bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generalized Anxiety Disorder Prevalence and Disparities Among U.S. Adults: The Roles Played by Job Loss, Food Insecurity, and Vaccinations During the COVID-19 Pandemic
Authors: Ma Chenyi , Smith Tony E , Culhane Dennis P 
Published: February 2025

Abstract

Objectives
The purposes of this study are to examine (i) to what extent job loss and food insecurity accounted for racial disparities in generalized anxiety disorder (GAD) risk among adults in the United States during the coronavirus disease 2019 (COVID-19) pandemic; and (ii) to what extent the COVID-19 vaccination mitigated such risk, especially among older adults.

Methods
First, we analyzed data from the U.S. Household Pulse Survey to report on the relative prevalence of GAD with respect to demographic characteristics, economic hardships, and COVID-19 vaccine status. We then adopted a series of logistic regression models to estimate the probabilities of having GAD by sequentially adding these possible explanatory factors.

Results
Findings demonstrated higher prevalence rates of GAD among Hispanic and non-Hispanic Black Americans than non-Hispanic White Americans, which can primarily be attributed to the fact that non-Hispanic White Americans were less vulnerable to job loss and food insecurity. Older adults were less susceptible to GAD than their middle-aged and young adult counterparts. Compared to unvaccinated older adults, the odds of having GAD were substantially reduced for older adults who were partially vaccinated, and even more significantly declined for fully vaccinated older adults.

Discussion
Racial and ethnic disparities in GAD were largely due to disproportionate experiences of job loss and food insecurity across different racial and ethnic groups during the pandemic. Social distancing measures partially explain the different prevalence of GAD between older adults and their counterparts. Rapid deployment of the COVID-19 vaccines played an effective role in suppressing GAD, especially among older adults.
Invasive Aspergillosis Caused by Cryptic Species in Transplant Recipients: A Review
Authors: Kimura Muneyoshi , Husain Shahid 
Published: February 2025

Abstract
The clinical and microbiological characteristics of invasive aspergillosis (IA) caused by cryptic Aspergillus species have not been well-defined in transplant settings. However, IA is among the most common mold infections in solid organ and hematopoietic stem cell transplant recipients. Among 55 causative isolates in the 53 reported cases, A. calidoustus, A. lentulus, A. tubingensis, and A. udagawae were the four most common causative cryptic Aspergillus species. Newer diagnostic modalities, such as matrix-assisted laser desorption ionization-time of flight mass spectrometry, may help diagnose these cryptic species. Of the 24 cases with detailed clinical information, 13 had antifungal breakthrough infections. The 12-week mortality rates of all 24 cases, 7 cases of A. calidoustus and 7 cases of A. lentulus were 46%, 43% and 43%, respectively. Based on antifungal susceptibility profiles obtained from previous studies, an empiric antifungal regimen such as liposomal amphotericin B with or without echinocandin is recommended for A. calidoustus. A combination of an anti-mold azole and liposomal amphotericin B with or without an echinocandin is suggested for A. lentulus and A. udagawae. Additionally, any one of voriconazole, isavuconazole or posaconazole with or without liposomal amphotericin B with or without an echinocandin is indicated for A. tubingensis. Newer antifungal agents may have more significant activity against Aspergillus cryptic species.
Impact of adding urine alkalization therapy to xanthine oxidase inhibitor in gout management: a prospective cohort study
Authors: Wang Can , Guo Kai , Dalbeth Nicola , Sun Mingshu , Lu Jie , Chen Ying , Zhang Hui , Wang Xuefeng , Ji Xiaopeng , Li Xinde , Sun Wenyan , Han Lin , Cui Lingling , Liu Zhen , Ji Aichang , He Yuwei , Terkeltaub Robert , Li Changgui 
Published: February 2025

Abstract

Objectives
Gout patients frequently have decreased urine pH, related to metabolic syndrome (MetS) and chronic kidney disease. Here, we aimed to investigate whether the addition of urine alkalization to urate-lowering therapy (ULT) is associated with improvements in albuminuria, gout flares or MetS outcomes in men with gout and low urinary pH (pH &lt; 6.2).

Methods
A prospective cohort study enrolled 385 participants starting ULT with febuxostat (initially 20 mg daily, escalated to 40 mg daily if serum urate ≥360 µmol/l), with or without alkalization based on patient preference using a 3.5 g bid citrate mixture. Participants were followed every 4 weeks to week 12. The primary outcome was urine albumin-to-creatinine ratio (UACR) at week 12.

Results
In total, 343 participants completed the week 12 visit (137 alkalization, 206 controls). At week 12, compared with controls, participants receiving alkalization required a significantly lower febuxostat dose (by ∼20%) but had no significant difference in serum urate at target &lt;360 µmol/l. Urine pH increased significantly in the alkalization group from week 4 (P &lt; 0.001). At week 12, the alkalization group had a significantly lower UACR compared with control (P &lt; 0.001), without significantly different eGFR. Participants in the alkalization group experienced fewer gout flares and had lower pain visual analogue scale scores (P &lt; 0.001). There were lower serum triglyceride levels (P &lt; 0.01) and higher HDL-C levels (P &lt; 0.001) in the alkalization group. No other differences in metabolic outcomes were observed.

Conclusion
Urine alkalization was associated with lower UACR, fewer gout flares, and improved serum lipid profile in febuxostat-treated men with gout and low urine pH.

Trial registration
ChiCTR, http://www.chictr.org.cn, ChiCTR2100043573.
Scale-up influences and definitions of scale-up ‘success’: evidence from globally scaled interventions
Authors: Koorts Harriet , Ma Jiani , Cassar Samuel , Bauman Adrian , Lawrence Mark , Rutter Harry , Salmon Jo 
Published: February 2025

Abstract
The World Health Organization ExpandNet framework for scaling up contains key recommendations to support the scaling of health interventions globally. Despite being widely used, it is not known how the framework informs intervention scale-up nor how ‘successful’ scale-up is defined. Using data from the Scaling Up InTErventions’ study, this paper assessed adoption of framework components using an international sample of scaled-up physical activity and nutrition interventions, and explored individuals’ definitions of scale-up ‘success’. An online survey with academic, community, and government representatives involved in scaling physical activity and nutrition interventions globally. Survey questions (n = 27) corresponded to 32 components of the ExpandNet framework, reflecting four core areas: (i) intervention; (ii) user organization; (iii) resource team; and (iv) scale-up strategy. Data were analysed descriptively and qualitative free-text survey responses coded thematically. In total, 62 survey responses were obtained [academia (n = 32), community (n = 20), and government (n = 10)], corresponding to 35 scaled-up interventions. Only 8% of participants reported all 32 framework components during scale-up. Four core elements (containing eight themes) underpinned successful scale-up: (i) scaling inputs (e.g., sustained partner buy-in); (ii) scaling outputs (e.g., sustained, quality implementation); (iii) scaling outcomes (e.g., increased and equitable reach, improved organization and system capacity) and; (iv) scaling context (e.g., partner mental models, and a context-specific construct). There is no universal definition of successful scale-up. We propose core elements of ‘successful scale-up’ that could be used as criteria for scale-up planning and evaluation, and are applicable to other areas of public health.
Culture of Family-Centered Care in the NICU
Authors: Strine Sophia , Karuri Stella , Fry Jessica T. , Bean Katherine , Horner Susan , Machut Kerri Z. 
Published: February 2025

Background:
Family centered-care (FCC) has documented benefits for infants, parents, and staff, but is variably practiced.

Purpose:
To describe parental and staff perspectives on the quality of FCC culture in a neonatal intensive care unit (NICU).

Methods:
Parents of hospitalized infants and staff at a referral NICU completed validated survey instruments to measure NICU FCC quality on topics including trust, communication, and shared decision-making at multiple time points. We compared parent and staff responses using a cumulative log-odds model with a single predictor to model the odds of a score lower than a prespecified value.

Results:
A total of 92 parents of 80 NICU infants and 96 NICU providers participated. Most rated items highly, indicating a positive experience with FCC. The items with the highest scores for parents were receiving guidance and being trusted in their infant’s care (both 97.1% positive); for staff, listening to parents (95%). Receiving/providing emotional support received the lowest scores from parents (19.1% negative or neutral) and staff (24.5%). Parent and staff answers differed significantly for 6 of 8 questions, with lower scores reported by staff relative to parents.

Implications for practice and research:
Parents and staff have variable perspectives on different aspects of FCC. Understanding these nuances of centers’ FCC culture can help target interventions and may strengthen FCC delivery for NICU infants and families and career satisfaction for staff. Future directions include assessing FCC quality over time and among specific infant, family, and staff cohorts, especially diverse populations to determine if FCC is equitably delivered.
Area Deprivation, Fragmented Care, and Colectomy Case Acuity in the Veterans Health Administration
Authors: Tessler Robert A. , Vaughan Sarrazin Mary , Gao Yubo , Jacobs Michael A. , Jacobs Carly A , Hausmann Leslie R. M. , Hall Daniel E. 
Published: February 2025

BACKGROUND:
Colectomy for benign or malignant disease may be elective, urgent, or emergent. Data suggest successively worse outcomes for non-elective colectomy. Few data exist on the contribution of high area deprivation index and care fragmentation to non-elective colectomy.

OBJECTIVE:
Determine the association between area deprivation and non-elective colectomy in the Veterans Health Administration and assess whether accounting for differences in care fragmentation alters the association across indications and for benign and malignant conditions separately.

DESIGN:
Retrospective cohort with multivariable multinomial logit models to evaluate associations between high deprivation care fragmentation, and the adjusted odds of non-elective colectomy. We calculated total, direct, and indirect effects to assess whether the association varied by levels of care fragmentation

SETTING:
Veterans receiving care in the private sector and Veterans Health Administration.

PATIENTS:
Veterans ≥ 65 years undergoing colectomy between 2013 and 2019.

MAIN OUTCOME/MEASURES:
Colectomy case acuity.

RESULTS:
We identified 6538 colectomy patients, of which 3006 (46.0%) were for malignancy. The odds of emergent colectomy were higher for patients in high deprivation areas when the indication was for benign pathology (aOR 1.51 95% CI: 1.15, 2.00). For malignant indications, there was no association between high deprivation and non-elective colectomy. More fragmented care was associated with a higher odds of urgent and emergent colectomy for both benign and malignant indications but the association between deprivation and non-elective colectomy did not vary by care fragmentation.

LIMITATIONS:
Inherent to large administrative retrospective databases.

CONCLUSIONS:
Veterans living in high deprivation areas are at higher risk for emergent colectomy for benign conditions. Care fragmentation is also associated with a higher risk of emergent colectomy across indications. Efforts to reduce care fragmentation and promote early detection of inflammatory bowel disease and diverticular disease in high deprivation neighborhoods may lower the risk for non-elective colectomy in Veterans. See Video Abstract.
Not All Deep Inferior Epigastric Artery Perforator Flaps Are Created Equal: A Review of Donor-site Morbidity in Abdominally Based Autologous Breast Reconstruction
Authors: DeVito Robert G. , Chou Jesse , Ke Benjamin G. , Wen Eileen , Campbell Chris A. 
Published: February 2025

Background:
Breast reconstruction after mastectomy is one of the most common procedures performed in plastic surgery. Autologous reconstruction is associated with better long-term patient satisfaction than implant-based reconstruction but with the requisite donor site and potential for associated morbidity.

Methods:
The authors review the literature regarding the technical evolution of abdominally based autologous breast reconstruction and the effect of these changes as well as patient morbidities on bulge, hernia, and all-cause donor-site morbidity.

Results:
The impact of patient risk factors on surgical outcomes is evaluated in the context of constantly improving technical surgical innovation. Patients’ premorbid abdominal condition and prior abdominal procedures along with traditional complicating factors such as age, obesity, and smoking are associated with increased rates of donor-site complications. Conversely, shorter fascial incisions with or without robotic and laparoscopic assistance are associated with lower rates of abdominal weakness and healing complications than traditional abdominal free flap harvest. Perforator selection and abdominal closure techniques also play a key role.

Conclusions:
There are contributions of both patient factors and technical aspects that when optimized can help minimize the risk of donor-site morbidity in deep inferior epigastric artery perforator flap breast reconstruction.
Image Quality and Safety of 300 mg versus 100 mg Fluorescein in Ultra-widefield Fluorescein Angiography: A Randomized Clinical Trial
Authors: Song Seok Hyeon , Joo Kwangsic , Woo Se Joon , Kim Min Seok 
Published: February 2025

Purpose:
To compare the image quality and safety of ultra-widefield fluorescein angiography (UWFA) using 3 ml (300 mg) versus 1 ml (100 mg) of 10% fluorescein.

Methods:
In this prospective, randomized clinical trial, a total of 144 patients who required UWFA examination for various retinal diseases were randomized 1:1 to 300 mg or 100 mg of fluorescein. Images were qualitatively graded by three retinal specialists and quantitatively analyzed. The primary outcome measure was the assessment of image quality (scored in a five-point scale). Quantitative sub-analysis among normal UWFA images through pixel intensity in posterior and mid-peripheral zone was also performed.

Results:
A total of 67 participants in each group were included in the analysis. The mean difference of image quality between two dose groups was within the predefined non-inferiority margin of 0.5 (0.005; 95% confidence interval, -0.145 to 0.154). The mean pixel intensity showed no significant differences in both posterior and mid-peripheral zone (P = 0.988 and 0.726, respectively). In the safety analysis, significantly fewer adverse events were observed with the lower dose (300 mg, 10 of 67 [14.9%] vs. 100 mg, 3 of 67 [4.5%], P = 0.041).

Conclusion:
We demonstrated the non-inferiority of image quality of low-dose fluorescein (100 mg) compared to a 300 mg dose with a reduction in the rate of adverse events associated with fluorescein angiography.
Change in retinal perfusion with aflibercept for central retinal vein occlusion: the two-year prospective observational HERMES study
Authors: Glacet-Bernard Agnès , Girmens Jean-François , Coscas Florence , Nghiem-Buffet Sylvia , Morel Christophe , Erginay Ali , Weber Michel , Wang Xavier , Jung Camille , Cohen Salomon-Yves , Aubert Tristan , Blanco-Garavito Rocio , Souied Eric H , Miere Alexandra 
Published: February 2025

Purpose:
To analyze retinal perfusion (RP) using ultrawide-field fluorescein angiography (UWFA) and optical coherence tomography angiography (OCTA), in patients with central retinal vein occlusion (CRVO) treated by intravitreal injection of aflibercept.

Methods:
Single-arm, multicenter, prospective, observational study. Treatment-naive eyes with CRVO initiated therapy with aflibercept. UWFA with correction of projection distortion and OCTA were performed at baseline (M0), M3, M12, and M24.

Results:
Fifty-six eyes were included. Visual acuity improved by 16 ETDRS letters at M12 (p<0.001), while mean central subfield thickness decreased from 801µm at M0 to 352µm at M12 (p<0.001). The ischemic index on UWFA increased from 17% at M0 to 23% at M3, and to 36% at M24. Ischemic CRVO accounted for 18% at M0, 25% at M3, and 39% at M24 (p<0.05). Vascular leakage was only present in 21% of eyes at M12. The density of the superficial and deep capillary plexus remained stable, but the foveal avascular zone enlarged from 0.37 mm2 at M0 to 0.61 mm2 at M24 (p=0.02). No cases of reperfusion were observed. The mean number of injections at M12 was 7.0±3.6.

Conclusion:
Changes in RP were characterized by worsening perfusion in the periphery, while macular capillaries maintained a generally stable density at M24, even in ischemic CRVO. These findings support the need for regular monitoring of peripheral retinal perfusion in treated patients to detect silent progression of nonperfusion, which may lead to neovascular complications, while visual acuity is maintained over the long term, likely due to the preserved macular capillary density.
Enormous Bilateral Optic Disc Drusen Presenting as a Central Retinal Vein and Cilioretinal Artery Occlusion
Authors: Naderi Amirreza , Spaide Richard 
Published: February 2025

Purpose:
To report a case of combined cilioretinal artery and central retinal vein occlusion in a patient with extremely large, asymptomatic optic disc drusen.

Methods:
A patient with sudden vision loss underwent a comprehensive examination, including multimodal imaging.

Results:
A 45-year-old man with no previous visual symptoms presented with a combined cilioretinal artery and central retinal vein occlusion in the right eye. The optic nerve in the right eye was slightly hyperemic and the nerve appeared normal in the left eye. His optic nerves did not have a nodular appearance but showed subtle hyperautofluorescence. A hematological and clotting work-up was unrevealing. Optical coherence tomography revealed an exceptionally large, deeply embedded optic disc druse (1604 x 1390 μm) that almost spanned the width of the optic canal, starting from 464 μm beneath the optic disc surface extending to below any visible lamina cribrosa. The right eye demonstrated a paracentral scotoma, while a minimal visual field defect was observed in the left eye despite the presence of a large-sized (1125 x 803 μm) druse.

Conclusion:
While optic disc drusen are typically small nodular aggregates in the prelaminar optic nerve head, this patient had an enormous buried solitary druse of the optic nerve in each eye. The unexpected size and location of the drusen, along with the lack of preceding symptoms, suggest that they may not be detected in routine evaluations, thus necessitating multimodal imaging. The redundancy of nerve fibers in the optic nerve may allow significant asymptomatic damage prior to vascular occlusion.
Presumed Mitomycin C-Induced Retinal Toxicity Following Combined Cataract and Xen Gel Stent Surgery
Authors: Tuttle Jared. J. , Scarboro Shannon D. , Fitzpatrick John C. , Harper C. Armitage 
Published: February 2025

Purpose:
To describe a case of presumed MMC-induced retinal toxicity following combined cataract and Xen gel stent surgery.

Methods:
Observational case report.

Results:
A 66-year-old male presents with progressive vision loss (20/25 baseline to light-perception (LP)) following combined cataract and Xen gel stent surgery in the left eye. The patient received 0.15 ml of 0.4 mg/ml of MMC via intra-tenon injection during the surgery. The patient reported severe eye pain following surgery which gradually resolved over time. Upon examination at post-operative day 41, vessel attenuation, sclerotic vessels, and optic nerve pallor are observed without any retinal hemorrhaging. At post-operative day 55, visual acuity remains at LP with a flat line electroretinogram. Outcomes remain consistent at postoperative day 125.

Conclusion:
Care should be taken to avoid intraocular MMC, especially when administered via intra-tenon injection during combined cataract and Xen gel stent surgery.
A case of Bartonella Neuroretinitis Presenting with Concomitant Frosted Branch Angiitis on long-term follow-up
Authors: Zhang Wenjing , Chen Cong , Song Yanping , Yan Ming 
Published: February 2025

Purpose:
To report a patient with Bartonella henselae-associated ocular inflammation that manifested with central retinal vein occlusion and neuroretinitis.

Methods:
A case report including multimodal imaging and indirect fluorescent antibody test results was used.

Results:
This case highlights the importance of clinical examination and maintaining a high diagnostic suspicion for neuroretinitis in a healthy young woman without vascular risk factors.

Conclusion:
Patients with B. henselae-associated ocular inflammation develop retinal vein occlusion. For young patients with central retinal vein occlusion and neuroretinitis who do not have a history of systemic diseases, a detailed medical history should be taken and potential causes should be investigated.
Infusion-Induced Macular Holes in Pars Plana Vitrectomy: A Case Series of Six Patients
Authors: Shuman Hannah , Trivedi Vichar , Patwa Dhir , Lee Patrick SY , Tran David V , Im Jacob , Me Rao , Komro Jack , Okeagu Chinwenwa , Le Kim , Lin Xihui 
Published: February 2025

Purpose:
To describe a series of six cases in which iatrogenic macular holes were induced by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system.

Methods:
This is a retrospective case series of six patients treated at Kresge Eye Institute between 2018 and 2024.

Results:
Iatrogenic macular holes caused by infusion fluid flow are a rare complication of PPV. In this series, five out of six patients had a history of diabetes mellitus and proliferative diabetic retinopathy. The majority of these patients were undergoing repair of tractional retinal detachments when the complication occurred. The average patient age was 47 years (range: 32–66 years). Four patients were pseudophakic, and only one had undergone prior vitrectomy. Preoperative visual acuity ranged from 20/50 to hand motion, while postoperative visual acuity ranged from 20/80 to hand motion. Two patients experienced an improvement in visual acuity postoperatively.

Conclusion:
This case series highlights the potential risk of macular hole formation due to infusion fluid dynamics during pars plana vitrectomy. In diabetic patients with tractional retinal detachments or significant macular ischemia, we recommend positioning the infusion cannula away from the posterior pole to mitigate the risk of this complication.