bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Lateral Overgrowth in Operatively Treated Lateral Condyle Fractures in Children
Authors: Bloodworth Adele , Nihalani Shrey , McGwin Gerald , Williams Kevin A. , Conklin Michael J. 
Published: August 2024

Background:
The most frequent sequelae of pediatric lateral condyle fractures is lateral condyle overgrowth (LCO). The purpose of our study was to investigate LCO in relation to age, quality of reduction, type of fixation, and fracture displacement.

Methods:
We retrospectively analyzed operatively treated lateral condyle fractures in children. The percent change in interepicondylar width (IEW) ((final − initial)/ initial x 100) was used to quantify LCO. IEW was measured from the medial and lateral epicondyles of the distal humerus, using the AP radiographs taken at admission (initial) and follow-up visits (final). The Song classification was used to classify fractures. Fixation was classified as pins, screws or both. The quality of reduction was defined as anatomic or nonanatomic (>2 mm of displacement). Patients were stratified into mild (0% to 10% overgrowth), moderate (10% to 20% overgrowth), and severe (>20% overgrowth) subgroups for further analysis.

Results:
Two hundred one patients were included in the study with an average time between initial and final radiograph measurements of 11.32 weeks. There was an average 11.84 %LCO. Using multivariable analysis, three variables demonstrated significant, independent associations with %LCO: age, race, and quality of reduction. Increasing age remained inversely associated with %LCO. Compared with White patients, Black and Asian patients had significantly greater %LCO. Patients with nonanatomic reductions had a significantly greater %LCO compared with anatomic reductions. When patients were stratified into mild, moderate, and severe groups, age in the mild group, nonanatomic reduction in the moderate group, and race in the severe group were found to be independently associated with increased %LCO using multivariable analysis.

Conclusions:
The amount of LCO was found to be related to nonanatomic reduction, younger age, and Black and Asian race. Interestingly, it was not related to the amount of initial displacement or type of hardware used. To date, this is the largest study investigating LCO in surgically treated lateral condyle fractures.

Level of Evidence:
Level III—retrospective cohort study.
Interpretable machine learning model for early prediction of acute kidney injury in patients with rhabdomyolysis
Authors: Zhang Ximu , Liang Xiuting , Fu Zhangning , Zhou Yibo , Fang Yao , Liu Xiaoli , Yuan Qian , Liu Rui , Hong Quan , Liu Chao 
Published: August 2024

Abstract

Background
Rhabdomyolysis (RM) is a complex set of clinical syndromes. RM-induced acute kidney injury (AKI) is a common illness in war and military operations. This study aimed to develop an interpretable and generalizable model for early AKI prediction in patients with RM.

Methods
Retrospective analyses were performed on 2 electronic medical record databases: the eICU Collaborative Research Database and the Medical Information Mart for Intensive Care III database. Data were extracted from the first 24 hours after patient admission. Data from the two datasets were merged for further analysis. The extreme gradient boosting (XGBoost) model with the Shapley additive explanation method (SHAP) was used to conduct early and interpretable predictions of AKI.

Results
The analysis included 938 eligible patients with RM. The XGBoost model exhibited superior performance (area under the receiver operating characteristic curve [AUC] = 0.767) compared to the other models (logistic regression, AUC = 0.711; support vector machine, AUC = 0.693; random forest, AUC = 0.728; and naive Bayesian, AUC = 0.700).

Conclusion
Although the XGBoost model performance could be improved from an absolute perspective, it provides better predictive performance than other models for estimating the AKI in patients with RM based on patient characteristics in the first 24 hours after admission to an intensive care unit. Furthermore, including SHAP to elucidate AKI-related factors enables individualized patient treatment, potentially leading to improved prognoses for patients with RM.
Erectile Dysfunction Risk Among Patients With Diabetes Mellitus Using Sodium–Glucose Cotransporter 2 Inhibitors
Authors: Hu Wei-Syun , Lin Cheng-Li 
Published: August 2024

Abstract:
The aim of this study was to explore the incidence of new-onset erectile dysfunction (ED) in diabetes mellitus (DM) patients with sodium–glucose cotransporter 2 inhibitors (SGLT2I) use compared with a control group of non-SGLT2I use by propensity score matching approach. Cox proportional hazards regression models were used to examine the effect of SGLT2I and risk factors on the risk of developing ED, presented as a hazard ratio with a 95% confidence interval. One lakhs fifty nine thousand seven hundred seventy three patients with DM using SGLT2I and 159,773 propensity score matching patients with DM who had never used SGLT2I were included. SGLT2I users had a higher risk of ED than the non-SGLT2I users (adjusted hazard ratio = 1.55, 95% confidence interval = 1.40–1.72). The likelihood of developing ED was higher in patients with SGLT2I use was found.
COMPARATIVE STUDY BETWEEN THE EFFECTIVENESS OF AMNION-CollaGee [COLLAGEN–GELATIN–ELASTIN] AS A BIOLOGICAL PRODUCT WOUND DRESSING AND CONVENTIONAL DRESSING ON THE DONOR SITE OF THE SPLIT THICKNESS SKIN GRAFT IN ANIMALS MODEL (RATS)
Authors: Alasadi Haider Ayad Ashour , Krishnan Illayaraja , Kamisan Ixora , Chin Tan Geok , Lokanathan Yogeswaran , Busra Mohd Fauzi Mh , Imran Farrah Hani , Latar Nani Harlina Md 
Published: August 2024

Abstract

Background
The clinical application of amniotic membrane wound healing products is limited partially due to handling challenges. Amnion-CollaGee sponge dressing (ACS) provides better alternatives to traditional therapy in facilitating wound healing.

Objective
To optimize the effectiveness of ACS as a healing agent in donor-site split-thickness skin graft (STSG) based on in vitro outcomes. Followed by comparing wound healing rates, pain sensitivity, and risks of infection between investigator ACS dressing with currently conventional Duoderm dressing (DD) via in vivo analysis.

Materials and methods
Seven male Sprague-Dawley rats underwent STSG harvesting, with 1x1cm grafts taken from both the right and left sides of the animals' backs. The wounds on the right side (Group 1) were dressed with ACS, while the wounds on the left side (Group 2) were dressed with DD. The donor site wounds were assessed on the seventh, fourteenth, and twenty-first days of the experiment. Primary outcomes measured were rate of healing, pain sensitivity, potential risks of infection. Secondary outcomes were lesion vascularity, pigmentation and histopathological features.

Results
The size of the wounds treated with ACS was statistically smaller compared to that treated with DD. On day 21st, both types of dressings showed complete healing, thus, contributing to better aesthetic value. Additionally, superior pain suppression was witnessed at ACS-treated graft sites compared to DD. Histopathological reports displayed better post-traumatic wound site inflammatory control, less tissue scarring, and abundant collagen growth in the ACS wing compared to the DD counterpart.

Conclusion
The biological ACS dressing appeared to facilitate rapid wound healing rates, reduce the risk of exposed wound infections, and enhance pain suppression in rodent models.
ACS based dressing agents are future interventional breakthroughs in graft donor site wound management.
The Impact of Cardiopulmonary Rehabilitation on Ventriculoarterial Coupling in Post-Coronavirus Disease-2019 Patients
Authors: Gounaridi Maria-Ioanna , Souvaliotis Nektarios , Vontetsianos Angelos , Chynkiamis Nikolaos , Lampsas Stamatios , Theofilis Panagiotis , Anastasiou Artemis , Goliopoulou Athina , Tzima Ioanna , Katsarou Ourania , Bakakos Petros , Vavouranakis Manolis , Koulouris Nikolaos , Siasos Gerasimos , Oikonomou Evangelos 
Published: August 2024

Purpose:
Coronavirus disease-2019 (COVID-19) affects the cardiovascular system even after the acute phase of the disease. Cardiopulmonary rehabilitation may improve post-COVID-19 symptoms. This study aims to evaluate the impact of a cardiopulmonary rehabilitation program after acute COVID-19 on arterial stiffness, left ventricular function, and ventriculoarterial coupling (VAC).

Methods:
Forty-eight adults were examined 1 (T0) and 3-mo (T1) following recovery from COVID-19 and randomized 1:1 to participate or not in a 3-mo rehabilitation program. Matched subjects were enrolled as a non-COVID-19 group. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (PWV). Left ventricular (LV) systolic performance was evaluated with global longitudinal strain (GLS). The PWV/LV-GLS ratio was calculated as an index of VAC. High-sensitivity C reactive protein (hs-CRP) was measured.

Results:
At T0, convalescent patients with COVID-19 had impaired PWV (P = .001) and reduced VAC (P = .001) compared to non-COVID-19 subjects. PWV (8.15 ± 1.37 to 6.55 ± 0.98 m/sec, P < .001) and LV-GLS (−19.67 ± 1.98 to −21.3 ± 1.93%, P < .001) improved only in convalescent patients with COVID-19 undergoing rehabilitation. Similarly, VAC was only improved in the rehabilitation group (−0.42 ± 0.11 to −0.31 ± 0.06 m · sec−1 ·%−1, P < .001). A significant improvement in VO2max was noted after rehabilitation (15.70 [13.05, 21.45] to 18.30 [13.95, 23.75] ml · kg−1 · min−1, P = .01). Finally, hs-CRP was improved in both groups with a significantly greater improvement in the rehabilitation group.

Conclusion:
A 3-mo rehabilitation program in convalesced patients with COVID-19 enhances the recovery of arterial stiffness, left ventricular function, and VAC, highlighting the beneficial mechanisms of rehabilitation in this patient population.
Effect of Inspiratory Muscle Training on Outcomes After Cardiac Surgery
Authors: Fang Linqi , Cheng Anqi , Zhu Zhaohua , Shao Mengming , Wang Guoai 
Published: August 2024

Purpose:
Inspiratory muscle training (IMT) has emerged as a potential intervention to improve respiratory outcomes for patients undergoing cardiac surgery. However, the extent of the IMT effects on preoperative and postoperative respiratory metrics remains uncertain. Hence, we designed this study to determine the effects of IMT on various outcomes of patients undergoing cardiac surgery.

Methods:
We conducted a comprehensive meta-analysis of studies evaluating the impact of preoperative and postoperative IMT on various respiratory variables and postsurgical outcomes. We synthesized data from multiple studies, encompassing diverse patient populations and IMT protocols. The key outcomes included the maximal inspiratory pressure (MIP), forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and others.

Results:
Our meta-analysis results showed that preoperative IMT significantly improved the MIP values with a pooled standard mean difference (SMD) of 0.62. The hospital stay length was also reduced with a SMD of − 0.4. Other variables such as FEV1 and FVC also improved significantly. Postoperative IMT improved the MIP and peak flow rate values, but the evidence was less robust than with preoperative interventions. We observed high heterogeneity across studies for several outcomes and found evidence of publication bias for some postoperative measures.

Conclusion:
Both preoperative and postoperative IMT offer benefits for patients undergoing operations, especially by enhancing respiratory muscle strength and potentially reducing hospital stays. However, the presence of heterogeneity and publication bias underscores the need for further standardized research to consolidate these findings and standardize IMT protocols for optimal patient outcomes.
CHARACTERISTICS OF “NOTCH” IN RETINOPATHY OF PREMATURITY AFTER INTRAVITREAL RANIBIZUMAB MONOTHERAPY
Authors: Zhang Fengjun , Zou Qiong , Liu Qiuping , You Zhipeng 
Published: August 2024

Purpose:
To explore the clinical features and significance of “notch” in reactivation of retinopathy of prematurity (ROP) post–intravitreal ranibizumab (IVR) monotherapy.

Methods:
Ninety-six infants (173 eyes) with Type 1 or aggressive ROP (A-ROP) post-IVR monotherapy were retrospectively analyzed; 51 eyes were notch (+) and 122 eyes were notch (−). General demographics and clinical outcomes were compared by notch status for Type 1 and A-ROP.

Results:
The notch primarily appeared in Stage 2 ROP (84.4% and 78.9%) at the junction of Zones I and II (68.8% and 63.2%) on the temporal side in Type 1 ROP and A-ROP. Notch was present in the Type 1 ROP group before first IVR but posttreatment in the A-ROP group. A significantly higher reactivation rate, longer follow-up duration, and postmenstrual age at the last follow-up were seen in the notch (+) versus the notch (−) group. In the notch (+) ROP group, the mean gestational age (28.34 ± 0.93 vs. 29.94 ± 1.48 weeks) was significantly lower in reactivated versus regressed eyes.

Conclusion:
Notches appeared at different times but similar locations in Type 1 ROP and A-ROP. The reactivation rate after IVR was increased in ROP with notches. Notch may be a useful biomarker for reactivation after IVR in ROP.
Disentangling the spinal mechanisms of illusory heat and burning sensations in the thermal grill illusion
Authors: Mitchell Alexandra G. , Ehmsen Jesper Fischer , Christensen Daniel Elmstrøm , Stuckert Anna Villaume , Haggard Patrick , Fardo Francesca 
Published: August 2024

Abstract
The thermal grill illusion (TGI), a phenomenon in which the juxtaposition of innocuous warm and cold temperatures on the skin elicits a burning sensation, offers a unique perspective to how pain occurs in response to harmless stimuli. We investigated the role of the spinal cord in the generation of the TGI across 2 experiments (total n = 80). We applied heat and cold stimuli to dermatomes, areas of skin innervated by a single spinal nerve, that mapped onto adjacent or nonadjacent spinal segments. Enhanced warm and burning ratings during the TGI were observed when cold and warm stimuli were confined within the same dermatome. Furthermore, we found the spatial organisation of warm and cold stimuli within and across dermatomes affected TGI perception. Perceived warmth and burning intensity increased when the cold stimulus projected to the segment more caudal to the warm stimulus, whereas perceived cold during the TGI decreased compared with the opposite spatial arrangement. This suggests that the perception of TGI is enhanced when cold afferents are projected to spinal segments positioned caudally in relation to those receiving warm afferents. Our results indicate distinct interaction of sensory pathways based on the segmental arrangement of afferent fibres and are consistent with current interpretations of the spread and integration of thermosensory information along the spinal cord.
High-Dose Propranolol for Severe and Chronic Aggression in Autism Spectrum Disorder
Authors: London Eric B. , Zimmerman-Bier Barbie L. , Yoo J. Helen , Gaffney Joseph W. 
Published: August 2024

Background
Despite the use of behavioral interventions and psychotropic medications, many individuals with autism spectrum disorder (ASD) who engage in severe aggression remain refractory to conventional treatment. Propranolol, a beta-blocker, has accumulated much anecdotal evidence as a promising option. However, well-designed studies are rare, and the apprehension about cardiovascular side effects from large doses continues to exist.

Purpose
The aims of this study were (1) to demonstrate the feasibility of treating aggression with high-dose propranolol using telehealth study visits and (2) to document cardiac safety.

Methods
This study utilized a randomized, double-blind, placebo-controlled, crossover design. Dosing was titrated up in a flexible but stepwise fashion until therapeutic response was obtained or up to 200 mg tid. Following washout, those who were assigned propranolol were crossed over to placebo and vice versa. Six participants between the ages 12–19 participated. The primary outcome measures were the final Clinical Global Impression Improvement Scale (CGI-I) and the Aberrant Behavior Checklist—Community Irritability (ABC-C/I) scores at 200 mg tid.

Results
The CGI-I indicated a 50% reduction in symptoms in the propranolol phase, while the ABC-I indicated a 37% reduction in comparison to placebo. The effect sizes (r) for the CGI-I and the ABC-C/I were large, −0.74 and −0.64, respectively. The average blood pressure was 122/68 during the placebo phase and 109/72 during the propranolol phase. All Holter monitor exams were unremarkable.

Conclusion
These results suggest that propranolol is an effective option in decreasing aggression in individuals with ASD. As this was a small study, a larger clinical trial is needed.
Development and validation of a virtual teaching method for minimally invasive surgery skills: a prospective cohort study
Authors: Das Bibek , Ledesma Frances , Naik Ravi , Law Sarah , Soleimani-Nouri Payam , Khan Omar A , Mylonas George , Pai Madhava , Ashrafian Hutan , Spalding Duncan , Fehervari Matyas 
Published: August 2024

Introduction:
The COVID-19 pandemic led to a significant reduction in operative exposure for surgical trainees, necessitating alternative training methods to mitigate the impact on surgical education. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using widely available technology with objective assessments of proficiency.

Methods:
This was a pilot observational study with a comparative assessment of face-to-face (F2F) and virtual training of novice learners in MIS skills. Performance and objective cognitive workload parameters [Surgical Task Load Index (SURG-TLX) score, heart rate, and pupil metrics] were evaluated. The assessments were peg transfer [McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS)] and suturing [Suturing Training and Testing (SUTT)] tasks performed using box trainers. Virtual teaching was conducted by expert trainers using a web-based streaming platform.

Results:
Technical challenges of delivering a virtual MIS skills course were addressed after a pilot course. Participants (n=20) in the final course had similar baseline characteristics and were randomly allocated to F2F (n=8) and virtual (n=12) teaching groups. Participants in the online group completed the peg transfer task faster than the F2F group (11.25 min vs. 16.88 min; P=0.015). There were no significant differences in all other MISTELS and SUTT performance measures between groups. Cognitive workload parameters (SURG-TLX score, heart rate, and pupil metrics) were also similar between groups.

Conclusion:
This study has demonstrated that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for low-cost, effective, and scalable MIS skills programs in the future.
Surgical removal of the largest transgastric migrated gossypiboma: A case report
Authors: Haji Mohamad Aya , Al-Jawad Mohammad , Anadani Abdulrazak , Matar Hilal , Niazi Ammar 
Published: August 2024

Rationale:
Gossypiboma is a term that refers to the condition of accidentally retained surgical gauze after surgeries. While many manifestations and complications are possible in this case, the migration of the retained gauze into the gastric cavity is one of the rarest. In this paper, we report the largest migrated surgical towel to the gastric cavity in the literature, measuring 90 cm × 90 cm.

Patient concerns:
A 33-year-old woman with recurrent epigastric pain unresponsive to treatment was referred to our hospital. She had undergone an open surgery cholecystectomy 11 years before admission during wartime in Syria.

Diagnoses:
Abdominal computed tomography with contrast showed a large mass in the stomach, indicating malignancy. However, upper gastrointestinal endoscopy revealed a gray–black foreign body occupying the entire gastric lumen, which indicated the presence of bezoar. Upon surgery, the final diagnosis of gastric gossypiboma was made; which was a retained surgical towel from the previous cholecystectomy that had fully migrated to the stomach and resembled both malignancy and bezoar upon investigation.

Interventions:
The patient underwent open surgery to excise the foreign body.

Outcomes:
The gossypiboma was successfully removed, and the patient was discharged 5 days after the operation without complications.

Lessons:
Retained surgical items, such as gossypiboma, can lead to significant medical complications. The migration of gossypiboma to the stomach, though rare, poses challenges in diagnosis and management, often requiring open surgical removal to prevent adverse outcomes. Early detection and intervention are crucial to avoiding associated morbidity and mortality. It is important to consider gossypiboma in patients with unexplained abdominal pain following surgery and to emphasize meticulous sponge counting to prevent this complication.
From thinning to disappearance: A case report on the healing pattern of multiple and giant plantar warts
Authors: Yu Tao , Yuan Cheng-da 
Published: August 2024

Rationale:
Plantar warts, caused by human papillomavirus (HPV) infection, are a common skin condition on the plantar surface. Despite the availability of various treatments, achieving satisfactory outcomes remains elusive. This study explores a novel therapeutic approach combining traditional Chinese medicine (TCM) soaking therapy with cryotherapy to address this challenge.

Patients concerns:
This study focuses on 3 patients who presented with multiple and giant plantar warts, each with a disease duration exceeding 2 years. These patients had undergone numerous unsuccessful cryotherapy treatments, leaving them with persistent and troublesome warts.

Diagnoses:
All 3 patients were diagnosed with multiple and giant plantar warts caused by HPV infection.

Interventions:
Following unsuccessful cryotherapies, the patients were administered TCM soaking therapy as an adjunct treatment.

Outcomes:
Remarkably, all 3 patients achieved complete remission of their plantar warts within 2 to 4 months after combining cryotherapy with TCM soaking therapy.

Lessons:
Our findings suggest that relying solely on cryotherapy is insufficient for effectively treating plantar warts. The key to successful treatment lies in inhibiting wart proliferation and continuously thinning them, which can be achieved through soaking in TCM. This study demonstrates the potential of combining cryotherapy with TCM soaking as a novel and effective therapeutic approach for treating multiple and giant plantar warts.