bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges towards an AIDS-free generation in Africa and Asia
Authors: Songtaweesin Wipaporn Natalie , Ahimbisibwe Grace Miriam , Puthanakit Thanyawee , Musoke Philippa 
Published: August 2024

Purpose of review
To review the latest data on prevention of HIV vertical transmission in Asia and Africa and discuss strategic directions to achieve an AIDS free generation by 2030.

Recent findings
Progress in vertical transmission elimination efforts in Africa and Asia have stalled in the last decade, with 130 000 new infections in 2022. Main causes of vertical transmissions vary; in Asia-Pacific due to its low-burden, thus low testing coverage, but high overall vertical transmission rates, in South and East Africa due to new HIV infections during pregnancy and breast/chestfeeding, whereas in Western and Central Africa due to low antiretroviral therapy (ART) coverage. Long-acting injectable ART and neutralizing antibodies for treatment and prevention show promise in supporting efforts to further reduce vertical transmissions. Integrated and more accessible pre- and postnatal care is needed to achieve an AIDS-free generation.

Summary
Much can be implemented to address existing HIV service gaps; including strengthening of HIV prevention services for youth and women of childbearing age and pregnant people, early detection and treatment, and the delivery of integrated services that can reach and retain pregnant and postpartum people living with HIV in care.
Adolescents and young adults with HIV and unsuppressed viral load: where do we go from here?
Authors: Rakhmanina Natella , Foster Caroline , Agwu Allison 
Published: August 2024

Purpose of review
Adolescents and youth living with HIV (AYLHIV) have worse outcomes at all stages of the care cascade when compared with adults, yet adolescents and youth with unsuppressed viral load are typically excluded from phase 3 studies of novel HIV therapeutic agents and emerging strategies. Long-acting agents have the potential to radically change outcomes for young people struggling with adherence to daily oral HIV medications.

Recent findings
1.5 million children aged less than 15 years live with HIV and more than 100 000 acquire HIV perinatally every year. Adolescents and youth aged 10–24 years comprise ∼40% of global incident HIV infections. Rates of viral suppression among AYLHIV vary markedly from 44 to 88%, resulting in morbidity and risks of transmission to partners and infants. Virological failure is mostly due to poor adherence, and AYLHIV express high levels of interest and acceptability of alternatives to oral daily medications, such as long-acting antiretroviral formulations. Emerging data regarding their use in populations with unsuppressed viral load are encouraging.

Summary
AYLHIV, including populations without virologic suppression, must be prioritized for the programmatic implementation and research of long-acting HIV drugs and other therapeutic strategies to prevent morbidity and mortality and to ultimately end the HIV epidemic.
Complex Frontal Bone Reconstruction Using Computer-designed Polyetheretherketone Implant: Case Report and Literature Review
Authors: Liu Yueqi , Xie Shao , Ding Jiahai , Zhang Yushun , Deng Liyi , Yao Yuancheng , Xiong Yang , Chen Yuliang , Wang Lei , Liu Yong 
Published: August 2024

Summary:
Calvarial reconstruction of complex frontal bone defects after head trauma surgery is challenging, especially when it coexists with an absence of eyebrow arch and supraorbital wall. Due to various reasons, the patient’s bone flap could not be used. Common alternative materials include polyetheretherketone (PEEK) and titanium. Careful and detailed planning is required to maximize functional and aesthetic reconstruction, thereby benefiting the patient. We present a case of a 36-year-old man who had multiple frontal bone defects after multiple operations for craniofacial fractures performed with reconstruction surgery using a PEEK implant successfully. With a follow-up for 2 years, the patient was satisfied with the long-term aesthetic effect without any consequences such as surrounding tissue infection or implant displacement. The authors believe that the PEEK implant has great potential for calvarial reconstruction due to its incredible strength, durability, and inertness.
Vascularized Omentum Lymphatic Transplantation as a Treatment for Chronic Inguinal Ulceration and Lymphedema
Authors: Tian Chenyang , Gao Xiaowen , Wang Kejia , Ji Peng , Zheng Zhao , Wang Yunchuan , Hu Dahai 
Published: August 2024

Background:
After tumor resection, lymphadenectomy, and radiotherapy, recurrent lymphatic fluid leakage and infection can occur in the inguinal region, contributing to severe localized tissue fibrosis. When wounds form in this region, they tend to heal slowly over extended periods, and no optimal approach for treating these complex wounds has yet been established.

Methods:
Groin wound debridement and dissection of the vessels in the wound recipient site were performed by the burn surgeon. A general surgeon performed the laparoscopic partial omentum excision. One portion of the omentum was used to fill the large inguinal space, whereas the other portion was laid flat on the wound sites in the groin and anterior perineum to facilitate the restoration of appropriate lymphatic fluid reflux. The vessels of the omentum were microsurgically anastomosed with the vessels in the recipient site. Thin split-thickness slices of skin were then taken from this donor site based on the size of the wound.

Results:
After the successful establishment of revascularization between the flap and recipient sites, lymphatic fluid leakage was not observed in this patient. No inguinal wounding or lymphatic exudate were evident in the patient during follow-up, and significant improvements in lymphedema of the lower extremities were evident.

Conclusions:
In this article, we discuss the advantages and disadvantages of vascularized omentum lymphatic transplantation. Overall, this procedure represents a promising new approach for the treatment of refractory wounds caused by lymphatic fistulas.
Documented Initial Growth Does Not Necessarily Indicate Treatment for Sporadic Vestibular Schwannomas
Authors: Bourque Jean-Michel , Panizza Benedict J. 
Published: August 2024

Objective
To report the natural history of vestibular schwannoma (VS) who elected an initial period of observation and identify prognostic factors. To describe the natural history of growing VS, identify prognostic factors, and review the most recent literature.

Study Design
Prospective cohort study and literature review.

Setting
Tertiary referral center.

Patients
Adult patients diagnosed with a VS between January 1998 and February 2023.

Intervention
Magnetic resonance imaging surveillance.

Main Outcome Measure(s)
Growth-free survival and subsequent growth-free survival considering significant growth as a change in size of ≥2 mm.

Results
Of 430 patients undergoing observation with serial magnetic resonance imaging, 193 (44.9%) demonstrated significant growth at a median of 1.6 years (interquartile range, 0.94–3.51). Of the 193 patients who presented an initial episode of growth, 137 elected to continue to be observed. Of those, 83 (60.6%) presented a second episode of growth at a median of 1.43 years (interquartile range, 1.00–2.49). The subsequent growth-free survival rates (95% confidence interval) at 1, 3, 5, 7, and 10 years were 91.79% (87.26–96.56%), 64.44% (56.56–73.42%), 52.52% (44.23–62.35%), 42.23% (33.92–52.56%), and 36.11% (27.89–46.76%), respectively. Univariate and multivariate Cox regression analyses showed that EC tumor location and initial growth rate were significant predictors of subsequent growth.

Conclusions
Close observation after documentation of growth is an appropriate management in well-selected cases given that only around 56% of the tumor will continue to grow. Extracanalicular tumor location and initial growth rate are promising prognostic factors to help determine which patient would be a better candidate for close surveillance after initial documentation of growth.
External Auditory Canal Erosion at the 6 O’clock Spot
Authors: Boya Mounika Naidu , Blumenstein Nicole , Redleaf Miriam 
Published: August 2024

Objective
To report a common site of external ear canal erosion in multiple pathologies, located inferiorly at 6 o’clock.

Patients
Otology patients who came in 2023 for treatment of external auditory canal erosions.

Intervention
This clinical capsule is an observational report of the external canal’s propensity to erosion at the 6 o’clock location. Patient treatments were canalplasty, mastoidectomy, and medical management.

Main Outcome Measure
Documentation of the propensity to erosion at the 6 o’clock location in the external auditory canal. Locations of the niduses of prior series of external auditory canal pathologies are documented.

Results
Eight patients are presented with external auditory canal erosion in 10 ears originating at the 6 o’clock position medial to the bony-cartilaginous junction. No other patient with spontaneous canal erosion presented with their nidus of pathology in another canal location. (A review of 42 case series of 291 patients found that keratosis obturans and bisphosphonate-induced osteonecrosis tended to arise from the same 6 o’clock lateral bony canal location, while 26% of necrotizing otitis externa cases arose there.)

Conclusions
The “6 o’clock spot” in the external canal is a common location of canal erosion for spontaneous wax and keratin collections and may be the precursor to keratosis obturans, bisphosphonate-induced osteonecrosis of the ear canal, and necrotizing otitis externa.
Strategies for management of patients with elevated lipoprotein(a)
Authors: Ellberg Charlotte C. , Bhatia Harpreet S. 
Published: August 2024

Purpose of review
There is growing literature that supports the testing of Lp(a). However, few patients are tested, including those with a personal or family history of cardiovascular disease (CVD). One often noted barrier to more widespread testing is uncertainty regarding what to do with an elevated Lp(a) level. Although guidelines vary, there is agreement on the use of Lp(a) as a risk enhancer to guide medical care and shared decision-making. This review will discuss a clinical approach with supporting evidence for management of patients with elevated Lp(a).

Recent findings
At the minimum, elevated Lp(a) increases cardiovascular risk and can be incorporated into existing risk stratification paradigms. The cornerstone of management is aggressive management of traditional cardiovascular risk factors, including LDL-cholesterol (LDL-C). More recent studies have highlighted the potential role for proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), aspirin in primary prevention, and prolonged dual antiplatelet therapy in secondary prevention.

Summary
Although there is optimism for Lp(a)-targeted therapies in the near future, an elevated Lp(a) level is actionable today, and uncertainty regarding the management of patients with elevated Lp(a) should not be a barrier to more widespread testing.
Risk of dementia associated with the use of anticholinergic medications: a review of recent literature
Authors: Ziadeh Hachem , Rhodes Stephen , Sheyn David , Hijaz Adonis 
Published: August 2024

Purpose of review
While there is an established association between the use of anticholinergic medications and its effects on cognition, the extent of this impact remains unclear. We outline recent studies addressing this topic.

Recent findings
We describe a series of recent articles discussing the risk of dementia associated with anticholinergic medication use in general, with further focus on the risk of overactive bladder (OAB) anticholinergic use, detailing short & long-term use effects, risk variation based on age and gender, and reporting alternative treatment options.

Summary
Anticholinergic medication use bears an increased risk of dementia development, and accelerated cognitive decline in individuals with preexisting dementia, with the risk being related to the medications dosages, length of exposure, and pharmacological profile. β3-adrenoceptor agonists have proven to be a potent alternative for OAB anticholinergics, owing to its safe profile in regards of no clear effects on cognitive function, and having similar efficacy in OAB treatment.
Severe Maternal Morbidity by Disability Status and Type in the United States
Authors: Akobirshoev Ilhom , Vetter Michael , Horner-Johnson Willi , Lomerson Nicole , Moore Simas Tiffany A. , Mitra Monika 
Published: August 2024

OBJECTIVE:
To estimate the risk of severe maternal morbidity (SMM) among women with disabilities compared with those without disabilities in a nationally representative sample of U.S. delivery hospitalizations.

METHODS:
We conducted a retrospective cohort analysis using the 2016–2021 Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. We identified delivery hospitalizations and disability status using International Classification of Diseases, Tenth Revision diagnosis codes. The primary outcome was SMM, which was determined using 21 indicators specified by the Centers for Disease Control and Prevention. We used Poisson regression to estimate unadjusted and adjusted relative risks (aRRs) and 95% CIs for the association between disability status and type with SMM outcomes.

RESULTS:
Among 4,331,457 delivery hospitalizations, 128,413 (3.0%) were to women with disabilities. Women with disabilities had significantly higher rates of SMM compared with those without disabilities (396/10,000 deliveries vs 177/10,000 deliveries). In fully adjusted models, women with disabilities had an aRR of 1.86 (95% CI, 1.80–1.91) for one or more SMM indicators. The risk of SMM varied by disability type, with the highest risks observed for women who had vision disabilities (aRR 3.02, 95% CI, 2.70–3.38) or had physical disabilities (aRR 2.44, 95% CI, 2.34–2.55). Women with disabilities had the highest risk for other medical complications (puerperal cerebrovascular disorders and sickle cell disease with crisis), followed by other obstetric complications, respiratory complications, cardiovascular complications, acute renal failure, sepsis, and bleeding complications compared with women without disabilities.

CONCLUSION:
Women with disabilities have a significantly higher risk of SMM during delivery compared with those without disabilities, with the magnitude of risk varying by disability type. Efforts to reduce SMM and maternal mortality in the United States must prioritize the unique needs of this population and ensure equitable, disability-competent care for all women.
Does Recurrent Implantation Failure Exist? Prevalence and Outcomes of Five Consecutive Euploid Blastocyst Transfers in 123 987 Patients
Authors: Gill Pavan , Ata Baris , Arnanz Ana , Cimadomo Danilo , Vaiarelli Alberto , Fatemi Human M. , Ubaldi Filippo Maria , Garcia-Velasco Juan A. , Seli Emre 
Published: August 2024

(Abstracted from Hum Reprod 2024;39(5):974–980
Recurrent implant failure (RIF) has been defined as repeated failed implantations following multiple embryo transfers. A landmark paper on RIF reported the cumulative sustained implantation and live birth rates achieved with 3 consecutive single euploid blastocyst transfers and found a similar live birth rate across the first 3 consecutive transfers with a “true” unexplained RIF rate of <5% in the in vitro fertilization population.
Electronic Nicotine-Delivery Systems for Smoking Cessation
Authors: Auer Reto , Schoeni Anna , Humair Jean Paul , Jacot-Sadowski Isabelle , Berlin Ivan , Stuber Mirah J. , Haller Moa Lina , Tango Rodrigo Casagrande , Frei Anja , Strassmann Alexandra , Bruggmann Philip , Baty Florent , Brutsche Martin , Tal Kali , Baggio Stéphanie , Jakob Julian , Sambiagio Nicolas , Hopf Nancy B. , Feller Martin , Rodondi Nicolas , Berthet Aurélie 
Published: August 2024

(Abstracted from N Engl J Med 2024;390:601–610
In a recent systematic review of randomized controlled trials (RCTs), e-cigarettes were found to be more effective for tobacco smoking cessation than nicotine replacement therapy (NRT). Yet, limited evidence exists on the safety and efficacy of e-cigarettes over standard-of-care cessation counseling and their ability to relieve respiratory symptoms like cough and phlegm compared with quitting tobacco cigarettes.
Utility of SATB2 and MOC-31 Immunostains to Distinguish Between Poorly Differentiated Rectal Adenocarcinoma and Anal Squamous Cell Carcinoma
Authors: Fang Jiayun M. , Assarzadegan Naziheh , Cheng Jerome , Lamps Laura 
Published: August 2024

Objectives:
Colorectal adenocarcinoma and squamous cell carcinoma (SCC) can arise in the anorectum and present a significant diagnostic challenge when poorly differentiated. Accurate diagnosis can significantly influence management, as the treatments for these conditions involve distinct neoadjuvant chemoradiotherapy regimens. MOC-31 and SATB2 have been utilized as specific markers of glandular differentiation and colorectal origin, respectively, but studies have shown that they may be positive in squamous cell carcinoma of other sites. This raises the concern that MOC-31 and SATB2 may be positive in squamous cell carcinoma of the anorectum, and overreliance on these stains may be a potential diagnostic pitfall in differentiating rectal poorly differentiated adenocarcinoma (PDA) from anal nonkeratinizing SCC.

Methods:
We identified biopsies from 10 rectal PDA and 17 anorectal nonkeratinizing SCC cases and stained them for MOC-31 and SATB2.

Results:
We found that MOC-31 was highly sensitive, being positive in 10/10 cases of rectal PDA, but not specific, as it was also positive in 11/17 SCC cases. In contrast, SATB2 was both sensitive, with positive staining in 10/10 rectal PDA cases, and specific, with negative staining in 17/17 SCC cases. This includes equivocal staining in 4 of these negative SCC cases. MOC-31 had a sensitivity of 100% and specificity of 35.3%, while SATB2 had a sensitivity of 100% and specificity of 100%.

Conclusions:
Unlike squamous mucosa of the head and neck, and esophagus, SCC of the anus does not frequently stain positively for SATB2. These data suggest that SATB2 is a reliable marker in distinguishing rectal PDA from anorectal nonkeratinizing SCC, whereas MOC-31 is commonly positive in SCC of the anus. It is also important to note that equivocal SATB2 staining may be seen in SCC.
Information Overload—Do We Read All the Posters Displayed Across the Walls on Hospital Wards?
Authors: Sahota Amunpreet , Wijayasiri Pramudi , Than Htet , Munir Mohsin , Sahota Opinder 
Published: August 2024

Background and Objectives:
To establish whether posters displayed across the walls on hospital wards are read, what information is important, and how the information should be received.

Methods:
Sixty-eight staff and 32 patients’ relatives were interviewed across 3 older people’s medical wards followed by 20 follow-up secondary questionnaires postintervention.

Results:
Only 23% of those interviewed were able to recall any of the posters displayed, and of those, 34% did not find the information useful. Those interviewed were enthusiastic about utilizing alternative media. A quarter felt the walls across the hospitals wards should be for artwork. Among patients’ relatives interviewed, common information requests were “the discharge pathway,” “delirium,” and “falls.” Based on the initial findings, a targeted information board was installed and a mural was painted across the wall in one of the wards. Further post-intervention interviews with patients’ relatives showed that the board was well received, but further unmet information needs were uncovered. Despite the new mural, 45% called for more paintings.

Conclusion:
Most people ignore the posters displayed across the walls of hospital wards, and unmet information needs are rife. An appetite exists for alternative media. Paintings were earnestly called for, highlighting how a comforting environment could be part of the holistic care we offer patients in hospital.
Quantitative Evaluation of Noncontrast Magnetic Resonance Enterography for Active Inflammation in Crohn Disease Using Native T1 and T2 Mapping
Authors: Morimoto-Ishikawa Daisuke , Hyodo Tomoko , Komeda Yoriaki , Fukushima Hiroyuki , Itoh Makoto , Ueda Yu , Kudo Masatoshi , Saito Shigeyoshi , Ishii Kazunari 
Published: August 2024

Purpose
The aim of this study was to investigate the utility of native T1 and T2 mapping in the bowel to evaluate disease activity in Crohn disease (CD) using endoscopy as the reference standard.

Methods
This was a prospective study. Magnetic resonance imaging was performed by using a 1.5-T Philips scanner. We used a modified look-locker inversion recovery and a multiecho gradient-spin-echo sequences for single breath-hold native T1 and T2 maps, respectively, for the short-axis image of the intestine, and the measurement at the most severe site was compared with partial Simple Endoscopic Score for Crohn's Disease (pSES-CD, assessed by an expert endoscopist). A pSES-CD ≥ 4 indicated active disease. Statistical analyses were performed using the Student t test, Spearman correlation, and receiver operating characteristic curve analysis.

Results
A total of 27 patients (mean age ± standard deviation, 37 ± 18 years; 20 men, 7 women) were included in this study. The native T1 value of active disease was significantly higher than that of inactive disease (1170.8 ± 100.5 milliseconds vs 924.5 ± 95.3 milliseconds; P = 0.018), but the T2 value was not significantly different between active and inactive disease (76.1 ± 7.8 milliseconds vs 69.3 ± 10.9 milliseconds; P = 0.424). A good correlation was found between native T1 value and pSES-CD (ρ = 0.71; P < 0.001) but not between T2 value and pSES-CD (ρ = 0.06; P = 0.790). The area under the receiver operating characteristic curve for differentiating the disease activity was 0.96 (95% confidence interval [CI]: 0.90–1.00) for T1 values and 0.68 (95% confidence interval: 0.41–0.96) for T2 values.

Conclusions
Native T1 mapping could be potentially used as a noninvasive method to differentiate disease activity in patients with CD and may be superior to T2 mapping for this purpose.
Application of Submucosal Trans-Septal Suturing Technique in a Septal Extension Graft With Porous High-Density Polyethylene and Concurrent Nasal Lateral Osteotomy
Authors: Gu Tianya , Gan Yufeng , Huang Xin , Peng Su , Wu Jie , Chen Xiang , Guo Zongke , Lin Jinde 
Published: August 2024

Background:
Recently, a submucosal trans-septal suturing (STSS) technique was introduced to obviate the dead space of septum after septal extension graft (SEG) with porous high-density polyethylene (pHDPE).

Objective:
To investigate STSS technique after SEG with pHDPE and concurrent nasal lateral osteotomy (LO).

Methods:
A retrospective study was conducted in 53 patients who underwent a STSS technique after SEG with pHDPE and concurrent LO. The postoperative discomfort (nasal pain and obstruction), the width of the nasal bony base, Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation (ROE), and complications were recorded and assessed.

Results:
The mean surgical duration of STSS was 862.53±227.73 seconds. The maximal mean score of postoperative nasal pain and nasal obstruction was 2.132±0.921 and 1.868±0.8995, respectively. The values on the width of the nasal bony base and ROE were significantly improved after surgery. There was no significant difference in NOSE values preoperatively versus 6 months postoperatively. An infection was found in 1 patient, a recurrent minor bleeding of septum in another patient, and a symptomatic nasal obstruction in other 2 patients. There was no major bleeding, hematoma, foreign body sensation, septal perforation, and other infection.

Conclusion:
STSS can eliminate the postoperative dead space of nasal septum with low discomfort and complications, and help to avoid a lateral displacement of osteotomized nasal bony segment (ONBS) in patients undergoing SEG with pHDPE and concurrent LO.