bluuebunny/crossref_metadata_2025_split huggingface dataset:
Jerks are useful: extracting pulse rate from wrist-placed accelerometry jerk during sleep in children
Authors: Weaver R Glenn , Chandrashekhar M V S , Armstrong Bridget , White III James W , Finnegan Olivia , Cepni Aliye B , Burkart Sarah , Beets Michael , Adams Elizabeth L , de Zambotti Massimiliano , Welk Gregory J , Nelakuditi Srihari , Brown III David , Pate Russ , Wang Yuan , Ghosal Rahul , Zhong Zifei , Yang Hongpeng 
Published: May 2024

Abstract

Study Objectives
Evaluate wrist-placed accelerometry predicted heartrate compared to electrocardiogram (ECG) heartrate in children during sleep.

Methods
Children (n = 82, 61% male, 43.9% black) wore a wrist-placed Apple Watch Series 7 (AWS7) and ActiGraph GT9X during a polysomnogram. Three-Axis accelerometry data was extracted from AWS7 and the GT9X. Accelerometry heartrate estimates were derived from jerk (the rate of acceleration change), computed using the peak magnitude frequency in short time Fourier Transforms of Hilbert transformed jerk computed from acceleration magnitude. Heartrates from ECG traces were estimated from R-R intervals using R-pulse detection. Lin’s concordance correlation coefficient (CCC), mean absolute error (MAE), and mean absolute percent error (MAPE) assessed agreement with ECG estimated heart rate. Secondary analyses explored agreement by polysomnography sleep stage and a signal quality metric.

Results
The developed scripts are available on Github. For the GT9X, CCC was poor at −0.11 and MAE and MAPE were high at 16.8 (SD = 14.2) beats/minute and 20.4% (SD = 18.5%). For AWS7, CCC was moderate at 0.61 while MAE and MAPE were lower at 6.4 (SD = 9.9) beats/minute and 7.3% (SD = 10.3%). Accelerometry estimated heartrate for AWS7 was more closely related to ECG heartrate during N2, N3 and REM sleep than lights on, wake, and N1 and when signal quality was high. These patterns were not evident for the GT9X.

Conclusions
Raw accelerometry data extracted from AWS7, but not the GT9X, can be used to estimate heartrate in children while they sleep. Future work is needed to explore the sources (i.e. hardware, software, etc.) of the GT9X’s poor performance.
Residual Acetabular Dysplasia at Walking Age: A Study of 470 Hips Treated With Pavlik Harness
Authors: Bavan Luckshman , Lloyd Thomas , Llewellyn-Stanton Lucy , Mifsud Maximillian , Kothari Alpesh 
Published: May 2024

Background:
This study aims to report on the acetabular indices of walking age children following successful DDH treatment with Pavlik harness and investigate risk factors for residual acetabular dysplasia (RAD).

Methods:
We retrospectively reviewed the data for children treated for DDH at a single centre between 2015 and 2020. Acetabular indices (AI) measured on pelvic radiographs taken at 2- and 4-year follow-up visits were referenced against age-matched and sex-matched normal data. Values ≥90th percentile were considered to represent RAD.

Results:
A total of 305 children with 470 hips were suitable for inclusion. The mean age at treatment initiation was 7.0±4.5 weeks and mean treatment duration was 15.9±4.3 weeks. Overall, 27% and 19% of hips were found to have RAD at 2- (n=448) and 4-year (n=206) follow-up, respectively. The χ2 test for independence demonstrated that the difference in the proportion of hips with RAD at both time points was significant (P=0.032). Patients with RAD at 2 years were found to have been treated for longer (P=0.028) and had lower alpha angles on final ultrasound assessment (P<0.001). Patients with RAD at 4 years were older at initiation of treatment (P=0.041), had lower alpha angles on final ultrasound assessment (P<0.001) and were more likely to have had RAD at 2 years (P<0.001). Multivariate analysis identified lower alpha angles on final ultrasound to be predictive for RAD at 2 years (P=0.011), and presence of RAD at 2 years to be predictive for RAD at 4 years (P<0.001).

Conclusions:
The risk of RAD beyond walking age in children successfully treated with Pavlik harness is not negligible. However, we observed that a significant proportion of children with RAD at 2-year follow-up had spontaneously improved without any intervention. This data suggests that routine long-term radiologic follow-up of children treated with Pavlik harness is necessary, and surgical intervention to address RAD should be delayed until at least 4 years of age.

Level of Evidence:
Level III—case-control study.
Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy
Authors: Thadani Sameer , Fuhrman Dana , Hanson Claire , Park Hyun Jung , Angelo Joseph , Srivaths Poyyapakkam , Typpo Katri , Bell Michael J. , Gist Katja M. , Carcillo Joseph , Akcan-Arikan Ayse 
Published: May 2024

OBJECTIVES:
Acute kidney injury requiring dialysis (AKI-D) commonly occurs in the setting of multiple organ dysfunction syndrome (MODS). Continuous renal replacement therapy (CRRT) is the modality of choice for AKI-D. Mid-term outcomes of pediatric AKI-D supported with CRRT are unknown. We aimed to describe the pattern and impact of organ dysfunction on renal outcomes in critically ill children and young adults with AKI-D.

DESIGN:
Retrospective cohort.

SETTING:
Two large quarternary care pediatric hospitals.

PATIENTS:
Patients 26 y old or younger who received CRRT from 2014 to 2020, excluding patients with chronic kidney disease.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Organ dysfunction was assessed using the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score. MODS was defined as greater than or equal to two organ dysfunctions. The primary outcome was major adverse kidney events at 30 days (MAKE30) (decrease in estimated glomerular filtration rate greater than or equal to 25% from baseline, need for renal replacement therapy, and death). Three hundred seventy-three patients, 50% female, with a median age of 84 mo (interquartile range [IQR] 16–172) were analyzed. PELOD-2 increased from 6 (IQR 3–9) to 9 (IQR 7–12) between ICU admission and CRRT initiation. Ninety-seven percent of patients developed MODS at CRRT start and 266 patients (71%) had MAKE30. Acute kidney injury (adjusted odds ratio [aOR] 3.55 [IQR 2.13–5.90]), neurologic (aOR 2.07 [IQR 1.15–3.74]), hematologic/oncologic dysfunction (aOR 2.27 [IQR 1.32–3.91]) at CRRT start, and progressive MODS (aOR 1.11 [IQR 1.03–1.19]) were independently associated with MAKE30.

CONCLUSIONS:
Ninety percent of critically ill children and young adults with AKI-D develop MODS by the start of CRRT. Lack of renal recovery is associated with specific extrarenal organ dysfunction and progressive multiple organ dysfunction. Currently available extrarenal organ support strategies, such as therapeutic plasma exchange lung-protective ventilation, and other modifiable risk factors, should be incorporated into clinical trial design when investigating renal recovery.
Protecting Our Own: A Method for Reducing Breast Radiation Exposure in Healthcare Workers
Authors: Westcott Lauren Zammerilla , Ogola Gerald O. , Rees Chet R. 
Published: May 2024

Abstract
Standard lead aprons do not protect the female breast adequately from radiation exposure, which has been associated with breast cancer in healthcare workers. A novel lead shield was designed to reduce radiation to the breast, axilla, and thyroid (BAT). A procedure room was simulated with an anthropomorphic phantom representing the operator. Dosimeters were positioned on the outer quadrant of each breast, the chest, the thyroid, and deep inside of a phantom acrylic female torso with neck and head. Standard lead vest plus a thyroid shield was used as control and compared to standard lead vest plus BAT shield. Three operator and two image receptor positions were tested. The reductions in radiation exposure were calculated. The standard vest plus BAT shield provided significant reductions in radiation exposure for all anatomic locations compared to control. When averaging all operator positions, the BAT provided reductions of 91% (p < 0.0001) for near breast. Reductions for far breast, chest, thyroid, and deep tissues were 76% (p = 0.016), 94% (p < 0.0001), 52% (p = 0.026), and 60% (p = 0.004). With operator 90° to the table using a cross-table lateral beam, the BAT provided a 97.7% reduction in radiation to the near breast and significant reduction in radiation to the chest, thyroid, and deep tissues. The BAT shield reduces radiation exposure to the breast, chest, thyroid and deep hematopoietic tissues. Such shields could benefit healthcare workers to reduce the risk of breast cancer and other radiation-associated cancers.
“They Just Love Me”—An Examination of Social Support Experiences and Values Among People With TBI
Authors: Kersey Jessica , Rice Hannah , Connor Lisa Tabor , Fields Beth , Hammel Joy 
Published: May 2024

Objective:
Social support is important for health and functional outcomes after traumatic brain injury (TBI), but many adults with TBI report inadequate social support. Little research has examined the social support priorities of adults with TBI or what an optimal social support network should include. The objective of this study was to describe the social support structures and experiences of adults with TBI.

Setting:
Community-based rehabilitation program.

Participants:
Community-dwelling adults with TBI, predominantly from racial and ethnic minority groups.

Design:
Cross-sectional collection of quantitative and qualitative data.

Main Measures:
Number of close social contacts and total social contacts, along with a report of the frequency of social support using the Medical Outcomes Study Social Support Survey. Qualitative interviews were used to examine the quality of social support and participant values and priorities.

Results:
Participants had an average of 4.3 close contacts (median 3.5, range 1-10), an average of 8.5 total social contacts (median 7, range 2-28), and a low frequency of social support (mean 28.4, SD = 24.7). Interview themes fell under 2 grand themes: structure of social networks (social networks are made up of families; proximity influences the type of support) and quality of social support (commitment vs indifference; doing things with and for others adds meaning; and “they just love me”).

Conclusion:
Participants in this study had small social networks and a low frequency of social support. Findings suggest that people with TBI value committed support partners, social inclusion, bidirectional relationships, and emotional connection, yet experience lower support in these areas compared to tangible support. Future research should examine how to adapt existing models of social support to more closely align with participant values. Rehabilitation services may need to focus more heavily on individual and family training, addressing strategies to develop and maintain relationships, emotional connection, and communication to enhance relationship and social support quality.
Nontraditional approaches to sedation for anterior segment surgery: a narrative review
Authors: Shapiro Jeremy N. , Mian Shahzad I. 
Published: May 2024

Purpose of review
Surgical and anesthetic technological advancement have made both cataract and noncataract anterior segment surgery significantly less invasive and time-intensive, facilitating the transition of some of these procedures from the operating room under monitored anesthesia care (MAC) to the office-based setting without MAC. This transition has been aided by the popularization of nonintravenous approaches to achieving patient sedation for these procedures. In this review, we discuss the literature surrounding traditional and nontraditional methods of achieving patient sedation for anterior segment surgery.

Recent findings
Our survey of the literature suggests that nonintravenous (IV) approaches to sedation for these procedures may be just as safe, effective, and satisfactory to patients as traditional IV approaches.

Summary
As anterior segment surgery becomes less invasive and less time-intensive, providers considering transitioning their cataract and anterior segment surgery out of the operating room and into the office-based setting without MAC anesthesia should consider the non-IV sedation options outlined in this review to achieve adequate patient sedation and comfort.
Intense pulsed light treatment for the management of meibomian gland dysfunction
Authors: Gupta Angela Satya , Massaro Mina , Bunya Vatinee Y. 
Published: May 2024

Purpose of review
Meibomian gland dysfunction (MGD) is one of the most common disorders encountered by ophthalmologists, and its management can prove challenging for both clinicians and patients. Intense pulsed light (IPL), which has been historically used in the field of dermatology, has emerged as a tool to help improve meibomian gland function. The goal of this review is to assess the clinical efficacy, utility, and safety of IPL for the treatment of MGD.

Recent findings
In recent randomized controlled trials, IPL has been shown to improve meibomian gland function, and subsequently tear film quality and dry eye symptoms. The mechanism of action still remains unclear. Recent literature suggests that IPL may also be used in conjunction with other therapies, such as meibomian gland expression, low-level light therapy, and thermal pulsation. Careful attention should be placed on each patient's Fitzpatrick skin type, as well as protecting the ocular structures to reduce the risk of adverse effects. Cost, accessibility, as well as a limited duration of efficacy may be drawbacks.

Summary
There is significant evidence supporting that IPL may be used as a potential well tolerated and effective treatment for MGD, though there are certain caveats regarding its long-term efficacy, accessibility, and cost.
Femtosecond laser-assisted in situ keratomileusis versus small-incision lenticule extraction: current approach based on evidence
Authors: Teo Zhen Ling , Ang Marcus 
Published: May 2024

Purpose of review
Laser keratorefractive surgery achieves excellent visual outcomes for refractive error correction. With femtosecond laser, small incision lenticule extraction (SMILE) is an increasingly viable alternative to laser-assisted in situ keratomileusis (LASIK). Comparative studies demonstrate similar efficacy and predictability between SMILE and LASIK, making it difficult for clinicians to choose which to use. This review thus compares femtosecond-LASIK (FS-LASK) and SMILE in various scenarios, to assist clinicians in deciding which refractive surgery procedure to recommend.

Recent findings
SMILE may be superior for highly myopic eyes due to a smaller decrease in functional optical zone. SMILE further induces less spherical aberration and less overall higher order aberrations in mesopic conditions. SMIILE also has less postoperative dry eye, making it suitable those with preexisting dry eye. For low to moderate myopic astigmatism correction, FS-LASIK has less undercorrection compared to SMILE. Lastly, SMILE has not yet received Food and Drug Administration or Conformité Européenne approval for hyperopic correction, rendering FS-LASIK the choice of procedure for hyperopic correction.

Summary
Both FS-LASIK and SMILE demonstrate good efficacy and predictability. Understanding specific clinical scenarios where one may be superior to the other will aid clinicians in choosing the most suitable procedure for personalized care.
Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy in Eyes With Prior Failed Glaucoma Surgery
Authors: Siddhartha Srihari , Krishnamurthy Rashmi , Dikshit Siddharth , Garudadri Chandrasekar , Ali Md Hasnat , Senthil Sirisha 
Published: May 2024

Précis:
This study concludes that GATT can be an effective and safe surgical alternative for managing IOP in eyes with prior failed glaucoma surgeries, associated with minimal complications.

Purpose:
To report outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior failed glaucoma surgery.

Patients and Methods:
A retrospective study involving 30 eyes of 30 patients, all of whom had open angles on gonioscopy, experienced prior glaucoma surgery failures, and subsequently underwent GATT. The primary outcome measure was success defined as complete when the intraocular pressure (IOP) was >5 and ≤21/16 mm Hg without glaucoma medications and qualified with medications.

Results:
The mean age was 51.8±16.1 years. Twenty-one eyes underwent GATT and 9 eyes underwent phaco-GATT. Twenty-seven eyes had failed trabeculectomy and 3 eyes had failed glaucoma drainage device. Post-GATT, the IOP decreased from 27.1±7 to 16.9±6 mm Hg (P<0.001) at the end of 15 months, with a mean drop in AGM from 4.9±1.0 to 2±1.6. At postoperative 1 year, the probability of complete success was 20% (95% CI: 9–43) for an IOP criterion of both 21 and 16 mm Hg. The qualified success probability at 1 year was 82% (67–100) for an IOP criterion of 21 mm Hg and 57% (38–84) for an IOP criterion of 16 mm Hg. Risk factor for failure was older age [hazard ratio (HR): 1.03, 95% CI: 1.01–1.06]. The complications noted were hyphema in 14 eyes (46%), majority resolved within 1 week and all by 2 weeks. None needed any intervention.

Conclusions:
This study concludes that GATT can be an effective and safe surgical alternative for managing IOP in eyes with prior failed glaucoma surgeries, associated with minimal complications.
Efficacy of Ab Interno Revision for Trabeculectomy Bleb Failure Using a Minimally Invasive Approach: A Prospective Study
Authors: Snehi Sagarika , Thattaruthody Faisal , Singh Jyoti , Singh Ashok , Pandav Surinder S. , Kaushik Sushmita 
Published: May 2024

Précis:
Ab interno bleb revision using the Grover and Fellman spatula offers potential benefits in improved intraocular pressure control and spares the conjunctiva for enhanced bleb management.

Purpose:
This study aimed to evaluate the safety and effectiveness of Ab-Interno Bleb Revision (AIBR) for treating failed trabeculectomy blebs.

Methods:
This noncomparative case series enrolled glaucoma patients with failed trabeculectomy blebs who underwent AIBR and were followed up for 1 year. Eligible patients received subconjunctival Mitomycin C 0.1 mL of 0.2 mg/mL (20 μg) 5 days before the AIBR, performed using the Grover and Fellman spatula. The primary outcome measures were intraocular pressure (IOP) and the usage of IOP-lowering medications 1 year after the procedure. Secondary outcomes included the procedure’s failure rate and complications. Complete success was defined as achieving an IOP between 5 and 21 mm Hg without medication, while qualified success required additional medical treatment.

Results:
The study comprised 23 eyes from 23 patients, having a mean age of 59.66±14.93 years. Preoperatively, the mean IOP was 23.54±10.7 mm Hg, and the mean antiglaucoma medication requirement was 3.99±0.65, both significantly reduced to 15.7±6.9 mm Hg (P=0.009) and 1.26±1.2 (P <0.001) at 1 year, respectively. Overall, 19 eyes (82.6%) achieved success (complete success: 39.2%, qualified success: 43.4%), while in 4 (17.4%) patients, the procedure failed (IOP >21 mm Hg). 5 patients had transient hyphema, but there were no sight-threatening complications such as hypotony or choroidal detachment.

Conclusions:
Ab-Interno Bleb Revision (AIBR) is a safe, effective, and minimally invasive intervention for managing failed trabeculectomy blebs. By eliminating the need to reopen the conjunctiva, this technique offers a promising alternative for the treatment of this challenging condition.
Risk Factors Associated With Open Fracture Complications Following Antibiotic Prophylaxis
Authors: Costanzo Elizabeth , Maynard Kaylee , Louie Ted , Shulder Stephanie , Gorczyca John , Jones Courtney MC , Croix Michael , Alpizar-Rivas Rodolfo , Escaler Patricia , Lipof Jason , Acquisto Nicole M. 
Published: May 2024

Background
The Eastern Association for the Surgery of Trauma guidelines provide antibiotic selection recommendations based on open fracture type. However, risk factors for open fracture complications (eg, infection, acute kidney injury [AKI], multi-drug resistant organisms, or Clostridioides infection [C. difficile]) and overall antibiotic prophylaxis guideline adherence are unclear at our institution.

Methods
This is a retrospective, observational study of patients who received antibiotic prophylaxis between March 2011 and October 2020 at a level 1 trauma center. We sought to identify open fracture injury complications and assess adherence to institution antibiotic prophylaxis guidelines. Descriptive data and bivariate analyses are reported. Multivariable logistic regression was performed to identify independent risk factors associated with infectious complications.

Results
A total of 401 patients met study criteria; median age of 48 ± 20 years, 62% male. Fracture classifications were similar: 30% type I, 39% type II, and 30% type III. Infection occurred in 18.5% of patients, AKI in 20.3%, multi-drug resistant organism in 3%, and no patients developed C. difficile. Eighty-one percent received guideline adherent antibiotics. In bivariate analysis, fracture classification (P = 0.02) and antibiotic choice (P = 0.004) were associated with infection. Receiving a concomitant nephrotoxic medication was associated with AKI (P = 0.01). In logistic regression, only fracture classification was reliably and independently associated with occurrence of infection.

Conclusions
Appropriate fracture classification and antibiotic choice is important to reduce infection following open fracture. Reducing concomitant exposure to nephrotoxic agents may reduce the risk of AKI.
The associations of opioid and benzodiazepine prescriptions with injuries among US military service members
Authors: Kelber Marija S. , Smolenski Derek J. , Belsher Bradley E. , O'Gallagher Kevin , Issa Fuad , Stewart Lindsay Thonsen , Evatt Daniel P. 
Published: May 2024

Abstract
Given the high rates of physical trauma and pain among service members, opioid-prescribing practices and use patterns have significant implications for the well-being of service members and can affect military medicine and personnel readiness. This study measured the association between prescribed opioid and benzodiazepine medications and subsequently reported injuries (accidental, alcohol and drug related, self-inflicted, and violence related) among active duty military members. Participants were service members who entered the military between January 1, 2005, and June 30, 2010. In a nested case–control design, we compared individuals with injuries to individuals without injuries with respect to their opioid and benzodiazepine prescriptions in the 30 days before the injury of an index case. We used a multiintercept, logistic regression model to compare coefficient estimates by injury type. Overall, approximately 17% of individuals with an injury and 4% of individuals without an injury had a recorded opioid prescription. Individuals with an injury of any type had greater odds of prior exposure to opioid prescriptions than controls. Although a dose–response effect was observed for all injury types, it reached a plateau sooner for natural or environmental accidents and self-inflicted injuries relative to alcohol-related and drug-related injuries, violence-related injuries, vehicle accidents, accidental falls, and other accidents. Benzodiazepine prescriptions were found in 3.5% of individuals with an injury and 0.5% of individuals without an injury. The association between benzodiazepine prescriptions and injuries was strongest for natural and environmental accidents.