bluuebunny/crossref_metadata_2025_split huggingface dataset:
Humanitarian Facial Recognition for Rare Craniofacial Malformations
Authors: Hennocq Quentin , Bongibault Thomas , Garcelon Nicolas , Khonsari Roman Hossein 
Published: May 2024

Summary:
Children with congenital disorders are unfortunate collateral victims of wars and natural disasters. Improved diagnosis could help organize targeted medical support campaigns. Patient identification is a key issue in the management of life-threatening conditions in extreme situations, such as in oncology or for diabetes, and can be challenging when diagnosis requires biological or radiological investigations. Dysmorphology is a central element of diagnosis for craniofacial malformations, with high sensibility and specificity. Massive amounts of public data, including facial pictures circulate daily on news channels and social media, offering unique possibilities for automatic diagnosis based on facial recognition. Furthermore, AI-based algorithms assessing facial features are currently being developed to decrease diagnostic delays. Here, as a case study, we used a facial recognition algorithm trained on a large photographic database to assess an online picture of a family of refugees. Our aim was to evaluate the relevance of using an academic tool on a journalistic picture and discuss its potential application to large-scale screening in humanitarian perspectives. This group picture featured one child with signs of Apert syndrome, a rare condition with risks of severe complications in cases of delayed management. We report the successful automatic screening of Apert syndrome on this low-resolution picture, suggesting that AI-based facial recognition could be used on public data in crisis conditions to localize at-risk patients.
Epidemiology and Treatment of Patients With Primary Open Angle Glaucoma in Germany: A Health Claims Data Analysis
Authors: Manz Karina C. , Mocek Anja , Höer Ariane , Simantiri Christina , Heuck Alexander , Eberhardt Alice , Mrosowsky Thora , Zander Stefanie , Fritz Björn , Schuster Alexander K. , Erb Carl 
Published: May 2024

Précis:
Based on a large administrative database of German claims data, our study provides current estimates of the prevalence and incidence of primary open angle glaucoma (POAG) in Germany and describes selected outcomes for prevalent patients with POAG.

Purpose:
To estimate the prevalence and incidence of POAG in Germany, to describe the patient population in terms of comorbidity burden, routine care, and overall healthcare resource utilization (HCRU) and associated costs, and to describe treatment patterns over time in patients undergoing relevant laser procedures.

Materials and Methods:
Based on anonymized German claims data, we carried out a retrospective, noninterventional study covering calendar years 2016–2021.

Results:
For the adult German population (≥18 y), we estimated a POAG 1-year prevalence of 1.70% and a 1-year incidence of 0.17% in 2018; both increased with age, peaking in 80- to 89-year-olds. Prevalence and incidence were lower in 2020 (1.65% and 0.16%, respectively), the first year of the SARS-CoV-2 pandemic. Most patients solely received topical treatment. Most surgically treated patients underwent laser trabeculoplasty, followed by laser iridotomy, trabeculectomy, and filtration operations with implant. In patients undergoing laser trabeculoplasty, the treatment regimen was nearly unchanged in the second year after, compared with 2 years before the procedure. Multimorbidity was commonly observed; 75.5% of patients had arterial hypertension and 50.0% had disorders of lipoprotein metabolism and other lipidemias, compared with 60.1% and 39.2%, respectively, in an age- and sex-matched control sample.

Conclusions:
Our study provides insights into epidemiology and routine care of POAG in Germany and HCRU in prevalent patients. There was little change in treatment regimens in patients who underwent laser trabeculoplasty, 2 years after the procedure. Most patients were multimorbid highlighting the need for comprehensive care.
Pneumonia in Children With Complex Chronic Conditions With Tracheostomy: An Emerging Challenge
Authors: García-Boyano Miguel , Climent Alcalá Francisco José , Rodríguez Alonso Aroa , García Fernández de Villalta Marta , Zubiaur Alonso Oihane , Rabanal Retolaza Ignacio , Quiles Melero Inmaculada , Calvo Cristina , Escosa García Luis 
Published: May 2024

Background:
Despite respiratory infections being a leading cause of hospitalization in children with tracheostomy tubes, there are no published guidelines for their diagnosis and management. This study aims to outline the clinical, laboratory and microbiological aspects of pneumonia in these children, along with the antibiotics used and outcomes. Additionally, it seeks to determine pneumonia incidence and associated risk factors.

Methods:
We conducted a retrospective study using the medical records of tracheostomized children at La Paz University Hospital in Madrid from 2010 to 2021.

Results:
Thirty-three pneumonia cases were observed in 25 tracheostomized children. Pseudomonas aeruginosa was the predominant bacterium (52%), followed by Escherichia coli, Staphylococcus aureus and Serratia marcescens. The same microorganism isolated in the tracheal aspirate culture during pneumonia was previously isolated in 83% of cases that had a similar culture, with some growth obtained within 7–30 days prior. Multiplex respiratory PCR detected respiratory viruses in 73% of cases tested. Antibiotic treatment was administered in all cases except 1, mostly intravenously (81%), with piperacillin/tazobactam and meropenem being commonly used. Only 1 of the described episodes had a fatal outcome.

Conclusions:
It is advisable to include coverage for P. aeruginosa, E. coli, S. aureus, and S. marcescens in the empirical antibiotic treatment for pneumonia in tracheostomized children, along with the microorganisms identified in tracheal cultures obtained within 7–30 days prior, if available. A positive PCR for respiratory viruses is often discovered in bacterial pneumonia in tracheostomized children.
Per- and Polyfluoroalkyl Substances May Be Correlated With Chlamydia trachomatis
Authors: Taylor Brandie DePaoli , Noah Akaninyene I. , Adekanmbi Victor , Zhang Yuanyi , Berenson Abbey B. 
Published: May 2024

Objective
Per- and polyfluoroalkyl substances (PFAS) alter immune function increasing infectious diseases risk. We examined the relationship between PFAS and chlamydia.

Methods
A total of 3965 nonpregnant adults ages 18–39 years from the National Nutrition Examination Survey 2003–2016 cycles were included. Poisson regression with robust error variance estimated the prevalence ratio and 95% confidence intervals for the association between PFAS and chlamydia. A g computation model was used to examine PFAS mixtures and chlamydia.

Results
In adjusted age and sex-stratified models, an increase in PFAS mixtures by one quintile was associated with chlamydia in older males and younger females. Associations were not observed before stratification.

Conclusions
PFAS exposure associated with higher chlamydia prevalence, but only in stratified models suggesting biological differences by gender and age. However, small sample sizes could have affected the precision of our models.
Novel locally nebulized indocyanine green for simultaneous identification of tumor margin and intersegmental plane
Authors: Jeon Ok Hwa , Kim Kyungsu , Kim Chang Geun , Choi Byeong Hyeon , Lee Jun Hee , Kim Beop-Min , Kim Hyun Koo 
Published: May 2024

Background:
Segmentectomy, recommended for early-stage lung cancer or compromised lung function, demands precise tumor detection and intersegmental plane identification. While indocyanine green (ICG) commonly aids in these aspects using near-infrared imaging, its separate administrations through different routes and times can lead to complications and patient anxiety. This study aims to develop a lung-specific delivery method by nebulizing low-dose ICG to targeted lung segments, allowing simultaneous detection of lung tumors and intersegmental planes across diverse animal models.

Methods:
To optimizing the dose of ICG for lung tumor and interlobar fissure detection, different doses of ICG (0.25, 0.1, and 0.05 mg/kg) were nebulized to rabbit lung tumor models. The distribution of locally nebulized ICG in targeted segments was studied to evaluate the feasibility of detecting lung tumor and intersegmental planes in canine lung pseudotumor models.

Results:
Near-infrared fluorescence imaging demonstrated clear visualization of lung tumor margin and interlobar fissure using local nebulization of 0.1 mg/kg ICG for only 4 min during surgery in the rabbit models. In the canine model, the local nebulization of 0.05 mg/kg of ICG into the target segment enabled clear visualization of pseudotumor and intersegmental planes for 30 min.

Conclusions:
This innovative approach achieves a reduction in ICG dose and prolonged the visualization time of the intersegmental plane and effectively eliminates the need for the hurried marking of tumors and intersegmental planes. The authors anticipate that lung-specific delivery of ICG will prove valuable for image-guided limited resection of lung tumors in clinical practice.
Finding the minimum number of retrieved lymph nodes and negative lymph nodes in gastric cancer surgery: a real-world study
Authors: Liu Yingxue , Zhou Changming , Gan Lu , Zhang Qiyang , Chang Jinjia , Wang Xin , Wang Xu , Xu Midie , Chen Jie , Sheng Weiqi , Liu Fenglin 
Published: May 2024

Background:
Lymph node retrieval deficiency can lead to understagement and postoperative cancer recurrence, it is crucial to establish the standard number of retrieved lymph nodes (rLNs) and negative lymph nodes (nLNs) for patients undergoing gastrectomy.

Methods:
Patients who has gastric adenocarcinoma and underwent either radical subtotal gastrectomy (RSG) or radical total gastrectomy (RTG) between 2000 and 2022 were retrospectively included. The authors utilized restricted cubic spline (RCS) analysis to determine the ideal threshold for rLNs and nLNs. Survival analysis was conducted using Kaplan–Meier (KM) curves, log-rank tests and forest plots. Propensity score matching (PSM) was utilized to balance parameters between two groups. The median follow-up time for this study was 3095 days.

Results:
Our study found that there are significant tumor characteristic differences between RSG and RTG. For patients with N0–N3a stage undergoing RSG, retrieving greater than or equal to 24 lymph nodes intraoperatively were associated with better prognosis both before and after PSM [overall survival (OS): P<0.001, P=0.019]; whereas for N3b stage, at least 32 rLNs were required (OS: P=0.006, P=0.023). Similarly, for patients with N0–N3a stage undergoing RTG, retrieving greater than or equal to 27 lymph nodes intraoperatively were associated with better prognosis both before and after PSM (OS: P<0.001, P=0.047); whereas for N3b stage, at least 34 rLNs were required (OS: P<0.001, P=0.003). Additionally, for patients undergoing RSG, having greater than or equal to 21 nLNs (OS: P<0.001, P=0.013), and for those undergoing RTG, having greater than or equal to 22 nLNs (OS: P<0.001, P<0.001), were also associated with better prognosis both before and after PSM.

Conclusions:
For patients receiving RSG, rLNs should reach 24 when lymph nodes are limited, and 32 when lymph node metastasis is more extensive, with a minimum number of nLNs ideally reaching 21. Similarly, for patients receiving RTG, rLNs should reach 27 when lymph nodes are limited, 34 when lymph node metastasis is more extensive, and a minimum number of nLNs ideally reaching 22.
The association between prehospital post–return of spontaneous circulation core temperature and survival after out-of-hospital cardiac arrest
Authors: Aziz Shadman , Clough Molly , Butterfield Emma , Starr Zachary , Lachowycz Kate , Price James , Barnard Ed B.G. , Rees Paul 
Published: May 2024

Background and importance
Following the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA), a low body temperature on arrival at the hospital and on admission to the ICU is reportedly associated with increased mortality. Whether this association exists in the prehospital setting, however, is unknown.

Objective
The objective of this study was to investigate whether the initial, prehospital core temperature measured post-ROSC is independently associated with survival to hospital discharge in adult patients following OHCA.

Design, setting and participants
This retrospective observational study was conducted at East Anglian Air Ambulance, a physician-paramedic staffed Helicopter Emergency Medical Service in the East of England, UK. Adult OHCA patients attended by East Anglian Air Ambulance from 1 February 2015 to 30 June 2023, who had post-ROSC oesophageal temperature measurements were included.

Outcome measure and analysis
The primary outcome measure was survival to hospital discharge. Core temperature was defined as the first oesophageal temperature recorded following ROSC. Multivariable logistic regression evaluated the adjusted association between core temperature and survival to hospital discharge.

Main results
Resuscitation was attempted in 3990 OHCA patients during the study period, of which 552 patients were included in the final analysis. The mean age was 61 years, and 402 (72.8%) patients were male. Among them, 194 (35.1%) survived to hospital discharge. The mean core temperature was lower in nonsurvivors compared with those who survived hospital discharge; 34.6 and 35.2 °C, respectively (mean difference, −0.66; 95% CI, −0.87 to −0.44; P < 0.001). The adjusted odds ratio for survival was 1.41 (95% CI, 1.09–1.83; P = 0.01) for every 1.0 °C increase in core temperature between 32.5 and 36.9 °C.

Conclusion
In adult patients with ROSC following OHCA, early prehospital core temperature is independently associated with survival to hospital discharge.
Socio-economic determinants influencing adherence to secondary prophylaxis in patients with rheumatic heart disease: a systematic review
Authors: Yadav Manish , Shah Newton Ashish , Bhandari Kritick , Iyer Aksharaa G. , Mishra Ashish , Lamichhane Pratik , Joshi Amir , Yadav Digraj , Singh Aanand K. , Shah Nischal , Yadav Samridhi 
Published: May 2024

Introduction:
Rheumatic heart disease (RHD) poses a substantial global health challenge, especially impacting resource-limited nations, with over 40.5 million cases reported in 2019. The crucial role of Benzathine penicillin G in both primary and secondary prevention, particularly the latter, emphasizes its significance.

Method:
Following PRISMA guidelines, our systematic review explored Medline, Scopus, Google Scholar, and Embase databases from 1990 to 2022. Registered with PROSPERO ), the review utilized quality appraisal tools, including the PRISMA checklist, Cochrane bias tool and Newcastle–Ottawa scale. The objective was to identify and stratify the impact of socio-economic factors on adherence to secondary prophylaxis in RHD.

Results and discussion:
The impact of education on adherence has been found to be significant. Socially disadvantaged environments significantly influenced adherence, shaped by education, socio-economic status, and geographical location and access to healthcare. Surprisingly, lower education levels were associated with better adherence in certain cases. Factors contributing to decreased adherence included forgetfulness, injection-related fears, and healthcare provider-related issues. Conversely, higher adherence correlated with younger age, latent disease onset, increased healthcare resources, and easy access.

Conclusion:
Patient education and awareness were crucial for improving adherence. Structured frameworks, community initiatives, and outreach healthcare programs were identified as essential in overcoming barriers to secondary prophylaxis. Taking active steps to address obstacles like long-distance commute, waiting time, injection fears, and financial issues has the potential to greatly improve adherence. This, in turn, can lead to a more effective prevention of complications associated with RHD.
Coexistence of severe peripheral ulcerative keratitis and lichen planus: case report
Authors: Lazaar Hamza , Boutaj Taha , Sefrioui Meryem , ElMoubarik Najoua , Azarkan Boutayna , Benchekroun Saad , Amazouzi Abdellah , Boutimzine Noureddine , Cherkaoui Lalla Ouafa 
Published: May 2024

Introduction and importance:
Ocular involvement in lichen planus is highly uncommon, primarily affecting the eyelids, conjunctiva, and less frequently, the cornea. Peripheral ulcerative keratitis (PUK), a rare subtype form of corneal lichen planus, has been reported only once in the literature.

Case presentation:
The authors report details of a 34-year-old man with confirmed cutaneous lichen planus who developed severe PUK, a rare ocular manifestation of lichen planus. Despite initial worsening with corticosteroids, successful resolution of PUK was achieved with topical Cyclosporin and azathioprine over 2 months but with a final visual acuity limited to light perception.

Clinical discussion:
To the best of our knowledge, very rare cases have been reported of the coexistence of severe PUK and lichen planus. Lichen planus should be considered in any case of PUKs associated with cutaneous-mucosal manifestations cyclosporin and azathioprine are crucial for effective management and favorable outcomes in such cases.

Conclusion:
This case aims to show the importance of dermatological examination in the presence of any peripheral ulcerative keratitis. It also sheds light on the therapeutic difficulties and the prognosis of this rare form of ocular lichen planus.
Molecular Imaging of Steroid Receptors in Breast Cancer
Authors: Keigley Quinton J. , Fowler Amy M. , O'Brien Sophia R. , Dehdashti Farrokh 
Published: May 2024

AbstractSteroid receptors regulate gene expression for many important physiologic functions and pathologic processes. Receptors for estrogen, progesterone, and androgen have been extensively studied in breast cancer, and their expression provides prognostic information as well as targets for therapy. Noninvasive imaging utilizing positron emission tomography and radiolabeled ligands targeting these receptors can provide valuable insight into predicting treatment efficacy, staging whole-body disease burden, and identifying heterogeneity in receptor expression across different metastatic sites. This review provides an overview of steroid receptor imaging with a focus on breast cancer and radioligands for estrogen, progesterone, and androgen receptors.
Oral preexposure prophylaxis uptake, adherence, and persistence during periconception periods among women in South Africa
Authors: Matthews Lynn T. , Jaggernath Manjeetha , Kriel Yolandie , Smith Patricia M. , Haberer Jessica E. , Baeten Jared M. , Hendrix Craig W. , Ware Norma C. , Moodley Pravi , Pillay Melendhran , Bennett Kara , Bassler John , Psaros Christina , Hurwitz Kathleen E. , Bangsberg David R. , Smit Jennifer A. 
Published: May 2024

Objective:
We developed the Healthy Families-PrEP intervention to support HIV-prevention during periconception and pregnancy. We evaluated preexposure prophylaxis (PrEP) use with three objective measures.

Design:
This single-arm intervention study enrolled women in KwaZulu-Natal, South Africa, who were HIV-uninfected, not pregnant, in a relationship with a partner with HIV or unknown-serostatus, and with pregnancy plans. PrEP was offered as part of a comprehensive HIV prevention intervention. Participants were followed for 12 months.

Methods:
We evaluated periconception PrEP uptake and adherence using quarterly plasma tenofovir concentrations. We modeled factors associated with PrEP uptake and high plasma tenofovir (past day dosing). Patterns of use were analyzed using electronic pillcap data. Dried blood spots to measure intracellular tenofovir product (past 2 months dosing) were analyzed for a subset of women.

Results:
Three hundred thirty women with median age 24 (IQR: 22–27) years enrolled. Partner HIV-serostatus was unknown by 96% (N = 316); 60% (195) initiated PrEP. High plasma tenofovir concentrations were seen in 35, 25, 22, and 20% of samples at 3, 6, 9, and 12 months, respectively. Similar adherence was measured by pillcap and dried blood spots. In adjusted models, lower income, alcohol use, and higher HIV stigma were associated with high plasma tenofovir. Eleven HIV-seroconversions were observed (incidence rate: 4.04/100 person-years [95% confidence interval: 2.24–7.30]). None had detectable plasma tenofovir.

Conclusion:
The Healthy Families-PrEP intervention supported women in PrEP use. We observed high interest in periconception PrEP and over one-third adhered to PrEP in the first quarter; one-fifth were adherent over a year. High HIV incidence highlights the importance of strategies to reduce HIV incidence among periconception women.

Clinical Trial Number:
NCT03194308
Reconstruction of Scalp and Skull Defects by a Free Anterolateral Thigh Flap Combined With Fascia Lata and Vastus Lateralis Muscle
Authors: Zhang Juan , Pei Jiaomiao , Li Yang , Han Yan , Song Baoqiang 
Published: May 2024

Background:
Reconstruction of composite scalp and skull defects is a great challenge for plastic surgeons, and this study aimed to report the therapeutic regimen of using free ALT flaps with fascia lata and vastus lateralis muscle to cover scalp and cranial defects.

Methods:
A retrospective analysis was performed including 10 patients with composite scalp and skull defects who were treated with a free ALT flap with fascia lata and vastus lateralis muscle from January 2012 to June 2020. All patients underwent a 1-stage operation and were followed up for 1 year with clinical data including sex, age, etiology, skull defect area, scalp defect area, flap area, dura mater involvement, recipient vessel, donor site repair, lumbar cistern drainage, and complications.

Results:
All flaps survived well, 2 patients developed complications, one had cerebrospinal fluid leakage, and another experienced partial skin graft necrosis; All patients were satisfied with both the appearance and functional outcomes of the procedure.

Conclusion:
Free tissue transplantation is an effective method for large defects of the scalp and skull. The combination of a free ALT flap with fascia lata and vastus lateralis muscle, which has a long pedicle, convenient flap designs, less donor-site morbidity, and effective prevention of cerebrospinal fluid leakage, is an ideal choice to repair the composite scalp and cranial defects in stage 1.