bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corner Osteotomy as the more Advanced Approach to Deformity Correction in Adult Spinal Deformity
Authors: Lee Ki Young , Lee Jung-Hee , Kang Kyung-Chung , Lee Won-Young , Kim Jin-Hyung 
Published: August 2024

Study Design.
A retrospective study

Objective.
To investigate the usefulness of corner osteotomy (CO) in patients with adult spinal deformity (ASD) by comparing with pedicle subtraction osteotomy (PSO) for lordosis correction.

Summary of Background Data.
PSO remains a valuable procedure for patients with ASD, but it has a limit to obtaining correction angles exceeding 45° in patients with a large pelvic incidence or with previous spinal fusion surgeries. Theoretically, CO can exceed the limitation of PSO and can achieve a wide range of correction angles. However, no study has analyzed the clinical data and usefulness of CO.

Methods.
This study included 115 patients (mean age 71.1 y, mean follow-up period 78.9 mo) with ASD who underwent deformity correction using PSO or CO. Comparative analysis was performed on spinopelvic parameters including segmental angle (SA) around the osteotomy site, and clinical and surgical assessment between the PSO and corner groups.

Results.
In the corner group, the postoperative SA (35° vs. −39.3°, P=0.004) and the degree of SA correction (34.8° vs. 39.7°, P=0.004) were greater, and a broader range of SA correction was also possible (18-51° vs. 18-61°). Although the operative time was longer in the corner group (316.8 min vs. 342.3 min, P=0.014), the estimated blood loss (EBL) was lower (2841.3 mL vs. 2465.4 mL, P=0.032). There was no difference in major complication rates, but the frequency of rod fracture (RF) was lower in the corner group (36/27 vs. 1/51, P<0.05).

Conclusion.
CO showed a greater SA correction and achieved a broader range of SA correction angles than PSO with no difference in the incidence of major complications. In addition, the EBL and the frequency of RF were lower. Based on these results, we expect that CO can serve as a promising surgical alternative to PSO for spinal deformity correction among patients with ASD.
Long-term Efficacy of Pulmonary Artery Desnervation Treatment in Heart Failure With Preserved Ejection Fraction: A Subgroup Analysis of 3-year Results From the PADN-5 Study
Authors: Zhang Hang , Yu Wande , Zhang Mengyu , Li Wei , Kan Jing , Xie Dujiang , Zhang Juan , Chen Shaoliang 
Published: August 2024

Objective:
The Pulmonary Arterial Denervation in Patients With Pulmonary Hypertension Associated With the Left Heart Failure (PADN-5) study proved that pulmonary artery denervation (PADN) is associated with significant improvements in hemodynamic and clinical outcomes in patients with combined pre- and post-capillary pulmonary hypertension (CpcPH). This study aimed to assess the 3-year clinical results of PADN in patients who had heart failure with preserved ejection fraction (HFpEF) developing into CpcPH (HFpEF-CpcPH).

Methods:
In this post hoc analysis of the PADN-5 trial, 38 patients with HFpEF were included in screening out of 98 patients with CpcPH who were randomly assigned to treatment with sildenafil and sham PADN (sham PADN (plus sildenafil) group, abbreviated as sham group) or PADN (PADN group). HFpEF in the PADN-5 trial was defined as a left ventricular ejection fraction ≥50%, and CpcPH was defined as a mean pulmonary arterial pressure ≥25 mmHg, a pulmonary arterial wedge pressure >15 mmHg, and a pulmonary vascular resistance >3.0 WU. The changes in the 6-minute walk distance (6-MWD) and the plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) at 6-month and 3-year follow-up, as well as the clinical endpoint of the occurrence of clinical worsening, defined as cardiopulmonary-related death, rehospitalization, or heart or lung transplantation at 3-year follow-up were examined.

Results:
Thirty-eight patients with HFpEF-CpcPH were assigned to the PADN group (n = 19) or the sham group (n = 19). At the 6-month follow-up, 6-MWD (433 (275, 580)m vs. 342 (161, 552)m), and reductions in NT-proBNP (−47% (−99%, 331%) vs. −12% (−82%, 54%)) were significantly improved in the PADN group (all P < 0.05). Over the 3-year follow-up period, PADN treatment resulted in marked increases in 6-MWD (450 (186, 510)m vs. 348 (135, 435)m) and reductions in NT-proBNP (−55% (−99%, 38%) vs. −10% (−80%, 95%)) (all P < 0.05). Clinical worsening was experienced by 12 patients (63%) in the sham group, but by only 5 patients (26%) in the PADN group (hazard ratio = 0.149, 95% confidence interval: 0.038–0.584, P = 0.006). The 6-MWD and PADN treatments were independent predictors of clinical deterioration in patients with HFpEF-CpcPH.

Conclusions:
PADN therapy is associated with improvements in exercise capacity and clinical outcomes. PADN therapy may have a potential role in patients with HFpEF-CpcPH for whom current treatment options are limited.
Preliminary clinical practice of radical prostatectomy without preoperative biopsy
Authors: Liu Ranlu , Yin Lu , Ma Shenfei , Yang Feiya , Lian Zhenpeng , Wang Mingshuai , Lei Ye , Dong Xiying , Liu Chen , Chen Dong , Han Sujun , Xu Yong , Xing Nianzeng 
Published: August 2024

Abstract

Background:
At present, biopsy is essential for the diagnosis of prostate cancer (PCa) before radical prostatectomy (RP). However, with the development of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and multiparametric magnetic resonance imaging (mpMRI), it might be feasible to avoid biopsy before RP. Herein, we aimed to explore the feasibility of avoiding biopsy before RP in patients highly suspected of having PCa after assessment of PSMA PET/CT and mpMRI.

Methods:
Between December 2017 and April 2022, 56 patients with maximum standardized uptake value (SUVmax) of ≥4 and Prostate Imaging Reporting and Data System (PI-RADS) ≥4 lesions who received RP without preoperative biopsy were enrolled from two tertiary hospitals. The consistency between clinical and pathological diagnoses was evaluated. Preoperative characteristics were compared among patients with different pathological types, T stages, International Society of Urological Pathology (ISUP) grades, and European Association of Urology (EAU) risk groups.

Results:
Fifty-five (98%) patients were confirmed with PCa by pathology, including 49 (89%) with clinically significant prostate cancer (csPCa, defined as ISUP grade ≥2 malignancy). One patient was diagnosed with high-grade prostatic intraepithelial neoplasia (HGPIN). CsPCa patients, compared with clinically insignificant prostate cancer (cisPCa) and HGPIN patients, were associated with a higher level of prostate-specific antigen (22.9 ng/mL vs. 10.0 ng/mL, P = 0.032), a lower median prostate volume (32.2 mL vs. 65.0 mL, P = 0.001), and a higher median SUVmax (13.3 vs. 5.6, P <0.001).

Conclusions:
It might be feasible to avoid biopsy before RP for patients with a high probability of PCa based on PSMA PET/CT and mpMRI. However, the diagnostic efficacy of csPCa with PI-RADS ≥4 and SUVmax of ≥4 is inadequate for performing a procedure such as RP. Further prospective multicenter studies with larger sample sizes are necessary to confirm our perspectives and establish predictive models with PSMA PET/CT and mpMRI.
Impact of UGT1A4 and UGT2B7 polymorphisms on lamotrigine plasma concentration in patients with bipolar disorder
Authors: Zhao Ting , Zhang Hui-lan , Feng Jie , Cui Long , Sun Li , Li Hong-jian , Yu Lu-hai 
Published: August 2024

Purpose
The purpose of this study was to evaluate the effect of UGT1A4 and UGT2B7 polymorphisms on the plasma concentration of lamotrigine in Chinese patients with bipolar disorder.

Methods
A total of 104 patients were included in this study. Steady-state plasma lamotrigine concentrations were determined in each patient after at least 21 days of continuous treatment with a set dose of the drug. Lamotrigine plasma concentrations were ascertained using ultra-performance liquid chromatography. Simultaneously, plasma samples were used for patient genotyping.

Results
The age, sex, BMI, daily lamotrigine dose, plasma lamotrigine concentration, and lamotrigine concentration/dose ratio of patients exhibited significant differences, and these were associated with differences in the genotype [UGT1A4 −142T>G and UGT2B7 −161C>T (P < 0.05)]. Patients with the GG and GT genotypes in UGT1A4 −142T>G had significantly higher lamotrigine concentration/dose values (1.6 ± 1.1 and 1.7 ± 0.5 μg/ml per mg/kg) than those with the TT genotype (1.4 ± 1.1 μg/ml per mg/kg). Likewise, patients with the UGT2B7 −161C>T TT genotype had significantly higher lamotrigine concentration/dose values (1.6 ± 1.1 μg/ml per mg/kg) than those with the CC genotype (1.3 ± 1.3 μg/ml per mg/kg). Multiple linear regression analysis showed that sex, lamotrigine dose, UGT1A4 −142T>G, and UGT2B7 −161C>T were the most important factors influencing lamotrigine pharmacokinetics (P < 0.001).

Conclusion
The study results suggest that the UGT1A4 −142T>G and UGT2B7 −161C>T polymorphisms affect lamotrigine plasma concentrations in patients with bipolar disorder.
THE EFFICACY OF INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR FOR RADIATION MACULOPATHY
Authors: Chi Sheng-Chu , Chang Hsin-Ho 
Published: August 2024

Background:
Antivascular endothelial growth factor (VEGF) therapy is the primary approach for managing radiation maculopathy. However, a noticeable gap exists in meta-analyses evaluating the efficacy of anti-VEGF therapy specifically in the context of radiation maculopathy.

Methods:
We conducted a review of comparative studies on anti-VEGF treatment up to October 2023. References were sourced from PubMed, EMBASE, and the Cochrane Library. The Cochrane Risk of Bias tool assessed the quality of randomized controlled trials, while the Risk Of Bias In Nonrandomized Studies of Interventions tool evaluated nonrandomized controlled trials.

Results:
Thirteen articles originating from 11 trials involving 2,525 eyes of 2,408 patients were included. Four trials with 2,226 eyes examined the effect of preventive anti-VEGF. Four trials with 189 eyes assessed the effect of anti-VEGF for preexisting maculopathy, and three trials with 110 eyes compared different anti-VEGF treatment modalities. In the preventive anti-VEGF treatment meta-analysis over a 24-month follow-up, the anti-VEGF group exhibited significantly fewer cases of radiation maculopathy (odds ratio: 0.40; 95% confidence interval: 0.25, 0.66, P= 0.0003, I2 = 45%). For the meta-analysis of anti-VEGF treatment for preexisting radiation maculopathy over a 6-month follow-up, the anti-VEGF group showed improved visual acuity (SMD: −1.13, 95% confidence interval, −1.69 to −0.56, P < 0.0000, I2 = 47%) and decreased central macular thickness (SMD: −0.59, 95% confidence interval, −1.13 to −0.05, P = 0.03, I2 = 62%).

Conclusion:
Prophylactic anti-VEGF effectively prevents radiation maculopathy and is also beneficial in treating preexisting radiation maculopathy. Intensive treatment initially provides early benefits, but the efficacy diminishes after transitioning to a treat-and-extend regimen.
OUTCOMES OF PRO RE NATA VERSUS TREAT-AND-EXTEND ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS FOR MYOPIC MACULAR NEOVASCULARIZATION IN MULTIETHNIC PATIENTS IN THE UNITED STATES
Authors: Swaminathan Shreya , Mahmoudzadeh Raziyeh , Wakabayashi Taku , Bowers Mallory , Momenaei Bita , Abishek Robert M. , Salabati Mirataollah , Hsu Jason , Dunn James P. 
Published: August 2024

Purpose:
To compare visual outcomes and recurrence rates between pro re nata (PRN), treat-and-extend and stop (TES), and treat-and-extend with chronic maintenance dosing (TEM) regimens of anti–vascular endothelial growth factor (vascular endothelial growth factor) injections for myopic macular neovascularization (MNV) in multiethnic patients.

Methods:
This retrospective study included patients treated with PRN, TES, or TEM for myopic MNV using intravitreal bevacizumab or ranibizumab. The primary outcome measure was visual improvement at 12 months.

Results:
Overall, 127 eyes of 117 patients (75 women and 42 men) were included. The mean follow-up duration was 37.9 months. The outcomes of PRN (47 eyes [37%]), TES (52 eyes [41%]), and TEM (28 eyes [22%]) were compared. All groups showed significant visual improvement at 12 months and at the final follow-up (all P < 0.05). Visual outcomes did not differ significantly between the three groups at 12 months and the final follow-up (all P > 0.05). However, the number of eyes with recurrences was significantly higher in the PRN group and significantly lower in the TEM group during the follow-up (38%, 21%, and 11% in the PRN, TES, and TEM groups, respectively; P = 0.020). The PRN group received the fewest injections during follow-up (5.3, 10.9, and 19.9 injections in the PRN, TES, and TEM groups, respectively; P < 0.001).

Conclusion:
Comparing myopic MNV treatment regimens, anti-VEGF injections with PRN, TES, or TEM are effective for myopic MNV and have comparable visual outcomes. Because PRN provides favorable outcomes with fewer injections, it should be the first-line approach. However, a treat-and-extend approach with TES and TEM may be an option given individual patient factors.
VASCULAR CHANGES AND IRREVERSIBLE COMPLICATIONS IN 120° FUNDUS USING WIDEFIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN VOGT–KOYANAGI–HARADA DISEASE
Authors: Guo Suo , Xia Lan , Hu Rong , Wang Jing , Yang Peizeng 
Published: August 2024

Purpose:
To characterize the changes in fundus corresponding to 120° field of view in chronic Vogt–Koyanagi–Harada disease in the quiescent phase and explore the associations with irreversible complications in the fundus using widefield swept-source optical coherence tomography angiography.

Methods:
Prospective cross-sectional study. Sixty-nine patients with chronic Vogt–Koyanagi–Harada disease (115 eyes) and 55 healthy control subjects (110 eyes) were included and underwent widefield swept-source optical coherence tomography angiography. Univariate analyses of variations in retinal and choroidal vessel density (VD), choroidal volume, and choroidal vascularity index in patients with Vogt–Koyanagi–Harada with different disease durations and the control subjects were conducted. Logistic regression analysis was used to identify the associations with irreversible complications, including choroidal neovascularization, vasoproliferative tumor of the retina, and chorioretinal atrophy.

Results:
The Welch analysis of variance showed lower VD of superficial retina, deep retina, choriocapillaris, and large-sized and medium-sized vessels of the choroid, and choroidal volume and choroidal vascularity index in the patients with disease duration of >24 months compared with those with disease duration of ≤24 months (all P ≤ 0.011). The regression analysis revealed that the disease duration (P = 0.008; OR = 1.02, 95% CI, 1.005–1.035) and VD of large-sized and medium-sized vessels of the choroid (P = 0.001; OR = 0.707, 95% CI, 0.575–0.87) were significantly correlated with the irreversible complications.

Conclusion:
Patients with chronic Vogt–Koyanagi–Harada in the quiescent phase with disease duration of >24 months exhibit more severe decreased VD in each layer of the retina and choroid, reduced choroidal volume, and sparse choroidal vascularity compared with those with disease duration ≤24 months. Prolonged duration and decreased VD of large-sized and medium-sized vessels of the choroid were associated with irreversible complications in the fundus.
Optical Coherence Tomography Angiography Assessment of Optic Nerve Head and Macula Across the Primary Angle Closure Disease Spectrum
Authors: Tun Tin A. , Atalay Eray , Liu Arthur , Liu Chang , Aung Tin , Nongpiur Monisha E. 
Published: August 2024

Précis:
The microvasculature of the optic disc and macula in eyes with acute primary angle closure and primary angle closure glaucoma was lower across the disease spectrum, but the significant difference was only observed in primary angle closure glaucoma.

Purpose:
To assess the microvasculature in the optic nerve head (ONH) and macula across the primary angle closure disease (PACD) spectrum using optical coherence tomography angiography (OCTA).

Materials and Methods:
OCTA (AngioVue, Fremont, CA) imaging was performed on 122 PACD subjects. Flow area (FA) and vessel density (VD) in the ONH, radial peripapillary capillary (RPC) network, and superficial and deep capillary plexuses of the macula were calculated and compared across the PACD spectrum using linear regression models with generalized estimating equations adjusted for inter-eye correlation.

Results:
A total of 234 eyes including 44 primary angle closure suspects (PACS), 93 primary angle closure (PAC), 79 primary angle closure glaucoma (PACG), and 18 PAC with a history of previous acute primary angle closure (APAC) were included in the analysis. Compared with other groups, PACG eyes showed smaller FA in the ONH (1.35±0.02 mm2), RPC (0.78±0.03 mm2), and the superficial retinal layer (1.08±0.03 mm2) (all P<0.05). Lower VD was also observed in the “whole image,” “inside disc,” and “peripapillary” regions of the ONH and RPC, and the “whole image” and “parafoveal” regions of the retinal layer in the PACG group when compared with other groups (all P<0.05). No significant differences were found for the other groups (all P>0.05). Lower VD in the ONH, RPC, and superficial retinal layer significantly correlated with worse visual field loss in PACG eyes (all P<0.05).

Conclusions:
Significant reduction in the microvasculature of the optic disc and macula in PACG suggests that glaucoma development may contribute to lower VD in these regions.
Assessing Delirium in Patients With Neurological Diseases
Authors: Nisgaard Maja Gjerløv , Boesen Signe Vestergaard , Jensen Janet 
Published: August 2024

ABSTRACT

BACKGROUND: Delirium is a common complication during hospitalization. Its consequences are severe, including reduced function, delayed rehabilitation, dementia, institutionalization, and death. Assessing delirium in neurological patients can be challenging due to the impact of neurological deficits. Therefore, the aim was to investigate the agreement between 2 delirium screening tools, factors associated with delirium, and assessing delirium in neurological patients. METHODS: This prospective observational study was conducted in 2 neurological units, using daily delirium screening. Intensive Care Delirium Screening Checklist and 2 versions of the Confusion Assessment Method were used to asses delirium in adult patients without baseline dementia, alcohol/drug detoxification, or palliative care. Descriptive analyses determined the number of delirium scores, and the analytical analyses were logistic regressions and a κ coefficient. RESULTS: The agreement between the screening tools was found to be substantial (κ = 0.71). Logistic regression analysis showed that the risk factors for a positive delirium screening were home care before admission (Confusion Assessment Method: odds ratio [OR], 4.21 [95% confidence interval (CI), 1.67–10.63]; Intensive Care Delirium Screening Checklist: OR, 6.14 [95% CI, 2.85–13.23]) and aphasia/dysarthria (Confusion Assessment Method: OR, 4.9 [95% CI, 1.32–6.81]; Intensive Care Delirium Screening Checklist: OR, 2.76 [95% CI, 1.3–5.87]). In total, 18.7% (n = 20/107) of the screening scores were positive. Specifically, the Confusion Assessment Method showed positive scores for 13.0% (n = 14/107) of participants, whereas the Intensive Care Delirium Screening Checklist showed positive scores for 16.8% (n = 18/107). CONCLUSION: The screening tools had a substantial degree of agreement. Therefore, nurses can use both screening tools to detect delirium in patients with neurological disorders. However, care should be taken in patients with aphasia to avoid misclassification with the Brief-Confusion Assessment Method. Moreover, special attention should be directed toward patients with language difficulties such as aphasia/dysarthria and those who received home care services before admission. These areas warrant further investigation in clinical practice and future studies.
Efficacy and safety of phototherapies for upper lip scars in cleft lip patients: a systematic review and meta-analysis
Authors: Wei Siqi , Zhang Guang , Wu Qian , Song Tao , Yin Ningbei , Wang Yongqian 
Published: August 2024

Objective:
Cleft lip is a prevalent congenital developmental defect, and its surgical repair often results in scarring that adversely impacts facial esthetics, function, and mental health. Numerous studies have examined the efficacy and safety of phototherapy for scar treatment. However, definitive evidence is lacking. This study aims to evaluate the effectiveness and safety of phototherapies for treating upper lip scars in cleft lip patients.

Methods:
The authors searched PubMed, Cochrane Library, Embase, and Web of Science databases using specific search terms. The authors collected clinical trials on laser or other phototherapy treatments for upper lip scars after cleft lip surgery published up to the end of March 2024. Two researchers independently screened the literature, extracted data, and assessed quality based on inclusion and exclusion criteria. The data were analyzed by using RevMan 5.4 statistical software.

Results:
A total of nine studies were included. 1 Analysis of the clinical efficacy rate between the control group (routine care) and the intervention group (phototherapy) showed that laser or intense pulsed light (IPL) treatment significantly reduced total VSS scores (P<0.0001). 2 Analysis of the Pretest-Post-test cohort showed that total VSS scores were significantly reduced after phototherapy (P<0.00001). 3 Timing of phototherapy intervention analysis: early postoperative phototherapy intervention had a better effect. None of the literature reported permanent complications, nor were there any serious adverse events, only localized temporary erythema or blisters.

Conclusion:
Phototherapy can effectively improve the total VSS scores of upper lip scars after cleft lip surgery (including skin color, vascular distribution, softness, and thickness) with no apparent adverse reactions or serious complications. Early phototherapy intervention for upper lip scars has a better effect.