bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the Seraph® 100 Microbind® Affinity blood filter under slow flow conditions through 18 G and 16 G central lines
Authors: Seffer Malin-Theres , Meyer Torsten M , Borchina Dan-Nicolae , Kielstein Jan T , Schmidt Julius J 
Published: February 2024

Introduction: The Seraph® 100 Microbind® Affinity blood filter (Seraph® 100) has been in use since 2019 for the treatment of fulminant or difficult to treat blood stream infections as an adjunct to pharmacotherapy. In 2020 the device received emergency use authorization by the US Food and Drug Administration for the treatment of critically ill COVID-19 patients with confirmed or imminent respiratory failure. Results of an international registry showed that the Seraph® 100 was operated under blood flow rates of 100–350 mL/min. As those conditions require a large bore central line, a dialysis catheter is currently considered indispensable to operate the Seraph® 100. The use of smaller catheter lumina has neither been evaluated in vitro nor in vivo. Methods: In vitro pressure data before and after the Seraph® 100 at various blood pump rates (prepump line 16 G, postpump line 18 G) with saline and human plasma were obtained. Further, anecdotal flow and pressure data of two patients treated with the Seraph® 100 for a COVID-19 infection are reported. Results: At a pump speed of 50 mL/min pre-Seraph® pressure using saline was −70 [−70 to −60] mm Hg. In comparison, using plasma pre-Seraph® pressure was lower at −120 [−120 to −105] mm Hg; p < 0.001 ( t-test). The post-Seraph® pressure at 50 mL/min using saline of 120 [110–130] mm Hg was not different from plasma at 130 [120–140] mm Hg, p = 0.152 ( t-test). Blood flow rates of 50 mL/min did not lead to preAP levels below −250 mm Hg in the two clinical cases. Conclusion: Seraph® 100 blood flow rate of 50 mL/min may be achieved using low flow vascular access, allowing to treat a blood volume 72 L in 24 h.
University students’ access to mental health services: A qualitative study of the experiences of health service professionals through the lens of candidacy in England
Authors: Osborn Tom G , Town Rosa , Bawendi Majeed , Stapley Emily , Saunders Rob , Fonagy Peter 
Published: February 2024

Objectives In order to develop a better understanding of students’ access to mental health services, we explored the experiences of health care professionals interacting with university students with mental health problems. Methods We interviewed 23 professionals working across university advice and counselling services, NHS general practice, crisis, and psychological services in North and East London between June 2022 and January 2023. Our approach drew on reflexive thematic analysis and the principles of abductive analysis. The notion of candidacy – that is, how different needs are deemed deserving of health service attention – was particularly helpful to our understanding of the ongoing phenomenon of interest in the data. Results Each student’s access to mental health support was highly contingent on the student’s dynamic social context and the pressures and organisation of the local health system. Professionals described how different students viewed different needs as deserving of health service attention. Which students reached the professional’s service depended on the resources and relationships a student could draw upon, and the service’s relative permeability. Once there, what action professionals took was strongly influenced by the professional’s service expertise, resource constraints, the relationships the professional’s service had with other organisations, the students’ wishes, and whether students regarded treatment offers as acceptable. Conclusions Candidacy offers a useful lens to view university students’ access to mental health support. Access appears to be an increasingly intricate task for students, given the fragmented service landscape, surging demand for mental health care and challenges of emerging adulthood. Our findings suggest that policy goals to increase use of mental health services are unlikely to improve outcomes for students without policy makers and health systems giving holistic consideration of inter-service relationships and available resources.
It’s our job to bridge the gap: Perspectives of bilingual autism providers on heritage language care
Authors: Martin Loya Melanie R , Meadan Hedda 
Published: February 2024

Autistic children from heritage-language-speaking homes in the United States are a growing group that would benefit from tailored support that honors their linguistic heritage. Bilingual autistic adults share benefits of their bilingualism abilities and report childhood learning environments as necessary for facilitating language learning or maintenance. Caregivers of young autistic children also report the desire to maintain their heritage languages but sometimes struggle to do so due to misconceptions and a lack of resources such as bilingual personnel. This study was the first to explore U.S.-based bilingual providers’ ( N = 16) experiences and perceptions of providing bilingual care for autistic children. Data analysis was conducted using reflexive thematic analysis, and resulted in five themes, including (a) You Don’t Have to Change Who You Are: Experiences and Beliefs About Bilingualism, (b) Having the “Other” Perspective: Empathy and Intersectionality, (c) Services as a Gateway: Beliefs Rooted in Social Justice, (d) He Was Like a Different Child: Impacts of Receiving Heritage-Language Support, and (e) It Was Just Business: Impacts of Not Receiving Same Language Support. Findings from this study suggest that autistic children and their families benefit from heritage language care, and the recruitment and retention of a linguistically diverse workforce is recommended. Additional implications for research and practice are discussed. Lay abstract In the United States, many people have heritage languages they speak in their homes other than English, such as Chinese or Spanish. Autistic children whose families speak different languages could benefit from support and teaching in their heritage languages. Still, caregivers have reported that it is challenging to do so. Many autism professionals make suggestions that are not based on research. To date, researchers have not examined the perspectives of the small group of bilingual professionals in the United States who provide bilingual support for autistic children. Therefore, this study explored how bilingual autism providers in the United States talked about their work, bilingualism, and the impacts their bilingual work has on autistic children and families. The bilingual providers in this study reported many positive outcomes for autistic children when they can learn and use their heritage languages and some negative outcomes when providers cannot communicate in the same language. Recommendations from this study highlight the need to recruit more bilingual providers in the field of autism.
Specimen tomosynthesis provides no additional value to specimen ultrasound in ultrasound-visible malignant breast lesions
Authors: Almasarweh Sa’ed , Sudah Mazen , Okuma Hidemi , Joukainen Sarianna , Vanninen Ritva , Masarwah Amro 
Published: February 2024

Background: The aim of this study was to evaluate the accuracy and added value of specimen tomosynthesis (ST) to specimen ultrasound (SUS) in margin assessment of excised breast specimens in breast-conserving therapy for non-palpable US-visible breast lesions. Materials: Between January 2018 and August 2019, all consecutive patients diagnosed with non-palpable breast cancer visible by ultrasound (US), treated with breast-conserving surgery (BCS) and requiring radiological intraoperative breast specimen assessment, were included in this study. Excised breast specimens were examined with SUS by radiologists blinded to the ST results, and margins smaller than 10 mm were recorded. STs were evaluated retrospectively by experienced radiologists. Results: A total of 120 specimens were included. SUS showed a statistically significant correlation with pathological margin measurements, while ST did not and provided no additional information. The odds ratios (ORs) for SUS to predict a positive margin was 3.429 (confidence interval (CI) = 0.548–21.432) using a 10-mm cut-off point and 14.182 (CI = 2.134–94.254) using a 5-mm cut-off point, while the OR for ST were 2.528 (CI = 0.400–15.994) and 3.188 (CI = 0.318–31.998), respectively. Conclusions: SUS was superior in evaluating intraoperative resection margins of US-visible breast resection specimens when compared to ST. Therefore, ST could be considered redundant in applicable situations.
Long-Term Outcomes of Endovascular Repair Within and Outside the Instructions for Use in Korean Patients With Abdominal Aortic Aneurysm
Authors: Lee Joonpyo , Oh Pyung Chun , Jang Albert Youngwoo , Ahn Chul-Min , Choi Donghoon , Ko Young-Guk , Kang Woong Chol 
Published: February 2024

Objective: Endovascular aneurysm repair (EVAR) has been used worldwide to treat abdominal aortic aneurysms (AAAs). Outcomes after EVAR within and outside the instruction for use (IFU) remain controversial. We analyzed long-term outcomes of EVAR within-the-IFU compared with that outside-the-IFU and baseline clinical/anatomical characteristics that influence outcomes of EVAR. Methods: The study included 546 patients who underwent EVAR for infrarenal AAA from 1997 to 2021 at 2 Korean medical centers. The primary endpoint was graft-related adverse events (GRAEs), including type 1 or 3 endoleak, reintervention (included open conversion), aneurysm sac enlargement, aneurysm-related mortality (ARM), rupture, stent-graft migration, and stent thrombotic occlusion. Results: The patients who underwent EVAR outside the IFU were 287 (52.6%). A neck angle of >60° was most common outside the IFU criteria (n=146, 50.9%). This study revealed that patients outside the IFU had a higher rate of GRAEs compared with patients within the IFU (hazard ratio [HR]: 1.879; 95% confidence interval [CI]: 1.045–2.386). A neck angle of >60° was a significant risk factor for GRAEs (adjusted HR: 2.229; 95% CI: 1.418–3.503), type 1 or 3 endoleak (adjusted HR: 2.640; 95% CI: 1.343–5.189), and reintervention (adjusted HR: 1.891; 95% CI: 1.055–3.388). Conclusions: Our study revealed EVAR with outside the IFU was associated with increased GRAEs, mainly attributed to endoleak and ARM, compared with EVAR with within the IFU. In addition, severe neck angulation was an independent risk factor for GRAEs, type 1 or 3 endoleak, and reintervention. Clinical Impact Our study revealed endovascular aneurysm repair (EVAR) with outside-the-instruction for use (IFU) was associated with increased graft-related adverse events (GRAEs) compared with EVAR with within-the-IFU. In the low-risk population, the incidence of GRAEs and Aneurysm related mortality were higher in the outside-the-IFU group rather than within-the-IFU group. In addition, severe neck angulation was an independent risk factor for GRAEs, type 1 or 3 endoleak and reintervention.
A Readability Study of Carpal Tunnel Release in 2023
Authors: Kayastha Ankur , Lakshmanan Kirthika , Valentine Michael J. , Kramer Hunter D. , Kim James , Pettinelli Nicholas , Kramer Robert C. 
Published: February 2024

Background: The National Institutes of Health (NIH) and the American Medical Association (AMA) recommend a sixth-grade reading level for patient-directed content. This study aims to quantitatively evaluate the readability of online information sources related to carpal tunnel surgery using established readability indices. Methods: Web searches for “carpal tunnel release” and “carpal tunnel decompression surgery” queries were performed using Google, and the first 20 websites were identified per query. WebFX online software tools were utilized to determine readability. Indices included Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, Coleman Liau Index, Automated Readability Index, Gunning Fog Score, and the Simple Measure of Gobbledygook Index. Health-specific clickthrough rate (CTR) data were used in order to select the first 20 search engine results page from each query. Results: “Carpal tunnel release” had a mean readability of 8.46, and “carpal tunnel decompression surgery” had a mean readability of 8.70. The range of mean readability scores among the indices used for both search queries was 6.17 to 14.0. The total mean readability for carpal tunnel surgery information was found to be 8.58. This corresponds to approximately a ninth-grade reading level in the United States. Conclusion: The average readability of carpal tunnel surgery online content is three grade levels above the recommended sixth-grade level for patient-directed materials. This discrepancy indicates that existing online materials related to carpal tunnel surgery are more difficult to understand than the standards set by NIH and AMA.
Hyperdense sign as a predictor for successful recanalization and clinical outcome in acute ischemic stroke: A systematic review and meta-analysis
Authors: Gharaibeh Khaled , Aladamat Nameer , Samara Mohammad , Mierzwa Adam T. , Ali Ahsan , Zaidi Syed , Jumaa Mouhammad 
Published: February 2024

Objective To assess the prognostic values of hyperdense sign on pretreatment non-contrast head CT scan for successful recanalization (mTICI ≥2b) and 90-day good functional outcome (mRs 0-2) in patients with acute ischemic stroke undergoing mechanical thrombectomy (MT). Methods Literature search on PubMed, EMBASE, and Cochrane databases from inception up to 1 November 2023 was conducted. Twelve studies which reported hyperdense sign, recanalization and clinical outcomes were included in qualitative synthesis and meta-analysis. Results Pooled analysis demonstrated a statistically significant association between successful recanalization and hyperdense sign-positive patients who underwent MT (odd ratios (OR) = 1.47, 95% confidence interval (CI) = 1.03–2.10, p = 0.04). No statistically significant association was demonstrated between presence of hyperdense sign and good functional outcome (OR = 1.04, 95% CI: 0.72–1.49, p = 0.85) or symptomatic intracranial hemorrhage sICH (OR: 1.80, 95% CI 0.72–4.47, p = 0.21) Conclusions This meta-analysis demonstrated that pre-intervention hyperdense sign on CT imaging might be useful in prediction of successful recanalization after MT.
Characteristics of Spinal Morphology According to the “Current” and “Theoretical” Roussouly Classification Systems in a Diverse, Asymptomatic Cohort: Multi-Ethnic Alignment Normative Study (MEANS)
Authors: Shen Yong , Sardar Zeeshan M. , Malka Matan , Katiyar Prerana , Greisberg Gabriella , Hassan Fthimnir , Reyes Justin L. , Le Huec Jean-Charles , Bourret Stephane , Hasegawa Kazuhiro , Wong Hee Kit , Liu Gabriel , Dennis Hey Hwee Weng , Riahi Hend , Kelly Michael , Lombardi Joseph M. , Lenke Lawrence G. ,   Multi-Ethnic Alignment Normative Study Group
Published: February 2024

Study Design Cross-sectional cohort study. Objective To classify spinal morphology using the “current” and “theoretical” Roussouly systems and assess sagittal alignment in an asymptomatic cohort. Methods 467 asymptomatic volunteers were recruited from 5 countries. Radiographic parameters were measured via the EOS imaging system. “Current” and “theoretical” Roussouly classification was assigned with sagittal whole spine imaging using sacral slope (SS), pelvic incidence (PI), and the lumbar apex. One-way analysis of variance (ANOVA) was performed to compare subject characteristics across Roussouly types, followed by post hoc Bonferroni correction. Results Volunteers were categorized into 4 groups (Types 1-4) and 1 subgroup (Type 3 AP) using the “current” and “theoretical” Roussouly systems. The mean PI in “current” Roussouly groups was 40.8° (Type 1), 43.6° (Type 2), 52.4° (Type 3), 62.4° (Type 4), and 43.7° (Type 3AP). The mean PI in “theoretical” Roussouly groups was 36.5° (Type 1), 39.1°(Type 2), 52.5° (Type 3), 67.3° (Type 4), and 51.0° (Type 3AP). The difference in PI between “current” and “theoretical” Roussouly types was significant for Type 1 ( P = .02), Type 2 ( P < .001), Type 4 ( P < .001), and Type 3AP ( P < .001). 34.7% of subjects had a “current” Roussouly type different from the “theoretical” type. Type 3 theoretical shape had the most frequent mismatch, constituting 61.1% of the mismatched subjects. 51.5% of mismatched Type 3 become “current” Type 4. Conclusion The distribution of Roussouly types differs depending on whether the “current” or “theoretical” classification are employed. A sizeable proportion of volunteers exhibited current and theoretical type mismatch, highlighting the need to interpret sagittal alignment cautiously when utilizing the Roussouly system.
Radiographic Incidence of Knee Osteoarthritis After Isolated ACL Reconstruction Versus Combined ACL and ALL Reconstruction: A Prospective Matched Study from the SANTI Study Group
Authors: Freychet Benjamin , Hopper Graeme , Coulin Bennoit , El Helou Abdo , An Jaesung , Dutra Vieira Thais , Sonnery-Cottet Bertrand , Shatrov Jobe 
Published: February 2024

Objectives: The aim of this study was to evaluate the incidence of OA with isolated ACLR in comparison with ACLR with ALLR at medium-term follow-up. We hypothesized that there would be no differences between the groups. Methods: Patients who underwent ACLR 1 ALLR with hamstring tendon autograft between January 2011 and March 2012 were propensity matched to patients who underwent isolated ACLR with bone–patellar tendon–bone (BPTB) or hamstring tendon autograft in the same period. Medium-term radiographic evaluation was performed using the International Knee Documentation Committee (IKDC) radiographic OA grading scale, modified Kellgren-Lawrence grade, and the surface fit method to assess percentage of joint space narrowing. Clinical outcomes were assessed with the following measures: IKDC, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Tegner, and ACL Return to Sport after Injury. Results: A total of 80 patients (42 ACLR 1 ALLR and 38 isolated ACLR) were analyzed with a mean follow-up of 104 months. There was no significant difference between groups for joint space narrowing in the medial or lateral tibiofemoral or lateral patellofemoral (PF) compartment. However, 36.8% in the isolated ACLR group versus 11.9% in the ACLR 1 ALLR group had narrowing of the medial PF compartment (P = .0118). A lateral meniscal tear increased the risk of lateral tibiofemoral narrowing by nearly 5 times (odds ratio, 4.9; 95% CI, 1.547-19.367; P = .0123). The risk of medial PF narrowing was .4-fold with an isolated ACLR (odds ratio, 4.8; 95% CI, 1.44-19.05; P = .0179). Between the isolated ACLR group and the ACLR 1 ALLR group, the secondary meniscectomy rate was 13.2% versus 11.9% (not significantly different). There was no difference between groups in KOOS, Tegner, or IKDC scores. There was also no difference between groups for grades of osteoarthritic change for any classification system. Patients who received a BPTB graft had medial PF joint narrowing in 66.7% of cases as compared with 11.9% in those who received ACLR 1 ALLR (P = 0.118). Conclusions: ACLR 1 ALLR did not increase the risk of OA in the lateral tibiofemoral compartment when compared with an isolated] ACLR at medium-term follow-up. Isolated ACLR using BPTB was associated with a significantly increased risk of medial PF joint space narrowing.
Perception of aesthetic impairment in patients with systemic sclerosis determined using a semi-quantitative scale and its association with disease characteristics
Authors: Farhat Méryem-Maud , Guerreschi Pierre , Morell-Dubois Sandrine , Deken Valérie , Labreuche Julien , Sanges Sebastien , Sobanski Vincent , Hachulla Eric , Cottencin Olivier , Launay David 
Published: February 2024

Background: Systemic sclerosis is a fibrotic disease. Body image assessments could be key in optimizing care; however, data are scarce. The main objective was to assess the perception of aesthetic impairment using a visual aesthetic evaluation scale in patients with systemic sclerosis compared with healthy subjects. The secondary objectives were to assess associations between the perception of aesthetic impairment and scores on standardized questionnaires for aesthetic impairment as well as clinical, psychological/quality of life, and functional parameters of patients with systemic sclerosis. Methods: This study evaluated and compared the perception of aesthetic impairment in two populations: patients with systemic sclerosis from a referral center at Lille Hospital, France, and healthy controls. Results: This study included 88 patients (69 (78.4%) women) with a median age of 52 years and 88 controls (49 (55.7%) women) with a median age of 45 years. The perception of aesthetic impairment assessed using the aesthetic evaluation scale was poorer in systemic sclerosis patients than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p = 0.028) and was statistically correlated with assessments using the adapted satisfaction with appearance, a specific aesthetic impact assessment questionnaire for patients with systemic sclerosis. Patients with anxiety or depressive symptoms had significantly higher aesthetic evaluation scale scores. Systemic sclerosis patients with facial involvement and pitting scars had a worse perception of aesthetic impairment. Compared with healthy controls, systemic sclerosis patients had a worse perception of aesthetic impairment, especially systemic sclerosis patients with anxiety or depression and those with facial and hand involvement. Conclusion: The aesthetic evaluation scale appears to be an easy-to-use tool to evaluate body image. Correlations of the aesthetic evaluation scale score with psychological and quality of life parameters reflect the importance of these parameters for body image evaluation and its complex assessment. Trial registration: Clinical Trial NCT03271320 (Registered 9 January 2017, https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1 ).
“Before I came to the hospice, I had nobody”. A qualitative exploration of what patients, family-caregivers, clinicians and volunteers valued most about home, day therapy or inpatient hospice services
Authors: Hughes Nicole Marie , Noyes Jane , Stringer Carys , Pritchard Trystan 
Published: February 2024

Background: Globally, the demand for hospice care continues to grow resulting in substantial resource burden. Whilst some countries are able to rely on fixed government contributions, statutory funding for palliative care in the United Kingdom is unequally distributed. These unstable funding streams and increased demand means that hospices need to evidence their value. Objective: This study explored the experiences of patients and family-caregivers to determine what they valued most from accessing hospice services in Wales. Methods: In this large multi-site qualitative study, 94 semi-structured interviews and 2 focus groups were conducted with hospice patients ( n = 45), family-caregivers ( n = 18), hospice staff ( n = 31) and volunteers ( n = 10). The audio recordings were transcribed verbatim and analysed using Framework analysis. Results: Seven themes described patient and family-caregiver experiences and what they valued most: relationships with staff and volunteers, greater support networks which reduced social isolation and loneliness, provision of information and advice which improved patient autonomy, symptom management and subsequent reduction in psychological distress, improvements in patient functionality, mobility and overall physical health and respite relief which promoted improved relationships. Conclusion: This is the largest study to explore what patients and family-caregivers value from hospice care. Findings indicate that hospice care provides a truly needs-led and strengths-based service to those who are nearing and at the end-of-life, which is highly valued by patients and family members.