bluuebunny/crossref_metadata_2025_split huggingface dataset:
Very Early Loading of a Bone-Anchored Hearing System Is Safe
Authors: Møller Marie Louise , Foghsgaard Søren , Hougaard Dan Dupont 
Published: May 2024

Objective
To investigate the feasibility of early sound processor loading with two separate bone-anchored hearing aid implants 1 to 2 weeks after implantation. Secondary endpoints included registration of any postoperative complications, skin reactions, and any adverse events.

Study Design
Prospective, nonrandomized, noncontrolled, multicenter clinical trial.

Setting
Tertiary referral center.

Patients
Sixty adult patients, eligible for bone-anchored hearing aid surgery, were enrolled.

Intervention
Implantation of the bone-anchored hearing aid implants were done using minimally invasive surgery with tissue preservation.

Main Outcome Measure
Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Follow-ups were scheduled 5 to 12 days, 4 to 8 weeks, 6 months, and 12 months postoperatively. Differences between the lowest ISQ values (ISQ low) over time were analyzed by paired-samples t test with a significance level of 0.05. Skin and soft tissue reactions were assessed according to Holger's classification.

Results
Loading time of the Ponto Wide implant was 11.6 ± 1.4 days (SD) in average (median, 12 d; range, 7–19 d). Loading of the Ponto BHX implant was done 9.7 ± 3.5 days (SD) postoperatively (median, 9 d; range, 5–19 d). The implant stability increased significantly during the 12-month study period with both implants. One Ponto BHX implant was lost. Skin and soft tissue reactions were few in both groups. Across all planned follow-up visits, no skin and soft tissue reactions were observed in 86% (Ponto BHX implant) and 85% (Ponto Wide implant).

Conclusion
Very early loading of sound processors after percutaneous bone-anchored hearing system surgery is safe already 1 to 2 weeks postoperatively.
Seven-Year Revision Rates for Cochlear Implants in Pediatric and Adult Populations of an Integrated Healthcare System
Authors: Connell Sarah S. , Chang Richard N. , Royse Kathryn E. , Benson Nicholas J. , Tran LenhAnh P. , Fasig Brian H. , Paxton Liz W. , Balough Ben J. 
Published: May 2024

Objective
We assessed three cochlear implant (CI) suppliers: Advanced Bionics, Cochlear Limited, and MED-EL, for implant revision requiring reoperation after CI placement.

Study Design
Retrospective cohort study of integrated-health-system database between 2010 and 2021. Separate models were created for pediatric (age <18) and adult (age ≥18) cohorts.

Patients
Pediatric (age <18) and adult (age ≥18) patients undergoing cochlear implantation within our integrated healthcare system.

Main Outcome Measure
Revision after CI placement. Cox proportional hazard regression was used to evaluate revision risk and adjust for confounding factors. Hazard ratios (HRs) and 95% confidence intervals (CIs) are presented.

Results
A total of 2,347 patients underwent a primary CI placement, and Cochlear Limited was most implanted (51.5%), followed by Advanced Bionics (35.2%) and MED-EL (13.3%). In the pediatric cohort, the 7-year crude revision rate was 10.9% for Advanced Bionics and 4.8% for Cochlear Limited, whereas MED-EL had insufficient cases. In adults, the rates were 9.1%, 4.5%, and 3.3% for Advanced Bionics, MED-EL, and Cochlear Limited, respectively. After 2 years of postoperative follow-up, Advanced Bionics had a significantly higher revision risk (HR = 8.25, 95% CI = 2.91–23.46); MED-EL had no difference (HR = 2.07, 95% CI = 0.46–9.25).

Conclusion
We found an increased revision risk after 2 years of follow-up for adults with Advanced Bionics CI devices. Although we found no statistical difference between manufacturers in the pediatric cohort, after 2 years of follow-up, there were increasing trends in the revision probability for Advanced Bionics. Further research may determine whether patients are better suited for some CI devices.
Management of facial nerve trauma
Authors: Greiner Rachel C. , Kohlberg Gavriel D. , Lu G. Nina 
Published: May 2024

Purpose of review
To present the current literature on management of facial nerve disorder secondary to trauma, with a focus on the utility of electrodiagnostic testing in this setting.

Recent findings
Patients with facial palsy related to temporal bone fractures should be started on high-dose corticosteroids as early as possible. Recent literature on the benefit of surgical intervention in the setting of temporal bone fracture is mixed. Some studies support early surgical decompression whereas others have found no benefit compared with conservative treatment.

Summary
The management of facial nerve trauma is based on location and extent of injury. Extratemporal trauma and transected nerve should be treated with surgical exploration and tension-free coaptation ideally within 72 h. There are no guidelines for intratemporal facial nerve trauma. Surgical decompression compared with medical management is debated in the literature without consensus and more large studies are needed.
Ergonomics in facial plastic and reconstructive surgery
Authors: Kamrava Brandon , Derakhshan Adeeb , Gadkaree Shekhar K. 
Published: May 2024

Purpose of review
Understanding effective ergonomic interventions is crucial for enhancing occupational health and career longevity. There is a paucity of clear ergonomics guidelines in facial plastic and reconstructive surgery (FPRS), placing practitioners at high risk of work-related musculoskeletal disorders (WMSDs) and their consequences.

Recent findings
There is mounting evidence that FPRS specialists are at increased risk of WMSDs as compared with the public and other surgical specialties. Numerous studies have demonstrated that implementation of ergonomics principles in surgery decreases WMSDs. Furthermore, WMSDs are reported as early as the first year of surgical residency, marking the importance of early intervention.

Summary
Fatigue and physical injuries among surgeons occur more often than expected, particularly during complex, extended procedures that necessitate maintaining a constant posture. FPRS procedure often place surgeons into procrustean positions. Thus, integrating ergonomic practices into the practice of FPRS is essential for reducing WMSDs.
Perspectives on the state of cleft lip and cleft palate patient care in Africa
Authors: Liu Rui Han , Manana Wayne , Tollefson Travis T. , Ntirenganya Faustin , Shaye David A. 
Published: May 2024

Purpose of review
Patients with cleft lip -palate (CLP) experience morbidity and social stigma, particularly in low-income and middle-income countries (LMICs) such as those of sub-Saharan Africa (SSA). Delays in treatment secondary either to lack of awareness, skills, equipment and consumables; poor health infrastructure, limited resources or a combination of them, has led to SSA having the highest rates of death and second highest rates of disability-adjusted life years in patients with CLP globally. Here we review current perspectives on the state of comprehensive cleft lip and palate repair in Africa.

Recent findings
To bridge gaps in government health services, nongovernmental organizations (NGOs) have emerged to provide care through short-term surgical interventions (STSIs). These groups can effect change through direct provision of care, whereas others strengthen internal system. However, sustainability is lacking as there continue to be barriers to achieving comprehensive and longitudinal cleft care in SSA, including a lack of awareness of CLP as a treatable condition, prohibitive costs, poor follow-up, and insufficient surgical infrastructure. With dedicated local champions, a comprehensive approach, and reliable partners, establishing sustainable CLP services is possible in countries with limited resources.

Summary
The replacement of CLP ‘missions’ with locally initiated, internationally supported capacity building initiatives, integrated into local healthcare systems will prove sustainable in the long-term.
Clinical Significance of MUC4 and Associated Proteins in Pancreatic and Periampullary Cancers
Authors: Rashid Sumaira , Singh Nidhi , Rashid Safoora , Das Prasenjit , Gupta Surabhi , Chauhan Shyam S. , Sati Hem Chandra , Dash Nihar Ranjan , Sharma Atul , Dey Sharmistha , Saraya Anoop 
Published: May 2024

Objective
This study primarily aimed to assess the expression of MUC4 in patients with pancreatic ductal adenocarcinoma (PDAC) as compared with controls and assess its clinical relevance.

Materials and Methods
Serum MUC4 levels and MUC4 gene expression in snap-frozen tissue were analyzed through surface plasmon resonance and quantitative polymerase chain reaction, respectively. Tumor tissues and control tissues were analyzed for MUC4 and other mucins through immunohistochemistry.

Result
MUC4 expression in tumor tissue was found to be significantly elevated in PDAC patients as compared with chronic pancreatitis tissues and normal pancreatic tissues. Periampullary carcinoma and cholangiocarcinoma tissue also showed increased expression of MUC4 and other mucins.

Conclusions
Differential expression of MUC4 in pancreatic tumor tissues can help to differentiate PDAC from benign conditions.
Research Progress on the Mechanism of Acute Hypertriglyceridemic Pancreatitis
Authors: Meng Yiteng , Han Peiyu , Ma Xiaoyu , He Yiting , Chen Hetian , Ren Hongbo 
Published: May 2024

Abstract
The incidence rate of hypertriglyceridemia pancreatitis (HTGP) has experienced a notable increase in recent years, with eclipsing alcohol as the second leading cause of acute pancreatitis (AP). HTGP is often associated with more severe local and systemic complications. Recognized as a metabolic disorder hypertriglyceridemia (HTG), it holds significant relevance in the pathogenesis of HTGP, yet its mechanisms are not fully understood. Both primary (genetic) and secondary (acquired) factors contribute to elevated triglyceride (TG) levels, which concurrently influence the progression of HTGP. This article presents a comprehensive review of the evolving research on HTGP pathogenesis, encompassing lipid synthesis and metabolism, calcium signal transduction, inflammatory mediators, endoplasmic reticulum stress, autophagy, mitochondrial injury by fatty acids, oxidative stress response, genetic factors, and gene mutations. By unraveling the intricate mechanisms underlying HTGP, this article aims to enhance physicians' understanding of the disease and facilitate the development of potential targeted pharmacological interventions for patients.
Bicycling for Rehabilitation of Persons With Parkinson Disease: A Scoping Review
Authors: Palmieri John L. , Jones Lesley , Schenkman Margaret , Deutsch Judith E. 
Published: May 2024

Background and Purpose:
Exercise is beneficial for persons with Parkinson disease (PwPD). The overarching purpose of this scoping review was to provide guidance to clinicians and scientists regarding current evidence for bicycling exercise for PwPD. A scoping review was conducted to examine the heterogeneous literature on stationary bicycling for PwPD to reduce motor symptoms and body function structure impairments, improve activities and motor performance, and reduce disease severity.

Methods:
The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. PubMed, CINAHL, and PEDro were searched from inception to January 23, 2023. Articles reporting original data on relevant outcome measures were included. Search results were screened and articles were extracted. Data were analyzed quantitatively with percentages of significant and clinically meaningful findings and qualitatively to extract themes.

Results:
Bicycling was categorized using bicycle types (assisted, nonassisted) and training modes (speed, aerobic, force). A high percentage of the 34 studies showed statistical significance for reducing motor symptoms (83%), body function structure impairments (78%), disease severity (82%), and improving activities (gait 72%, balance 60%). Clinically meaningful findings were achieved in 71% of the studies for reduction in disease severity and in 50% for improving gait.

Discussion and Conclusions:
The literature on bicycling for PwPD has evolved from speed to aerobic studies. The terminology describing types of bicycling was simplified. Of all the outcomes reported, reduction of disease severity achieved the highest frequency of clinical meaningful improvements. Bicycling was comparable with other forms of aerobic training for walking speed and endurance. Opportunities for translation to practice and research are presented.

Video Abstract available
for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A462).
Clonotypic VDJ Rearrangements in Mixed Phenotype Acute Leukemia can be Successfully Utilized to Track Minimal Residual Disease
Authors: Hennawi Marah , Quadeer Faatima , Pakasticali Nagehan , Osman Sami , Tashkandi Hammad , Hussaini Mohammad Omar 
Published: May 2024

Introduction:
Multiplex polymerase chain reaction (PCR) and next-generation sequencing (NGS) can both be used to identify a neoplastic clonotype by targeting CDR3 and assessing rearrangements in IgH, IgK, IgL, TCR-β, and TCR-gamma loci. The clonotypic sequence can be robustly used to track minimal residual disease (MRD). The ability to track MRD by NGS in mixed phenotype acute leukemia (MPAL) is unknown and warrants investigation.

Methods:
Institutional Review Board (IRB) approval was obtained. Central Moffitt Cancer Center (MCC) database was searched to locate any patients with MPAL from over 600,000 entries. Patient charts were manually curated to identify those with clonoSEQ data, and clinical data was procured from the electronic medical record (EMR).

Results:
Twenty-nine patients with MPAL were identified. Only 2 patients with clonoSEQ testing were found. Both demonstrated a B/myeloid phenotype, and both were bilineal. NGS (clonoSEQ) identified 4 dominant (IGH) (patient A; 8/2019) and 2 dominant sequences (patient B; 10/2019), respectively. In both patients, clonoSEQ testing successfully tracked minimal residual disease and mirrored clinical disease burden.

Conclusions:
This report is the first to confirm the utility of NGS-based MRD tracking in patients with MPAL and shows increased sensitivity of NGS over MRD flow cytometry.
Safety and Efficacy of Ethanol for Catheter Salvage and Central Line-Associated Bloodstream Infection Prophylaxis in Polyurethane Catheters in the PICU
Authors: Weber Mark D. , Woods-Hill Charlotte , Resendiz Karla , Nelson Eileen , Ryan Monica , Brennan Lauren , Srinivasan Abhay , Conlon Thomas 
Published: May 2024

OBJECTIVES:
Ethanol lock therapy (ELT) is a potential method of central catheter salvage following central line-associated bloodstream infection (CLABSI) although there is potential risk of catheter damage in polyurethane catheters. Further, there is limited efficacy data across the spectrum of common pediatric catheters, and published ELT protocols describe dwell times that are not feasible for critically ill children. We sought to evaluate the safety and efficacy of ELT in polyurethane catheters using brief (30 min to 2 hr) dwell times in our PICU.

DESIGN:
Investigational pilot study using historical control data.

SETTING:
PICU in quaternary care, free-standing children’s hospital.

INTERVENTIONS:
ELT in polyurethane central venous catheters for catheter salvage.

RESULTS:
ELT with brief dwell times was used in 25 patients, 22 of whom were bacteremic. Ultimately 11 patients, comprising 14 catheters, were diagnosed with a primary CLABSI. The catheter salvage rate in primary CLABSI patients receiving ELT was 92% (13/14) and significantly higher than the salvage rate in patients receiving antibiotics alone (non-ELT) (62%, 39/64; mean difference 0.32, 95% CI [0.14–0.50], p = 0.03). The rate of catheter fracture in all patients receiving ELT was 8% (2/25) while the rate of fracture in the non-ELT group was 13% (8/64; mean difference –0.05, 95% CI [–0.18 to 0.09], p = 0.72). The rate of tissue plasminogen activator (tPA) use in the ELT group was 8% (2/25), whereas the rate of tPA use in the non-ELT group was significantly higher at 42% (26/64; mean difference –0.34, 95% CI [–0.49 to –0.17], p = 0.002).

CONCLUSIONS:
The use of ELT for catheter salvage and prophylaxis in the PICU is safe in a variety of polyurethane catheters. Dwell times ranging from 30 minutes to 2 hours were effective in sterilizing the catheters while allowing other therapies to continue. This approach may decrease the need for frequent line changes in a medically fragile pediatric population.
Comparative genomics of the world’s smallest mammals reveals links to echolocation, metabolism, and body size plasticity
Authors: Cossette Marie-Laurence , Stewart Donald T. , Shafer Aaron B.A. 
Published: May 2024

AbstractOriginating 30 million years ago, shrews (Soricidae) have diversified into around 400 species worldwide. Shrews display a wide array-array of adaptations, with some species having developed distinctive traits such as echolocation, underwater diving, and venomous saliva. Accordingly, these tiny insectivores are ideal to study the genomic mechanisms of evolution and adaptation. We conducted a comparative genomic analysis of four shrew species and 16 other mammals to identify genomic variations unique to shrews. Using two existing shrew genomes andde novoassemblies for the maritime (Sorex maritimensis) and smoky shrew (S. fumeus), we identified mutations in conserved regions of the genomes, also known as accelerated regions, gene families undergoing significant expansion, and positively selected genes. Our analyses unveiled shrew-specific genomic variants in genes associated with the nervous, metabolic, and auditory systems, which can be linked to unique traits in shrews. Notably, genes suggested to be under convergent evolution in echolocating mammals exhibited accelerated regions in shrews, and pathways linked to putative body size plasticity were detected. These findings provide insight into the evolutionary mechanisms shaping shrew species, shedding light on their adaptation and divergence over time.
RSV-Related Healthcare Burden: A Prospective Observational Study in a Resource-Constrained Setting
Authors: Saha Senjuti , Sudipta Saha SM , Kanon Naito , Hooda Yogesh , Islam Mohammad Shahidul , Islam Shuborno , Ahmed Zabed Bin , Rahman Sheikh Wasik , Alam Md Jahangir , Anik Ataul Mustufa , Sarkar Probir K , Ahsan Mohammed Rizwanul , Amin Md. Ruhul , Saha Samir K 
Published: May 2024

AbstractBackgroundRespiratory syncytial virus (RSV) is a leading cause of pediatric hospitalizations worldwide, straining health systems. Data gaps in resource-limited settings and limited RSV immunization impact estimates hinder policymaking.MethodsFrom January to December 2019, we conducted a prospective study at Bangladesh’s largest pediatric hospital to assess RSV’s burden on the health system. Outcomes for RSV-positive under-five children were analyzed. We followed outcomes of children denied hospitalization due to bed shortages. Adjusted hazard ratios for children denied admission versus admitted were estimated using survival analysis. Monte Carlo simulations with a queuing model were used to estimate effects of RSV interventions on admission denials and mortality.FindingsOf 40,664 children admitted, 31,692 were under-five; 19,940 were in study wards. Among 7,191 admitted with possible respiratory infections, 6,149 (86%) had samples taken, with 1,261 (21%) testing RSV-positive. Median age of RSV cases was 3 months, with a median hospital-stay of 5 days; 24 (1.9%) died in hospital. RSV cases accounted for 8,274 of 151,110 bed days. Additionally, of 9,169 children denied admission, outcomes were tracked for 3,928 and compared with 2,845 admitted. The hazard ratio for death was 1.56 [95%CI:1.34-1.81] for children denied versus admitted, highest within neonates at 2.27 [95%CI:1.87-2.75]. RSVpreF maternal vaccine or Nirsevimab could have reduced denials by 677 [95%PI:63-1347] and 1,289 [95%PI:684-1865], respectively, potentially preventing 130 [95%PI:-60-322] and 258 [95%PI:32-469] deaths.InterpretationRSV strains healthcare in Bangladesh, increasing mortality risks. Preventive interventions could lessen its impact, boosting healthcare capacity and child health in resource-limited settings.
Altered brain glucose metabolism in nicotine use but not in hazardous alcohol consumption or problem gambling of healthy middle-aged adults
Authors: Shin Seunghyeon , Kim Keunyoung , Kim Jihyun , Nam Hyun-Yeol , Seok Ju Won , Pak Kyoungjune 
Published: May 2024

ABSTRACTObjectivesWe aimed to determine whether chronic nicotine use, alcohol consumption, and gambling alters brain glucose metabolism.MethodsWe retrospectively analyzed data from 473 healthy men who participated in health checkups at Samsung Changwon Hospital Health Promotion Center during 2013 (baseline) and 2018 (follow-up). The health checks included a brain18F-fluorodeoxyglucose positron emission tomography (PET), a questionnaire of tobacco use, the Alcohol Use Disorders Identification Test (AUDIT; Korean version), and the Problem Gambling Severity Index (PGSI). From brain PET scans, the mean uptake in regions-of-interest was scaled to the mean global cortical uptake by each individual, defining the standardized uptake value ratio. We established a model for tobacco use, AUDIT, and PGSI with regional SUVR as a dependent variable and tobacco use, AUDIT, and PGSI as predictors adjusted for age using Bayesian hierarchical modelling. Bayesian models were estimated using four Markov chains, each of which had 4,000 iterations including 1,000 warm-ups, thus totaling 12,000 post-warmup samples. The sampling parameters were slightly modified to facilitate convergence (max tree depth = 20). All data were analyzed using R (The R Foundation for Statistical Computing, Vienna, Austria).ResultsThis study included 131 healthy males (mean age at baseline and follow-up: 43.0 ± 3.4, 48.1 ± 3.3 years, respectively). Tobacco use was negatively associated with glucose metabolism in the caudate, thalamus, cingulate, and frontal lobe, and positively associated with the cerebellum, whereas AUDIT or PGSI were not associated.ConclusionTobacco use was associated with altered brain glucose metabolism in the caudate, thalamus, cingulate, frontal lobe, and the cerebellum. However, neither hazardous alcohol consumption, nor problem gambling showed any association with brain glucose metabolism. Our findings might provide new insights into the neural mechanisms of chronic nicotine use.
A Seven-Year Retrospective Assessment Evaluating the Effectiveness of Electronic Consultation (e-Consult) Service in Genetics
Authors: Biswas Sawona , So Joyce , Wallerstein Robert , Gonzales Ralph , Tout Delphine , DeAngelis Lisa , Rajkovic Aleksandar 
Published: May 2024

ABSTRACTElectronic consultation (e-Consult) programs serve as a conduit between healthcare providers and specialized genetic experts. This retrospective chart review and summary report presents the experience of implementing a Genetics e-Consult Service at the University of California San Francisco (UCSF) from 2016 through 2024 across multiple disciplines. The study examines 622 requests managed by the Genetics team, resulting in the completion of 360 e-Consults (57.8%) and the decline of 262 e-Consults (42.1%). Provider-to-provider consultations, conducted by board-certified geneticists, were completed within 3 days (83.9%), with consultation times ranging from 5 to 20 minutes in most cases (67%). Most requests originated from general practitioners in primary care, pediatrics, and family medicine (48.1%). Analysis of a subset of e-Consults (n=144) revealed that diagnostic queries accounted for 50.6% of requests, followed by management of symptoms (17%) and test interpretation (11%). Providers adhered to geneticists’ recommendations in 84% of cases. These findings underscore the potential of e-Consult frameworks as a viable strategy to enhance accessibility to genetic healthcare services.