bluuebunny/crossref_metadata_2025_split huggingface dataset:
An improvement in visual acuity accompanied by the development of RPE tear: A Case Report
Authors: Liu Xinyu , Liu Shulin , Xu Zhiyan , Chen Youxin 
Published: July 2024

Abstract

Background
One well-known side effect of retinal pigment epithelial detachment was retinal pigment epithelium tear. It was widely acknowledged as a disastrous event causing major decline in visual acuity. However, in our case, the retinal pigment epithelium tear led to the improvement of visual acuity.
Case presentation:
A 68-year-old male complained of blurry vision in his right eye over a month. A diagnosis of pachychoroid neovasculopathy was made. After three anti-vascular endothelial growth factor injections once a month, the choroidal neovascular membrane gradually diminished, while the pigment epithelial detachment expanded, subretinal fluid increased and the patient’s visual acuity deteriorated. Three months later, a retinal pigment epithelium tear was detected near the fovea, surprisingly along with a complete resolution of the subretinal fluid and a remarkable improvement of visual acuity.
Conclusions
Our case report presents a significant improvement in visual acuity after the retinal pigment epithelium tear development. The main reason was the drainage of pigment epithelial detachment by retinal pigment epithelial tear. The case indicated that surgical drainage of pigment epithelial detachment can be an effective treatment and needs further exploration.
Clinical Diagnostic Study of Inflammatory Cytokines in Aqueous Humor of Patients with Posner-Schlossman Syndrome
Authors: Liu Yu , Kong Xiangmei , Li Shengjie , Wang Zhujian , Cao Wenjun , Gong Yifan 
Published: July 2024

Abstract

Purpose: To detect the levels of inflammatory cytokines in the aqueous humor (AH) of Posner-Schlossman syndrome (PSS) patients and to evaluate their correlation with ophthalmic parameters in PSS patients.
Methods: Aqueous humor (AH) samples were obtained from 29 eyes of PSS patients and 16 eyes of age-related cataract (ARC) patients (control group) diagnosed in the Eye and ENT Hospital, Fudan University. Multiplex microsphere flow cytometric immunoassay was used to detect multiple inflammatory cytokines in AH, including interleukin 1β (IL-1β), interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10), interleukin 12 (IL-12), interleukin 17 (IL-17), tumor necrosis factor (TNF)α, and interferon (IFN) γ. We collected ophthalmic parameters, including corneal endothelial cell density, visual acuity, intraocular pressure (IOP), and visual field respectively. Independent sample t-tests/Mann-Whitney U tests were used for intergroup comparisons, and ROC curves were analyzed using MedCalc19.6.
Results: The levels of IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IFN-γ, and TNF-α in the AH of PSS patients were significantly higher than that in the control group (P<0.05). IL-6 showed a positive correlation with PSS key ophthalmic parameters IOP (r=0.430, P=0.025) and relative decrease in CECD loss between the affected eye and the fellow eye (RECL) (r=0.453, P=0.039) and a negative correlation with corneal endothelial cell count (r=-0.463, P=0.035). The ROC curves showed that IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IFN-γ, and TNF-α had diagnostic value for PSS (P<0.05).
Conclusion: The cytokine levels in the AH of PSS patients were abnormal, suggesting that inflammatory cytokines may also be involved in the pathogenesis of PSS.
Note: CECD, corneal endothelial cell density; RECL, relative decrease in CECD loss between the affected eye and the fellow eye
A digital twin study on thoracic endovascular repair for Stanford type B aortic dissection
Authors: Liu Xiao , Cao Zhongze , Luo Mingyao , Tao Fei , Shu Chang 
Published: July 2024

Abstract

Thoracic endovascular aortic repair (TEVAR) remains the treatment of choice for Stanford type B aortic dissection (TBAD). In this study, we apply a novel machine learning-based (ML-based) digital twin (DT) method to study the relationship between preoperative indicators, inflammation markers, endoleaks (EL) and long-term outcome of patients who received TEVAR. Our result shows that most postoperative indicators are closely related to their preoperative indicators. We also find that height and onset time of TBAD may be related to the occurrence of EL, while long-term outcome is more related to age, body weight and proximal diameter of endograft applied. Besides, our models successfully predict the occurrence of EL and long-term outcome of patients to some extent based only on pre-operative and operative information. In conclusion, this study represents a novel application of DT technology in clinical settings, which could lead to predictive, preventive and personalized treatments in future.
Neurochemical Dynamics during Two Hypnotic States: Evidence from Magnetic Resonance Spectroscopy
Authors: Bruegger Mike , de Matos Nuno Prates , Staempfli Philipp , Zoelch Niklaus , Seifritz Erich 
Published: July 2024

Abstract

This study explores neurochemical changes in the brain during hypnosis, targeting the parieto-occipital (PO) and posterior superior temporal gyrus (pSTG) regions using proton magnetic resonance spectroscopy (MRS). We examined 52 healthy, hypnosis experienced participants to investigate how two different hypnotic states of varying depth impacted brain neurochemistry in comparison to each other and to their respective non-hypnagogic control conditions. Alongside neurochemical assessments, we recorded respiration and heart rate variability (HRV) to further explore possible association between physiological correlates of hypnotic depth. Significant myo-Inositol concentration changes were observed in the PO region during the deeper hypnosis state, possibly indicating reduced neuronal activity. No significant neurochemical shifts were detected in the pSTG region. Additionally, our findings revealed notable physiological changes during hypnosis. Respiratory rates were significantly slowed in both hypnotic states compared to the respective controls, with more pronounced slowing in the deeper hypnotic state. Furthermore, breathing rate differed significantly between both hypnosis states with a stronger decrease during the deeper state This study contributes a first-time insight into neurochemical responses during hypnotic states. We hope offering a foundation for further research in understanding the neurobiological correlates of hypnosis in both, basic science and – down the line - clinical applications.
Combining restricted gene flow, local microhabitat, and habitat fragmentation shapes the fine-scale spatial genetic structure of Fagus hayatae Palib. ex Hayata in Micang Mountain
Authors: Chen Jiayu , Xie Gang , Jiang Chaoyang , Zhang Xuemei , Han Hongyan , Yin Qingxiao , Tang Kun , Gan Xiaohong 
Published: July 2024

Abstract

The beech species Fagus hayatae Palib. ex Hayata is an important relict tree species in subtropical China, which accumulated a wealth of genetic variation during evolution. To revealing its regeneration dynamics, we analyzed the spatial genetic structure and gene flow of Fagus hayatae natural population in Micang Mountain (MCM), China, by using 10 pairs of microsatellite primers. The genetic diversity of F. hayatae MCM population was at the low level among tall trees. The results of Fij and Sp analysis showed that the SGS strength of F. hayatae in MCM were 40 m, the strength of SGS was stronger in saplings compared to adult and old trees. The mean dispersal distance of pollen and seeds were 83.04 m and 30.14 m, respectively. In fine-scale space, F. hayatae population in MCM is poor in genetic variation due to the restricted gene flow and significant SGS, and the strength of SGS and the dispersal distance of gene flow of F. hayatae are influenced by the limited seed dispersal, habitat fragmentation, and microhabitats. During ex situ protection of F. hayatae, the sampling distance between individuals should be greater than 40 m to ensure the most complete genetic efficiency.
Stabilization of the Proximal Ulnar Stump in the Sauvé-Kapandji Procedure by Reconstructing Distal Oblique Bundle
Authors: Shanqing Yin , Chenxi Zhang , Yaopeng Huang , Chuan Chen , Jiadong Pan , Xin Wang , Liu Xiaodong 
Published: July 2024

Abstract

Background
The most common Sauvé-Kapandji (S-K) postoperative complication is instability of the proximal Ulnar Stump. The distal oblique bundle (DOB) is a stable tissue used to stabilize the distal radioulnar joint. we have applied a method to stabilize the proximal ulnar stump by using an improved extensor carpi ulnaris to fix the ulnar stump and reconstruct the DOB to achieve a combination of dynamic and static stable tissue.
Methods
15 patients who underwent the S-K operation after partial ulnar wrist extensor tendon fixation of the ulnar stump and reconstruction of DOB to stabilize the proximal ulnar stump were recruited. After surgery, the patients' wrist pain was evaluated with a visual analog scale (VAS). The Mayo scoring system was used to evaluate total function. The imaging findings included the ulnar and radial distances and the palmar/dorsal displacement distance of the proximal ulna stump.
Results
All 15 patients were followed up for an average of 32.5 months (ranging from 9 to 60 months). The wrist pain of all patients improved from an average of 6.5 ± 2.5 points before the operation to 2.4 ± 2.1 points after the operation. The grip strength increased from 4.5 (4.3) kg before surgery to 7.5 (3.5) kg after surgery, and the forearm rotation activity improved from 61 (16)° before surgery to 81 (13)° after surgery. The average radius of the ulna decreased from 11 mm to 9 mm, but there was no significant difference among the 12 patients. Lateral X-ray imaging revealed no instability of the proximal Ulnar Stump.
Conclusion
Extensor carpi ulnaris fixation of the ulnar stump and reconstruction of the DOB can achieve the combination of dynamic and static stable tissue, which is an effective method for preventing instability of the proximal ulnar stump
Type of study/level of evidence Therapeutic IV.
Electronic Continuing Professional Development (e-CPD) to Improve Competencies of Indonesian Clinical Nurses: An exploratory action research study protocol
Authors: Sari Novita Kurnia , Prihatiningsih Titi Savitri , Lusmilasari Lely 
Published: July 2024

Abstract

Background.
The CPD programs available for nurses in Indonesia need an organized structure to align with individual nurses' specific career trajectories. The distribution of opportunities for CPD is inequitable, posing problems for nurses engaging in CPD activities. These challenges arise from insufficient financial support, a lack of time, and constraints due to work schedules. These programs should be designed in accordance with fundamental principles, advancements in educational technology, cost-effectiveness, ease of access, and the advantages they offer for career advancement and the development of competencies. Study aims to explore and develop the e-CPD model as it is applied on clinical nurses in Indonesia.
Methods.
Research design used Exploratory action research. Data collection will occur in two primary stages: exploration and acting. During the exploration stage, the research team conducted Focus Group Discussions (FGDs) with three distinct groups of participants. Simultaneously, inside the acting stage’s scope, instructional design development, e-CPD platform creation, and user testing will be undertaken.
Discussion.
The e-CPD is a ward-based learning activity that facilitates self-directed learning by providing information resources such as protocols and literature. The inherent nature of this model promotes the distribution of concise segments of essential content presented in platform formats that facilitate engagement among peers and mentors, interactivity, user-friendly digital learning opportunities, and support from peers and mentors. This study offers new light on how an e-CPD might be used as an alternative CPD model for clinical nurses.
Trial Registration.
This trial is registered under ClinicalTrial.gov with identifier number NCT06047652 on September 14, 2023.
Randomized controlled trial evaluating the efficacy of the "Water on Tray" anesthesia technique compared to the Halsted tecnique
Authors: Hosseini Hadi , Haradasht Sadra Amirpour , Khazaei Amir Hossein , Parhizkar Sepehr , Dehabadi Farnaz 
Published: July 2024

Abstract

Objective
With respect to the high failure rate of conventional IANB technique and other associated disadvantages, in this study we focused on an alternative called Water on Tray technique and assessed the efficiency of this method compared to the conventional technique.
Materials and Methods
This single-blind, single center randomized controlled trial was carried out among 90 individuals referred to the dental clinic of the International Branch of Guilan University of Medical Sciences (IB-GUMS) from November to December of 2017. The patients were randomly assigned into two groups. Injection pain was assessed using Numeric Rating Scale (NRS) and patients were asked to report any tingling sensation on the lip and tongue on the side of injection. Electric pulp test (EPT) and the stick test were also performed. If no numbness was report within 15 minutes, the injection was deemed unsuccessful. SPSS software version 25 was used with the significance level of p < 0.05
Results
The WOT technique demonstrated a significantly higher success rate of achieving adequate anesthesia on the first attempt (p < 0.05). Additionally, the WOT technique exhibited other significant advantages, including no instances of positive aspiration, rapid onset of action coupled with lingual nerve block, and reduced pain during injection.
Conclusion
The Water on Tray is a favorable technique to achieve inferior alveolar nerve block due to its ease and high success rate compared to the conventional technique.
Clinical Relevance:
This technique allows dentists to achieve a higher success rate with inferior alveolar nerve blocks and reduce injection pain in patients.
Anal fissure treatment in 2022 - A global snapshot audit conducted by the International Society of University Colon and Rectal Surgeons (ISUCRS)
Authors: Dulskas Audrius , Nunoo-Mensah Joseph , Fortunato Richard , Huneidy Majid , Bugra Dursun , Lohsiriwat Varut , Aukstikalnis Tomas , Samalavicius Narimantas 
Published: July 2024

Abstract

Background
An anal fissure is a longitudinal tear in the mucosa of the anal canal, distal to the dentate line. It is usually situated in the posterior midline but can occur in any quadrant. This condition affects both genders and is associated with pain, bleeding, anal discomfort, amongst other symptoms.
Aim
The aim of this study is to evaluate the global treatment and follow-up of patients with anal fissures in different countries and continents.
Method
A prospective cohort audit database was created with the cooperation of fifty-six doctors from twenty-one different countries. The patients were evaluated according to the type of anal fissure they had, treatment they underwent and results of 8-week post-treatment.
Results
Overall, 302 patients were included, with 106 (35%) diagnosed with an acute anal fissure and 196 (65%) a chronic anal fissure. Leading symptoms were painful defecation (n = 280, 92.7%) followed by anal bleeding (n = 194, 64.2%) and painful bleeding during defecation (n = 182, 60.2%). A total of 111 (36.8%) underwent surgical treatment. Out of the 264 (87%) who underwent follow-up at 8-weeks, 116 patients (44%) were cured, 86 (32.6%) showed marked improvements, 46 patients (17.4%) showed some improvement, 16 (5.0%) reported no change and one patient (0.3%) had worsened symptoms. Complications arising after treatment was recorded in 18 (6%) patients, with 15 (83%) complaining of headaches, 2 (5%) indicated hypotension, perineal sepsis, anal bleeding and/or allergies to medications used during treatment. Comparing pre-treatment and post-treatment Wexner Incontinence Scores, no patients had worsening fecal incontinence, 95.7% showed stable scores, while 13 (4.3%) showed improved scores.
Conclusion
The majority of surgeons chose a non-surgical approach as a first line treatment for anal fissures whether acute or chronic. Overall, 94% of all patients had resolution or improved symptoms, with none of the surgically treated patients developing fecal incontinence afterwards.
Predictive Factors for Post-Stroke Dysphagia in Patients after endovascular thrombectomy for Anterior Circulation Large Vessel Occlusion: A Retrospective Cohort Study
Authors: Yang Shu-Mei , Wu Hao-Wei , Hsueh Hsueh-Wen , Lin Yen-Heng , Lai Ting-Ju , Lin Meng Ting 
Published: July 2024

Abstract

Purpose
To identify the predictive variables for post-stroke dysphagia (PSD) among anterior circulation large vessel occlusion (LVO) stroke patients who underwent endovascular thrombectomy (EVT).
Methods
This retrospective cohort study enrolled hospitalized patients with anterior LVO stroke who underwent EVT between January 1, 2018 and October 31, 2022. PSD was defined as the unsuccessful removal of the nasogastric (NG) tube. Factors such as premorbid characteristics, laboratory results, EVT, rehabilitation-related parameters, and neuro-imaging were analyzed for correlations to PSD at 4 and 12 weeks.
Results
The study enrolled 136 patients and found that lower albumin, lower body mass index (BMI), higher initial and 24-hour post-EVT National Institute of Health Stroke Scale (NIHSS) scores, stroke-associated pneumonia, poor initial sitting balance and ability to sit up, insula or frontal operculum lesions, and bilateral hemisphere involvement were all associated with PSD at both 4 and 12 weeks in the univariate logistic regression. Moreover, the multivariate analysis revealed that lower BMI, insular lesions, and bilateral hemisphere involvement were significant predictors of PSD at both time points.
Conclusions
In patients with anterior LVO following EVT, PSD was associated with lower BMI, higher NIHSS scores, poor initial sitting balance and sitting ability, insular lesions, and bilateral hemisphere involvement.
Coronary Angiography and Interventions in a Sub-Saharan African Country: A 6-year Retrospective Review at Korle-Bu Teaching Hospital.
Authors: Agyekum Francis , Akumiah Florence , Ganatra Khushali , Nguah Samual , Doku Alfred , Adadey Martin , Ampofo Eugene , Asamoah Kofi , Akamah Joseph 
Published: July 2024

Abstract

Background
Coronary artery disease (CAD) is the leading cause of death globally, with unique challenges in Sub-Saharan Africa. This study examines the clinical profile, angiographic severity, and in-hospital outcomes of percutaneous coronary interventions in a Teaching Hospital in Ghana.
Methods
We retrospectively reviewed coronary angiography and percutaneous coronary interventions performed at Korlebu Teaching Hospital between January 2017 and December 2022. This included demographic data, atherosclerotic cardiovascular disease (ASCVD) risk factors, clinical presentation, lesion severity, type of intervention, and in-hospital outcomes.
Results
463 patients were analyzed, with a median age of 60 years. The most prevalent ASCVD risk factors were hypertension (81.4%), old age (61.9%), dyslipidemia (39.6%), diabetes mellitus (35.5%), and obesity (25.8%). Most of the patients had three or more ASCVD risk factors. 127 patients (27.5%) had normal coronary angiograms, 74 (16.0%) had mild non-obstructive CAD, 90 (19.5%) had single-vessel disease, 70 (15.2%) each had two-vessel disease, and three-vessel disease respectively. Thirty-one patients (6.7%) had significant left-main disease. Twice more males than females had severe three-vessel and left-main disease. Although Akans comprised the majority, Ga-Adangbe had more three-vessel and left-main diseases. Six patients (1.3%) died, five of whom were males. The in-hospital mortality rate was higher in emergency cases than in elective cases (6.6% versus 0.3%, p-value < 0.001)
Conclusion
Many patients referred for coronary angiography had multiple ASCVD risk factors. Many of the patients had obstructive coronary artery disease and underwent successful PCI in a resource-constrained center. PCI outcomes were better in elective than emergency cases.
Habitat use by nomadic ibis and spoonbills post-dispersal from breeding sites
Authors: McGinness Heather M. , Lloyd-Jones Luke R. , Robinson Freya , Langston Art , O’Neill Louis G. , Rapley Shoshana , Jackson Micha V. , Hodgson Jessica , Piper Melissa , Davies Micah , Martin John M. , Kingsford Richard , Brandis Kate , Doerr Veronica , Nally Ralph Mac 
Published: July 2024

Abstract

Context
Nomadic waterbirds are highly mobile across a range of spatial and temporal scales, which makes it difficult to monitor, quantify, and predict their habitat use with traditional methods, especially between breeding events when individuals and flocks can move over vast areas.
Objectives
This study aimed to provide accurate information on habitat use to improve strategic conservation management of these species, particularly the provisioning of environmental water.
Methods
To overcome the challenges of distance and remoteness, we analysed a 7-year GPS satellite telemetry dataset from 141 individuals. We quantified habitat selection post-dispersal from breeding sites, and predicted habitat preference for two wading waterbird species of the Threskiornithidae family that frequently nest together at the same sites: straw-necked ibis (Threskiornis spinicollis) and royal spoonbill (Platalea regia).
Results
Both long-term and short-term landscape-scale habitat associations differed between species. Royal spoonbills used fewer and more restricted habitat types than straw-necked ibis. Spoonbills displayed strong preferences for reservoirs, marshes and permanent wetlands, while ibis used both aquatic and terrestrial habitat, including areas of intensive animal production, modified pasture, and woodlands. Analysis of nocturnal versus diurnal space use showed that roosting and foraging habitat requirements for both species are distinct.
Conclusions
Analysing over 1 million telemetry points revealed species-level variability in habitat use, informing resource allocation for environmental water management. Royal spoonbills are more vulnerable to habitat change due to water regime alterations, highlighting the need for focused conservation management. Differences in day and night habitat use indicate the necessity of considering roosting habitats alongside foraging habitats for effective conservation. This comprehensive understanding of waterbirds' spatiotemporal interactions with their environment is crucial for long-term management aimed at increasing waterbird numbers and maintaining diversity.