bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative Cardiopulmonary Complications in Smokers and Non-smokers Undergoing Elective Surgery: A Prospective Study
Authors: Reddy Venumula Vikram , Mallem Dinakar , Krishna Sonnaila Rama , Kotra Vijay , Chooi Wen Han , Goh Khang Wen , Ming Long Chiau , Kanakal Mahibub Mahamadsa , Abbas Syed Atif , Husain Khairulanwar 
Published: May 2024

Background Studies indicated that smoking alters the response to anesthetics and alters the outcome of perioperative care. A full understanding of the impact of smoking cessation to enhance surgical outcomes is pertinent. Purpose This research aimed to compare perioperative cardiopulmonary complications in smokers and non-smokers during elective surgery under general anesthesia. We aimed to determine the incidence of complications in patients with a history of smoking, identify those at an increased risk, and assess the relationship between smoking duration and complications Materials and Methods A total of 100 patients, comprising 50 smokers and 50 non-smokers, were enrolled in the study. Various parameters, including heart rate increase during intubation, severe coughing, bronchospasm, oral secretions, oxygen desaturation, reintubation, opioid antagonist use, pulmonary edema, and other cardiopulmonary events, were assessed perioperatively. Statistical analysis involved both continuous and categorical variables. For continuous variables, the Student’s t-test and the Mann–Whitney U test were used for normally and non-normally distributed data, respectively. For categorical variables, chi-squared tests were employed. Sub-group analysis assessed the influence of smoking duration on the measured parameters. Results Smokers exhibited significantly higher incidences of severe coughing, heart rate elevation during intubation, and bronchospasm compared to non-smokers. Additionally, smokers experienced more pronounced oxygen desaturation throughout the perioperative period. Furthermore, a longer history of smoking was associated with an increased risk of complications, with individuals smoking for 10 or more years displaying a higher incidence of adverse events. Conclusion Smokers, particularly those with extended smoking histories, are at an increased risk of cardiopulmonary complications during elective surgery under general anesthesia. Emphasizing preoperative optimization, meticulous airway management, and smoking cessation support is essential to mitigate these risks. The study underscores the significance of these measures for enhancing perioperative safety and calls for further research to explore the long-term impacts and patient satisfaction associated with these interventions. These steps are essential not only for perioperative care but also for long-term health benefits among this patient population.
Proximal Medial Gastrocnemius Recession for Recalcitrant Plantar Fasciitis
Authors: Slullitel Gaston A. , Martinez de Albornoz Pilar , Oller Boix Anna , Rey Cañas Roberto , Vazquez Vidosa Javier , Monteagudo de la Rosa Manuel 
Published: May 2024

Background: Recalcitrant plantar fasciitis (RPF) is characterized by its unresponsiveness to conservative treatments, and its surgical management remains controversial. Although there is some evidence to suggest that gastrocnemius recession can be an effective treatment for RPF, no large series of patients with mid- to long-term follow-up has been published. The objective of this study was to compare physical performance, as measured by the Foot and Ankle Ability Measure activities of daily living score (FAAM-ADL), and pain levels before and 1 year after undergoing proximal medial gastrocnemius recession (PMGR) as a treatment for RPF. Additionally, we aimed to assess this cohort of patients in the mid- to long-term follow-up. Methods: This retrospective cohort study included 167 patients who underwent PMGR to address RPF between 2009 and 2021. Patients were examined with the FAAM ADL, visual analog scale (VAS) and satisfaction scores at baseline, 1 year, and at the end of follow-up. Other variables recorded were weight, duration of symptoms until surgery, time between surgery to substantial clinical improvement, calf power and Silfverskiold test, and postoperative complications. Results: We observed that before surgery patients had an FAAM-ADL score of 22.5 (SD 11.1) and a VAS score of 8.6 (SD 9.3). One year after surgery, patients had an FAAM-ADL score of 89 (SD 17) and VAS of 1.33 (SD 2) ( P < .01). We also observed that the FAAM-ADL score in the long-term follow-up (>12.5 years) group had a median of 86.4 (SD 22.6), the VAS score was 1.90 (SD 2.84), and the patient satisfaction score had a median of 1 (interquartile range 0-1). Regarding complications, we observed 1 lateral gastrocnemius recession and 1 sural nerve neuritis. Conclusion: Our study provides substantial evidence supporting the use of PMGR as an effective treatment for RPF. The long-term follow-up and large sample size of our series contribute to the existing literature on this topic.
Xanthinuria in a familial group of Munchkin cats and an unrelated domestic shorthair cat
Authors: Pritchard Emily C , Haase Bianca , Wall Meredith J , O’Brien Carolyn R , Gowan Richard , Mizzi Kim , Kicinski Annie , Podadera Juan , Boland Lara A 
Published: May 2024

Case series summary Four confirmed cases of xanthinuria in cats, and one suspected case based on pedigree analysis, were identified. Clinical presentations varied and included haematuria, pollakiuria, dysuria, and urethral and ureteral obstruction. All cats had upper urinary tract uroliths. Diagnosis was obtained through infrared mass spectrometry of uroliths or urine. Clinical signs commenced at 3–8 months of age and reduced in all cats in the medium to long term after the introduction of a protein-restricted diet. Four cats were castrated males and one was a spayed female. Cases consisted of four Munchkin pedigree cats and one unrelated domestic shorthair cat. All four affected Munchkin pedigree cats were related, with three cases full siblings and the fourth case a half-sibling. No connection to the Munchkin pedigree could be established for the domestic shorthair cat. A candidate causative genetic variant ( XDH p.A681V) proposed for this cat was excluded in the Munchkin family. Relevance and novel information All affected cats presented diagnostic challenges and routine urinalysis was insufficient to obtain a diagnosis. Cases of feline xanthinuria may be underdiagnosed due to situations where uroliths cannot be retrieved for analysis and there is an inability to make a diagnosis using crystal morphology alone on routine urinalysis. Metabolic screening of urine may provide an effective mechanism to confirm xanthinuria in suspected cases where uroliths are inaccessible or absent. In this case series, male cats were more common. Their anatomy may increase the risk of lower urinary tract signs and urethral obstruction developing secondary to xanthine urolithiasis. A protein-restricted diet appears to reduce clinical signs as part of long-term management. Plain language summary Four closely related Munchkin cats and one domestic shorthair cat were found with a suspected genetic disease causing high levels of xanthine in their urine. The case series looks at similarities and differences in their clinical signs, as well as difficulties experienced in obtaining a correct diagnosis. All cats had upper urinary tract stones and required metabolic testing of the stones or urine to diagnose. All cats were young when their clinical signs started and were on a high-protein diet. Four cats were desexed males and one was a desexed female. A genetic variant that may have caused the disease in the domestic shorthair cat was ruled out in the Munchkin family. Cases of high xanthine levels in feline urine may be underdiagnosed as the stones may not be accessed for testing. In this case series, male cats were more common. Their anatomy may increase the risk of lower urinary tract signs. A protein-restricted diet appears to reduce clinical signs as part of long-term management.
Children born preterm or small for gestational age to mothers with multiple sclerosis: Do these children have an increased risk of infections in early life?
Authors: Andersen Mette Louise , Jølving Line Riis , Iachina Maria , Stenager Egon , Knudsen Torben , Nørgård Bente Mertz 
Published: May 2024

Background: Mothers with multiple sclerosis are at increased risk of preterm birth and small for gestational age infants. Both conditions pose a risk of morbidity, including early-life infections. Objective: This study aimed to assess the risk of infections in the first 3 years of life among children born preterm or small for gestational age to mothers with multiple sclerosis. Methods: We used Danish national health registers to establish the study cohort of all births by women with MS born from 1995 to 2023. In Cox regression models, we estimated hazard ratios (HRs) of infections in preterm or small for gestational age children. Results: Preterm children had an adjusted HR of 1.49 (95% confidence interval (95% CI) 1.15–1.93) for hospital-diagnosed infection and 0.88 (95% CI 0.72–1.06) for antibiotic prescriptions. Small for gestational age children had an adjusted HR of 0.81 (95% CI 0.54–1.22) for hospital-diagnosed infection and 1.07 (95% CI 0.82–1.38) for antibiotic prescriptions. Conclusion: Children born preterm to mothers with multiple sclerosis had an increased risk of hospital-diagnosed infections in the first 3 years of life, but not of mild-to-moderate infections evaluated on prescriptions. Children born small for gestational age did not have an increased risk of infections.
Playing with persona: Highlighting older adults’ lived experience with the digital media
Authors: Hjorth Larissa , Sheahan Jacob , Figueiredo Bernardo , Martin Diane , Reid Mike , Aleti Torgeir , Buschgens Mark 
Published: May 2024

During the COVID-19 pandemic lockdowns (2020-2021), almost all facets of life were rendered digital – health, work, schooling, and logistics. In this phenomenon, not only did digital access become synonymous with social inclusion but inequalities were also amplified – particularly in the case of older adults (65 years and over). Contemporary older adults represent one of the most diverse spectrums of digital media users – spanning from technologically savvy to non-users. As the first generation of older adults to age in and through data in a data-saturated world, their understandings and experiences can teach us much about the possibilities and limitations of new media. Understanding these practices through cultural probes – like drawing, photos and writing prompts – can enable playful behaviours that not only elicit new thoughts and actions but also allow insight into some of the tacit lived experience that can support opportunities for technological use. In this paper, we ask: How can we playfully co-design through personas to enhance understandings of older adults’ lived experience of digital media? In this paper, we focus on the six co-design workshops in which we deployed personas as representations of digital experience to challenge, explore, provoke and help build nuanced tools for implementation. Through personas, speculative fiction and lived experience collide, offering some fascinating ways to rethink the digital-social dimension for older adults now and into the future.
Health-related inequalities in out-of-pocket expenditure under universal health coverage in Taiwan: A cross-sectional decomposition analysis
Authors: Lee Miaw-Chwen , Pu Christy 
Published: May 2024

Objectives Studies have investigated income-related inequality in out-of-pocket expenditure (OOPE) on health care but less is known about health-related inequality of OOPE distribution. This study analysed the relationship between health-related inequality and OOPE and the factors contributing to OOPE inequality in Taiwan. Methods We developed a household OOPE questionnaire and conducted a nationally representative cross-sectional survey of households in Taiwan between January and August 2022, using two-stage probability proportional-to-size sampling based on a national address registry in Taiwan. We calculated a concentration index to determine OOPE inequality in health. We then identified factors contributing to OOPE inequality in health distribution by performing a decomposition analysis. Results A total of 657 people responded to the survey (81.4% response rate). The two largest categories of OOPE were spending on curative care and on medical goods and pharmaceuticals, with concentration indices of −0.265 ( p < .001), −0.272 ( p = .006) and −0.227 ( p = .003), respectively, indicating that the OOPE burden fell disproportionately on people with poor health. Socioeconomic status explained significant proportions of inequality in total, curative and medical goods and pharmaceuticals OOPE. Utilisation of health care increased the OOPE burden among people with poor health while having private health insurance worked in the opposite direction. Conclusion In Taiwan, people in poor health faced a disproportionately high OOPE burden, indicating that the National Health Insurance scheme may not meet their needs for health care. There is a need for policies to take account of the different factors affecting health inequalities in OOPE in order to enhance equity in Taiwan’s universal health system.
Caregivers with limited English proficiency: Satisfaction with primary pediatric healthcare
Authors: Duong Linda Thanh , Tran My-An 
Published: May 2024

With a growing 25.5 million people in the United States experiencing limited-English proficiency (LEP), there is a concern over these individuals’ experiences in healthcare. Health outcomes of LEP status are well-documented for adults in hospitals; however, less is known about patient experience, pediatric populations, and primary care settings. This study investigated differences in caregiver satisfaction between families with and without LEP receiving healthcare for their child. A sample of 25,118 caregivers whose children from birth to 17 years had met with any healthcare providers in the past year was used. Analyses consisted of unpaired t-tests comparing mean satisfaction of LEP and English-proficient (EP) caregivers in the domains of how often primary healthcare providers spent enough time with the child, listened, provided specific information, demonstrated sensitivity to the family’s values, and made the respondent feel like a partner. In all aspects of caregiver satisfaction, mean satisfaction scores were significantly lower for LEP caregivers than EP caregivers. The largest drops were seen in perceived time and sensitivity. These results highlight a need to ensure LEP families receive equitable and high-quality primary care services, ultimately building trust in the healthcare system and improving children’s health and well-being.
Carotid Disease Classification: Impact of the 2021 Intersocietal Accreditation Commission Updated Recommendations vs 2003 Society of Radiologists in Ultrasound Consensus Conference Criteria
Authors: Wooster Elizabeth M. , Williams David M. , Wooster Douglas L. 
Published: May 2024

Introduction: In 2021, the Intersocietal Accreditation Commission (IAC) introduced modified criteria for carotid duplex interpretation based on peak systolic velocity (PSV) and PSV ratio. The most significant change compared to the 2003 Society of Radiologists in Ultrasound (SRU) criteria involved re-defining the thresholds for <50 and 50% to 69% stenosis ranges. Patients identified in <50% vs 50% to 69% ranges may face different disease severity assignments, variable surveillance protocols, medical management approaches, and recommendations for intervention. Facilities may experience altered payment coverage, issues of staff re-training, and questions from referring physicians regarding patient treatment and disease management expectations. The objective of this study was to assess the impact of re-defining these stenosis ranges using the 2021 IAC criteria vs the SRU criteria. Methods: Anonymized patient data from carotid duplex examinations were collected as part of an internal laboratory quality improvement strategy. These data were analyzed in an electronic database using the IAC and SRU threshold criteria to determine the degree of carotid stenosis. Patients with normal arteries, unilateral studies, or complete occlusions were excluded. Results: Of the 1000 patients considered, 850 met the eligibility criteria. Using PSV: for the right carotid, 242 (28.5%) showed a change and 608 (71.5%) showed no change in stenosis classification; for the left carotid, 228 (27%) showed a change and 622 (73%) showed no change. All changes were a downgrading of disease to <50% stenosis. Using PSV ratio: for the right carotid, re-assignment of 53 (22% of changed, 6% of total cohort); for the left carotid, re-assignment of 48 (21% of changed, 5.6% of total cohort). All changes resulted in re-assignment to the 50% to 69% stenosis category. Conclusions: Implementation of the IAC criteria resulted in patients being re-assigned to lower stenosis categories (27% for PSV and 21% for PSV ratio). The impact of these changes on patient care and facility logistics needs careful consideration.
Quantitative evaluation of the effects of flow diverter treatment on aneurysm hemodynamics using time-resolved rotational angiography
Authors: Peterson Jeremy C , DiNitto Julie M , Birkhold Annette , Kahn Nickalus , Nickele Christopher , Hoit Dan , Inoa Violiza , Elijovich Lucas , Dornbos David , Arthur Adam S 
Published: May 2024

Background There have been immense advancements in the hardware and software of digital subtraction angiography systems over the last several years. These advancements continue to make progress toward the goals of offering better visualization and reducing radiation exposure. A newer advancement in this arena is presenting three-dimension data over time resulting in four-dimensional-digital subtracted angiography visualization. We have evaluated these protocols related to the evaluation of the treatment of intracranial aneurysms with pipeline flow diversion. Methods Four-dimensional-digital subtracted angiography imaging was acquired on an Artis Q Biplane angiographic system (Siemens Healthcare AG, Forchheim, Germany). A six second four-dimensional-digital subtracted angiography protocol was performed pre and post flow diverter placement. Pre and post reconstructed images were sent through a dedicated prototype research workstation (Syngo X-Workplace; Siemens Healthineers AG) for further flow evaluation. Results The treatment of an aneurysm with flow diversion led to a filling delay of 0.278 ± 0.422 s inside the aneurysms, whereas distal to the aneurysms the filling of the vessel segment occurred earlier post procedural (negative filling delay of −0.15 ± 0.31 s. The flow ratio inside the aneurysm decreased to 63.6 ± 23% of its pre-treatment value and distal to the aneurysm the flow remained substantially the same (flow ratio: 95.6 ± 0.29%). Data showed a relative filling delay of the aneurysm normalized to the distal vessel of 0.43 ± 0.36 s. The relative flow ratio of the aneurysm in comparison to the distal parent vessel was 72.2 ± 31%. Conclusions Analysis of a four-dimensional-digital subtracted angiography acquisition allows assessment of the effects of flow diversion treatment on aneurysm hemodynamic parameters and shows a significant decrease in flow inside the aneurysm compared to the parent vessel distal to the aneurysm.
The efficacy of atherectomy combined with percutaneous transluminal angioplasty (PTA)/drug-coated balloon (DCB) compared with PTA/DCB for infrapopliteal arterial diseases: A systematic review and meta-analysis
Authors: Wang Hui , Su Zhixiang , Guo Julong , Guo Jianming , Gu Yongquan 
Published: May 2024

Objectives With the development of endovascular therapies, some studies have indicated a therapeutic potential for infrapopliteal arterial revascularization with atherectomy (AT). This study was designed to perform a meta-analysis to investigate the efficacy of AT combined with percutaneous transluminal angioplasty (PTA) or drug-coated balloon (DCB) compared with PTA or DCB for infrapopliteal arterial diseases. Methods This is a systematic review and meta-analysis. The Pubmed, Web of Science, and Cochrane Library were systematically searched for articles published up to November 2022, reporting using atherectomy devices for infrapopliteal arterial patients. Randomized controlled trials and retrospective studies were included, and clinical characteristic outcomes were extracted and pooled. Then, we analyzed the efficacies of the AT (AT + PTA or DCB) group and the non-AT (DCB or PTA) group for infrapopliteal arterial patients. Results We identified 6 studies with 1269 patients included in this meta-analysis. The risk ratios (RRs) of primary patency for patients treated with atherectomy group compared to non-atherectomy group at 6 months was 1.03 (95% confidence intervals (CIs) 0.86–1.23, p = .74), at 12 months was 1.05 (95% CIs 0.84–1.30, p = .66), in the subgroup analysis between AT combined with DCB and DCB alone, the RRs of primary patency was 1.56 (95% CIs 1.02–2.39, p = .04). The RRs of freedom from target lesion revascularization (TLR) at 6 months was 1.04 (95% CIs 0.93–1.17, p = .45), at 12 months was 1.20 (95% CIs 0.83–1.75, p = .33). The RRs of mortality at 6 months was 0.57 (95% CIs 0.29–1.11, p = .10), and at 12 months was 0.79 (95% CI 0.50–1.25, p = .31). The RRs of limb salvage at 12 months was 0.99 (95% CIs 0.92–1.07, p = .87). The standardized mean difference (SMD) of (Ankle-brachial index) ABI at 12 months was 0.16 (95% CIs 0.06–0.26, p = .001). Conclusions According to this systematic review and meta-analysis, no significant advantages were found with the addition of atherectomy to balloon angioplasty in the below-the-knee segment. Only in the analysis of a small subgroup of atherectomy + DCB versus DCB alone was the primary patency rate at six months significantly higher when adding atherectomy. No further significant differences were found related to 12 months of primary patency, TLR, limb salvage, and mortality among groups.