bluuebunny/crossref_metadata_2025_split huggingface dataset:
Firearm Injury, It’s Not Just Physical: The Adverse Impact on Patient-Reported Socioeconomic, Mental Health, and Quality-of-Life Outcomes
Authors: Geller Jennifer E. , Teichman Amanda L. , Charles Eric J. , Pierce Anne , Patel Khushi , Park John , Getrajdman Joelle , Piplani Charoo , Cong Alexander , Reese James , Englert Zachary P. , Narayan Mayur , Choron Rachel L. 
Published: June 2024

Background: The burden of firearm injury (FI) extends beyond hospitalization; however, literature focuses mostly on short-term physical outcomes. This study aimed to assess changes in patient-reported outcomes following firearm-related trauma. We hypothesized long-term patient-reported socioeconomic, mental health, and quality-of-life (QoL) outcomes are worse post-FI compared to pre-FI. Methods: This was a retrospective study where a phone survey was conducted with FI survivors admitted between January 2017 and August 2022 at a level 1 trauma center. Survey questions assessed demographics, socioeconomics, and mental and physical health pre-FI vs ≥ 6 months post-FI; the McNemar test was used for comparisons. The PROMIS-29 + 2v2.1 NIH validated instrument was used to assess long-term QoL. Standardized NIH PROMIS T-scores were calculated using the HealthMeasures Scoring Service. Results: Of 204 eligible FI survivors, 71 were successfully contacted and 38 surveyed. Respondents were male (86.8%), Black (76%), and aged 18-29 (55.3%), and 68.4% had high school level education. Post-FI, patients were more likely to be unemployed (55.2% vs 13.2%, P < .001) and report increased mental health needs (84.2% vs 21%, P < .001) compared to pre-FI. Most (73.7%) also reported lasting physical disability. Similarly, the PROMIS instrument demonstrated largely worse health-related QoL scores post-FI, particularly high anxiety/fear (T-score 60.2, SE 3.1, CI 54.6-66.3, Table 2), pain resulting in life interference (T-score 60.0, SE 2.3, CI 55.7-63.9), and worse physical function (T-score 42.5, SE 3.0, CI 38.2-46.9). Conclusions: Firearm injury survivors had more unemployment and worse mental health post-FI compared to pre-FI. Firearm injury survivors also reported significantly worse health-related QoL metrics including pain, anxiety, and physical function 6 months following their trauma. These long-term patient-reported outcomes are a framework to build future outpatient resources. Level of Evidence: IV.
Beta-blockade for the treatment of refractory hypoxaemia during venovenous extracorporeal membrane oxygenation: An in-silico study
Authors: Brown Alastair , Udy Andrew , Burrell Aidan , Joyce Christopher J 
Published: June 2024

Introduction Venovenous extracorporeal membrane oxygenation (VV ECMO) is used for refractory hypoxemia, although despite this, in high cardiac output states, hypoxaemia may persist. The administration of beta-blockers has been suggested as an approach in this scenario, however the physiological consequences of this intervention are not clear. Methods We performed an in-silico study using a previously described mathematical model to evaluate the effect of beta-blockade on mixed venous and arterial saturations ([Formula: see text], S a O 2), in three different clinical scenarios and considered the potential effects of beta-blockers on, cardiac output, oxygen consumption and recirculation. Additionally we assessed the interaction of beta-blockade with haemoglobin concentration. Results In scenario 1: simulating a patient with high cardiac output and partial lung shunt [Formula: see text] decreased from increased 53.5% to 44.7% despite S a O 2 rising from 74.2% to 79.2%. In scenario 2 simulating a patient with high cardiac output and complete lung shunt [Formula: see text] remained unchanged at 52.2% and S a O 2 rose from 71.9% to 85%. In scenario 3 a patient with normal cardiac output and high recirculation [Formula: see text] fell from 50.8% to 25.5% and also fell from 82.4% to to 78.3%. Across the remaining modelling examples the effect on [Formula: see text] varied but oxygen delivery was consistently reduced across all scenarios. Conclusion The administration of beta-blockers for refractory hypoxemia during VV ECMO are unpredictable and may reduce oxygen delivery, although this will vary with patient and circuit features. This study does not support the use of beta-blockers for this indication.
Phytochemistry and Pharmacological Activities of Panax japonicus: A Comprehensive Review
Authors: Wang Li , Zhou Ao-jia , Zhang Yi-dan , Fan Cheng , Hu Shan-shan , Zhou Zhi-yong , Yuan Ding , Wang Ting 
Published: June 2024

Background Panax japonicus ( P. japonicus) belongs to the Panax genus of Araliaceae and is used as medicine mainly with the bamboo whiplike rhizome, which has the functions of dispelling blood stasis and hemostasis, attenuating swelling and pain, eradicating phlegm and relieving cough, tonifying, and strength. Purpose This review intends to summarize the chemical constituents and pharmacological activities of P. japonicus to provide a scientific and systematic basis for better utilization of its rational applications. Methods The literature was searched using PubMed, Baidu Scholar and Science Hub search engines. Results The chemistry components isolated from P. japonicus are mainly saponins, besides also including polysaccharides, amino acids, volatile oils, inorganic elements, etc. P. japonicus exhibits extensive pharmacological activities including anti-inflammatory, antioxidant, lipid lowering activities, and therefore show extensive protective effects on the central nervous system, cardio-cerebrovascular system, digestive system. Conclusion This article included a thorough summary of the botany, phytochemistry, and pharmacology of P. japonicus and provided evidence for its further research and clinical applications.
Presurgical Reduction of the Cleft Palate: Serendipitous Benefit of the Stanford Orthodontic Airway Plate Treatment (SOAP) for Infants with Robin Sequence
Authors: Kim Jin-Woo , Wan Alison , Kim Jun-Young , Choo HyeRan 
Published: June 2024

Objective Narrowing of the palatal cleft is often observed in infants with Robin sequence (RS) treated with the Stanford Orthodontic Airway Plate treatment (SOAP) even though SOAP is utilized primarily to establish airway patency. The current study quantified dimensional changes of the cleft palate (CP) in infants with RS treated with SOAP. Design A retrospective chart review. Patients Infants with RS and CP who completed SOAP and had maxillary arch models at both pre- and post-treatment time points at a single tertiary referral hospital between September 2019 and July 2023. Setting and Outcome Measure Maxillary arch models were measured and analyzed using Bivariate statistical analysis. Results Seventeen infants were included in the study. The median age (min, max) was 6.7 weeks (1.1, 21.9) at pre-treatment and 26.6 weeks (18.7, 37.0) at post-treatment. The median Obstructive Apnea Hypopnea Index was 36.2 events/hour (8.1, 103.1) at pre-treatment and 4.1 events/hour (1.9, 8.6) at post-treatment. The pre-treatment width of CP decreased by an average (± standard diviation) of 6.37 mm (± 3.55, p < 0.001) at post-treatment. The ratio of the posterior cleft width to the total maxillary arch width decreased from 40% (± 9.1) at pre-treatment to 22% (± 11) at post-treatment (p < 0.001). Conclusion The dimensions of CP reduced significantly during SOAP in infants with RS and CP treated for their severe upper airway obstruction. The findings highlight a potential benefit of SOAP that may contribute favorably to the palate repair surgery.
Periprocedural Edoxaban Management and Clinical Outcomes in Patients Undergoing Transcatheter Cardiovascular Procedures in the EMIT-AF/VTE Program
Authors: Unverdorben Martin , Colonna Paolo , Jin James , Köhler Sabine , Santamaria Amparo , Saxena Manish , Borrow Amanda , Chen Cathy , von Heymann Christian , Vanassche Thomas 
Published: June 2024

Annually, 10% of patients with atrial fibrillation (AF) or venous thromboembolism (VTE) treated with non-vitamin K oral anticoagulants undergo diagnostic or therapeutic procedures. This subanalysis of the multicenter, prospective, observational Edoxaban Management in Diagnostic and Therapeutic Procedures real-world registry included patients in Europe and Asia with AF or VTE who underwent transcatheter cardiovascular (CV) procedures. Edoxaban interruption and clinical outcomes were assessed for all arterial or venous access procedures and stratified by bleeding risk. Overall, 2695 procedures were reported; 755 (28.0%) were transcatheter CV procedures, of which 373 (49.4%) were arterial access and 382 (50.6%) were venous access procedures. Patients with arterial versus venous access procedures had significantly higher bleeding and stroke and thromboembolism risk scores ( P < 0.0001 for both) and underwent procedures that were more frequently classified as having a higher European Heart Rhythm Association bleeding risk. Edoxaban was interrupted in 59.5% (222) arterial versus 42.4% (162) venous access procedures, mostly either only preprocedurally or both pre- and postprocedurally. The combined incidence of clinically relevant ischemic or bleeding event rates and deaths was low (0.8 events/100 procedures). This subanalysis showed that while edoxaban was interrupted in approximately half of all interventions, ischemic events and major bleeding were low, suggesting transcatheter CV procedures can be performed safely in high-risk patients with AF or VTE. Patient and procedural factors should be considered to personalize the decision of edoxaban management around the time of a transcatheter CV procedure. Clinical trial registration number: NCT02950168, NCT02951039
Covered Endovascular Reconstruction of the Iliac Artery Bifurcation (CERIB)
Authors: Keschenau Paula Rosalie , Stark Mirja , Weiss Benjamin , Palacios Daniel , Kalder Johannes 
Published: June 2024

Purpose: The aim of this study was to present the covered endovascular reconstruction of the iliac artery bifurcation (CERIB) technique as a revascularization option for aorto-iliac occlusive disease (AIOD) involving the iliac artery bifurcation. Methods: This was a retrospective single-center study including all patients undergoing a CERIB procedure from January 2021 until December 2022. Covered endovascular reconstruction of the iliac artery bifurcation procedures were performed percutaneously with bilateral femoral access, excepting cases where simultaneous open femoral artery reconstruction was required due to the extension of peripheral arterial occlusive disease. Standard patient, procedural, and follow-up (FU) data including survival and arterial reinterventions were gathered and analyzed. Results: A total of 13 patients were included (11/13 male, median age=70 [60-76] years). Additional open and/or endovascular procedures included endarterectomy of the femoral bifurcation (n=6), rotational atherectomy (n=2), and 1 axillary artery cutdown for upper limb access (n=1). Median operating time was 2.9 hours (1.5-4.9 hours); median radiation duration and dose were 28.4 (14.3-63.3 minutes) and 4090.6 (384.4-9430.1 cGray/cm2), respectively. The stent grafts used for CERIB were BeGraft peripheral n=31, BeGraft Aortic n=4 and BeGraft peripheral plus n=1 (Bentley InnoMed GmbH, Hechingen, Germany). In 2 patients with prior stenting of the common iliac artery (CIA), only the internal and external iliac arteries (IIA and EIA) were treated in this study, and in 2 cases, additional uncovered stents were required for relining. Technical success was 100%. During a midterm FU (median 18 [4-31] months), 2 patients died from cardiovascular reasons and 1 patient with prior iliac stenting required reinterventions for recurring occlusion. Conclusion: Covered endovascular reconstruction of the iliac artery bifurcation is a straightforward option for treating AIOD involving the iliac artery bifurcation that allows preservation of internal iliac artery perfusion and shows good early and midterm results. Prior iliac artery stenting may be a risk factor for early occlusion after CERIB. Clinical impact Aorto-iliac occlusive disease with involvement of the internal iliac artery is encountered regularly in vascular surgical practice, but the internal iliac artery is often not included in the revascularization strategy. The present article will increase the awareness for the relevance of including the internal iliac artery in revascularization strategies and presents CERIB as another method to be added to the armamentarium of (endo-)vascular surgeons and interventionalists.
Endovascular and medical management strategies for carotid-cavernous fistulas: A safety and efficacy analysis
Authors: Vranic Justin E. , Regenhardt Robert W. , Awad Amine , Doron Omer , Rabinov James 
Published: June 2024

Background Carotid-cavernous fistulas (CCFs) are complex arteriovenous shunting lesions of the cavernous sinus with diverse clinical presentations. This study aimed to analyze clinical outcomes and differentiate patients treated with conservative observation versus those needing endovascular intervention. Methods A retrospective analysis of 84 patients with angiographically confirmed CCF was conducted from 2000 to 2022. Endovascular treatment decisions were made at the discretion of neurointerventionalists. Clinical and angiographic data were collected, including Barrow CCF classification and treatment outcomes. Results Patients managed conservatively ( n = 17) had longer symptom duration (165 vs 42 days) and more indirect CCF (100% vs 68%) compared to those treated with endovascular embolization ( n = 67). High-risk clinical symptoms, including proptosis, diplopia, decreased visual acuity, and chemosis, were more common in the embolization group. Cortical venous reflux and ophthalmic venous reflux were more prevalent in the embolization group (39% and 91%, respectively). Overall, 31% of embolized CCFs required retreatment, mainly Barrow type D lesions (65%). Transvenous coil embolization was the primary technique used (78%), followed by feeder artery embolization (16%), and internal carotid artery flow diversion (8%). Conclusion In selected CCF patients without high-risk symptoms or angiographic features, conservative observation is a safe and effective alternative to endovascular embolization. High-risk symptoms and angiographic features favor endovascular intervention. Complications were rare, and most were transient, emphasizing the safety of endovascular management. Longitudinal angiographic and ophthalmologic surveillance is essential for monitoring fistula persistence or recurrence.
Is choice of approach associated with risk of avascular necrosis in pediatric septic hip?
Authors: Nihalani Shrey , Cruz Francis , Hawkins Jacob K , Griswold Branum Gage , Mabry Scott E , McGwin Gerald , Gilbert Shawn R , Conklin Michael J 
Published: June 2024

Purpose: Septic arthritis of the hip in children and adolescents is a common condition requiring timely diagnosis and intervention. Surgical irrigation and debridement is typically performed through the anterior approach because of concerns about injury to the medial femoral circumflex artery leading to avascular necrosis. While there are multiple studies investigating the sequelae of anterior and medial approaches for reduction of developmental dislocation of the hip, none have compared these approaches for the pediatric septic hip. We hypothesize that there will be no significant difference in the rate of avascular necrosis when comparing the medial and anterior approaches to the septic hip in pediatric patients. Methods: A retrospective review was performed of pediatric septic hips treated with irrigation and debridement through either a medial or anterior approach at a single institution over an 18-year period of time. The primary outcome measure was the development of avascular necrosis. Results: Thirteen of 164 patients (7.9%) developed avascular necrosis. Avascular necrosis was noted in 9 of 101 patients who had anterior approach and 4 of 63 patients who underwent medial approach (p = 0.76). The average age for patients developing avascular necrosis was 10.0 years old versus 6.8 years old in patients who did not develop avascular necrosis (p = 0.01). The average follow-up was 3.3 years in patients with avascular necrosis versus 1.5 years for patients who did not develop avascular necrosis (p = 0.01). Conclusion: Medial approach to the pediatric septic hip does not increase the rate of avascular necrosis compared to the anterior approach. Level of evidence: Retrospective comparison study, Level III
ChatGPT-3.5 passes Poland’s medical final examination—Is it possible for ChatGPT to become a doctor in Poland?
Authors: Suwała Szymon , Szulc Paulina , Guzowski Cezary , Kamińska Barbara , Dorobiała Jakub , Wojciechowska Karolina , Berska Maria , Kubicka Olga , Kosturkiewicz Oliwia , Kosztulska Bernadetta , Rajewska Alicja , Junik Roman 
Published: June 2024

Objectives: ChatGPT is an advanced chatbot based on Large Language Model that has the ability to answer questions. Undoubtedly, ChatGPT is capable of transforming communication, education, and customer support; however, can it play the role of a doctor? In Poland, prior to obtaining a medical diploma, candidates must successfully pass the Medical Final Examination. Methods: The purpose of this research was to determine how well ChatGPT performed on the Polish Medical Final Examination, which passing is required to become a doctor in Poland (an exam is considered passed if at least 56% of the tasks are answered correctly). A total of 2138 categorized Medical Final Examination questions (from 11 examination sessions held between 2013–2015 and 2021–2023) were presented to ChatGPT-3.5 from 19 to 26 May 2023. For further analysis, the questions were divided into quintiles based on difficulty and duration, as well as question types (simple A-type or complex K-type). The answers provided by ChatGPT were compared to the official answer key, reviewed for any changes resulting from the advancement of medical knowledge. Results: ChatGPT correctly answered 53.4%–64.9% of questions. In 8 out of 11 exam sessions, ChatGPT achieved the scores required to successfully pass the examination (60%). The correlation between the efficacy of artificial intelligence and the level of complexity, difficulty, and length of a question was found to be negative. AI outperformed humans in one category: psychiatry (77.18% vs. 70.25%, p = 0.081). Conclusions: The performance of artificial intelligence is deemed satisfactory; however, it is observed to be markedly inferior to that of human graduates in the majority of instances. Despite its potential utility in many medical areas, ChatGPT is constrained by its inherent limitations that prevent it from entirely supplanting human expertise and knowledge.
Risk Factors and Comorbidities Associated With Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Virus Infection
Authors: Weidemann Helen , Yeh Kristen , Hunter Krystal , Roy Satyajeet 
Published: June 2024

Introduction/Objectives: Chronic hepatitis B virus infection (CHBVI) is a major public health problem affecting about 296 million people worldwide. HBV infects the liver, and when it becomes chronic, may cause cirrhosis and hepatocellular carcinoma (HCC). The aim of our study was to identify the risk factors and comorbid medical conditions that were associated with HCC in patients who had CHBVI. Methods: We performed a retrospective electronic medical record review of adult patients diagnosed with CHBVI, who presented to our primary care office between October 1, 2017 and October 21, 2022. Selected variables in patients with CHBVI with HCC (HCC group) were compared to those without HCC (NoHCC group). Results: Among 125 patients with CHBVI, 24% had HCC and 76% did not have HCC. There were higher frequencies of association of certain comorbidities in the HCC group compared to NoHCC group, such as anemia (63.3% vs 26.3%; P < .001), ascites (53.3% vs 1.1%; P < .001), portal hypertension (43.3% vs 0.0%; P < .001), chronic kidney disease (40.0% vs 13.7%; P = .002), and HCV coinfection (13.3% vs 7.4%; P < .001). The logistic regression model showed increased odds of HCC for each year of increase in age (OR = 1.06, 95% CI = 1.01-1.11; P = .014), and increased odds in men (OR = 5.96, 95% CI = 1.71-20.73; P = .005). Although Asians represented the racial majority in both the groups, there was no significant difference in the race distribution between the two groups. Conclusion: In patients with CHBVI, increasing age and male sex are factors associated with increased odds of having HCC. Patients with CHBVI and HCC have higher frequencies of association of tobacco use, recreational drug use, anemia, ascites, portal hypertension, chronic kidney disease, and co-infection with HCV.
Subjective Well-Being and Burnout Among the Maternal and Child Health Workforce
Authors: Brown-Kaiser Carolyn , Vyas Amita 
Published: June 2024

Objectives: This study investigates burnout and subjective well-being among the Maternal and Child Health (MCH) workforce, considering recent events such as the Dobbs decision, the maternal mortality crisis, and the COVID-19 pandemic. Methods: An anonymous web-based, cross-sectional survey was conducted among 313 MCH professionals in the United States. Data were collected using validated measures, including the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Oxford Happiness Questionnaire (OHQ) short scale. Sociodemographic characteristics and factors associated with burnout and subjective well-being were examined using univariate statistics and multivariable models. Results: Analysis revealed moderate levels of burnout among MCH professionals, particularly in emotional exhaustion. However, subjective well-being levels were relatively high. After controlling for covariates, significant associations were found between subjective well-being and burnout dimensions, as well as sociodemographic factors such as sex and race. Conclusions: The study’s findings indicate that higher subjective well-being is significantly associated with lower burnout, emotional exhaustion, and higher personal accomplishment. Variations in burnout and well-being are also influenced by sociodemographic factors such as age, sex, race, and occupation. Tailored interventions addressing the specific needs of MCH professionals are essential for building a resilient workforce. Organizational reforms and legislative measures are crucial for fostering supportive workplace environments and ensuring access to care and services amidst workforce challenges.