bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infinity: A Prospective Trial for Safety and Accuracy of Navigated Posterior Cervical and Thoracic Instrumentation in long-segment Fusions
Authors: Wang Joshua L. , Eaton Ryan G. , Dhaliwal Joravar , Lam Chi Shing , Xu David S. , Viljoen Stephanus V. , Grossbach Andrew J. 
Published: August 2024

Study Design.
Unblinded single-arm prospective clinical trial

Objective.
Evaluate safety and accuracy of navigation for placement of posterior cervicothoracic instrumentation.

Summary of Background Data.
Computer assisted stereotactic navigation for placement of spinal instrumentation has been widely studied and implemented in the thoracic and lumbar spine. However less literature exists regarding the use of computer assisted navigation for posterior cervical instrumentation, particularly with lateral mass fixation. Here we present the first prospective study of navigated cervical lateral mass screw placement for cervicothoracic fusion.

Methods.
Patients who met indications for posterior cervical fusion were screened, consented, and enrolled preoperatively for instrumentation with Medtronic Infinity Occipital-Cervical-Thoracic implants, with use of intraoperative O-arm and stereotactic Stealth navigation. Postoperative CTs of the instrumented levels were obtained during the same hospital admission. Primary outcome of the trial was safety. Secondary outcomes were screw accuracy assessed by Gertzbein-Robbins grade, neurologic exams, and patient reported outcomes on the PROMIS 29 questionnaire.

Results.
A total of 50 patients underwent surgery, and 557 screws were placed. There were no adverse events related to the use of navigation or screw malposition. Gertzbein-Robbins grade A or B placement comprised 95% of navigated screws. There was a decrease in positive Hoffmann sign rate postoperatively, and sensory and motor exams remained stable. There was improvement in patient reported pain and sleep domains.

Conclusions.
Navigation for cervicothoracic instrumentation is safe overall and leads to high rates of accurately placed screws. Longer term follow up could provide more insight to whether the use of this technology results in durable improvement in spinal alignment parameters and patient reported outcomes.

Level of Evidence.
3
Conservation of resources perspective on authentic leadership and employee well-being: The influence of job stress and emotional intelligence
Authors: Shih Fang-Chi , Yeh Shu-Chuan Jennifer 
Published: August 2024

Background
Health care industries must consider their sustainable development, and employee well-being is a crucial environmental, social, and governance indicator that should be prioritized. During events such as the COVID-19 pandemic, information transparency is a concern for health care workers. Authentic leaders can build trust by openly sharing their thoughts and feelings. Understanding how authentic leadership affects employee well-being through job stress and how emotional intelligence reduces job stress is essential for health care workers.

Purposes
This study investigated the effect of authentic leadership on employee well-being and considered the mediating role of job stress and moderating role of emotional intelligence in this effect.

Methodology/Approach
A time-lagged survey of 452 full-time health care workers (comprising nurses, allied health professionals, and administrative workers) from a general hospital in Taiwan was conducted.

Findings
Authentic leadership was positively associated with employee well-being, and job stress mediated the effects of authentic leadership on employee well-being. Among the employees who perceived leadership to be authentic, those with higher emotional intelligence felt less job stress.

Conclusion
From the perspective of conservation of resources theory, authentic leadership was identified as a crucial factor influencing how health care workers reduce job stress and improve their well-being. Emotional intelligence was identified as essential in enhancing the effects of authentic leadership on reducing the job stress of health care workers.

Practice Implications
Organizations should promote authentic interactions between leaders and followers and provide training for developing authentic leadership. They should also provide training to improve their employees' emotional intelligence.
PERFLUOROCARBON LIQUID USE DURING VITRECTOMY FOR MACULA-OFF RETINAL DETACHMENT HAS NO IMPACT ON MACULAR FOLDS AND METAMORPHOPSIA
Authors: Wurtz Mathieu , Dormegny Lea , Muller Candice , Bourcier Tristan , Ballonzoli Laurent , Gaucher David , Saleh Maher 
Published: August 2024

Purpose:
To compare two drainage techniques in macula-off retinal detachment surgery: perfluorocarbon liquid (PFCL)-assisted drainage and partial subretinal fluid drainage without PFCL. This study investigated morphological and functional outcomes, focusing on metamorphopsia quantification.

Methods:
Eighty eyes with macula-off retinal detachment were retrospectively included. All underwent a 25-gauge pars plana vitrectomy. In the PFCL group, subretinal fluid drainage was performed using PFCL. In the partial subretinal fluid drainage (SRFD) group, subretinal fluid was partially drained through a preexisting retinal break without PFCL. A follow-up at 3 months and 6 months evaluated anatomical outcomes using optical coherence tomography, best-corrected visual acuity, and metamorphopsia quantified with M-charts.

Results:
Reattachment rates were comparable in the PFCL group (97.5%) and the SRFD group (95%) (P > 0.05). Mean best-corrected visual acuity (logMAR) was 0.23 ± 0.32 (PFCL group) and 0.15 ± 0.13 (SRFD group) (P = 0.206). Metamorphopsia was reported by 19 patients (47.5%) in the PFCL group and by 12 patients (30%) in the SRFD group (P = 0.332). The mean metamorphopsia score was similar in both groups (0.27 ± 0.12 in the PFCL group and 0.28 ± 0.11 in the SRFD group, P = 0.866). Morphological optical coherence tomography findings were comparable in both groups.

Conclusion:
Morphological and functional outcomes were similar in PFCL and SRFD groups. Metamorphopsia quantification scores did not improve with PFCL. While both of these techniques might be effective and could be recommended for primary macula-off retinal detachment management, potential PFCL toxicity should be kept in mind and its use dedicated to selected cases.
Engineered autologous nasal cartilage for repair of nasal septal perforations: a case series
Authors: Kaiser Benedict , Miot Sylvie , Wixmerten Anke , Pullig Oliver , Eyrich Matthias , Fulco Ilario , Vavrina Josef , Schaefer Dirk J. , Martin Ivan , Barbero Andrea , Haug Martin D. 
Published: August 2024

Objective:
This phase I clinical trial assessed the use of autologous nasal chondrocyte tissue-engineered cartilage (N-TEC) for functional repair of nasal septal perforations (NSP).

Background:
The most widely used technique to treat NSP, namely interposition grafting with a polydioxanone (PDS) plate combined with a deep temporal fascia (DTF) graft, is still suboptimal towards patient satisfaction and revision rates.

Methods:
Patients (n=5, all female, age range: 23–54 years) had a 0.5–2.0 cm diameter NSP. N-TEC was manufactured by expansion and 3D culture of autologous nasal septum chondrocytes into Chondro-Gide collagen membranes. N-TEC was then shaped intraoperatively and enveloped in the harvested DTF before suturing it into the NSP. Safety (primary outcome) was assessed by the number of serious adverse reactions (SAR) until 12 months. Secondary outcomes included feasibility, assessed by surgical graft manipulation, and efficacy, assessed using subjective scoring (nasal obstruction symptom evaluation, NOSE, and visual analog scale, VAS, scores) and objective breathing function tests. Structural closure of NSP after 12 months was defined using endoscopy and computed tomography (CT) scans.

Results:
NSP treatment by N-TEC implantation was safe and feasible, as no SAR and no challenge in graft manipulation was recorded for any of the patients. One year postoperative, subjective scoring improved in all patients, unless already optimal (average improvement of 23 and 28.6 points out of 100, respectively, for NOSE and VAS scores). Objective respiratory function overall confirmed – with the exception of one case – the observations above (average improvement of 172 ml/s). NSP were closed and the mucosae completely healed in three patients.

Conclusion:
Autologous N-TEC is a valid treatment for NSP and warrants further clinical tests.
The reduction of LEDD leads to visual dysfunction in patients with PD after STN-DBS: a randomized clinical trial
Authors: Sun Jinxing , Ma Shengmei , Li Zhenke , Jia Junheng , Wu Qianqian , Hou Ying , Wang Hong , Wang Qi , Zhang Guangjian , Zhao Zhimin , Huang Bin , Ma Xiangyu , Li Xingang , Li Weiguo , Zhang Chao 
Published: August 2024

Background:
Medication adjustment after deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD) may influence visual function. However, no clinical trials have been designed specifically to investigate this effect.

Objectives:
To compare the effects of levodopa-equivalent daily dose (LEDD) reduction and non-reduction on visual function in patients with Parkinson’s disease (PD) following STN-DBS.

Methods:
This was a multi-center, prospective, randomized, double-blinded clinical trial. A total of 208 patients with Parkinson’s disease were referred for DBS between June 2019 and July 2021 and analyzed between June 2023 and July 2023. STN-DBS was performed, and the LEDD was reduced in one study arm but not in the other. The primary outcome measure was visual impairment in Parkinson’s disease questionnaire (VIPD-Q) with or without LEDD reduction 12 months postoperatively, and the secondary outcomes included retinal nerve fiber layer (RNFL) thickness, vessel density, eye-tracking system results, contrast sensitivity and visual field.

Results:
During the short-term follow-up, DBS implantation and stimulation did not significantly affect visual function (VIPD-Q, baseline vs. 1 month, 9.269±8.385 vs. 8.938±7.666, Mann–Whitney U tests; P=0.6746). In the long-term follow-up, the reduction group demonstrated a significant decline in visual function, RNFL thickness, and vessel density after STN-DBS compared with the control group without STN-DBS (P<0.001).

Conclusions:
Visual dysfunction, particularly a thinner RNFL and lower vessel density, is related to LEDD reduction after STN-DBS. Prolonged administration of dopamine-mimetic drugs prevents visual symptoms. Thus, physicians should consider LEDD adjustment when patients report visual dysfunction before surgery or severe visual symptoms after STN-DBS.
Papillary thyroid carcinoma with invasion of the trachea
Authors: Mohtasib Mohammad Eid Al , Sharabate Khulood “Mohammad Marwan” , Dweik Raghad Faisal Yahia , Shawar Fatimah Iyad Azmi , Shehadeh Daleen Ashraf Azmi 
Published: August 2024

Introduction:
Papillary thyroid carcinoma typically has a favourable survival rate and a low recurrence rate. However, extrathyroidal extension has a significant negative impact on survival. Among the extrathyroidal extensions, invasion of the trachea by papillary thyroid carcinoma is rare and serves as a marker of more aggressive tumour behaviour. This case report aims to highlight the unusual clinical course of papillary thyroid carcinoma.

Case presentation:
A 75-year-old female patient from Gaza has been diagnosed with papillary thyroid carcinoma in 2020. With mediastinal lymph node invasion. she underwent total thyroidectomy and neck dissection and mediastinal lymph node dissection. After the surgery, the patient did not follow up regularly or receive radioiodine treatment. On 2023 presented with hemoptysis, shortness of breath computed tomography (CT) and bronchoscopy reveal thyroid cancer with tracheal invasion, which has invaded the trachea to the left side. The authors treat the patient by bronchoscopy debulking and sent for oncological management.

Discussion:
Papillary thyroid carcinoma is the most common type of thyroid cancer and generally has a good prognosis. Tumour staging through various imaging techniques is crucial for determining the next steps. Cases involving tracheal invasion should undergo bronchoscopy for tumour debulking. Surgical management followed by iodine therapy has shown positive outcomes.

Conclusion:
When patients with Papillary thyroid carcinoma have haemoptysis, and the imaging examinations reveal a space-occupying lesion in airway, clinicians should focus on Papillary thyroid carcinoma with tracheal invasion, a bronchoscopic examination must be immediately performed because the subsequent surgical management depends on the degree of tracheal invasion.
Elacestrant in the treatment landscape of ER-positive, HER2-negative, ESR1-mutated advanced breast cancer: a contemporary narrative review
Authors: Qureshi Zaheer , Jamil Abdur , Altaf Faryal , Siddique Rimsha , Adilovic Edin , Fatima Eeshal , Shah Shivendra 
Published: August 2024

Introduction:
Estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer with ESR1 mutations presents a significant therapeutic challenge due to its adaptive resistance mechanisms to chemotherapy, especially endocrine treatment. Elacestrant, a novel oral selective estrogen receptor degrader (SERD), has emerged as a promising agent in this treatment-resistant era.

Method:
A comprehensive search was conducted on pivotal clinical trials, including the RAD1901-005 Trial, EMERALD TRIAL, ELIPSE, and ELEVATE, focusing on their methodologies, patient populations, treatment regimens, and outcomes.

Discussion:
This narrative review describes the available preclinical and clinical evidence on elacestrant, focusing on its pharmacodynamics, pharmacokinetics, efficacy, and safety within the existing literature. Elacestrant has demonstrated excellent activity against ESR1 mutations associated with resistance to first-line endocrine therapies. Clinical trials have shown improved progression-free survival in patients with advanced ER+/HER2−, ESR1-mutated breast cancer. Safety profiles indicate a tolerable side effect spectrum consistent with other agents. Its oral bioavailability offers a convenient alternative to injectable SERDs, with potential implications for patient adherence and quality of life. The review also discusses the comparative efficacy of elacestrant relative to existing endocrine therapies and its possible use in combination regimens.

Conclusion:
Ongoing clinical trials assessing elacestrant and other SERDs will yield data that might aid clinicians in determining the optimal selection and order of endocrine treatment drugs for ER+ breast cancer. The integration of targeted and immunotherapeutic agents with traditional chemotherapy represents a pivotal shift in Breast Cancer treatment, moving towards more personalized and effective regimens.
The pulse of sleep: novel interventions in understanding the sleep-cardiovascular connection: a literature review
Authors: Uwishema Olivier , Nazir Abubakar , Munyangaju Isabelle , Shariff Sanobar , Al Komi Omar , Chibueze Nweke , Wojtara Magda 
Published: August 2024

Introduction:
Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD.

Methods:
The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included.

Results:
Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP).

Conclusion:
Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.
The relationship between parenting styles and self-esteem of medical students with age and gender as moderators
Authors: Gul Fahad , Abbas Khawar , Saeed Sajeel , Haider Tehseen , Qayyum Sardar Noman , Noori Samim 
Published: August 2024

Introduction:
Among various factors that determine an individual’s self-esteem, parenting styles play a significant role. This study investigates the link between parenting styles and self-esteem among medical students while exploring the role of age and gender in this context.

Methodology:
A cross-sectional study was carried out among medical students from December 2020 to March 2021. An online survey was prepared using the Rosenberg Self-Esteem Scale and Parental Authority Questionnaire-Short Version, and students were asked to fill it out. Data were gathered from 255 students by simple random sampling technique, of which 230 forms were filled. SPSS version 26.0 was used to enter and analyze the data. One sample t-test, Pearson Correlation, and Hierarchal regression analysis were applied. AMOS version 26.00 was used for confirmatory factor analysis.

Results:
Out of 230 participants, 60% of the sample population experienced an authoritative parenting style. Authoritarian and authoritative parenting styles were significantly correlated with self-esteem. Females who experienced authoritative parenting and males who experienced authoritarian and permissive parenting styles had higher self-esteem than their respective counterparts.

Conclusion:
Authoritative parenting was the most common and the only parenting style with a statistically significant positive correlation with self-esteem. This study further highlights the importance of consistent parental supervision and open communication in determining an individual’s self-esteem.
Herpes Simplex Type 1 as the Predominant Cause of Genital Herpes in College Students
Authors: Falk-Hanson Elizabeth , Marconi Agustina , Sarrouf Elena Beatriz , Sullivan Phoebe 
Published: August 2024

Background
Genital herpes etiology has been shifting to include a greater proportion of herpes simplex virus type 1 (HSV-1) infection in the last few decades. A prior study published in 2003 found that 48.9% of infections in a college health population were HSV-1.

Methods
We evaluated the number of positive HSV polymerase chain reaction test results obtained from anogenital sites from undergraduate and graduate students from 2013 to 2022 in a college health clinic setting and analyzed the number caused by HSV-1 and HSV type 2 and compared by sex. This was then compared with the prior study from 1993 to 2001.

Results
We received 691 (of 2685 samples) positive polymerase chain reaction results for HSV of both types in the period analyzed. Overall, 600 (86.8%) of these were HSV-1, and 520 (75.2%) were in female patients. The prior study in 1993 to 2001 found that 48.9% (244 of 675) of all positive test results were HSV-1; we observed an increase in the percentage of positive HSV-1 over all positive test results of 1.8 (χ
2 = 16.548; P < 0.001).

Conclusions
Our study shows that 86.8% of the positive genital HSV test results from 2013 to 2022 were HSV-1. This shows that most positive HSV test results in this setting are now HSV-1, a substantial increase from the previous study in our clinic.
The Experience in Lower Eyelid Blepharoplasty
Authors: Yang Jinxiu , He Leren 
Published: August 2024

Objective
This study characterizes the appearance changes associated with aging of the human lower eyelid, grounded in its anatomical basis. Tailored approaches to lower eyelid bag are performed by these anatomical manifestations.

Methods
From January 2017 to January 2023, lower eyelid blepharoplasty was performed on 137 patients, aged 20 to 60 years. These patients were divided into 3 groups according to the periorbital aging appearance, primarily characterized by the presence and location of the “bag” bulge of the lower eyelid. We analyzed the corresponding changes in anatomical structures for each type, which included a weakened fibrous orbital support system, reduced muscle tone, and increased orbital fat. Patients were treated with tailored blepharoplasty techniques according to their classification. All patients in this study ranged in follow-up from 1 to 12 months. With patients' permit, photographs and clinical information were taken to evaluate the preoperative and postoperative outcome.

Results
Our study identified 3 morphologies of the lower eyelid. Type 1 presents a “bubble bag” in the medial and inferior aspect of the lower eyelid. Type 2 features a double convexity contour, with separate fat pad herniations demarcated by fibrous connective tissue. Type 3 exhibits a single convexity with a uniform herniation of fat pads across the entire lower eyelid. We have delineated the anatomical changes associated with each morphology type. With an approach grounded in “remodeling” and “recovery,” the surgical treatment targets the fibrous support tissue to improve the outcomes of lower eyelid rejuvenation. No complications occurred. All postoperative results reached both surgeon's and patient's expectations.

Conclusions
Surgeons must recognize the pivotal role of fibrous connective tissues—including the arcuate expansion, fascia of the inferior oblique muscle, and the orbicularis retaining ligament—and endeavor to preserve or reinforce these structures during surgical procedures. An anatomically based surgical approach would more effectively and safely to resist the facial aging process.