bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pattern and Profile of Orofacial Clefts in Somaliland: A Review of 40 Consecutive Cleft Lip and Palate Surgical Camps
Authors: Rhodes Isaiah J. , Alston Chase C. , Zhang Ashley , Arbuiso Sophia , Medina Samuel J. , Liao Matthew , Ng Jinggang J. , Romeo Dominic , Dahir Shugri , Rhodes William R. , Otterburn David M. 
Published: June 2024

Introduction:
Somaliland is an autonomously run country that is not internationally recognized. As such, it has been largely excluded by global health development programs despite being the world’s fourth poorest country. The purpose of this study was to provide the first known description of the pattern and clinical profile of patients with cleft lip and palate from this nation.

Methods:
The authors performed a retrospective chart review on all patients who received cleft lip and palate repair by a single surgeon in 40 separate surgical camps at Edna Adan University Hospital in Hargeisa, Somaliland, between 2011 and 2024. Information regarding patient age, sex, cleft etiology, surgical management, and home location was retrieved. Descriptive statistical analysis was performed.

Results:
A total of 767 patients (495 male, 64.5%) received 787 surgical procedures. The average age of primary surgery was 73.7 months. The most common chief complaint was left cleft lip with cleft palate (316, 41.2%). Males received primary surgery 19.2 months later than did females (73.7 and 54.6 mo, respectively, P<0.001). Patients residing in Hargeisa received their initial procedure an average of 17.8 months younger than those who lived elsewhere in Somaliland (62.9 and 80.7 mo, respectively, P=0.004).

Conclusions:
In this severely economically depressed region, patients received treatment at ages that lagged far beyond recommended guidelines. Our finding of earlier treatment for females than males is rare in the literature and likely relates to cultural sex expectations. Patients from rural locations were especially vulnerable to receiving delayed treatment. Further efforts to decrease the burden of craniofacial deformities in Somaliland should be pursued in earnest.
Long-Term Outcomes of Enucleation and Secondary Orbital Implantation Surgeries Using Polyester Mesh-Wrapped Acrylic Orbital Implants
Authors: Şendül Yekta , Alkan Abdurrahman Alpaslan 
Published: June 2024

Objective:
To reveal the long-term outcomes of enucleation and secondary orbital implantation surgeries employing nonabsorbable surgical mesh-wrapped acrylic orbital implants for various reasons.

Methods:
A retrospective interventional study of 48 eyes that underwent primary or late primary enucleation and secondary orbital implantation using polyester mesh-wrapped acrylic orbital implants, between 2012 and 2021. Patient demographics, diagnosis, prior ophthalmic surgery, implant size, follow-up periods, and implant-associated complications were evaluated.

Results:
The records of 36 patients who underwent primary or late primary enucleation and 12 who underwent secondary orbital implantation due to sphere extrusion were evaluated. Patients’ mean age was 38.7 (range: 2–75) and the mean follow-up period was 48.3 months (range: 24–72 mo). Major causes for surgeries were trauma and malignancies (54.1% and 33.3%, respectively). No complications, such as conjunctival dehiscence, implant exposure or extrusion, contracted socket, or fornix insufficiency were observed in any patient during the long-term follow-up period postsurgeries.

Conclusion:
Using polyester mesh-wrapped acrylic orbital implants in enucleation and secondary orbital implantation surgeries proves to be a successful, safe, and cost-effective option.
Recommendations of the SUFU/AUGS/ICS Female Stress Urinary Incontinence Surgical Publication Working Group: A Common Standard Minimum Data Set for the Literature
Authors: Rovner Eric , Chermansky Christopher , Costantini Elisabetta , Dmochowski Roger , Enemchukwu Ekene , Ginsberg David A. , Heesakkers John , Menefee Shawn , Nadeau Geneviève , Rardin Charles R. , Zimmern Philippe 
Published: June 2024

Introduction and Objectives
Relevant, meaningful, and achievable data points are critical in objectively assessing quality, utility, and outcomes in female stress urinary incontinence (SUI) surgery. A minimum data set female SUI surgery studies was proposed by the first American Urological Association guidelines on the surgical management of female SUI in 1997, but recommendation adherence has been suboptimal. The Female Stress Urinary Incontinence Surgical Publication Working Group (WG) was created from members of several prominent organizations to formulate a recommended standard of study structure, description, and minimum outcome data set to be utilized in designing and publishing future SUI studies. The goal of this WG was to create a body of evidence better able to assess the outcomes of female SUI surgery.

Methods
The WG reviewed the minimum data set proposed in the 1997 AUA SUI Guideline document, and other relevant literature. The body of literature was examined in the context of the profound changes in the field over the past 25 years. Through a DELPHI process, a standard study structure and minimum data set were generated. Care was taken to balance the value of several meaningful and relevant data points against the burden of creating an excessively difficult or restrictive standard that would disincentivize widespread adoption and negatively impact manuscript production and acceptance.

Results
The WG outlined standardization in four major areas: 1) study design, 2) pretreatment demographics and characterization of the study population, 3) intraoperative events, and 4) post-treatment evaluation, and complications. Forty-two items were evaluated and graded as: STANDARD - must be included; ADDITIONAL - may be included for a specific study and is inclusive of the Standard items; OPTIMAL - may be included for a comprehensive study and is inclusive of the Standard and Additional items; UNNECESSARY/LEGACY - not relevant.

Conclusions
A reasonable, achievable, and clinically meaningful minimum data set has been constructed. A structured framework will allow future surgical interventions for female SUI to be objectively scrutinized and compared in a clinically significant manner. Ultimately, such a data set, if adopted by the academic community, will enhance the quality of the scientific literature, and ultimately improve short and long-term outcomes for female patients undergoing surgery to correct SUI.
Patients with atrial fibrillation and diabetes mellitus affected by nonalcoholic fatty liver disease have a greater risk of mortality and worse clinical outcomes
Authors: Khokhlov Leonid , Siraw Bekure , Ali Mehnaaz , Hussain Fatima , Brown Amanda , Shemisa Kamal 
Published: June 2024

Background
Nonalcoholic fatty liver disease (NAFLD) is associated with several adverse clinical outcomes. In this study, we assessed the association between NAFLD and several clinical outcome measures in patients with diabetes mellitus (DM) and atrial fibrillation (AF).

Methods
We queried the National Inpatient Sample (NIS) between 2016 and 2019 for adult patients who were hospitalized with DM and AF. NAFLD was the independent variable. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), invasive mechanical ventilation, length of stay, and total hospital charges. A multivariable logistic regression model was used to estimate odds ratios with a 95% confidence interval (CI) and a P value of less than 0.05 was considered significant.

Results
There were 6 723 293 hospitalizations with AF and DM and 253 639 (3.7%) had NAFLD. NAFLD and non-NAFLD cohorts had a mean age of 70.4 vs. 73.8 years, respectively. Overall, 55.6% were male and 73.8% were White. NAFLD was found to be significantly associated with in-hospital mortality [adjusted odds ratio (AOR), 4.2; 95% CI, 4.08–4.32], cardiogenic shock (AOR, 4.78; 95% CI, 4.59–4.98), cardiac arrest (AOR, 3.43; 95% CI, 3.27–3.59), GIB (AOR, 1.92; 95% CI, 1.86–1.98), length of stay, and total hospital charges.

Conclusion
In patients with AF and DM patients, the presence of NAFLD was associated with significantly worse clinical outcomes and higher resource utilization. Adverse cardiovascular events were common as well as GIB. Screening and prevention strategies modifying the risk and disease severity of NAFLD are needed.
Impact of Cardiac Position, Morphology and Operative Technique on Long-Term Fontan Outcomes in Heterotaxy
Authors: Kadowaki Sachiko , uçar Zeynep , Fan Chun-Po Steve , Zahiri Yasmin , Yap Kok Hooi , Tocharoenchok Teerapong , Chen Weidan , Dipchand Anne I. , Honjo Osami , Barron David J. 
Published: June 2024

AbstractObjectivesHeterotaxy is characterized by complex venous connections and cardiac position requiring individualized strategies for Fontan. This study aimed to assess 25-year outcomes of heterotaxy patients undergone Fontan operation, with particular focus on morphological features and surgical techniques.Methods82 consecutive heterotaxy patients who underwent Fontan operation from 1985 to 2021 were compared to 150 with tricuspid atresia (TA) and 144 with hypoplastic left heart syndrome (HLHS). Kaplan-Meier method and Cox proportional hazard model were used for transplant-free survival and predictor analysis.ResultsRight Atrial Isomerism (RAI) was present in 45 cases and Left Atrial Isomerism (LAI) in 37. The 20-year transplant-free survival was comparable between the groups (RAI vs. LAI, 76% [95% confidence interval, 57-87%] vs. 68% [47-82%], p=0.22). Techniques were extracardiac in 66%, intra-atrial conduit in 9%, lateral tunnel in 18%. More intervention on pulmonary veins occurred in the RAI group. Cardiac position and apicocaval juxtaposition did not influence outcome. The IVC-contralateral PA Fontan was associated with 100% survival, while the IVC-ipsilateral PA Fontan at the side of the cardiac apex showed 67% [34-87%] survival at 20 years. Moderate or severe ventricular dysfunction at 20 years was found in 15% (6-39%) and 0% of RAI and LAI patients among hospital survivors, respectively (p=0.09). In-hospital mortality was higher in heterotaxy (9.8% [5-19%]) compared to TA (1.3% [0.3-5.3%], p<.01) and HLHS (2.8% [1.1-7.3%], p=0.02). There was no in-hospital death after 2000 in any of groups. The 20-year transplant-free survival in heterotaxy (72% [59-82%]) was worse than that in TA (95% [89-97%], p<0.001) but was not significantly different from that in HLHS (80% [69-87%], p=0.11). Reintervention rate at 20 years was significantly higher in heterotaxy (18% [11-29%]) vs. HLHS (8% [4-16%]) (p=0.01). Ventricular dysfunction was a predictor for death (univariate p<0.001).ConclusionVarious routing techniques can be successfully applied to overcome the anatomical challenges of heterotaxy. Although higher in-hospital mortality and reintervention rate were found in heterotaxy in the early era, overall survival post Fontan was similar to that in HLHS. RAI had comparable survival to LAI with greater proportion requiring pulmonary vein intervention at time of Fontan.
Rates of biome shift predict diversification dynamics in flowering plants
Authors: Boyko James D. , Vasconcelos Thais 
Published: June 2024

AbstractThe remarkable diversity of angiosperm species has prompted a search for universal drivers that modulate rates of speciation and extinction across this clade. To date, attempts to explain differences in species diversity have focused on the potential correlation of diversification rates with particular key traits.However, an often-overlooked explanation is that evolutionary lability, here defined as the rates of trait change, is a better predictor of the diversification dynamics than the observed traits themselves. This hypothesis, first proposed in the context of biome shifts 50 years ago, is based on the idea that the capacity to adapt to environmental changes is the key element defining angiosperm diversification dynamics. Using a phylogenetic dataset of 49 angiosperm clades including 18,617 species we demonstrate that the propensity of change between open and closed-canopy biomes is significantly correlated with lineage speciation and extinction rates across clades. Additionally, we find that transition rates tend to be faster from open to closed-canopy biomes. This results in ancestral state estimates that favor several deep time origins of open-canopy biomes, contrary to prevailing ideas that lineages occurring in open-canopy biomes tend to emerge from closed-canopy ones in angiosperms. We propose that a shift in focus from static traits to dynamic evolutionary processes may provide a more comprehensive understanding into how biodiversity is generated and maintained, in angiosperms and other organisms.
The Inner Ear and Aging Brain: A Cross-Sectional Study of Vestibular Function and Morphometric Variations in the Entorhinal and Trans-Entorhinal Cortex
Authors: Vania Claire , Padova Dominic , Ratnanather J. Tilak , Agrawal Yuri 
Published: June 2024

AbstractWhile the vestibular system is widely known for helping to maintain balance, posture, and stable vision, mounting research has also demonstrated its importance in cognition and aging. Recent studies have found that peripheral vestibular loss is significantly associated with deficits in spatial cognitive function in older adults. However, the exact neural pathways through which vestibular loss affects spatial cognitive ability in older adults are unknown. Clinical and subclinical studies have shown that vestibular loss is associated with structural and functional alterations in the spatial cognitive network. Yet, studies on the entorhinal cortex (ERC) and trans-entorhinal cortex (TEC)—two key cortical regions in the vestibular spatial cognitive network—are scarce. This cross-sectional study examines the relationship between vestibular end-organ function and morphometric changes in the ERC and TEC. We used a subset of 103 patients from the Baltimore Longitudinal Study for Aging who had T1-weighted MRI and vestibular physiological data during the same visit to investigate the relationship between age-related vestibular function and the shape of the ERC and TEC. The vestibular end-organ function was evaluated through the cervical vestibular-evoked myogenic potential (cVEMP) test to assess saccular function, the ocular VEMP (oVEMP) test to evaluate the utricular function, and the video head-impulse test (vHIT) to assess semicircular canal function based on vestibular ocular reflex (VOR). Shape alterations were evaluated in terms of surface expansion/contraction relative to the average ERC or TEC shape. Reduced saccular function was associated with surface expansion in the pro-rhinal region of the left ERC, which is hypothesized to be involved in spatial cognitive function, in the intermediate caudal and intermediate superior regions of the right ERC, and the sulcal region of the right TEC. Reduced utricular function was associated with surface contraction in the left lateral TEC and the anterior sulcal and transentorhinal regions of the left ERC, and surface expansion in the lateral region of the left ERC. Reduced canal function is predominantly associated with surface contraction in the pro-rhinal and lateral regions of the right ERC and with posterior sulcal and transentorhinal regions of the right TEC. These end-organ-specific and differential findings highlight the complex relationship between vestibular function and the shapes of the ERC and TEC, key regions that subserve spatial cognitive ability and other crucial cognitive abilities. Future work will determine whether these structural alterations related to vestibular loss may underlie the observed deficits in spatial cognitive ability in older adults and Alzheimer’s disease.
Communicating cancer treatment with pictogram-based timeline visualizations
Authors: Jambor Helena Klara , Ketges Julian , Otto Anna Lea , von Bonin Malte , Trautmann-Grill Karolin , Teipel Raphael , Middeke Jan Moritz , Uhlig Maria , Eichler Martin , Pannasch Sebastian , Bornhäuser Martin 
Published: June 2024

AbstractObjectiveThis study evaluated the legibility, comprehension, and clinical usability of visual timelines for communicating cancer treatment paths. We examined how these visual aids enhance participants and patient understanding of their treatment plans.Materials and MethodsThe study included two online surveys and one in-person survey with hematology cancer patients. The online surveys involved 306 and 160 participants respectively, while the clinical evaluation included 30 patients (11 re-surveyed) and 24 medical doctors. Participants were assessed on their ability to understand treatment paths provided with audio information alone or with visual aids. The study also evaluated the comprehension of key treatment terms and the ability of patients to recall their cancer treatment paths.ResultsVisual representations effectively communicated treatment terms, with 7 out of 8 terms achieving over 85% transparency as pictograms, compared to 5 out of 8 for comics and 4 out of 8 for photos. Visual treatment timelines improved response quality, increased confidence, and were rated higher in information quality than audio-only information. In the clinical evaluation, patients showed good comprehension (mean response quality: 0.82) and recall (mean response quality: 0.71 after several weeks), and both patients and physicians found the visual aids helpful.DiscussionWe discuss that visual timelines enhance patient comprehension and confidence in cancer communication. We also discuss limitations of the online surveys and clinical evaluation. The importance of accessible visual aids in patient consultations is emphasized, with potential benefits for diverse patient populations.ConclusionVisual aids in the form of treatment timelines improve the legibility and comprehension of cancer treatment paths. Both patients and physicians support integrating these tools into cancer treatment communication.
Exploring pathways to compulsory detention in psychiatric hospital and ways to prevent repeat detentions; Service user perspectives
Authors: Birken Mary , Kular Ariana , Nyikavaranda Patrick , Parkinson Jordan , Mitchell Lizzie , Fraser Kathleen Lindsay , White Valerie Christina , Seale Janet , Hardy Jackie , Stone Cady , Holden Mark Keith , Elliott Tyler , Li Zishi , Mbeah-Bankas Henrietta , Wood Lisa , Lobban Fiona , Lloyd-Evans Brynmor , Johnson Sonia 
Published: June 2024

AbstractPurposeThis study, co-produced by a team of academics, lived experience researchers and clinicians, explores the views and experiences of people who have been compulsorily detained in hospital under the Mental Health Act (1983) (MHA) in England, to understand how and why, from their perspective, compulsory detentions occur, and what might help prevent them.MethodsSemi-structured qualitative interviews were conducted with 20 people (55% male, 40% Black/Black British, 30% White British) who had been compulsory detained in hospital within the past 5 years. Lived experience researchers with relevant personal experience carried out interviews via telephone or videoconference and participated in analysis of data via a template approach.ResultsWe derived three over-arching themes from interviews. The first theme “Individual factors increasing or reducing likelihood of being detained” encompassed factors related to people’s own lives and attitudes, including life stressors, not taking medication, the risk individuals may pose to themselves or others, and their attitude to and management of their mental health. The second theme “Family and Support Network” reflects how attitudes and support from family, friends and support network may contribute to compulsory detentions or support people to stay well. The third theme “Need for improvement in Service Responses” identified limitations of services that contribute to detention, including lack of collaborative care and choice, poor quality of professional support, and discriminatory attitudes from staff. Each theme also included potential approaches to addressing these limitations and reducing compulsory detentions.ConclusionFindings suggest multiple interacting factors may lead to people being detained in hospital under the MHA, and that improvements to services, such as increasing collaborative care and service user-led family involvement, could prevent further detentions.
Risk of Heart Failure among Individuals with Metabolic Syndrome Components
Authors: Lamichhane Rajan , Bharti Vijay , Lamichhane Aarshi R , Zaheer Kamran 
Published: June 2024

AbstractMetabolic dysfunction of metabolic syndromes (MetS) has been widely reported to be a significant risk factor for heart failure (HF). While this interaction is well studied, what combinations of MetS factors pose the greatest risk for HF are not well defined. We hypothesize that some components of MetS are of higher risk of HF compared to others. We explored the relationship between the independent components of MetS and their combinatory effect on the risk of HF. All metabolic syndrome components except hypertriglyceridemia were significant individually (P-value<0.001), while hypertension (HTN) and diabetes or insulin resistance (IR) had the higher risk of developing heart failure when taken collectively. The odds of heart failure among the individuals who had HTN and IR was 7.7 times those who didn’t have any MetS components. We observed the additive effect of number of metabolic components on HF, for the individuals who had only one MetS symptom, the odd of HF was 5.4 time compared to those who didn’t have any of MetS symptoms. Similarly, these odds of HF were 6.4 and 7.4 times for those who had at least 2 or at least 3 symptoms respectively. Even though obesity is a significant risk factor for cardiovascular diseases, we found the protective effect of obesity on heart failure, which is an interesting result and needs further investigation.
Efficient generation of human dendritic cells from iPSC by introducing a feeder-free expansion step for hematopoietic progenitors
Authors: Elahi Zahra , Jameson Vanta , Sakkas Magdaline , Butcher Suzanne K , Mintern Justine D , Radford Kristen J , Wells Christine A 
Published: June 2024

AbstractDendritic cells (DCs) are rare innate immune cells that are essential regulators of anti-tumour, anti-viral and vaccine responses by the adaptive immune system. Conventional dendritic cells, particularly the cDC1 subset, are most desired for DC-based immunotherapies, however, it can be difficult to isolate sufficient numbers of primary cells from patients. The most common alternate sources of DC areex vivo, such as monocyte-derived or DC expanded from cord blood hematopoietic progenitors. Induced pluripotent stem cells (iPSC) offer a promising solution, providing an opportunity forin vitrogenerating DCs that are suitable for patient-derived or off-the-shelf batch-manufactured cells. Here, we developed anin vitroprotocol designed to maximise the yield of iPSC-derived DC progenitors, with the specific goal of generating DC1-like cells. The iPSC-DCs subsets generated by our method could be partitioned by cell surface phenotypes of cDC1, cDC2 and DC3, but they were most transcriptionally similar to monocyte-derived DC (MoDC). Stimulated iPSC-DCs generated pro-inflammatory cytokines, expressed migratory chemokine receptors including CCR7 which indicates capacity to traffic through lymphatic endothelium, and upregulated co-stimulatory molecules, indicating their potential for productive interactions with T-cells. This method offers a promising step towards an expandable source of allogeneic human dendritic cells for future applications.