bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasopharyngeal tumors with unusual presentations: a retrospective analysis from Saudi Arabia
Authors: Alzahrani Rajab Ahmed 
Published: May 2024

The most common malignant lesion in the nasopharynx is the nasopharyngeal carcinoma (NPC), commonly presents with painless upper cervical lymphadenopathy secondary to nodal metastasis and the undifferentiated type is the most common diagnosis. Compared with other types of cancers, NPC is uncommon, albeit with a high difference in geographical distribution where the worldwide cases account for only 0.6% of all annually diagnosed cancers diagnosed, however, in Saudi Arabia the overall incidence among all age groups is 0.1–0.13 per 10 000. Other rare types of malignancies are also seen at the nasopharynx and due to the nonspecific clinical and imaging characteristics; the preoperative diagnosis may be difficult. This study retrospectively assessed the nasopharyngeal tumors diagnosed in a referral hospital in Al-Baha regions, Saudi Arabia during 10 years period that came with unusual presentations at the level of clinical, radiological, or pathological features to raise the awareness of healthcare provides by these entities. Twenty patients were included and revealed unusual (atypical) clinical presentation in 50% of case including a case presented with respiratory symptoms as a first presentation where multiple lung foci were seen and proved to be a metastatic NPC. Histopathological diagnoses were challenging for 40% of the cases revealing unusual malignant types. In summary, however, the nasopharyngeal malignancy is a rare entity, accurate diagnosis may be missed in clinical or even in the pathology examination. Surgeons and pathologists should be aware of the unusual presentation to provide early and more accurate diagnosis for such serous tumors.
Preservation Rhinoplasty: A New Approach to Mestizo Noses
Authors: Anco Norman , Caballero Gonzalo , Adrianzen Gerardo 
Published: May 2024

Background:
Preservation rhinoplasty is a widely used technique; however, its use on mestizo noses is poorly documented. Our objective was to assess the level of satisfaction of our mestizo patients 1 year after their preservation rhinoplasty.

Methods:
The Rhinoplasty Outcome Evaluation (ROE), a Likert-type questionnaire validated in Spanish, was used to assess the level of satisfaction of 14 mestizo patients who underwent preservation rhinoplasty from March to July 2021 at 1 year after their surgery at the Higuereta Clinic in Lima, Peru.

Results:
The study included 14 patients, three men and 11 women, who underwent preservation rhinoplasty. A presurgical ROE questionnaire was applied, presenting a minimum value of 6, a maximum value of 21, and a mean of 12. When applied 1 year after surgery, the same ROE questionnaire presented a minimum value of 28, a maximum value of 30, and a mean of 30. The variation had a minimum value of 9 and a maximum value of 23, with a mean of 17 (P < 0.001).

Conclusions:
Preservation rhinoplasty can be successfully implemented in mestizo noses with good aesthetic results.
Association of 24-h central hemodynamics and stiffness with cardiovascular events and all-cause mortality. The VASOTENS Registry
Authors: Omboni Stefano , Alfie Jose , Arystan Ayana , Avolio Alberto , Barin Edward , Bokusheva Jamilya , Bulanova Natalia , Butlin Mark , Cuffaro Paula , Derevyanchenko Maria , Grigoricheva Elena , Gurevich Alexandra , Konradi Alexandra , Muiesan Maria Lorenza , Paini Anna , Pereira Telmo , Statsenko Mikhail E. , Tan Isabella ,   the VASOTENS Registry Study Group
Published: May 2024

Objectives:
In hemodialysis patients, central hemodynamics, stiffness, and wave reflections assessed through ambulatory blood pressure monitoring (ABPM) showed superior prognostic value for cardiovascular (CV) events than peripheral blood pressures (BPs). No such evidence is available for lower-risk hypertensive patients.

Methods:
In 591 hypertensive patients (mean age 58 ± 14 years, 49% males), ambulatory brachial and central BP, pulse wave velocity (PWV), and augmentation index (AIx) were obtained with a validated upper arm cuff-based pulse wave analysis technology. Information on treatment for hypertension (73% of patients), dyslipidemia (27%), diabetes (8%), CV disease history (25%), was collected. Patients were censored for CV events or all-cause death over 4.2 years.

Results:
One hundred and four events (24 fatal) were recorded. Advanced age [hazard ratio and 95% confidence interval: 1.03 (1.01, 1.05), P = 0.0001], female sex [1.57 (1.05, 2.33), P = 0.027], CV disease [2.22 (1.50, 3.29), P = 0.0001], increased 24-h central pulse pressure (PP) [1.56 (1.05, 2.31), P = 0.027], PWV [1.59 (1.07, 2.36), P = 0.022], or AIx [1.59 (1.08, 2.36), P = 0.020] were significantly associated with a worse prognosis (univariate Cox regression analysis). The prognostic power of peripheral and central BPs was lower. However, PWV [1.02 (0.64, 1.63), P = 0.924], AIx [1.06 (0.66, 1.69), P = 0.823], and central PP [1.18 (0.76, 1.82), P = 0.471], were not significant predictors in multivariate analyses.

Conclusions:
In hypertensive patients, ambulatory central PP, PWV, and AIx are associated with an increased risk of CV morbidity and all-cause mortality. However, this association is not independent of other patient characteristics.
Accuracy of methods to estimate central aortic SBP via upper arm cuff: a systematic review and meta-analysis
Authors: Picone Dean S. , Côté Nadège , Corney Raphaela , Sharman James E. , Agharazii Mohsen , Goupil Rémi 
Published: May 2024

Objectives:
Central aortic BP may predict cardiovascular outcomes better than upper arm brachial BP. In recent years, technology has enabled central BP estimation by recording a peripheral BP waveform from a standard upper arm cuff. The accuracy of these devices is not well documented, and this study aimed to address this issue.

Methods:
This study was a systematic review, conducted according to PRISMA guidelines, of observational studies published between 2008 and 2023 that reported accuracy testing of cuff-based central BP devices, compared with reference invasive aortic BP. The primary analysis was stratified according to each commercially available device. Pooled estimates were calculated using random-effects models based on mean differences and standard errors.

Results:
Six thousand four hundred and fifteen studies were screened, and 27 studies met inclusion criteria (plus one unpublished study). This generated data for seven devices that are commercially available, which were tested among 2125 adult participants. There was very high heterogeneity when all devices were pooled (I
2 = 97.5%), and, when stratified by device, the accuracy of estimated central BP was highly device-dependent (range of accuracy across different devices −12.4 mmHg (−16.3 to −8.5) to 3.2 mmHg (0.2–6.1). Two of the seven commercially available devices had not undergone external validation testing.

Conclusion:
The accuracy of commercially available cuff-based central BP devices is highly device-specific and not all are accurate for the estimation of central SBP. These findings have major implications for the appropriate interpretation of studies that use cuff-based estimated central BP.
Outcomes of Nonpenetrating Versus Penetrating Deep Sclerectomy in Open Angle Glaucoma
Authors: Merlo Pich Francesco Giorgio , Oliverio Leandro , Gillmann Kevin , Mermoud André 
Published: May 2024

Précis:
In this retrospective study, nonpenetrating deep sclerectomy (NPDS) and penetrating deep sclerectomy (PDS) interventions showed similar >90% complete success rates at 1-year postsurgery. However, NPDS achieved a superior safety profile in terms of best-corrected visual acuity (BCVA) recovery and rates of post-surgical complications.

Objective:
Comparing the surgical outcomes of 2 surgical techniques: NPDS and PDS.

Patients and Methods:
This was a retrospective, longitudinal, comparative study including 66 eyes from 57 patients aged 69 ± 9 years who underwent either NPDS or PDS for medically uncontrolled open angle glaucoma. Outcome measurements included intraocular pressure (IOP), BCVA, rates of complications, postoperative corrective interventions, and glaucoma medications at baseline and at all postoperative appointments up to 1 year. An exploratory mixed-effect model was used to assess the intergroup differences between IOP and BCVA.

Results:
One-year postsurgery, a similar significant IOP reduction from baseline was observed in NPDS (from 19.9 ± 1.3 to 11.5 ± 0.9 mm Hg, P < 0.001) and PDS (from 19.5 ± 1.1 to 10.7 ± 0.6 mm Hg, P < 0.001). A conservative complete success rate (defined as medicated IOP ≤16 mm Hg and ≥20% reduction in IOP) was 87% for NPDS and 97% for PDS. No BCVA changes were observed between baseline and 1-year postsurgery in both groups, and glaucoma medications showed a similar 10-fold reduction in both groups (P < 0.001 vs baseline). However, a significant difference in the speed of postoperative BVCA recovery was observed between NPDS and PDS (P < 0.01), with NPDS showing a faster recovery. Moreover, lower numbers of postsurgical complications and postoperative interventions were observed after NPDS compared with PDS [NPDS, n = 30 and 34 vs PDS, n = 80 and 48 (P < 0.05), respectively].

Conclusions:
The present study confirmed that both NPDS and PDS are highly effective surgical interventions for the management of primary open angle glaucoma. However, NPDS had a superior safety profile in terms of BCVA recovery, complication rates, and postoperative interventions.
Evaluation of Visual Cortex Activity Using Functional Near-Infrared Spectroscopy in Primary Open Angle and Primary Angle Closure Glaucoma: A Pilot Study
Authors: Angku Hage , Verma Rohit , Mahalingam Karthikeyan , Naik Anand , Angmo Dewang , Gupta Shikha , Sihota Ramanjit , Dada Tanuj 
Published: May 2024

Précis:
Functional near-infrared spectroscopy (fNIRS) was used to assess visual cortical activity in patients with primary open angle (POAG) and primary angle closure (PACG) glaucomas. There was decreased activity in the visual cortex of glaucoma patients correlating with the severity of glaucoma.

Objective:
To evaluate visual cortex activity using fNIRS in POAG and PACG compared with healthy controls.

Methods:
A total of 30 POAGs, 31 PACGs, and 30 healthy aged-matched controls from a single centre were recruited in this cross-sectional observational pilot study with purposive sampling. The POAG and PACG groups were age-matched but were not matched for disease severity at recruitment. All participants underwent fNIRS testing using a multichannel continuous-wave near-infrared system NIRSport 8×7 device (NIRx Medizintechnik GmbH). The visual cortex activity was evaluated in terms of the maximum amplitude of change in oxyhemoglobin (OxyHb) concentration over 10 seconds, and a comparison was done among 3 groups. Both POAG and PACG groups were combined (termed as glaucoma group) to assess the relationship of visual cortical activity with disease severity (by visual field defect (mean deviation) and retinal nerve fibre layer thickness).

Results:
All participants showed the characteristic response of increased OxyHb and decreased deoxyhemoglobin during stimulus presentation. The maximum amplitude of change in OxyHb concentration over 10 seconds was significantly lower in both POAG and PACG groups compared with control in the right and left middle occipital gyri (P < 0.05). There was no significant difference between PACG and POAG. Importantly, there was a negative correlation between the visual cortex activity with the visual field defects (mean deviation; P < 0.05) and a positive correlation with retinal nerve fibre layer thickness in the glaucoma group (P < 0.05).

Conclusion:
In patients with glaucoma, a reduction in visual cortical activity was observed, which may be indicative of neuronal degeneration occurring in the occipital cortex. Disease severity in glaucoma appears to be closely correlated with visual cortex activity. fNIRS can serve as a useful neuroimaging modality for assessing the hemodynamic and neurodegenerative changes in glaucoma.
Artificial Intelligence in Anterior Chamber Evaluation: A Systematic Review and Meta-Analysis
Authors: Olyntho Marco A.C. , Jorge Carlos A.C. , Castanha Everton B. , Gonçalves Andreia N. , Silva Barbara L. , Nogueira Bernardo V. , Lima Geovana M. , Gracitelli Carolina P.B. , Tatham Andrew J. 
Published: May 2024

Précis:
In this meta-analysis of 6 studies and 5269 patients, deep learning algorithms applied to AS-OCT demonstrated excellent diagnostic performance for closed angle compared with gonioscopy, with a pooled sensitivity and specificity of 94% and 93.6%, respectively.

Purpose:
This study aimed to review the literature and compare the accuracy of deep learning algorithms (DLA) applied to anterior segment optical coherence tomography images (AS-OCT) against gonioscopy in detecting angle closure in patients with glaucoma.

Methods:
We performed a systematic review and meta-analysis evaluating DLA in AS-OCT images for the diagnosis of angle closure compared with gonioscopic evaluation. PubMed, Scopus, Embase, Lilacs, Scielo, and Cochrane Central Register of Controlled Trials were searched. The bivariate model was used to calculate pooled sensitivity and specificity.

Results:
The initial search identified 214 studies, of which 6 were included for final analysis. The total study population included 5269 patients. The combined sensitivity of the DLA compared with gonioscopy was 94.0% (95% CI: 83.8%–97.9%), whereas the pooled specificity was 93.6% (95% CI: 85.7%–97.3%). Sensitivity analyses removing each individual study showed a pooled sensitivity in the range of 90.1%–95.1%. Similarly, specificity results ranged from 90.3% to 94.5% with the removal of each individual study and recalculation of pooled specificity.

Conclusion:
DLA applied to AS-OCT has excellent sensitivity and specificity in the identification of angle closure. This technology may be a valuable resource in the screening of populations without access to experienced ophthalmologists who perform gonioscopy.
Defining the optimal segmentation method for measuring somatostatin receptor expressing tumor volume on 68Ga-DOTATATE positron emission tomography/computed tomography to predict prognosis in patients with gastroenteropancreatic neuroendocrine tumors
Authors: Filizoglu Nuh , Ozguven Salih , Akin Telli Tugba , Ones Tunc , Dede Fuat , Turoglu Halil T. , Erdil Tanju Y. 
Published: May 2024

Objective
We aimed to compare different segmentation methods used to calculate prognostically valuable volumetric parameters, somatostatin receptor expressing tumor volume (SRETV), and total lesion somatostatin receptor expression (TLSRE), measured by 68Ga-DOTATATE PET/CT and to find the optimal segmentation method to predict prognosis.

Patients and methods
Images of 34 patients diagnosed with gastroenteropancreatic neuroendocrine tumor (GEPNET) who underwent 68Ga-DOTATATE PET/CT imaging were reanalyzed. Four different threshold-based methods (fixed relative threshold method, normal liver background threshold method, fixed absolute standardized uptake value (SUV) threshold method, and adaptive threshold method) were used to calculate SRETV and TLSRE values. SRETV of all lesions of a patient was summarized as whole body SRETV (WB-SRETV) and TLSRE of all lesions of a patient was computed as whole body TLSRE (WB-TLSRE).

Results
WB-SRETVs calculated with all segmentation methods were statistically significantly associated with progression-free survival except WB-SRETVat which was calculated using adaptive threshold method. The fixed relative threshold methods calculated by using 45% (WB-SRETV45%) and 60% (WB-SRETV60%) of the SUV value as threshold respectively, were found to have statistically significant highest prognostic value (C-index = 0.704, CI = 0.622–0.786, P = 0.007). Among WB-TLSRE parameters, WB-TLSRE35%, WB-TLSRE40%, and WB-TLSRE50% had the highest prognostic value (C-index = 0.689, CI = 0.604–0.774, P = 0.008).

Conclusion
The fixed relative threshold method was found to be the most effective and easily applicable method to measure SRETV on pretreatment 68Ga-DOTATATE PET/CT to predict prognosis in GEPNET patients. WB-SRETV45% (cutoff value of 11.8 cm3) and WB-SRETV60% (cutoff value of 6.3 cm3) were found to be the strongest predictors of prognosis in GEPNET patients.
Clinical Results of Asymmetric Blepharoplasty Plastic Repair
Authors: Li Yanqi , Li Hanlin , Zhang Yankun 
Published: May 2024

Objective:
To investigate plastic surgery repair’s effects and adverse reactions in the clinical therapy of asymmetric double eyelids.

Methods:
All 126 sufferers who came to the hospital for asymmetric double eyelid plastic repair from January 2022 to October 2022 were selected as the research objects, and they were divided into a control group and an observation group using the random number method, with 63 cases in each group, in which sufferers in the control group underwent full incision blepharoplasty and sufferers in the observation group underwent small incision liposuction with submerged sutures. The general data, treatment results, treatment satisfaction, related surgical indicators, and frequency of adverse reactions of the 2 groups of sufferers with asymmetric double eyelid plastic repair were compared.

Results:
It had no statistically obvious distinction between the control group and the observation group of sufferers in terms of general data such as sex, age, weight, and height (P>0.05); the total therapy efficiency of the sufferers in the observation group (95.24%) was greater than the control group (74.60%), with P value <0.05; the total treatment satisfaction of the patients in the observation group (96.83%) was significantly higher than that in the control group (76.19%), with P value <0.05; compared with the control group, patients in the observation group had shorter operative time and healing time and less intraoperative bleeding, with P value <0.05; the total frequency of adverse reactions of sufferers in the observation group (4.76%) was less than the control group (17.46%), with P value <0.05.

Conclusion:
Small incision liposuction with submerged sutures for plastic repair has significant efficacy, relatively high patient satisfaction, and low incidence of adverse reactions, in line with patient esthetic review, which has a broad clinical application prospect.
Successful Extension of Vascularized Composite Allograft Perfusion Cold Storage to 24 h in a Rat Hindlimb Transplant Model
Authors: Ng Po’okela K. , Yoeli Dor , Huang Joy L. , Luo Yuhuan , Wang Yong , Li Bing , Wang Zhaohui , Schold Jesse , Jain Swati , Su An-Jey A. , Mathes David W. , Washington Kia M. , Farkash Evan , Jani Alkesh H. , Huang Christene A. 
Published: May 2024

Background.
Vascularized composite allograft transplantation is a treatment option for complex tissue injuries; however, ischemia reperfusion injury and high acute rejection rates remain a challenge. Hypothermic machine perfusion using acellular storage perfusate is a potential solution. This study evaluated the University of Wisconsin Kidney Preservation Solution-1 (KPS-1) compared with normal saline (NS) for preservation of donor rat hindlimbs subjected to 24 h of ex vivo perfusion cold storage.

Methods.
Hindlimbs were subjected to 24-h perfusion cold storage with heparinized KPS-1 (n = 6) or heparinized NS (n = 6). Flow, resistance, and pH were measured continuously. At the end of the 24-h period, tissue was collected for histological analysis of edema and apoptosis.

Results.
KPS-1 perfused limbs showed significantly less edema than the NS group, as evidenced by lower limb weight gain (P < 0.001) and less interfascicular space (P < 0.001). KPS-perfused muscle had significantly less cell death than NS-perfused muscle based on terminal deoxynucleotidyl transferase dUTP nick-end labeling (P < 0.001) and cleaved caspase-3 staining (P = 0.045). During hypothermic machine perfusion, a significant decrease in pH over time was detected in both groups, with a significantly greater decline in pH in the KPS-1 group than in the NS group. There were no significant differences overall and over time in flow rate or vascular resistance between the KPS and NS groups.

Conclusions.
Perfusion with KPS-1 can successfully extend vascularized composite allograft perfusion cold storage for 24 h in a rat hindlimb model without significant edema or cell death.
Multilevel Analysis of the Neovascularization and Integration Process of a Nonvascularized Rectus Fascia Transplantation
Authors: Muylle Ewout , Maes Arne , De Hertogh Gert , Van De Winkel Nele , Kerckhofs Greet , Dubois Antoine , Vandecaveye Vincent , Thorrez Lieven , Hennion Ina , Emonds Marie-Paule , Pans Steven , Deferm Nathalie P. , Monbaliu Diethard , Canovai Emilio , Vanuytsel Tim , Pirenne Jacques , Ceulemans Laurens J. 
Published: May 2024

Background.
Failure to close the abdominal wall after intestinal transplantation (ITx) or multivisceral Tx remains a surgical challenge. An attractive method is the use of nonvascularized rectus fascia (NVRF) in which both layers of the donor abdominal rectus fascia are used as an inlay patch without vascular anastomosis. How this graft integrates over time remains unknown. The study aims to provide a multilevel analysis of the neovascularization and integration process of the NVRF.

Methods.
Three NVRF-Tx were performed after ITx. Clinical, radiological, histological, and immunological data were analyzed to get insights into the neovascularization and integration process of the NVRF. Moreover, cryogenic contrast-enhanced microfocus computed tomography (microCT) analysis was used for detailed reconstruction of the vasculature in and around the NVRF (3-dimensional histology).

Results.
Two men (31- and 51-y-old) and 1 woman (49-y-old) underwent 2 multivisceral Tx and 1 combined liver-ITx, respectively. A CT scan showed contrast enhancement around the fascia graft at 5 days post-Tx. At 6 weeks, newly formed blood vessels were visualized around the graft with Doppler ultrasound. Biopsies at 2 weeks post-Tx revealed inflammation around the NVRF and early fibrosis. At 6 months, classical 2-dimensional histological analysis of a biopsy confirmed integration of the fascia graft with strong fibrotic reaction without signs of rejection. A cryogenic contrast-enhanced microCT scan of the same biopsy revealed the presence of microvasculature, enveloping and penetrating the donor fascia.

Conclusions.
We showed clinical, histological, and microCT evidence of the neovascularization and integration process of the NVRF after Tx.
Ethnoracial Identity and Cognitive Impairment
Authors: Wood Isabella , Song Ruopu , Zhang Yingjin , Jacobsen Erin , Hughes Tiffany , Chang Chung-Chou H. , Ganguli Mary 
Published: May 2024

Background:
Identifying potentially modifiable risk factors associated with MCI in different ethnoracial groups could reduce MCI burden and health inequity in the population.

Methods:
Among 2845 adults aged 65+ years, we investigated potential risk exposures including education, physical and mental health, lifestyle, and sensory function, and their cross-sectional associations with MCI. We compared proportions of exposures between Black and White participants and explored relationships among race, MCI, and exposures. Logistic regression modeled MCI as a function of each exposure in the overall sample adjusting for age, sex, educational level, and race, and investigating race*exposure interactions.

Results:
Compared with White participants, Black participants had greater odds of MCI (OR 1.53; 95% CI, 1.13 to 2.06) and were more likely to report depressive symptoms, diabetes, and stroke, to have high blood pressure and BMI, and to be APOE-

4 carriers. Exposures associated with higher odds of MCI were diabetes, stroke, lifetime smoking, sleep disturbances, social isolation, loneliness, depression and anxiety symptoms, and vision and hearing loss. There were no significant interactions between race and any exposure.

Conclusions:
Black participants had 53% higher odds of MCI adjusting for age, sex, and education. The same exposures were associated with MCI in Black and White participants.