bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective study of the prevalence of postanaesthetic hypothermia in cats
Authors: Redondo J. I. , Suesta P. , Gil L. , Soler G. , Serra I. , Soler C. 
Published: November 2011

A retrospective study of 275 anaesthetic records of cats was undertaken to examine the prevalence of postanaesthetic hypothermia, its clinical predictors and consequences. Temperature was recorded throughout anaesthesia. The temperature reached at the end was classified as hyperthermia (>39.50°C), normothermia (38.50 to 39.50°C), slight hypothermia (38.49 to 36.50°C), moderate hypothermia (36.49 to 34.00°C) or severe hypothermia (<34.00°C). Statistical analysis consisted of multiple regression to identify the factors that affect the temperature at the end of the procedure. Before premedication, the mean (sd) temperature was 38.2 (1.0)°C. At 60, 120 and 180 minutes from induction, the temperature was 35.4 (1.4)°C, 35.0 (1.5)°C and 34.6 (1.5)°C, respectively. The prevalence of hypothermia was slight 26.5 per cent (95 per cent CI 21.7 to 32.0 per cent), moderate 60.4 per cent (95 per cent CI 54.5 to 66.0 per cent) and severe 10.5 per cent (95 per cent CI 7.4 to 14.7 per cent). The variables associated with a decrease in the temperature recorded at the end of anaesthesia were the duration of anaesthesia, the reason for anaesthesia (abdominal and orthopaedic surgeries significantly reduced the temperature when compared with minor procedures) and the anaesthetic risk (high‐risk cats showed lower temperatures than low‐risk cats). The temperature before premedication was associated with an increase in the final temperature.
Symptomatic Neonatal Arterial Ischemic Stroke: The International Pediatric Stroke Study
Authors: Kirton Adam , Armstrong-Wells Jennifer , Chang Taeun , deVeber Gabrielle , Rivkin Michael J. , Hernandez Marta , Carpenter Jessica , Yager Jerome Y. , Lynch John K. , Ferriero Donna M. ,   for the International Pediatric Stroke Study Investigators
Published: November 2011

BACKGROUND:
Neonatal arterial ischemic stroke (AIS) has emerged as a leading cause of perinatal brain injury, cerebral palsy, and lifelong disability. The pathogenesis is poorly understood, which limits the development of treatment and prevention strategies. Multicenter studies must define epidemiology, risk factors, treatment practices, and outcomes to advance clinical trials and improve the adverse outcomes suffered by most survivors.

METHODS:
The International Pediatric Stroke Study is a global research initiative of 149 coinvestigators (30 centers in 10 countries). Patients with clinical and neuroimaging confirmation of symptomatic neonatal AIS were enrolled (2003–2007). Standardized, Web-based data entry collected clinical presentations, risk factors, investigations, treatments, and early outcomes. We examined predictors of infarct characteristics and discharge outcome by using multivariate logistic regression.

RESULTS:
Two hundred forty-eight neonates were studied (57% male, 10% premature). Most of them presented with seizure (72%) and nonfocal neurologic signs (63%). MRI was completed for 92% of the infants, although &lt;50% had vascular imaging. Infarcts preferentially involved the anterior circulation and left hemisphere and were multifocal in 30%. Maternal health and pregnancies were usually normal. Neonates often required resuscitation (30%) and had systemic illnesses (23%). Cardiac and prothrombotic abnormalities were identified in &lt;20% of the infants. Antithrombotic treatment was uncommon (21%) and varied internationally. Half (49%) of the infants had deficits at discharge, and data on their long-term outcomes are pending.

CONCLUSIONS:
Newborns with AIS are often systemically sick, whereas their mothers are usually healthy. Definitive causes for most neonatal AISs have not been established, and large-scale case-control studies are required to understand pathogenesis if outcomes are to be improved.
Prevention and Management of Positional Skull Deformities in Infants
Authors: Laughlin James , Luerssen Thomas G. , Dias Mark S. ,   the Committee on Practice and Ambulatory Medicine, Section on Neurological Surgery
Published: November 2011

This Clinical Report was retired February 2018.
Positional skull deformities may be present at birth or may develop during the first few months of life. Since the early 1990s, US pediatricians have seen an increase in the number of children with cranial asymmetry, particularly unilateral flattening of the occiput, likely attributable to parents following the American Academy of Pediatrics “Back to Sleep” positioning recommendations aimed at decreasing the risk of sudden infant death syndrome. Positional skull deformities are generally benign, reversible head-shape anomalies that do not require surgical intervention, as opposed to craniosynostosis, which can result in neurologic damage and progressive craniofacial distortion. Although associated with some risk of positional skull deformity, healthy young infants should be placed down for sleep on their backs. The practice of putting infants to sleep on their backs has been associated with a drastic decrease in the incidence of sudden infant death syndrome. Pediatricians need to be able to properly differentiate infants with benign skull deformities from those with craniosynostosis, educate parents on methods of proactively decreasing the likelihood of the development of occipital flattening, initiate appropriate management, and make referrals when necessary. This report provides guidance for the prevention, diagnosis, and management of positional skull deformity in an otherwise normal infant without evidence of associated anomalies, syndromes, or spinal disease.
US Abortion Bans and Infant Mortality
Authors: Gemmill Alison , Franks Alexander M. , Anjur-Dietrich Selena , Ozinsky Amy , Arbour David , Stuart Elizabeth A. , Ben-Michael Eli , Feller Avi , Bell Suzanne O. 
Published: February 2025

ImportanceThe impact of recent abortion bans on infant mortality is not fully understood. There is also limited evidence on how these bans may interact with long-standing racial and ethnic disparities in infant health.ObjectiveTo examine the association of abortion bans with changes in infant mortality and to compare this association in racial and ethnic groups based on analyses within and across states.Design, Setting, and ParticipantsThis population-based, serial, cross-sectional study used a bayesian panel model to examine infant mortality rates in 14 states that implemented complete or 6-week abortion bans and compared them with predictions of infant mortality rates based on pre-ban mortality rates and states without bans. Data included all live births and infant deaths from all 50 US states and the District of Columbia for 2012 through 2023. Models accounted for temporal trends and state-specific factors, with analyses stratified by race and ethnicity, timing of death, and cause of death.ExposureComplete or 6-week abortion bans.Main Outcome and MeasuresInfant mortality rate, analyzed overall and by subgroups.ResultsThe analysis found higher than expected infant mortality in states after adoption of abortion bans (observed vs expected, 6.26 vs 5.93 per 1000 live births; absolute increase, 0.33 [95% credible interval (CrI), 0.14-0.51]; relative increase, 5.60% [95% CrI, 2.43%-8.73%]). This resulted in an estimated 478 excess infant deaths in the 14 states with bans during the months affected by bans. The estimated increases were higher among non-Hispanic Black infants compared with other racial and ethnic groups, with 11.81 observed vs 10.66 expected infant deaths per 1000 live births, an absolute increase of 1.15 (95% CrI, 0.53-1.81) and relative increase of 10.98% (95% CrI, 4.87%-17.89%). The observed infant mortality rate due to congenital anomalies was 1.37 vs 1.24 expected (absolute increase, 0.13 [95% CrI, 0.04-0.21]; relative increase, 10.87% [95% CrI, 3.39%-18.08%]), while the rate not due to congenital anomalies was 4.89 observed vs 4.69 expected (absolute increase, 0.20 [95% CrI, 0.02-0.38]; relative increase, 4.23% [95% CrI, 0.49%-8.23%]). Texas had a dominant influence on the overall results and there were larger increases in southern vs nonsouthern states.ConclusionsUS states that adopted abortion bans had higher than expected infant mortality after the bans took effect. The estimated relative increases in infant mortality were larger for deaths with congenital causes and among groups that had higher than average infant mortality rates at baseline, including Black infants and those in southern states.
Trends in Axillary Lymph Node Dissection After Mastectomy Among Patients With Limited Nodal Burden
Authors: Wang Ton , Jones Tyler , Thomas Samantha M. , Van den Bruele Astrid Botty , Rosenberger Laura H. , Chiba Akiko , Parrish Kendra J. Modell , Dossett Lesly A. , Plichta Jennifer K. , McDuff Susan , DiNome Maggie L. , Hwang E. Shelley 
Published: February 2025

ImportanceCurrent practices in axillary treatment for patients with breast cancer who receive a mastectomy for node-positive disease are unknown. For patients who receive postmastectomy radiotherapy (PMRT), the addition of axillary lymph node dissection (ALND) may result in significant overtreatment.ObjectivesTo evaluate trends in axillary treatment for patients with limited nodal metastases who receive a mastectomy and identify factors that can be targeted to reduce axillary overtreatment.Design, Setting, and ParticipantsA retrospective cohort study was conducted of patients identified from the National Cancer Database who received a diagnosis of breast cancer from January 1, 2012, to December 31, 2021. Patients included were women aged 18 years or older with clinical (c) T1-T2N0 breast cancer who underwent mastectomy with axillary staging with sentinel lymph node biopsy (SLNB) and/or ALND and had 1 to 2 positive lymph nodes. Patients who received neoadjuvant therapies were excluded. Statistical analysis was performed from December 2023 to July 2024.ExposureAxillary management based on ALND and PMRT receipt: (1) ALND alone, (2) PMRT alone, (3) both ALND and PMRT, and (4) neither ALND nor PMRT.Main Outcomes and MeasuresAxillary management strategies were evaluated, and clinicopathologic characteristics based on treatment type were compared with multivariable analysis.ResultsIn total, 62 332 patients were included (median age, 58 years [IQR, 48-68 years]; 82.2% with Charlson-Deyo comorbidity score 0). The proportion of patients who received ALND alone decreased from 47.1% to 17.6% from 2012 to 2021, while the percentage of patients who received PMRT alone increased from 9.8% to 36.8%. Overall, 21.3% of patients received treatment with both ALND and PMRT, with little change over time (from 21.7% in 2012 to 17.7% in 2021). Most patients (88.4%) who received both PMRT and ALND underwent ALND at the same operation as SLNB. Younger age (odds ratio [OR] per year increase, 0.98 [95% CI, 0.98-0.98]; P &amp;lt; .001), high-grade tumors (grade 2: OR, 1.18 [95% CI, 1.09-1.29]; P &amp;lt; .001; grade 3: OR, 1.34 [95% CI, 1.22-1.48]; P &amp;lt; .001), presence of lymphovascular invasion (OR, 1.26 [1.19-1.33]; P &amp;lt; .001), and larger tumor size (cT2 tumors compared with cT1: OR, 1.10 [95% CI, 1.03-1.17]; P = .004; upstaging to pathologic T3 tumors: OR, 2.29 [95% CI, 1.15-4.99]; P = .03) were associated with increased likelihood of concurrent treatment with ALND and PMRT.Conclusions and RelevanceIn this retrospective cohort study of patients with breast cancer who received a mastectomy, a substantial proportion of those with 1 to 2 positive lymph nodes were treated with both ALND and PMRT. Delaying the decision for ALND until after multidisciplinary input may reduce overtreatment.
Federally Qualified Health Centers as a Model to Improve Vision Health
Authors: Bai Patricia , Burt Spencer S. , Woodward Maria A. , Haber Scott , Newman-Casey Paula Anne , Henderer Jeffrey D. , Chan R. V. Paul , Chen Aiyin ,   American Academy of Ophthalmology Task Force on Ophthalmology and Community Health Centers, Modjtahedi Bobeck S. , Muir Kelly W. , Nyanwanwu Kristen H. , Rhodes Lindsay A. , Russo Diane , Scanzera Angelica C. 
Published: February 2025

ImportanceDisparities in eye health are associated with lower-income and minoritized populations, many of whom seek care at federally qualified health centers (FQHCs).ObjectiveTo examine the literature addressing vision and eye health care provided at FQHCs, identify barriers to providing care at FQHCs, and highlight recommendations on how FQHCs can decrease disparities in eye health.Evidence ReviewA systematic review of Embase, SCOPUS, and PubMed was performed, and articles regarding eye and vision health at FQHCs within the US published between January 1, 1965, and July 14, 2023, were included. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Structured data and case studies were extracted and collated using an a priori method to reduce bias.FindingsThe systematic review yielded 423 unique articles, with 43 meeting inclusion criteria. Only 18.3% to 29% of FQHCs reported on-site vision services with the remainder relying on external referrals to vision specialists. Primary eye conditions evaluated included diabetic retinopathy (26 studies), general eye health (11 studies), and glaucoma (6 studies). Telehealth vision initiatives were an important method to expand access (18 studies). Other topics included economic analysis (5 studies) and policy suggestions (3 studies) to increase vision services at FQHCs. Systemic barriers to accessing care at FQHCs were the lack of eye clinicians available to provide services, the cost of resources, and limited reimbursement to implement screening programs. Patient barriers to accessing care included financial constraints for specialist care, limited awareness of the importance of eye examinations, and difficulty navigating the insurance system.Conclusions and RelevanceFindings of this systematic review suggest that FQHCs are well positioned to increase vision services and thus improve vision health equity, serving populations who are at a higher risk for vision disorders. Results find systemic and patient-level barriers to vision health that may need to be addressed. Policy leaders could leverage existing gaps for purposeful advocacy, set standards and metrics for vision health at FQHCs, promote novel models of care, and encourage collaboration of eye clinicians with partnering FQHCs.
Hyperacute Outer Retinal Dysfunction
Authors: Cheng Yizhe , Liu Xinyu , Lu Jinglin , Ren Jianing , Fei Ping , Chen Meini , Tang Changting , Zhang Jianping , Zhang Minglian , Yuan Miner , Sun Limei , Zhang Linyan , Hou Aohan , Jin Yili , Lai Yanting , Wang Qiong , Yan Wenjia , Ke Shuya , Li Xiaoxin , Ding Xiaoyan 
Published: February 2025

ImportancePattern recognition of pediatric retinal diseases can streamline the workup and guide the prognosis.ObjectiveTo characterize the clinical features, retinal imaging findings, and 1-year prognosis of pediatric patients who experienced sudden, severe bilateral vision loss with diffuse ellipsoid zone (EZ) and external limiting membrane (ELM) disruptions after fever.Design, Setting, and ParticipantsThis multicenter case series included 8 pediatric patients (16 eyes) who presented with an unusual set of clinical symptoms, including sudden, severe bilateral vision loss; nyctalopia; and diffuse EZ and ELM disruptions, subsequent to a febrile illness. The patients visited or were referred to a pediatric retina service between November 2022 and May 2023.Main Outcome MeasuresChanges in visual acuity, visual field, electroretinography (ERG) results, and presence of characteristic retinal imaging signs during follow-up.ResultsA total of 16 eyes from 8 children (6 boys and 2 girls) were included in this study; the patients’ mean (SD) age was 5.1 (1.2) years (range, 3-7 years; median, 5.0 years). Their sudden bilateral vision loss occurred a mean of 16.1 days after fever onset. Initial symptoms included sudden vision loss, visual field constriction, nyctalopia, and dyschromatopsia. Baseline visual acuity was predominantly below counting fingers. A sudden, diffuse loss of the EZ and ELM was observed in all eyes with gradual recovery beginning around the fourth week. After 1 year, visual acuity showed substantial improvement in most cases, with 7 of 8 patients (88%) achieving 20/40 or better, including 4 patients (50%) achieving 20/25 or better. The macular EZ and ELM appeared intact in 12 eyes (75%) and 14 eyes (88%), respectively, while the extrafoveal regions remained absent of EZ and ELM. ERG revealed extinguished cone and rod responses in 8 patients (100%), and multifocal ERG remained extinguished despite the recovery of visual acuity in all 8 patients (100%).Conclusions and RelevanceThis case series identifies a potentially underrecognized disease in pediatric patients after fever characterized by sudden vision loss, diffuse EZ and ELM disruption, and distinct retinal imaging features. The term hyperacute outer retinal dysfunction is recommended as descriptive while further investigations are recommended to better understand its pathophysiology and optimal management strategies.
Cost-Benefit Analysis of Intraoperative Autofluorescence for Parathyroid Identification
Authors: Serrao-Brown Hazel G. , Papachristos Alexander J. , Sidhu Stanley B. 
Published: February 2025

ImportanceHypoparathyroidism (hypoPT) is the most common complication post–total thyroidectomy and is associated with increased morbidity and mortality when chronic. Conventionally, the prevention of hypoPT has involved visual inspection of parathyroid glands; however, near-infrared autofluorescence detection systems have been recently used as adjuncts. These systems involve significant outlay and ongoing costs.ObjectiveTo evaluate the cost-effectiveness of autofluorescence for hypoPT prevention and to determine the chronic hypoPT rate at which this technology would become economically feasible.Design, Setting, and ParticipantsIn this cost-benefit analysis, a decision tree economic model was developed to compare thyroidectomies performed with autofluorescence to visual inspection only. All costs associated with conventional surgery, autofluorescence, and the costs of managing hypoPT were captured. Morbidity was defined in terms of disutility, quantified as quality-adjusted life-years, determined over a lifetime time horizon. The model was used to calculate the incremental cost-effectiveness ratio for autofluorescence-guided surgery and to identify determinants that influenced this ratio, and hence the economic feasibility of the use of autofluorescence. This study was based on the health care setting in Australia, in which more than 3500 thyroidectomies are performed annually. A probe-based autofluorescence detection system was used for analysis based on its availability in Australia. All costs were quantified in Australian dollars (A$) and were adjusted for 2024. The study data spanned from June 2022 to May 2023, and the data were analyzed in June 2023.ResultsThe economic model analysis indicated that autofluorescence involved an additional cost of A $1024 (US $639) per surgery, offset by an increase in quality-adjusted life-years of 0.0080, resulting in an incremental cost-effectiveness ratio of A $128 234 (US $80 060). In Australia, it is generally assumed that interventions with a ratio of up to A $70 000 (US $43 703) may be considered cost-effective. Cost-effectiveness was most sensitive to a change in the overall hypoPT rate, chronic hypoPT rate, and the efficacy of autofluorescence. Autofluorescence-guided surgery achieved the cost-effectiveness threshold at a chronic hypoPT rate of greater than or equal to 5%.Conclusions and RelevanceAlthough the use of autofluorescence involves significant costs, its economic feasibility for the prevention of postsurgical hypoPT is determined by the underlying chronic and overall hypoPT rate, as well as the efficacy of autofluorescence for the reduction of hypoPT. The findings of this cost-benefit analysis are relevant in determining the prioritization and allocation of finite health care resources.
Associations Between Serum IL‐17A, Renal Function and Diabetic Retinopathy in Type 2 Diabetes Mellitus: Evidence From a Chinese Han Population
Authors: Wang Wensu , Huang Yan , Shen Jianguo , Jin Li , Chen Zhuo 
Published: February 2025

ABSTRACTBackgroundEvidence suggested that IL‐17A was associated with renal function in type 2 diabetes. We used ultra‐sensitive measurement to detect the concentration of IL‐17A in human peripheral blood and explored the association of IL‐17A with diabetic kidney disease (DKD).MethodsWe recruited 138 participants from the Shanghai Diabetes Institute Inpatient Database of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Eighty‐four individuals diagnosed as DKD were cases, and 54 type 2 diabetes individuals without DKD or diabetic retinopathy (DR) were controls. The concentration of serum IL‐17A was detected by the High Sensitivity Immunoassay Quantitative Kit. Data was analysed by SAS.ResultsThe concentration of serum IL‐17A in our population ranged from 0.07 pg/mL to 2.96 pg/mL with the median of 0.502 pg/mL. Our results suggested that the level of serum IL‐17A in DKD case group was higher than in the control (P unadjusted = 0.0496, P adjusted = 0.0298). And serum creatinine, eGFR, ACR were used as indicators of renal function. Serum creatinine and ACR were positive correlated with the level of serum IL‐17A (P adjusted = 0.0148; P adjusted = 0.0369), while eGFR showed a negative correlation (P adjusted = 0.0167). Additionally, the level of serum IL‐17A was also significantly higher in DR case group compared with the control group (p = 0.0224).ConclusionSerum IL‐17A level is associated with renal function decline and diabetic retinopathy in patients with type 2 diabetes in a Chinese Han population. Our results suggested that IL‐17A may be a potential biomarker of DKD and DR.
Comparative Evaluation of Extraction Protocols for Point‐Of‐Need Molecular Diagnostics
Authors: Kobialka Rea Maja , Ceruti Arianna , Truyen Uwe , Abd El Wahed Ahmed 
Published: February 2025

ABSTRACTBackgroundIn the rapidly evolving field of molecular diagnostics, identifying a suitable extraction method is crucial in determining the applicability of the point‐of‐need device. Extraction, which serves as the initial and important step in the diagnostic process, plays a vital role in the accuracy, reliability, and speed of detecting pathogens. Extraction methods range from traditional approaches like organic extraction to modern advancements such as magnetic bead‐based separation, each offering unique advantages and limitations.MethodsThis study explored the comparative effectiveness of 10 commercially available protocols (denoted as I–X), focusing on their practicality and efficiency in point‐of‐need scenarios. By considering criteria such as ease of use, turnaround time, and robustness in handling different sample matrices, we aimed to highlight the critical factors that influence the selection of an appropriate extraction method for immediate and reliable diagnostic outcomes in diverse settings. The effectiveness of each protocol was evaluated by comparing the time threshold and fluorescence signal using isothermal amplification (namely reverse transcription‐recombinase‐aided amplification). For comparison, samples were also extracted with Qiagen spin column extraction.ResultsThe performance of each protocol in extracting feline Coronavirus (FCoV) RNA differed depending on the sample type, such as nasal swab, serum, and feces. Overall, protocol VIII proved to be flexible and reliable for point‐of‐need diagnostics owing to its consistent extraction efficiency across different sample types and its excellent sensitivity (2 × 101 RNA copies/μL from supernatant and nasal swab and 2 × 102 RNA copies/μL from serum).ConclusionThis study emphasizes the significance of considering the specific sample type and diagnostic goal in selecting the right extraction protocol.