bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU
Authors: Weatherly Allison J. , Johnson Cassandra A. , Liu Dandan , Kannankeril Prince J. , Smith Heidi A.B. , Betters Kristina A. 
Published: July 2024

OBJECTIVE:
ICU delirium commonly complicates critical illness associated with factors such as cardiopulmonary bypass (CPB) time and the requirement of mechanical ventilation (MV). Recent reports associate hyperoxia with poorer outcomes in critically ill children. This study sought to determine whether hyperoxia on CPB in pediatric patients was associated with a higher prevalence of postoperative delirium.

DESIGN:
Secondary analysis of data obtained from a prospective cohort study.

SETTING:
Twenty-two-bed pediatric cardiac ICU in a tertiary children’s hospital.

PATIENTS:
All patients (18 yr old or older) admitted post-CPB, with documented delirium assessment scores using the Preschool/Pediatric Confusion Assessment Method for the ICU and who were enrolled in the Precision Medicine in Pediatric Cardiology Cohort from February 2021 to November 2021.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Of 148 patients, who underwent cardiac surgery, 35 had delirium within the first 72 hours (24%). There was no association between hyperoxia on CPB and postoperative delirium for all definitions of hyperoxia, including hyperoxic area under the curve above 5 predetermined Pao
2 levels: 150 mm Hg (odds ratio [95% CI]: 1.176 [0.605–2.286], p = 0.633); 175 mm Hg (OR 1.177 [95% CI, 0.668–2.075], p = 0.572); 200 mm Hg (OR 1.235 [95% CI, 0.752–2.026], p = 0.405); 250 mm Hg (OR 1.204 [95% CI, 0.859–1.688], p = 0.281), 300 mm Hg (OR 1.178 [95% CI, 0.918–1.511], p = 0.199). In an additional exploratory analysis, comparing patients with delirium within 72 hours versus those without, only the z score for weight differed (mean [sd]: 0.09 [1.41] vs. –0.48 [1.82], p < 0.05). When comparing patients who developed delirium at any point during their ICU stay (n = 45, 30%), MV days, severity of illness (Pediatric Index of Mortality 3 Score) score, CPB time, and z score for weight were associated with delirium (p < 0.05).

CONCLUSIONS:
Postoperative delirium (72 hr from CPB) occurred in 24% of pediatric patients. Hyperoxia, defined in multiple ways, was not associated with delirium. On exploratory analysis, nutritional status (z score for weight) may be a significant factor in delirium risk. Further delineation of risk factors for postoperative delirium versus ICU delirium warrants additional study.
Prospective Clinical Trial Demonstrating the Efficacy of Hyaluronic Acid Filler for the Improvement of Atrophic Facial Scars up to 2 years
Authors: Siperstein Robyn , Nestor Elizabeth , Meran Suzanne 
Published: July 2024

BACKGROUND
Hyaluronic acid (HA) filler longevity has been studied for wrinkles. However, its long-term use for treating atrophic facial scars has not yet been analyzed in long-term prospective studies.

OBJECTIVE
Analyze the safety and duration of a HA filler for the use in atrophic scars.

MATERIALS AND METHODS
Fifteen subjects received VYC-17.5L in atrophic scars on 1 randomized cheek and saline on the other, with 1 optional touch-up treatment and crossover after the short-term trial. Grading for this long-term extension was done on Day 720, using the Global Aesthetic Improvement Scale (GAIS) and the Quantitative Global Scarring Grading System.

RESULTS
On Day 720, a live blind evaluator rated the VYC-17.5L assigned side as having significant reduction in scar severity (−7.2 [t(22) = −6.01, p = .00009]) and number of scars (−8.8 [t(22) = −6.25, p = .00006]) as compared with baseline. There was no significant difference in the results from Day 120 to Day 720. Ninety-two percent (11/12) of subjects reported improvement (GAIS), were satisfied with the treatment, thought it looked natural, and had fewer side effects than expected. There were no persistent or late-onset side effects.

CONCLUSION
VYC-17.5L improved rolling atrophic facial scars, and the results were sustained throughout the 2-year trial without side effects.
The factors that influence the diagnostic accuracy and sample adequacy of EUS-guided tissue acquisition for the diagnosis of solid pancreatic lesions
Authors: Sun Liqi , Li Yuqiong , Song Qiuyue , Peng Lisi , Xing Ying , Huang Haojie , Jin Zhendong 
Published: July 2024

ABSTRACT

Background and Objectives
EUS-guided tissue acquisition (EUS-TA) is the preferred method to acquire pancreatic cancer (PC) tissues. The factors associated with false-negative outcomes and inadequate samples should be explored to gain an understanding of EUS-TA.

Methods
The patients who underwent EUS-TA for suspected solid PC but whose results were false-negative were analyzed. The PC patients who underwent EUS-TA with true-positive results on the first day of every month during the study period were selected as the control group. The factors influencing diagnostic accuracy and sample adequacy were explored.

Results
From November 2017 to January 2022, 184 patients were included in the false-negative group, and 175 patients were included in the control group. Multivariate logistic regression demonstrated that the recent acute pancreatitis [odds ratio (OR): 0.478, 95% confidence interval (CI): 0.250–0.914, P = 0.026] and high echo component within the tumor (OR: 0.103, 95% CI: 0.027–0.400, P = 0.001) were independently associated with false-negative EUS-TA results. Meanwhile, using fine-needle biopsy (FNB) needles (OR: 2.270, 95% CI: 1.277–4.035, P = 0.005), more needle passes (OR: 1.651,95% CI: 1.239–2.199, P = 0.005), large tumor size (OR: 1.053, 95% CI: 1.029–1.077, P < 0.001), and high CA-19-9 level (OR: 1.001, 95% CI: 1.000–1.001, P = 0.019) were independently associated with true-positive EUS-TA outcomes. Three needle passes are needed to achieve optimal EUS-TA outcomes. Tumor location in the body/tail (OR: 1.38, 95% CI: 1.01–1.72; P = 0.04), needle passes ≥3 (OR: 1.90; 95% CI: 1.22–2.56; P < 0.001), and using the FNB needle (OR: 2.10; 95%: 1.48–2.85; P < 0.001) were independently related to sample adequacy.

Conclusion
Numerous factors were identified to be associated with the diagnostic accuracy and sample adequacy of EUS-TA.
Nonsurgical Correction of Congenital Auricular Anomalies: Design and Effectiveness of the Ear Splint
Authors: Chang Yachun , Chen Lirong 
Published: July 2024

Summary:
Congenital auricular anomaly is a common problem for newborns. In recent years, the correction technology of ear molding has gradually become the mainstream therapy. Therefore, the purpose of this case report is to describe ear molding devices with low-temperature thermoplastic splints, designed by occupational therapists and called the Ear Splint for Taiwan, and to explore its effectiveness in treating newborns with congenital auricular anomalies. The ear splint is made by an occupational therapist based on the theory of corrective mechanics. The molded splint adjusts the ear to normal shape. Patients who received ear treatments at the Mennonite Christian Hospital in 2020 were enrolled as the subjects. A posttest research design was adopted in this case report to conduct a questionnaire survey among parents. The ear splint is a double C-shaped bracket. In this case report, there were two subjects in total, and two different types of malformed ears. According to the questionnaire survey, the average score of auricle shape improvement effectiveness after interventions were 5 and 4 points (5 excellent; 1 bad). The results of this case report indicate that it is feasible for occupational therapists to use the ear splint to mold the congenital auricular anomalies of newborns. Preliminary evidence shows that ear shapes can be corrected. The ear splint provides an early interventional therapy for newborns with congenital auricular anomalies in Taiwan.
Serologic extracellular matrix remodeling markers are related to fibrosis stage and prognosis in a phase 2b trial of simtuzumab in patients with primary sclerosing cholangitis
Authors: Thorburn Douglas , Leeming Diana J. , Barchuk William T. , Wang Ya , Lu Xiaomin , Malkov Vladislav A. , Ito Kaori L. , Bowlus Christopher L. , Levy Cynthia , Goodman Zachary , Karsdal Morten A. , Muir Andrew J. , Xu Jun 
Published: July 2024

Background:
Novel noninvasive predictors of disease severity and prognosis in primary sclerosing cholangitis (PSC) are needed. This study evaluated the ability of extracellular matrix remodeling markers to diagnose fibrosis stage and predict PSC-related fibrosis progression and clinical events.

Methods:
Liver histology and serum markers of collagen formation (propeptide of type III collagen [Pro-C3], propeptide of type IV collagen, propeptide of type V collagen), collagen degradation (type III collagen matrix metalloproteinase degradation product and type IV collagen matrix metalloproteinase degradation product), and fibrosis (enhanced liver fibrosis [ELF] score and its components [metalloproteinase-1, type III procollagen, hyaluronic acid]) were assessed in samples from baseline to week 96 in patients with PSC enrolled in a study evaluating simtuzumab (NCT01672853). Diagnostic performance for advanced fibrosis (Ishak stages 3–6) and cirrhosis (Ishak stages 5–6) was evaluated by logistic regression and AUROC. Prognostic performance for PSC-related clinical events and fibrosis progression was assessed by AUROC and Wilcoxon rank-sum test.

Results:
Among 234 patients, 51% had advanced fibrosis and 11% had cirrhosis at baseline. Baseline Pro-C3 and ELF score and its components provided moderate diagnostic ability for discrimination of advanced fibrosis (AUROC 0.73–0.78) and cirrhosis (AUROC 0.73–0.81). Baseline Pro-C3, ELF score, and type III procollagen provided a moderate prognosis for PSC-related clinical events (AUROC 0.70–0.71). Among patients without cirrhosis at baseline, median changes in Pro-C3 and ELF score to week 96 were higher in those with than without progression to cirrhosis (both p < 0.001).

Conclusions:
Pro-C3 correlated with fibrosis stage, and Pro-C3 and ELF score provided discrimination of advanced fibrosis and cirrhosis and predicted PSC-related events and fibrosis progression. The results support the clinical utility of Pro-C3 and ELF score for staging and as prognostic markers in PSC.
Nuclear imaging techniques for cardiac amyloidosis
Authors: Saad Jean Michel , Al-Mallah Mouaz H. 
Published: July 2024

Purpose of review
Cardiac amyloidosis is a condition marked by the misfolding of precursor proteins into insoluble amyloid fibrils, leading to restrictive cardiomyopathy and heart failure symptoms. This review discusses advancements in nuclear imaging techniques that enhance the diagnosis and guide the management of cardiac amyloidosis, addressing the critical need for early and accurate detection in clinical practice.

Recent findings
Recent studies and guidelines emphasizes the pivotal role of nuclear imaging techniques in diagnosing cardiac amyloidosis. Cardiac scintigraphy, using bone-avid tracers like 99mTc-PYP, 99mTc-DPD, and 99mTc-HMDP, is instrumental in distinguishing between transthyretin amyloidosis and light chain amyloidosis. PET, with tracers such as 11C-Pittsburgh Compound B (11C-PiB) and 18F-Florbetapir, offers significant potential in measuring amyloid burden and monitoring disease progression, providing detailed insights into the myocardial involvement.

Summary
The advancements in nuclear imaging techniques significantly impact the management of cardiac amyloidosis. These methods allow for a more accurate diagnosis, detailed assessment of disease extent, and better differentiation between amyloidosis types, which are crucial for tailoring treatment approaches. The integration of these techniques into clinical practice is essential for improving patient outcomes and advancing research in cardiac amyloidosis.
Systemic anti-VEGF biosimilar therapy associated with improved macular anatomy and duration of effect in a patient with nearly recalcitrant neovascular age-related macular degeneration
Authors: Morgan Kipp R , Richards Paige J , Chang Jonathan S 
Published: July 2024

Purpose:
To present a patient with neovascular AMD treated systemically with the biosimilar bevacizumab-awwb (Mvasi) with superior SRF resolution when compared to continuous and repeated intravitreal treatments.

Methods:
Retrospective single case report.

Results:
After 3 years of monthly aflibercept treatment for nAMD, the patient had persistent subretinal fluid (SRF). Systemic bevacizumab-awwb (Mvasi) infusions were initiated by her oncologist for ovarian cancer and SRF resolved for the first time. After one additional aflibercept injection, and continued bevacizubam-awwb infusions for her cancer, SRF did not recur. Thirteen weeks later, at final follow-up before the patient passed away, the macula remained dry and no additonal intravitreal treatment was given.

Conclusion:
When systemic anti-VEGF biosimilar therapy was administered, there was improved anatomy and prolonged duration of effect compared to the intravitreal therapy alone. Adverse systemic effects limit the routine use of systemic anti-VEGF therapy for retinal disease. However if a patient requires systemic anti-VEGF or anti-VEGF biosimilar therapy for malignancy, it may also benefit retinal disease leading to benefits in quality of life and fewer office visits.
Recalcitrant Peripapillary Pachychoroid Syndrome Responds to High-Dose Aflibercept Therapy
Authors: Feo Alessandro , Abraham Neda , Mafi Mostafa , Sarraf David 
Published: July 2024

Purpose:
To describe a case of recalcitrant bilateral peripapillary pachychoroid syndrome (PPS) treated with high-dose (HD) intravitreal aflibercept injections.

Methods:
Medical and imaging records were retrospectively evaluated. Multimodal imaging included ultra-widefield indocyanine green and fluorescein angiography and fundus autofluorescence. Tracked optical coherence tomography (OCT) B scans were reviewed to assess intra- (IRF) and subretinal fluid (SRF), and to measure choroidal thickness (CT). Macular neovascularization was excluded with OCT angiography.

Results:
A 75-year-old man with bilateral PPS and severe peripapillary and macular edema underwent multiple sessions of photodynamic therapy, intravitreal aflibercept injections, and corticosteroid eye drop application with minimal improvement of the fluid. After two monthly intravitreal HD aflibercept injections, the peripapillary and macular fluid was almost completely resolved with commensurate choroidal thickness reduction and significant visual gain in each eye.

Conclusion:
High-dose intravitreal aflibercept therapy may lead to remarkable anatomical and functional improvement in eyes with recalcitrant PPS.
Concurrent Central Retinal Vein Occlusion and Rhegmatogenous Retinal Detachment in Two Young Healthy Patients
Authors: Rashid Simatul , Meshkin Ryan S. , Cakir Bertan , Hoyek Sandra , Rossin Elizabeth J. , Eliott Dean , Patel Nimesh A. 
Published: July 2024

Purpose:
Central retinal vein occlusion (CRVO) and rhegmatogenous retinal detachment (RRD) are two distinct retinal conditions that typically affect older patient populations with comorbidities or predisposing risk factors. This case report presents unusual co-occurrences of CRVO and RRD in two young, healthy adult patients and proposes potential etiological factors contributing to the complex presentations.

Methods:
Retrospective case-series of two young, healthy males with no history of systemic diseases who presented with concurrent CRVO and RRD.

Results:
The first case was a 28-year-old male construction worker, who presented with acute, painless vision loss and extensive intra-retinal hemorrhages in the right eye, tortuous dilated retinal veins, significant macular edema, optic disc edema, and a macula sparing RRD. Treatment included intravitreal injections of bevacizumab followed by RRD repair with scleral buckle, cryotherapy, external drainage, and later a pneumatic retinopexy. His visual acuity had improved from 20/200 to 20/30 in the right eye. The second case was a 19-year-old male patient who also presented with acute painless vision loss in the left eye and was diagnosed with CRVO and concomitant RD. Treatment included intravitreal bevacizumab injections, oral prednisone trial, and surgical repair with scleral buckle, vitrectomy, and silicone oil insertion. Workup for inflammatory, infectious, and hypercoagulable conditions was negative in both cases.

Conclusions:
Concurrent CRVO and RRD can occur in young healthy patients. Prompt surgery is indicated and treatment with anti-VEGF can be initiated in the perioperative period without complications.
Quantum Molecular Resonance Electrotherapy for the Treatment of Pediatric Ocular Rosacea
Authors: Surapaneni Leena , Giachos Ioannis , Palioura Sotiria 
Published: July 2024

Purpose:
The purpose of this study was to report the outcomes of quantum molecular resonance (QMR) electrotherapy in the management of refractory pediatric ocular rosacea.

Methods:
This is a retrospective case series on 3 female pediatric patients (ages 12, 15, 14 years) with ocular rosacea. Two patients presented with corneal stromal neovascularization and punctate epithelial erosions while 1 patient presented with corneal scarring and paracentral stromal thinning. After failing conservative management, the patients were treated with 4 consecutive QMR electrotherapy sessions with the intensity set at 5 corresponding on average to a power of 12 W, with 60 V voltage and 200 mA current. Informed consent was obtained for off-label use. Patients were assessed for changes in vision, foreign body sensation, tearing, photophobia, and redness at each visit to determine symptomatic improvement. Outcome measures include best-corrected visual acuity, use of supplemental therapies (eg topical steroids) for symptom relief, extent of corneal neovascularization via serial slitlamp photography, and corneal scar remodeling via high resolution anterior segment optical coherence tomography.

Results:
Two of the 3 patients experienced improvement in visual acuity after QMR electrotherapy. Corneal neovascularization and scarring regressed significantly in all 3 patients. Two months post-QMR electrotherapy, corneal remodeling was evident on optical coherence tomography in 2 patients. All 3 patients were able to discontinue topical immunosuppressants and remain symptom-free at 1.5 years of follow-up.

Conclusions:
QMR electrotherapy is a promising alternative in the treatment of refractory ocular rosacea in childhood and puberty, and it may potentiate corneal remodeling.
“Blue Scrub Lid Retraction”: Changes in Eyelid Position on the Day of Surgery
Authors: Ducker Laurence G. , Halbach Caroline S. , Piazza Amber N. , Rajjoub Raneem D. , Kamboj Alisha , Harrison Andrew R. , Mokhtarzadeh Ali 
Published: July 2024

Purpose:
The aim of this study is to test the hypothesis that margin-reflex distance 1 (MRD1) on the day of surgery will be higher than the MRD1 measured at the in-clinic consult visit among patients undergoing blepharoptosis repair due to an increased sympathetic drive.

Methods:
Patients evaluated for involutional blepharoptosis repair were prospectively enrolled over a 12-month period in this single-center, self-controlled study. Three investigators independently determined MRD1 using cropped photos taken of patients at the in-clinic consult visit and on the day of surgery. A difference in height was tested for by using the 2-tailed Wilcoxon signed rank test.

Results:
Evaluated in this study were 76 eyelids from 38 patients. Over 3-quarters of study participants had a higher MRD1 in the right and OSs on the day of surgery than at their in-clinic consultation visit (p < 0.001). The mean increase in MRD1 for the right eyelid and left eyelid was 1.0 mm (range: 0–3.15 mm) and 1.1 mm (range: 0–2.7 mm), respectively.

Conclusions:
In patients with involutional blepharoptosis, we conclude that MRD1 is higher on the day of surgery as compared with the in-clinic consult visit. This may be secondary to the stress of surgery and an associated increase in sympathetic drive. In some cases, this change in eyelid position led to resolution of apparent involutional ptosis altogether. Caution should be used when considering deferral of ptosis repair on the basis of exam findings present on the day of surgery.
What is associated with painful polyneuropathy? A cross-sectional analysis of symptoms and signs in patients with painful and painless polyneuropathy
Authors: Gierthmühlen Janne , Attal Nadine , Baskozos Georgios , Bennedsgaard Kristine , Bennett David L. , Bouhassira Didier , Crombez Geert , Finnerup Nanna B. , Granovsky Yelena , Jensen Troels Staehelin , John Jishi , Kennes Lieven Nils , Laycock Helen , Pascal Mathilde M.V. , Rice Andrew S.C. , Shafran-Topaz Leah , Themistocleous Andreas C. , Yarnitsky David , Baron Ralf 
Published: July 2024

Abstract
It is still unclear how and why some patients develop painful and others painless polyneuropathy. The aim of this study was to identify multiple factors associated with painful polyneuropathies (NeuP). A total of 1181 patients of the multicenter DOLORISK database with painful (probable or definite NeuP) or painless (unlikely NeuP) probable or confirmed neuropathy were investigated clinically, with questionnaires and quantitative sensory testing. Multivariate logistic regression including all variables (demographics, medical history, psychological symptoms, personality items, pain-related worrying, life-style factors, as well as results from clinical examination and quantitative sensory testing) and machine learning was used for the identification of predictors and final risk prediction of painful neuropathy. Multivariate logistic regression demonstrated that severity and idiopathic etiology of neuropathy, presence of chronic pain in family, Patient-Reported Outcomes Measurement Information System Fatigue and Depression T-Score, as well as Pain Catastrophizing Scale total score are the most important features associated with the presence of pain in neuropathy. Machine learning (random forest) identified the same variables. Multivariate logistic regression archived an accuracy above 78%, random forest of 76%; thus, almost 4 out of 5 subjects can be classified correctly. This multicenter analysis shows that pain-related worrying, emotional well-being, and clinical phenotype are factors associated with painful (vs painless) neuropathy. Results may help in the future to identify patients at risk of developing painful neuropathy and identify consequences of pain in longitudinal studies.
Interleukin-1β-stimulated macrophage-derived exosomes improve myocardial injury in sepsis via regulation of mitochondrial homeostasis: experimental research
Authors: Ma Chunhua , Yang Zhaocong , Wang Jing , She Han , Tan Lei , Mo Xuming , Li Tao , Liu Liangming 
Published: July 2024

Background:
The purpose of this study was to investigate the effects of interleukin-1β (IL-1β) stimulation on the protection of macrophage-derived exosomes miR-146a (M-IL-exo-146a) on sepsis-induced myocardial injury (SMI) in vitro and in vivo.

Materials and methods:
Macrophage-derived exosomes (M-exo) and IL-1β-stimulated macrophage exosomes (M-IL-exo) were isolated from macrophages of sepsis with or without IL-1β. The expressions of miR-146a in M-exo and M-IL-exo were detected by fluorescence quantitative PCR. Related molecular biology technologies were used to evaluate the role and mechanism of M-exo-146a and M-IL-exo-146a on SMI and the enhancing effect of IL-1β.

Results:
Compared with M-exo, the expression of miR-146a in M-IL-exo was significantly increased. M-IL-exo-146a significantly alleviated SMI by decreasing the level of serum myocardial enzymes, serum and myocardial oxidative stress and cytokines, and improved myocardial mitochondrial imbalance. The mechanism responsible for IL-1β enhancing the production of IL-M-exo miR-146a was via JNK-1/2 signal pathway. The mechanism responsible for M-exo-IL-miR-146a protecting SMI was related to miR-146a inhibiting inflammatory response and mitochondrial function via MAPK4/Drp-1 signal pathway.

Conclusions:
This study provides a new strategy for the treatment of SMI by delivering M-IL-exo.