients were included with a mean age of 81.76 ± 6.37 at baseline, and 65.51% were females. Over five years, there was a significant increase in the mean GA area from 8.44 ± 8.98 mm² to 13.32 ± 10.07 mm² (P < 0.001), with an annual growth rate of 1.14 ± 0.78 mm². The annual growth rates in females were slightly higher compared to males (1.29 ± 0.89 mm2 vs 0.96 ± 0.49 mm2, p = 0.569), and in smokers was slightly higher than non-smokers (1.35 ± 0.85 mm2 vs 0.94 ± 0.66 mm2, p = 0.100). Larger GA areas at the baseline showed higher GA progression in mm2 per year (P = 0.04). Smaller GA areas and fovea-spared GA at the baseline exhibited a larger percentage increase (P < 0.001 and P = 0.015, respectively). There was a lower GA progression rate in eyes with outer retinal tubulations (ORT) (P = 0.027), yet no significant correlation was found between GA progression and other OCT features. Conclusions Smaller, fovea-sparing GA eyes experienced a more substantial proportional increase over five years. Also, The presence of ORT was associated with a slower rate of GA progression. Additionally, we observed a trend of faster GA growth in smokers and female genders.
Effect of preoperative heart failure on arteriovenous access patency and prognosis in patients on hemodialysis
Authors: Han Youngjin , Choi Eol 
Published: October 2024

Background: The risk of arteriovenous (AV) access failure is associated with hemodynamic factors, clinical factors, or technical issues. Although several studies have shown the detrimental effects of AV access on heart function, few studies have assessed whether heart function affects AV access patency. We investigated the impact of cardiac function on AV access patency. Additionally, we evaluated the influence of heart failure (HF) on the prognosis of patients on dialysis. Methods: Patients who underwent dialysis and had echocardiographic reports between 2011 and 2013 were retrospectively included. Left ventricular ejection fraction (LVEF) was used to measure cardiac function. Data on demographics, clinical features, and technical factors associated with AV access surgery were collected. Univariate and multivariate analyses were performed to evaluate the risk factors for AV access patency loss and the prognosis of patients on dialysis. Results: During the study period, 395 patients initiated on dialysis underwent echocardiography. In multivariate analysis, older age (hazard ratio (HR) 1.02 (1–1.03), p = 0.028), smoking (HR 2.05 (1.19–3.53), p = 0.01), lower LVEF (HR 0.98 (0.97–1), p = 0.015), and graft use (HR 2.29 (1.47–3.58), p = 0.001) were significant risk factors for primary patency loss. Regarding secondary patency loss, lower LVEF (HR 0.98 (0.96–1), p = 0.035) was the sole risk factor. In multivariate analysis, risk factors for cardiac events (acute coronary syndrome and aggravation of HF) in patients on dialysis were age (HR 1.06 (1.04–1.09), p = 0.001), diabetes (HR 2.46 (1.31–4.63), p = 0.005), pre-existing coronary artery disease (HR 2.84 (1.57–5.14), p = 0.001), and HF (HR 1.93 (1.05–3.56), p = 0.036). Conclusion: Decreased cardiac function adversely affects the primary and secondary patency of AV access, but its impact is limited. Additionally, HF is associated with future cardiac events in dialysis patients. However, HF is not independently associated with patient survival.
The management of high flow arteriovenous fistula and possible solutions
Authors: Cristiano Fabrizio , Lodi Massimo 
Published: October 2024

Background: The development of a high flow rate arteriovenous fistula (AVF) can expose the patient to development of heart failure due to increased cardiac preload and pulmonary hypertension. Objectives: AVF flow measurement (Qa) is considered a screening tool for AVF surveillance, aiming to evaluate the access dysfunction and prevent complications, like a non-maturation, suspected stenosis, high-flow AVF, and distal ischemia. In the upper arm AVF, a high Qa may develops, which can expose the patient to the risk of high-output heart failure and ischemia. Although, the exact threshold to define high-flow access is not universally accepted, AVF with a Qa of 1–1.5 L/min or cardio-pulmonary recirculation (Qa/CO) >20% are considered at risk. Subjects: In our work we describe the treatment performed in three patients with high flow AVF treated with DRIL technique with interposition of a Prosthetic Patch, revascularization procedures such as distal inflow revision or RUDI and with innovative technique a “tench snout,” removal the previous anastomosis and reconstruction of the integrity of the radial artery at the terminal in pre and post anastomosis. A PTFE prosthetic segment measuring 5 cm in length and 5 mm in diameter was interposed, terminally anastomosed with the efferent cephalic vein and terminally lateral with the radial artery, reducing the anastomosis to approximately 4 mm. Results: All treated patients showed a clear improvement in the clinical picture in particularly heart failure. The calculation of the post-intervention flow rate approximately 1500 mL/min. Conclusion: The patient on hemodialysis with arteriovenous fistula must be constantly monitored with clinical examination, monitoring during the hemodialysis session and color Doppler ultrasound of the AVF with calculation of the flow rate. The surgical technique used for flow reduction is chosen on the surgical experience of each operator with the main objective of preserving the autologous AVF.
Optimizing venous anastomosis for forearm loop arteriovenous grafts: A comparative analysis of elbow veins and upper arm basilic veins in end-stage kidney disease patients
Authors: Oh Young Ju , Kim Hyo Kee , Park Jee Hyun , Jung Cheol Woong , Jun Heungman 
Published: October 2024

Introduction: Optimizing vascular access for hemodialysis in end-stage kidney disease is crucial. While arteriovenous fistulas (AVFs) are preferred for better patency and fewer complications, many patients require alternatives options like arteriovenous grafts (AVGs) due to anatomical constraints. This study compares outcomes between elbow and upper arm (UA) basilic veins for forearm loop AVGs, highlighting the potential benefits of the UA basilic vein to improve patency and feasibility in patients with poor elbow veins through retrospective analysis. Methods: This retrospective study analyzed 59 limbs of patients who underwent forearm loop AVG formation from January 2018 to June 2022. Elbow veins (basilic, median cubital, brachial) and UA basilic veins were evaluated for suitability using duplex ultrasonography. AVG decisions were based on patient age, health, and vein diameter (⩾2.3 mm). Statistical analyses compared baseline characteristics and evaluated primary and secondary patency rates at 12 and 18 months using Pearson’s chi-square, Student’s t-test, Kaplan-Meier survival analysis, and the Log-rank test. Results: Thirty-six patients had elbow anastomosis, while 23 had UA anastomosis for forearm loop AVG. The elbow group had a higher male proportion (72.7% vs 34.7% in UA, p = 0.005) and larger elbow vein diameters (2.52 ± 0.19 mm vs 2.16 ± 0.21 mm in UA, p < 0.001). Primary patency rates at 12 months were 72.7% for elbow and 56.2% for UA; at 18 months, 59.4% and 25.5%, respectively ( p = 0.376). Secondary patency rates at 12 months were 75.7% for elbow and 62.2% for UA; at 18 months, 67.8% and 33.9%, respectively ( p = 0.238). Conclusion: The primary and secondary patency rates of forearm loop AVG with UA basilic vein anastomosis were not inferior to those with elbow veins anastomosis. UA basilic vein can be a feasible alternative for creating forearm loop AVG when elbow veins are not suitable.
Feasibility and climate adaption of shallow geothermally driven direct ventilation
Authors: Shen Cong , Pan Zhen , Wei Tong , Yu Chuck Wah , Luo Xilian 
Published: October 2024

Ground heat exchangers in ground source heat pump (GSHP) systems can provide low-temperature water, which has the potential to be utilized for pre-cooling in building ventilation. In this study, a novel shallow geothermally driven direct ventilation system was established. Experimental measurements were conducted to evaluate the effectiveness of the system. In addition, a TRNSYS software dynamic numerical model was developed to assess the long-term operational characteristics. The results of the long-term experiments indicated stable shallow soil temperatures, which were significantly lower than the outdoor temperatures in summer. Even when the outdoor temperature rose to 39.0°C, the system could provide an air supply temperature of 19.5°C, maintaining an average indoor temperature of 24.9°C. Numerical simulation results demonstrated that a shallow geothermally driven direct ventilation system could achieve an 88.9% rate of satisfaction for the cooling season. The system performed efficiently in dry and cold regions, such as Xi’an, and in severely cold regions, such as Shenyang. The results showed that two buried pipes exhibited optimal operational efficiencies. Therefore, installing a ventilation cooling system with buried pipes covering an effective cooling area of 18 m2 is recommended. These findings provide valuable reference data for effective promotion of shallow geothermal energy in low-energy buildings.
The impact of different lifestyle factors on disability in multiple sclerosis at older ages: a monocentric retrospective study
Authors: Wecker Sophie , Freudenstein David , Ganser Iris , Angstwurm Klemens , Lee De-Hyung , Linker Ralf A. 
Published: October 2024

Background: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system affecting approximately 2.8 million people worldwide. In addition to genetic and environmental factors, various lifestyle factors contribute to disease development and progression. Objectives: We performed a monocentric retrospective study and investigated the effect of lifestyle factors such as obesity, smoking, alcohol consumption, physical activity, and dietary habits on the degree of disability in a cohort of people with MS (pwMS) with an average onset of disease after the age of 55. Design: This late-onset MS (LOMS) study group ( n = 47) was characterized by a mean age of 60.9 years and a mean duration of disease of 5.0 years. The LOMS study group was compared with two control groups. The study participants in the “old control group” (Cold) were on average as old and in the “young control group” (Cyoung) as long suffering from MS as the pwMS in the LOMS group. Methods: Data from medical documentation and a questionnaire were analyzed using descriptive frequency analyses and testing for correlation between different variables also by generalized estimating equations. The Expanded Disabilty Status Scale (EDSS) score and the progression index were used as a measure of disability. Results: We found a significant association between smoking history and the current EDSS score in the Cyoung group, but not in the two older study groups. For physical activity, there was a significant negative correlation with EDSS score in the study group and the Cold group, alcoholic beverage consumption correlated with decreased EDSS in the Cold group. The intake of meat negatively correlated with the progression index in the LOMS group. Conclusion: In summary, different life-style factors correlated with disability depending on patient age and disease duration. These life-style factors may be considered in the future counseling of pwMS at older ages.
Characteristics, utilization of reproductive health services and AI prediction among Taiwanese adolescent mothers during the COVID-19 pandemic
Authors: Chen Ching Hsuan , Hsiao Ching Hua , Liao Pei Hung , Hu Hsiang Wei , Wei Shiow-Jing , Chen Shu Wen 
Published: October 2024

Background Although adolescent birth rates have declined globally, the sexual and reproductive health of adolescent mothers remains an area of specific concern, and these were impacted by the COVID-19 pandemic. This study investigates characteristics, utilization of reproductive health services (RHS) and artificial intelligence (AI) prediction during the pandemic. Methods We conducted an exploratory study using data for 2020–2022 from the Taipei City Government Health Bureau. Adolescent mothers under the age of 20 received post-birth telephone-based RHS, covering contraception, abortion, postpartum care, and social welfare support. The data analysis included descriptive statistics, and various machine learning techniques were employed, including random forest, SVM, KNN, logistic regression, and Bayesian network analysis. Results Of 112 participants, most were aged 17 to 19 (80.4%) and married (58.0%). The majority had full-term deliveries (86.6%) with healthy infants. A high percentage had not used contraception before conception (60.7%), and some had had earlier abortion or termination experiences (13.4%). In the examination of eight influential factors, the machine learning models, specifically the random forest and Bayesian network analyses, exhibited the highest accuracy, achieving 90.91% and 89%, respectively, in predicting service acceptance. The key determinants identified were abortion experience and marital status, directly influencing the acceptance of services. Conclusion The COVID-19 pandemic reduced hospital visits for adolescent mothers, but the RHS provided timely guidance. Telemedicine consultations and internet-based psychological consultations may play a crucial role in facilitating such services in the future.
The i-CanManage program to improve exercise and symptom management for Vietnamese women after cancer: A pilot randomized controlled trial protocol
Authors: Hoa Nguyen Huyen Thi , Bui Linh Khanh , Tran Tran Ngoc , Thuy Nguyen Ngan Thi , Phuong Anh Hoang , Pham Hieu Huy , Taylor-Robinson Andrew W , Duc Tran Quang , Thanh Nguyen Huong Thi 
Published: October 2024

Background Women dealing with cancer often face a myriad of physical and psychological challenges. Regular physical activity and mobile applications offering healthcare consultation, information, and health tracking have shown promise in aiding this demographic. Therefore, this study aims to examine the effectiveness of the i-CanManage program in improving physical activity, self-efficacy in symptom management, and the quality of life (QoL) among Vietnamese women after completion of cancer treatment. Methods A two-arm pilot randomized controlled trial will be conducted. Eligible participants will be randomly allocated to intervention and control groups. Members of both groups will be provided with a Cancer Management Handbook containing information on Life After Cancer and Symptom Management. Intervention group participants will be offered a 12-week personalized exercise program called i-CanManage via a Cancer Wellness Program smart application—an artificial intelligence-based mobile app developed for monitoring patients’ symptoms with a Fitbit Charge 5 wearable device. Data will then be collected at weeks 0, 6, and 12 concerning physical activity, symptom severity, self-efficacy, self-care, and QoL. App usability and user experience will also be explored using both quantitative and qualitative methods. Discussion This pilot study will assess the effectiveness of the internet-based cancer management program on physical activity, self-efficacy in symptom management, and QoL of women following cancer treatment in Vietnam, as well as evaluate users’ experience with the smart app. The findings will contribute to the growing evidence on the role of mhealth in oncology care, providing insights into how technology-driven interventions can empower patients in their cancer recovery journey. Datasets collected from this study will be openly available to the research community to foster new advances in the field.
Association of Anterior Knee Pain With Extension Deficit After Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Georgoulis Jim D. , Savvidou Olga D. , Patras Kostas , Melissaridou Dimitra , Hadjimichael Argyris C. , Papagelopoulos Panayiotis J. , Georgoulis Anastasios D. 
Published: October 2024

Background: Previous systematic reviews have reported the incidence of anterior knee pain (AKP) and extension deficit (ED) after anterior cruciate ligament reconstruction (ACLR); however, both outcomes are estimated separately and thus are assumed to be uncorrelated. Purpose: To estimate whether there is a clinically relevant association between the population effects of ED and AKP after ACLR. Study Design: Systematic review; Level of evidence, 2. Methods: Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted by searching PubMed, EMBASE, and the Cochrane Library electronic databases for published articles reporting incidence of both AKP and ED after ACLR with either bone–patellar tendon–bone (BPTB) or hamstring (HS) graft that returned 298 studies after the initial search. A Bayesian hierarchical measurement error model estimated the population effect of ED and AKP. Results: Twelve publications involving 976 patients (mean follow-up, 77.9 months; range, 24-180 months) were included in the systematic review. There was a clear, moderate correlation between population ED and population AKP for the BPTB ( r = 0.40; 95% CI, 0.39-0.42) and the HS grafts ( r = 0.35; 95% CI, 0.33-0.36). Model expected estimates for the population effects of AKP and ED were 24.1% (95% CI, 17.4%-31.9%) and 17.5% (95% CI, 10.6%-25.0%), respectively, for the BPTB graft and 16.1% (95% CI, 9.2%-23.9%) and 13.1% ED (95% CI, 6.0%-20.8%) for the HS graft, respectively. The posterior mean difference in AKP between BPTB and HS grafts was clear and substantial (8.3% [95% CI, 0.3% to 16.1%]); there was no substantial difference in the posterior mean difference of ED between BPTB and HS grafts (4.3% [95% CI, –3.8% to 13.0%). Conclusion: Our systematic review demonstrated a moderate but clear correlation between ED and AKP irrespective of graft type. From a clinical perspective, this association emphasizes the need for intraoperative achievement of full extension and avoidance of situations that may cause ED. The higher incidence of AKP in patients with BPTB graft may also be attributed to factors related to the graft harvest site. Future metaregression analyses could investigate whether additional factors such as follow-up duration or rehabilitation protocols can moderate the association between AKP and ED after ACLR with either BPTB or HS graft.
Arthroscopic ankle lateral ligament instabilities repair
Authors: Pitarini Astuti 
Published: October 2024

Lateral ankle sprain is one of the most common sports injuries both in high level and recreational athletes. The frequency of injuries increases in recent years as more sports participations grow. Untreated ankle sprain can lead to deteriorated chronic lateral ankle instability (CLAI/LAI), thus understanding the management is of most important. Surgery for ankle instability can varied from a simple non augmented repair, augmented repair using autograft/allograft/or other choices of internal bracing, and revision cases of failed primary repair. The decision of what surgery is of the surgeon learning curves. However, with a proper diagnosis, a simple non augmented repair is acceptable with high success rate. In certain population and narrow indication, surgeon need other armamentarium such as augmented reconstruction using graft or other technique to avoid failure of primary case that leads to revision. Anterior arthroscopic for anterior talofibular ligament (ATFL) repair is widely performed for CLAI. Many studies have reported excellent outcomes, however recurrent instabilities still become a common concern for many. Selected individuals with good indication will prevent the surgeon from revision surgeries. Surgeon need to add the risk factors such as poor ATFL remnants, involvement of calcaneofibular ligament (CFL), and preoperative activity level to their decision making. At last, the success of lateral ankle instability surgery is also dependent on proper phases of rehabilitation period. Understanding all matter that involves in the recovery of lateral ankle ligament repair is of most important for the best outcome of the patients.