bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Results of Punctoplasty With Canalicular Triangular Flap in Punctal Stenosis
Authors: Taskiran Comez Arzu , Kirmaci Kabakci Asli , Livan Turkoglu Elif Hazal 
Published: May 2024

Purpose:
The aim was to describe the punctoplasty technique with canalicular triangular flap, and present the long-term results of the technique in patients with inferior punctal stenosis.

Methods:
The files of the patients who were diagnosed with punctal stenosis grade 0, 1, and 2 and underwent a canalicular triangular flap were evaluated retrospectively. The study was approved by the local ethical committee of the University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul. The demographic data, symptoms, prior interventions, punctal stenosis grading, associated eye pathologies, fluorescein clearance test, Munk score, and follow-up time were recorded. The puncta were evaluated biomicroscopically, and photographs were taken at each visit. The patients with at least 6 months of follow-up were included in the study. The loss of epiphora symptom, positive dye disappearance, and puncti ≥grade 3 opening were accepted as a success.

Results:
A hundred and nine inferior puncti of 64 patients with symptoms of epiphora and punctal stenosis diagnosis were included in the study. Thirteen eyes were excluded as they were diagnosed to have punctal atresia or canalicular stenosis of a variable degree beyond punctum. The rest 96 eyes of 55 patients—65 eyes of 36 females and 31 eyes of 19 males—were included in the study as having pure punctal stenosis. The mean age of the patients was 64.3 ± 9.01 years (40–88 years). Forty-one patients had bilateral and 14 patients had unilateral punctal stenosis. Sixty-six were grade 1, and 30 were grade 2. Epiphora was the most commonly reported symptom.
The mean follow-up time was 21.17 ± 10.5 months (6–46 months). In 76 (79.1%) eyes of 96, Munk score was 0 and in 15 (15.6%) eyes, Munk score was 1. Anatomical success as having puncta larger than grade 2 was recorded in 97.9%, and functional success was recorded in 94.6% of anatomically successful eyes. No restenosis was recorded in any punctum.

Conclusion:
Although the techniques of 1-snip, 2-snip, 3-snip, and 4-snip punctoplasty are performed with variable success rates in punctal stenosis patients, there is always a risk of restenosis due to the incision of the flap and unpredictability of the way the tissues will epithelize. In the canalicular triangular flap technique, the canalicular mucosal flap is preserved, and the continuity of the lacrimal mucosa with conjunctiva is provided, which utilizes appropriate re-epithelization of the wound edges, resulting in a wide punctal opening for the upper lacrimal system in the long term.
Effects of Teprotumumab on Eyelid Retraction in Thyroid Eye Disease
Authors: Al-Sharif Eman M. , Zhou Jason , Shoji Marissa K. , Acuff Kaela , Liu Catherine Y. , Korn Bobby S. , Kikkawa Don O. 
Published: May 2024

Purpose:
This study evaluates the efficacy of teprotumumab in reducing eyelid retraction in thyroid eye disease (TED) patients.

Methods:
This retrospective study included patients with active or chronic moderate-to-severe TED who completed at least 4 cycles of teprotumumab. Patients with upper and/or lower eyelid retraction, defined as margin-to-reflex distance (MRD) 1 and/or MRD2 of more than 5 mm, in one or OU were included. The main outcome measure was a change in MRD1 and MRD2 after treatment. Changes in MRD1 and MRD2 were each analyzed for correlation (r) with changes in exophthalmolmetry. Student t test was performed for each comparison, and p values <0.05 were considered significant.

Results:
The study included 91 patients, predominantly female (87%), with an average age of 52.02 ± 14.6 years. The mean baseline proptosis measurement was 21.8 ± 2.9 OD and 21.7 ± 3.3 OS. The average MRD1 was 5.5 ± 1.5 OD and 5.4 ± 1.7 OS, and the average MRD2 was 6.1 ± 1.1 OD and 6.2 ± 1.1 OS. The follow-up duration post-treatment was 37.5 ± 31.7 weeks. At first follow-up post-treatment, the mean change in proptosis, MRD1, and MRD2 were −2.6 ± 2.0 OD, −2.5 ± 2.1 OS, −0.8.5 ± 1.4 OD, −0.8 ± 1.0 OS, and −0.7 ± 0.9 OD, −0.8 ± 1.0 OS, respectively. Correlation analysis showed that proptosis reduction was positively correlated with MRD1 and MRD2 reduction at the first post-treatment follow-up (MRD1: r = 0.23, p value < 0.01; MRD2: r = 0.17, p = 0.03].

Conclusion:
Teprotumumab treatment improves upper and lower eyelid retraction. The improvement in MRD correlated positively with proptosis reduction, indicating the influence of globe position on eyelid position.
Methods for pragmatic randomized clinical trials of pain therapies: IMMPACT statement
Authors: Hohenschurz-Schmidt David , Cherkin Dan , Rice Andrew S.C. , Dworkin Robert H. , Turk Dennis C. , McDermott Michael P. , Bair Matthew J. , DeBar Lynn L. , Edwards Robert R. , Evans Scott R. , Farrar John T. , Kerns Robert D. , Rowbotham Michael C. , Wasan Ajay D. , Cowan Penney , Ferguson McKenzie , Freeman Roy , Gewandter Jennifer S. , Gilron Ian , Grol-Prokopczyk Hanna , Iyengar Smriti , Kamp Cornelia , Karp Barbara I. , Kleykamp Bethea A. , Loeser John D. , Mackey Sean , Malamut Richard , McNicol Ewan , Patel Kushang V. , Schmader Kenneth , Simon Lee , Steiner Deborah J. , Veasley Christin , Vollert Jan 
Published: May 2024

Abstract
Pragmatic, randomized, controlled trials hold the potential to directly inform clinical decision making and health policy regarding the treatment of people experiencing pain. Pragmatic trials are designed to replicate or are embedded within routine clinical care and are increasingly valued to bridge the gap between trial research and clinical practice, especially in multidimensional conditions, such as pain and in nonpharmacological intervention research. To maximize the potential of pragmatic trials in pain research, the careful consideration of each methodological decision is required. Trials aligned with routine practice pose several challenges, such as determining and enrolling appropriate study participants, deciding on the appropriate level of flexibility in treatment delivery, integrating information on concomitant treatments and adherence, and choosing comparator conditions and outcome measures. Ensuring data quality in real-world clinical settings is another challenging goal. Furthermore, current trials in the field would benefit from analysis methods that allow for a differentiated understanding of effects across patient subgroups and improved reporting of methods and context, which is required to assess the generalizability of findings. At the same time, a range of novel methodological approaches provide opportunities for enhanced efficiency and relevance of pragmatic trials to stakeholders and clinical decision making. In this study, best-practice considerations for these and other concerns in pragmatic trials of pain treatments are offered and a number of promising solutions discussed. The basis of these recommendations was an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) meeting organized by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks.
Translation of paclitaxel-induced peripheral neurotoxicity from mice to patients: the importance of model selection
Authors: Cavaletti Guido , Alberti Paola , Canta Annalisa , Carozzi Valentina , Cherchi Laura , Chiorazzi Alessia , Crippa Luca , Marmiroli Paola , Meregalli Cristina , Pozzi Eleonora , Rodriguez-Menendez Virginia , Steinkühler Christian , Licandro Simonetta Andrea 
Published: May 2024

Abstract
Paclitaxel-induced peripheral neurotoxicity (PIPN) is a potentially dose-limiting side effect in anticancer chemotherapy. Several animal models of PIPN exist, but their results are sometimes difficult to be translated into the clinical setting. We compared 2 widely used PIPN models characterized by marked differences in their methodologies. Female C57BL/6JOlaHsd mice were used, and they received only paclitaxel vehicle (n = 38) or paclitaxel via intravenous injection (n = 19, 70 mg/kg) once a week for 4 weeks (Study 1) or intraperitoneally (n = 19, 10 mg/kg) every 2 days for 7 times (Study 2). At the end of treatment and in the follow-up, mice underwent behavioral and neurophysiological assessments of PIPN. At the same time points, some mice were killed and dorsal root ganglia, skin, and sciatic and caudal nerve samples underwent pathological examination. Serum neurofilament light levels were also measured. The differences in the neurotoxicity parameters were analyzed using a nonparametric Mann-Whitney test, with significance level set at P < 0.05. Study 1 showed significant and consistent behavioral, neurophysiological, pathological, and serological changes induced by paclitaxel administration at the end of treatment, and most of these changes were still evident in the follow-up period. By contrast, study 2 evidenced only a transient small fiber neuropathy, associated with neuropathic pain. Our comparative study clearly distinguished a PIPN model recapitulating all the clinical features of the human condition and a model showing only small fiber neuropathy with neuropathic pain induced by paclitaxel.
Development and Validation of Prognostic Nomogram to Predict Overall Survival for Older Patients Who Age 75 Years or Older With Urothelial Carcinoma of Bladder
Authors: Li Junwei , Ye Yanfang , Li Xiaojing , Xie Xinxin , Qin Tao 
Published: May 2024

Purpose:
Age is an important factor for prognostic factor in bladder cancer. However, most clinical studies targeting bladder cancer have limited the upper age limit to 75 years. With the higher age of diagnosis of older patients with bladder cancer, there is a lack of prognostic data for bladder cancer at advanced ages. In this study, we analyzed the prognostic factors of older patients with bladder cancer 75 years or older using Surveillance, Epidemiology, and End Results (SEER) data.

Materials and Methods:
Clinical parameters that constitute potential risk factors were analyzed by downloading a total of 13,505 patients with bladder cancer from the SEER database using univariate and multifactorial Cox proportional risk regression. Nomogram was constructed based on parameters significantly associated with overall survival (OS). The consistency index (c-index) and area under the curve were used to evaluate the predictive performance of the model.

Results:
From the SEER database, we analyzed 13,505 cases and found that the median survival time for the whole cohort was 52 months. However, the median survival was 11 months, 8 months, and 6 months in 75 to 79 years subgroup, 80 to 84 years subgroup, and older than 85 years subgroup, when patients were diagnosed with stage IV. OS was poorer in the high histological grade patients. Furthermore, it was found that patients with lymph node metastasis had a significantly unfavorable prognosis than those with negative lymph nodes. The more advanced stage and distant metastases of patients had the shorter survival. Patients who underwent surgery had better overall survival than nonsurgical patients, and chemotherapy had prolonged survival. Conversely, survival was documented to be shorter with radiotherapy than those without radiotherapy.

Conclusions:
The overall prognosis of older patients with bladder cancer was poor, especially in patients with lymph node metastasis, high histological grade, and advanced stage, while a combination of surgery and chemotherapy could prolong survival.
Improving our understanding on the clinical role of plasmin-mediated von Willebrand factor degradation
Authors: Otmani Hinde El , Vanhoorelbeke Karen , Tersteeg Claudia 
Published: May 2024

Purpose of review
Von Willebrand factor (VWF) plays a pivotal role in primary hemostasis. A Disintegrin And Metalloproteinase with a ThromboSpondin type 1 motif, member 13 (ADAMTS13) is primarily responsible for cleaving ultra-large VWF multimers into smaller, less adhesive forms. However, plasmin has also been shown to cleave VWF multimers. This proteolytic cleavage of VWF results in a decreased multimer size and, hence, a lower VWF activity. This review aims to present a comprehensive overview of the involvement of plasmin-mediated VWF proteolysis in (micro)thrombosis.

Recent findings
Plasmin-mediated VWF proteolysis has been suggested to play a role in various pathologies involving microthrombosis in combination with an imbalance in VWF antigen levels and ADAMTS13 activity, as well as activation of the fibrinolytic system, but quantitative assays to demonstrate this were lacking. Recently, a VHH-based bioassay was developed designed specifically to quantify plasmin-cleaved VWF (cVWF). The novel ELISA assay holds significant promise for gaining further insights into the clinical relevance of plasmin-mediated VWF proteolysis in several pathologies. Furthermore, local plasmin activation at the site of microthrombosis has been shown to be a promising treatment strategy by degrading VWF-rich microthrombi.

Summary
Plasmin-mediated proteolysis of VWF is observed during microthrombosis; however, it remains unclear whether it impacts disease severity. A novel ELISA method to detect cVWF will improve our understanding of the clinical role of plasmin-mediated VWF degradation.
Graft repair during machine perfusion: a current overview of strategies
Authors: Broere Roberto , Luijmes Stefan H. , de Jonge Jeroen , Porte Robert J. 
Published: May 2024

Purpose of review
With changing donor characteristics (advanced age, obesity), an increase in the use of extended criteria donor (ECD) livers in liver transplantation is seen. Machine perfusion allows graft viability assessment, but still many donor livers are considered nontransplantable. Besides being used as graft viability assessment tool, ex situ machine perfusion offers a platform for therapeutic strategies to ameliorate grafts prior to transplantation. This review describes the current landscape of graft repair during machine perfusion.

Recent findings
Explored anti-inflammatory therapies, including inflammasome inhibitors, hemoabsorption, and cellular therapies mitigate the inflammatory response and improve hepatic function. Cholangiocyte organoids show promise in repairing the damaged biliary tree. Defatting during normothermic machine perfusion shows a reduction of steatosis and improved hepatobiliary function compared to nontreated livers. Uptake of RNA interference therapies during machine perfusion paves the way for an additional treatment modality.

Summary
The possibility to repair injured donor livers during ex situ machine perfusion might increase the utilization of ECD-livers. Application of defatting agents is currently explored in clinical trials, whereas other therapeutics require further research or optimization before entering clinical research.
Laparoscopic antegrade spleen-preserving distal pancreatectomy with conservation of the splenic vessels: a prospective multi-centre case series (with video)
Authors: Nguyen Hoang , Luong Tuan Hiep , Nguyen An Khang , Nguyen Thanh Khiem 
Published: May 2024

Introduction:
Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with conservation of the splenic artery and vein (Kimura’ technique) is considered a technically challenging procedure that requires a high level of expertise in laparoscopic and pancreatic surgery.

Methods:
A prospective descriptive study on 18 patients with laparoscopic “antegrade” spleen-preserving distal pancreatectomy with Kimura’ technique from 2018 to 2023. The perioperative indications, clinical data, intraoperative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated.

Results:
The mean age was 39.4±13.3. Only 2 male patients accounted for 11.1%. The average operating time is 171±23 min. The average blood loss is 65.7±43 ml. The average tumor size is 4.1 cm. The average hospitalization is 9.4 days. The rate of pancreatic fistula is 66.7%. There is no case of transferring open surgery or blood transfusion during surgery. The results of pathological after surgery there were eight cases of solid pseudopapillary tumors, four cases of mucinous cystadenoma, six cases of neuroendocrine tumors.

Conclusion:
Kimura’s technique for laparoscopic spleen-preserving distal pancreatectomy is safe and feasible, which can be applied to benign tumors in the body and tail of the pancreas. However, this is a difficult technique in laparoscopic surgery that requires surgeons to have a lot of experience and equipment need to be adequate.
Accelerated Diffusion-Weighted Magnetic Resonance Imaging of the Liver at 1.5 T With Deep Learning–Based Image Reconstruction: Impact on Image Quality and Lesion Detection
Authors: Ginocchio Luke A. , Jaglan Sonam , Tong Angela , Smereka Paul N. , Benkert Thomas , Chandarana Hersh , Shanbhogue Krishna P. 
Published: May 2024

Objective
To perform image quality comparison between deep learning–based multiband diffusion-weighted sequence (DL-mb-DWI), accelerated multiband diffusion-weighted sequence (accelerated mb-DWI), and conventional multiband diffusion-weighted sequence (conventional mb-DWI) in patients undergoing clinical liver magnetic resonance imaging (MRI).

Methods
Fifty consecutive patients who underwent clinical MRI of the liver at a 1.5-T scanner, between September 1, 2021, and January 31, 2022, were included in this study. Three radiologists independently reviewed images using a 5-point Likert scale for artifacts and image quality factors, in addition to assessing the presence of liver lesions and lesion conspicuity.

Results
DL-mb-DWI acquisition time was 65.0 ± 2.4 seconds, significantly (P < 0.001) shorter than conventional mb-DWI (147.5 ± 19.2 seconds) and accelerated mb-DWI (94.3 ± 1.8 seconds). DL-mb-DWI received significantly higher scores than conventional mb-DWI for conspicuity of the left lobe (P < 0.001), sharpness of intrahepatic vessel margin (P < 0.001), sharpness of the pancreatic contour (P < 0.001), in-plane motion artifact (P = 0.002), and overall image quality (P = 0.005) by reader 2. DL-mb-DWI received significantly higher scores for conspicuity of the left lobe (P = 0.006), sharpness of the pancreatic contour (P = 0.020), and in-plane motion artifact (P = 0.042) by reader 3. DL-mb-DWI received significantly higher scores for strength of fat suppression (P = 0.004) and sharpness of the pancreatic contour (P = 0.038) by reader 1. The remaining quality parameters did not reach statistical significance for reader 1.

Conclusions
Novel diffusion-weighted MRI sequence with deep learning–based image reconstruction demonstrated significantly decreased acquisition times compared with conventional and accelerated mb-DWI sequences, while maintaining or improving image quality for routine abdominal MRI. DL-mb-DWI offers a potential alternative to conventional mb-DWI in routine clinical liver MRI.
Development of “Explore Plastic Surgery”
Authors: Friedman Rosie , Shen Abra H. , Kim Erin , Taskindoust Mahsa , Boustany Ashley N. , Singhal Dhruv , Lin Samuel J. , Lee Bernard T. 
Published: May 2024

Background
Medical students who attend institutions without plastic surgery residency programs are at a disadvantage in the plastic surgery match. We developed an educational program for medical students without home programs called Explore Plastic Surgery to provide an overview of the steps toward a career in plastic surgery. The purpose of this study was to assess the impact, utility, and success of the novel program.

Methods
Pre- and postevent surveys were distributed to participants. Survey data were analyzed including participant demographics, perceptions of barriers unique to those without home programs, and the overall event utility.

Results
Two hundred seventeen students registered for the program. Ninety-five participants completed the pre-event survey (44%), and of those, 57 participants completed the post-event survey (60%). There was an increase in understanding of the steps toward a career in plastic surgery (P < 0.001), confidence in overcoming barriers (P = 0.005), and level of comfort in reaching out to faculty for opportunities (P = 0.01). There was a decrease in the perceived negative impact that attending medical schools without a home program will have on their abilities to pursue careers in plastic surgery (P = 0.006).

Conclusions
After the event, participants demonstrated an increase in their confidence in overcoming barriers and a decrease in their perceptions that attending an institution without a home program would negatively impact their ability to pursue plastic surgery. Initiatives focused on early exposure and recruitment of medical students may be important to promote accessibility and diversity within plastic surgery.
Mandibular Distraction in Patients With Pierre Robin Sequence
Authors: Goza Shelby D. , Brown Madyson I. , Hopper Samuel J. , Phillips John , Sink Matthew C. , Brown Kathryn W. , Fernstrum Colton J. , Friel Michael T. , Humphries Laura S. , Hoppe Ian C. 
Published: May 2024

Objective
Mandibular distraction osteogenesis (MDO) is rapidly becoming a standard of care for management of patients with severe Pierre Robin sequence. The tongue is brought forward to alleviate airway obstruction. This study will look at an institutional, multisurgeon experience with MDO over 10 years.

Design
A retrospective chart review was conducted.

Setting
All patients who underwent MDO at the authors' institution from 2012 to 2022 were included. Three craniofacial surgeons performed all interventions.

Patients
Demographics, preoperative and postoperative respiratory and feeding status, and distraction data were collected for 27 patients meeting inclusion criteria.

Main Outcome Measures
Primary outcomes were avoidance of a gastrostomy tube, avoidance of a tracheostomy, discharge from hospital on room air, and complications. A significance value of 0.05 was utilized.

Results
The average age at MDO was 135 days, mean activation phase was 13.6 days, mean distraction length was 14.9 mm, and mean consolidation phase was 64.2 days. A longer activation phase was associated with discharge with a gastrostomy tube and a shorter activation phase was associated with discharge on full oral feeds. The ability to discharge on room air was associated with a shorter latency phase, shorter activation phase, and decreased distance of distraction.

Conclusions
The goal of MDO is to achieve full oral feeds with no respiratory support. Several different latency periods were used in this study, and a short latency period was demonstrated to be safe.