bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between cheese intake and risk of atherosclerosis: a two-sample Mendelian randomization phenome-wide study
Authors: Wen Song , Huang Zehan , He Guodong , Zhang Bin , Huang Yuqing 
Published: March 2024

Background and purpose:
Previous observational studies have yielded conflicting results regarding the association between cheese intake and atherosclerosis. Also, relative contribution to each subtype (coronary atherosclerosis, peripheral atherosclerosis, cerebral atherosclerosis, and arterial stiffness) remains unclear. The primary objective of this investigation was to assess the causal association between cheese intake and atherosclerosis.

Methods:
A two-sample Mendelian randomization (MR) study was conducted based on summary statistics from published genome-wide associations of cheese intake (n = 451,486 individuals), coronary atherosclerosis (n = 14,334 cases, 346,860 controls), peripheral atherosclerosis (n = 6,631 cases, 162,201 controls), arterial stiffness (n = 151,053 individuals, no available cases/controls), cerebral atherosclerosis (n = 104 cases, 218,688 controls), and atherosclerosis (excluding cerebral, coronary, and peripheral arterial disease [PAD]) (n = 6,599 cases, 212,193 controls). Primary analysis was conducted using an inverse-variance weighted (IVW) method. Sensitivity analyses included weighted median, MR Egger, and weighted mode analyses. Results are shown as odds ratio (OR) and 95% confidence interval (CI).

Results:
In the IVW analysis, genetically predicted cheese intake was inversely associated with coronary atherosclerosis (OR: 0.98, 95% CI: 0.97–0.99; P = 0.002), peripheral atherosclerosis (OR: 0.56, 95% CI: 0.37–0.84; P = 0.006), arterial stiffness (OR: 0.87, 95% CI: 0.81–0.94; P = 0.001), and atherosclerosis (excluding cerebral, coronary, and PAD) (OR: 0.65, 95% CI: 0.43–0.98; P = 0.037), but not with cerebral atherosclerosis (OR; 0.91, 95% CI: 0.07–11.28: P = 0.941). The sensitivity analyses supported an association of cheese intake with coronary atherosclerosis, peripheral atherosclerosis, arterial stiffness, and atherosclerosis (excluding cerebral, coronary, and PAD), but not cerebral atherosclerosis.

Conclusions:
This study suggested that cheese intake is inversely associated with coronary atherosclerosis, peripheral atherosclerosis, arterial stiffness, and atherosclerosis (excluding cerebral, coronary, and PAD), but not cerebral atherosclerosis. These findings support dietary interventions, especially increasing cheese intake, in subjects with high risk to cardiovascular diseases.
Intraoperative Immunohistochemistry During Mohs Micrographic Surgery and Staged Excision Decreases Local Recurrence Rates for Invasive Cutaneous Melanoma: A Systematic Review and Meta-Analysis
Authors: O'Hern Keegan , Crum Olivia M. , Demer Addison M. , Brewer Jerry D. 
Published: March 2024

BACKGROUNDMohs micrographic surgery (MMS) is increasingly used to treat cutaneous melanoma. However, it is unclear whether intraoperative immunohistochemistry (IHC) improves surgical outcomes.OBJECTIVETo determine whether intraoperative IHC during MMS and staged excision is associated with a decreased risk of poor surgical outcomes.MATERIALS AND METHODSSearch of 6 databases identified comparative and noncomparative studies that reported local recurrence after MMS or staged excision with or without IHC for melanoma. Random-effects meta-analysis was used to estimate pooled local recurrence rates, nodal recurrence, distant recurrence, and disease-specific mortality.RESULTSOverall, 57 studies representing 12,043 patients with cutaneous melanoma and 12,590 tumors met inclusion criteria. Combined MMS and staged excision with IHC was associated with decreased local recurrence in patients with invasive melanoma (0.3%, 95% CI: 0–0.6) versus hematoxylin and eosin alone (1.8%, 95% CI: 0.8%–2.8%) [p< .001]. Secondary outcomes including nodal recurrence, distant recurrence, and disease-specific mortality were not significantly different between these 2 groups. Study heterogeneity was moderately-high.CONCLUSIONLocal recurrence of invasive melanoma is significantly lower after MMS and staged excision with IHC as opposed to without IHC. These findings suggest that the use of intraoperative IHC during MMS or staged excision should strongly be considered, particularly for invasive melanoma.Trial RegistrationPROSPERO Identifier: CRD42023435630.
The influence of habitual physical activity and sedentary behavior on objective and subjective hot flashes at midlife
Authors: Witkowski Sarah , White Quinn , Shreyer Sofiya , Brown Daniel E. , Sievert Lynnette Leidy 
Published: March 2024

Abstract
The years surrounding the transition to menopause are marked by multiple challenges to health. Hot flashes are a commonly reported symptom of women at this time, and their frequency has been associated with disease risk. Regular physical activity and reduced sedentary time are recommended for health and well-being. However, the effect of physical activity and sedentary behavior on hot flashes remains unclear.

Objective
The purpose of this study was to evaluate relationships between physical activity, sedentary time, and hot flashes during both waking and sleeping periods using concurrent objective and subjective measures of hot flashes in midlife women.

Methods
Women aged 45 to 55 years (n = 196) provided self-reported data on physical activity and underwent 24 hours of hot flash monitoring using sternal skin conductance. Participants used event marking and logs to indicate when hot flashes were perceived. Wake and sleep periods were defined by actigraphy. Mean ambient temperature and humidity were recorded during the study period. Generalized linear regression modeling was used to evaluate the effect of physical activity types and sedentary time on hot flash outcomes. Isotemporal substitution modeling was used to study the effect of replacing sedentary time with activity variables on hot flash frequency.

Results
Modeled results indicated that increasing sitting by 1 hour was associated with a 7% increase in the rate of objectively measured but not subjectively reported hot flashes during sleep. Replacing 1 hour of sitting with 1 hour of vigorous activity was associated with a 100% increase in subjectively reported but not objectively measured waking hot flashes. There was little evidence for an effect of temperature or humidity on any hot flash outcome.

Conclusions
These data provide support for relations between sedentary time, physical activity, and hot flashes and highlight the importance of using objective and subjective assessments to better understand the 24-hour hot flash experience.
Intraoperative Near-infrared Spectroscopy Can Predict Skin Flap Necrosis
Authors: Hill W.F. , Kinaschuk K. , Temple-Oberle C. 
Published: March 2024

Background:
The study aimed to validate the previously identified capacity of near-infrared spectroscopy (NIRS) to detect clinically relevant differences in tissue perfusion intraoperatively.

Methods:
Consecutive patients undergoing oncologic resection requiring flap reconstruction were analyzed. Clinicians were blinded to tissue oxygen saturation (StO2) measurements taken intraoperatively. Measurements were taken at (1) control areas not affected by the procedure, (2) areas at risk of necrosis based on distal location, and (3) areas of skin flap necrosis (SFN) identified during the follow-up period. Mean StO2 values were compared using a single-sample t test and analysis of variance (ANOVA) to determine differences in oxygenation.

Results:
There were 102 patients included from April 2018 to May 2019. Reconstruction was undertaken following resection for breast cancer (46), melanoma (35), sarcoma (9), and other cutaneous malignancies (12). Breast reconstruction involved 38 alloplastic reconstructions and eight autologous free flaps. Other skin flap reconstruction involved 42 local/regional skin flaps, 13 pedicled flaps, and one free flap. Eighteen patients (17.6%) developed SFN. Mean intraoperative StO2 measurements for control areas, areas at risk, and areas of SFN were 74.8%, 70.9%, and 54.3%, respectively. StO2 values equal to or less than 60% were highly specific (96%) for SFN, whereas StO2 values above 85% were highly sensitive (96%) to rule out SFN.

Conclusion:
These results further support the use of NIRS to objectively assess variations in skin flap oxygenation and tissue perfusion that are correlated with the development of postoperative SFN.
Clinical outcomes of a toric continuous range of vision presbyopia-correcting intraocular lens
Authors: Orbegozo Javier , Pérez Angelica , Basterra Iñaki , Noguera Helena , González Laura , Lauzirika Gorka , Piñero David P. 
Published: March 2024

Purpose:To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended depth-of-focus (EDOF) pattern and a diffractive multifocal platform.Setting:Miranza COI Bilbao, Bilbao, Spain.Design:Prospective case series.Methods:35 patients (51 to 84 years) with corneal astigmatism ranging from 0.75 to 2.19 diopters (D) undergoing bilateral cataract surgery with implantation of the Synergy Toric II IOL were evaluated during a 3-month follow-up. Visual acuity, refraction, defocus curve, and patient-reported outcomes with the Catquest-9SF questionnaire were analyzed. A vectorial analysis was used to analyze the accuracy of astigmatic correction.Results:Mean 3-month monocular postoperative uncorrected distance, intermediate (80 cm) and near (40 cm) visual acuities were 0.06 ± 0.11 logMAR, 0.13 ± 0.12 logMAR, and 0.13 ± 0.09 logMAR, respectively. Mean monocular distance-corrected intermediate (80 cm) and near visual acuity (40 cm) were 0.11 ± 0.12 logMAR and 0.10 ± 0.10 logMAR, respectively. Mean binocular defocus curve showed visual acuities of 0.10 logMAR or better for defocus levels from +0.50 to −2.50 D. Residual cylinder was within ±0.50 D in 97.0% of eyes. The surgically induced astigmatism prediction error ranged between −0.49 D and 0.50 D, with a mean value of 0.04 ± 0.16 D. Mean absolute IOL rotation was 3.79 ± 2.94 degrees. Significant improvements were found in all Rasch-calibrated scores obtained with Catquest-9SF (P< .001).Conclusions:The implantation of the toric presbyopia-correcting IOL evaluated provides an efficacious astigmatic correction while providing a fully restoration of the visual function across different distances.
Risk factors for venous thromboembolism after primary total joint arthroplasty: An analysis of 7511 Taiwanese patients
Authors: Chang Wei-Lin , Pai Fu-Yuan , Tsai Shang-Wen , Chen Cheng-Fong , Wu Po-Kuei , Chen Wei-Ming 
Published: March 2024

Background:The need for thromboprophylaxis in Asian patients after primary total joint arthroplasty (TJA) remains inconclusive. We aimed to identify the risk factors for venous thromboembolism (VTE) events following primary TJA in a Taiwanese population.Methods:From January 2010 to December 2019, we studied 7511 patients receiving primary TJA from a single surgeon. We validated the incidence and risk factors for 30- and 90-day symptomatic VTE events, including age, sex, body mass index (BMI), smoking, medical comorbidities, VTE history, presence of varicose veins, total knee arthroplasty (TKA) vs total hip arthroplasty (THA), unilateral vs bilateral procedure and receipt of VTE prophylaxis, transfusion, and length of stay.Results:The incidence of 30- and 90-day symptomatic VTE events was 0.33% and 0.44%, respectively. Multivariate regression analysis showed that BMI ≥30 (adjusted odds ratio (aOR): 4.862, 95% CI, 1.776-13.313), bilateral TJA procedure (aOR: 2.665, 95% CI, 1.000-7.104), and presence of varicose veins (aOR: 9.946, 95% CI, 1.099-90.024) were associated with increased odds of 30-day symptomatic VTE events. Age ≥77 years (aOR, 2.358, 95% CI, 1.034-5.381) and BMI ≥30 (aOR: 2.832, 95% CI, 1.039-7.721) were associated with increased odds of 90-day symptomatic VTE events.Conclusion:Age ≥77 years, BMI ≥30, bilateral TJA procedure, or presence of varicose veins may require pharmacological thromboprophylaxis because such patients have a higher risk of VTE after primary TJA.
The Global Burden of Early-Onset Pancreatic Cancer and Its Risk Factors
Authors: Danpanichkul Pojsakorn , Suparan Kanokphong , Jaroenlapnopparat Aunchalee , Polpichai Natchaya , Fangsaard Panisara , Detboon Areeya , Moolkaew Pinyada , Sripusanapan Adivitch , Srisurapanont Karan , Kanjanakot Yatawee , Duangsonk Kwanjit , Wallace Michael B. , Wijarnpreecha Karn 
Published: March 2024

Objectives
Despite evidence of increased incidence of early-onset pancreatic cancer (EOPC), defined as pancreatic cancer diagnosed in patients below 50 years old, and its risk factors in the Western region, global epidemiological data addressing this issue is still lacking.

Materials and Methods
Utilizing data from the Global Burden of Disease Study 2019, we aimed to conduct a comprehensive analysis of the incidence, deaths, and disability-adjusted life years (DALYs) associated with EOPC and its risk factors, including smoking, obesity, and diabetes. The analysis examined the annual percentage change (APC) over the period.

Results
In 2019, the incidence of EOPC surpassed 35,000 cases worldwide. This burden of EOPC tends to be more prevalent in males, as well as in Europe and high SDI countries. However, there is a noticeable upward trend in the burden of EOPC in the Eastern Mediterranean. While there is a global decline in EOPC mortality attributed to smoking (APC −0.33%), there is a concerning increase in mortality associated with diabetes (APC +2.84%) and obesity (APC +2.12%).

Conclusions
The burden of EOPC has been increasing. The mortality is rising mainly from metabolic factors. There is an urgent need for national policy development for reducing the burden of this disease.
Characterization of Telerehabilitation Visits and Patient Satisfaction in Outpatient Physical Medicine and Rehabilitation Clinics From March 2020 to November 2021
Authors: Wright Brittany , Osborne Candice , Alahari Swapnika , Juengst Shannon B. , Kumar Rupali , Smith Jason , Barshikar Surendra 
Published: March 2024

Objective
The aim of the study is to explore the usability of and satisfaction with telerehabilitation services provided to rehabilitation patients with various diagnoses at two large urban medical facilities during the COVID-19 pandemic.

Design
This was a usability study and all patients that received telerehabilitation services from March 2020 to November 2021 were included. Of the 4070 surveys sent via mail or email links to REDCap, 405 were completed (10% response rate). Participants completed demographic surveys, surveys on the telerehabilitation visit characteristics, telerehabilitation usability, and overall satisfaction with the visit.

Results
Patients were mostly women (64.4%), White, non-Hispanic (74.3%), and English-speaking (99%). Most patients were seen via telerehabilitation due to COVID-19 restrictions (37.1%). Patients were generally satisfied with their telerehabilitation visit (3.64 out of 4). Additionally, patients generally found telerehab to be useful (6.4 out of 7), easy to use (6.3 out of 7), effective (6.2 out of 7), satisfactory (6.3 out of 7), and comparable to in-person visits (6.5 out of 7).

Conclusions
Patients generally reported feeling satisfied and comfortable with telerehabilitation visits and felt that they were comparable to in-person visits. Future research should examine the impact of socioeconomic factors on telerehabilitation use, with a focus on education level and non-English speakers.
Central nervous system infections in the tropics
Authors: T Angel Miraclin , Singh Bhagteshwar , Rupali Priscilla 
Published: March 2024

Purpose of review
Emerging and re-emerging central nervous system (CNS) infections are a major public health concern in the tropics. The reasons for this are myriad; climate change, rainfall, deforestation, increased vector density combined with poverty, poor sanitation and hygiene. This review focuses on pathogens, which have emerged and re-emerged, with the potential for significant morbidity and mortality.

Recent findings
In recent years, multiple acute encephalitis outbreaks have been caused by Nipah virus, which carries a high case fatality. Arboviral infections, predominantly dengue, chikungunya and Zika are re-emerging increasingly especially in urban areas due to changing human habitats, vector behaviour and viral evolution. Scrub typhus, another vector borne disease caused by the bacterium Orientia tsutsugamushi, is being established as a leading cause of CNS infections in the tropics.

Summary
A syndromic and epidemiological approach to CNS infections in the tropics is essential to plan appropriate diagnostic tests and management. Rapid diagnostic tests facilitate early diagnosis and thus help prompt initiation and focusing of therapy to prevent adverse outcomes. Vector control, cautious urbanization and deforestation, and reducing disturbance of ecosystems can help prevent spread of vector-borne diseases. Regional diagnostic and treatment approaches and specific vaccines are required to avert morbidity and mortality.
Image Quality and Radiation Exposure in Abdominal Angiography
Authors: Werncke Thomas , Becker Lena S. , Maschke Sabine K. , Hinrichs Jan B. , Meine Timo C.H. , Dewald Cornelia L. A. , Brüsch Inga , Rumpel Regina , Wacker Frank K. , Meyer Bernhard C. 
Published: March 2024

Objectives
This phantom and animal pilot study aimed to compare image quality and radiation exposure between detector-dose–driven exposure control (DEC) and contrast-to-noise ratio (CNR)–driven exposure control (CEC) as functions of source-to-image receptor distance (SID) and collimation.

Materials and Methods
First, an iron foil simulated a guide wire in a stack of polymethyl methacrylate and aluminum plates representing patient thicknesses of 15, 25, and 35 cm. Fluoroscopic images were acquired using 5 SIDs ranging from 100 to 130 cm and 2 collimations (full field of view, collimated field of view: 6 × 6 cm). The iron foil CNRs were calculated, and radiation doses in terms of air kerma rate were obtained and assessed using a multivariate regression. Second, 5 angiographic scenarios were created in 2 anesthetized pigs. Fluoroscopic images were acquired at 2 SIDs (110 and 130 cm) and both collimations. Two blinded experienced readers compared image quality to the reference image using full field of view at an SID of 110 cm. Air kerma rate was obtained and compared using t tests.

Results
Using DEC, both CNR and air kerma rate increased significantly at longer SID and collimation below the air kerma rate limit. When using CEC, CNR was significantly less dependent of SID, collimation, and patient thickness. Air kerma rate decreased at longer SID and tighter collimation. After reaching the air kerma rate limit, CEC behaved similarly to DEC. In the animal study using DEC, image quality and air kerma rate increased with longer SID and collimation (P < 0.005). Using CEC, image quality was not significantly different than using longer SID or tighter collimation. Air kerma rate was not significantly different at longer SID but lower using collimation (P = 0.012).

Conclusions
CEC maintains the image quality with varying SID and collimation stricter than DEC, does not increase the air kerma rate at longer SID and reduces it with tighter collimation. After reaching the air kerma rate limit, CEC and DEC perform similarly.
Resolution of Overactive Bladder Symptoms After Anterior and Apical Prolapse Repair
Authors: Abrams Megan , Sears Sarah , Wherley Susan , Rhodes Stephen , Mangel Jeffrey , Sheyn David 
Published: March 2024

Importance
Patients often present with both overactive bladder (OAB) and pelvic organ prolapse (POP) concerns. It is unknown whether treatment of POP improves OAB.

Objective
This study aimed to evaluate whether OAB improves after anterior/apical POP repair for anterior wall prolapse.

Study Design
This was a prospective study of women with anterior/apical prolapse at or beyond the hymen and concomitant OAB symptoms, undergoing apical repair. Overactive bladder severity was evaluated with the Urogenital Distress Inventory-6 (UDI-6) questionnaire and the Incontinence Impact Questionnaire-7 preoperatively and 2, 6, 12, and 24 weeks postoperatively. The primary outcome was a reduction of ≥11 points or greater on the UDI-6 at 6 months. Those who reported an ≥11-point reduction were termed responders. Multivariable regression analyses were performed to evaluate factors associated with reduction in OAB symptoms after POP surgery.

Results
A total of 117 patients met the criteria for analysis, with 79.5% reporting improved OAB symptoms after POP repair at 6 months. There were no preoperative differences between groups. The mean preoperative UDI-6 and Incontinence Impact Questionnaire-7 scores were higher in the responder group (51.1 ± 16.8 vs 26.4 ± 15.1 [P < 0.001] and 44.6 ± 23.8 vs 22.8 ± 21.4 [P = 0.001], respectively), and the presence of detrusor overactivity was lower (29.0% vs 54.2%, P = 0.02). After regression, a higher preoperative UDI-6 total was associated with an increased likelihood of symptom improvement at 6 months (adjusted odds ratio, 1.14 per point [1.08–1.19]), whereas detrusor overactivity on preoperative urodynamics was associated with a decreased likelihood of OAB symptom improvement (adjusted odds ratio, 0.10 [0.02–0.44]).

Conclusion
Overactive bladder symptoms improve in the majority of patients undergoing apical repair for anterior/apical prolapse beyond the hymen.
Availability of Electroconvulsive Therapy in Public Health Services in the Last Decade in Brazil
Authors: Mazucco Júlia Pellizon , Smaira Sumaia Inaty , da Silva Antonio Geraldo , Brunoni Andre Russowsky , Gallucci-Neto Jose 
Published: March 2024

Objective
To identify the current treatment options for electroconvulsive therapy (ECT) therapy in public services linked to the Unified Health System in Brazil and compare them with data published in 2012 based on their availability.

Methods
In this retrospective observational study, we mapped institutions that perform ECT under public health services in Brazil. A questionnaire was administered to active and inactive service centers between August 2022 and June 2023.

Results
We identified 16 institutions that performed ECT, including 12 linked to public universities and 4 with various links. In the last decade, 2 new public services that perform ECT in the country have emerged, whereas 4 services have ceased function. In 2022, the number of individuals treated with ECT per 100,000 population was 1.86, whereas the number of procedures performed per 100,000 people was 6.55.

Conclusions
Although 2 new public ECT services have been identified, 4 have turned inactive. Most services are linked to public universities, and inactive service points to financial issues as the main factor in service interruption. Brazil has one of the lowest rates of individuals treated with ECT per 100,000 population compared with countries in North America and Europe. Thus, it is essential to raise awareness to improve ECT adoption rates and bring it out of the shadows in Brazil.