bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Assessment of Magnetic Resonance Spectroscopy and Diffusion-Weighted Imaging in Diffuse Glioma: Insights Into Histological Grading and IDH Classification
Authors: Zhang Han-Wen , Zhang Hong-Bo , Liu Xiao-Lei , Deng Hua-Zhen , Zhang Yu-Zhe , Tang Xu-Mei , Lin Fan , Huang Biao 
Published: April 2024

Purpose: To assess the diagnostic utility of clinical magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) in distinguishing between histological grading and isocitrate dehydrogenase ( IDH) classification in adult diffuse gliomas. Methods: A retrospective analysis was conducted on 247 patients diagnosed with adult diffuse glioma. Experienced radiologists evaluated DWI and MRS images. The Kruskal-Wallis test examined differences in DWI and MRS-related parameters across histological grades, while the Mann–Whitney U test assessed molecular classification. Receiver Operating Characteristic (ROC) curves evaluated parameter effectiveness. Survival curves, stratified by histological grade and IDH classification, were constructed using the Kaplan–Meier test. Results: The cohort comprised 141 males and 106 females, with ages ranging from 19 to 85 years. The Kruskal-Wallis test revealed significant differences in ADC mean, Cho/NAA, and Cho/Cr concerning glioma histological grade ( P < .01). Subsequent application of Dunn’s test showed significant differences in ADC mean among each histological grade ( P < .01). Notably, Cho/NAA exhibited a marked distinction between grade 2 and grade 3/4 gliomas ( P < .01). The Mann–Whitney U test indicated that only ADC mean showed statistical significance for IDH molecular classification ( P < .01). ROC curves were constructed to demonstrate the effectiveness of the specified parameters. Survival curves were also delineated to portray survival outcomes categorized by histological grade and IDH classification. Conclusions: Clinical MRS demonstrates efficacy in glioma histological grading but faces challenges in IDH classification. Clinical DWI’s ADC mean parameter shows significant distinctions in both histological grade and IDH classification.
Assessing Clinical Profile and Short-term Outcomes of Neonates Retrieved by Neonatal Transport Service and Their Co-relation with Neonatal Severity Illness Scores: An Observational Study
Authors: Reddy Neetha M. , Athreya Rajath 
Published: April 2024

Introduction Newborn transport is a key component of neonatal perinatal care, and its delay is attributed highly to neonatal mortality. Aim Our study aimed to assess the clinical profile and short-term outcomes (<48 hours of admission) and to apply the severity illness scores to know the impact on outcomes of retrieved neonates. We used Transport Risk Index of Physiological Stability (TRIPS II) score to correlate with short-term morbidities and Score of Neonatal Physiology Perinatal Extension (SNAPPE II) to correlate with overall outcomes of retrieved neonates. Materials and Methods It was an observational study done on 160 out-born neonatal retrievals over 13 months by a dedicated transport team at a level III NICU in Bengaluru, India. A validated TRIPS II score was recorded pre-transport, at Admission and at 12 and 24 hours of admission, and the SNAPPE II score was recorded at admission. An ROC curve was used to predict the utility of these scores. Results Among 141 eligible neonates, the common indication for transport was respiratory distress syndrome 57 (40.4%). Extreme pre-terms (<28 weeks; p = .001) and ELBW (<1000 g; p = .001) are associated with an increased mortality rate. The area under the curve (AUC) for TRIPS II in predicting pulmonary bleed (AUC of ROC 0.866, 0.833, 0.823, 0.836), IVH (0.776, 0.79, 0.78, 0.77), worsening of respiratory settings (0.786, 0.814, 0.78, 0.79), and increase in ionotropic support (0.882, 0.904, 0.904, 0.902) at pre-transport, at admission, at 12 hours, and at 24 hours, respectively, was good. The AUC for SNAPPE II was 0.895, which is good in predicting mortality. Conclusion A dedicated neonatal transport service can reduce the mortality rate significantly to 7.8%. TRIPS II and SNAPPE II scores were good in predicting the morbidities and mortality in retrieved neonates.
Reference Values for Placental Weight and Placental:Fetal Weight Ratio in a Swedish Population
Authors: Waldheim Frida , Sirotkina Meeli , Pettersson Karin , Kublickas Marius , Papadogiannakis Nikos 
Published: April 2024

Introduction: There is important clinical information from placental weight and its ratio to the fetal weight. The aim with this study was to establish reference values for the placental weight and the placental:fetal weight ratio for gestational weeks 13–43 in a Swedish population. Materials and Methods: Cases were retrospectively collected from the database used at the Pathology Department at Karolinska University Hospital and information about the placental weight, fetal weight, and gestational age was retrieved. Conditions, which could affect the placental- or fetal weight were excluded. Thereafter percentile curves were calculated for the placental weight and the placental:fetal weight ratio for gestational weeks. Results: A total of 730 cases were included and percentile curves for the placental weight for gestational week 13–43 and placental:fetal weight ratio for gestational week 18–43 are presented. Conclusions: Reference values for post fixation placental weight and its ratio to fetal weight for a Swedish population are presented. The reference values are lower than the current reference values used in our institution, and this will be of importance when interpreting findings after placental examination.
Enhancement of hydrophilicity and color strength in plasma treated PET with water vapor post-exposure using a new in-line pilot scale DBD plasma
Authors: Abbassi Shanbehbazari Mohammad Sadegh , Alihoseini Mohammadreza , Khani Mohammadreza , Ostovarpour Farzaneh , Hosseini Seyed Iman , Jalili Mojtaba , Shokri Babak 
Published: April 2024

Due to its low hydrophilicity, direct sublimation inkjet printing on woven polyester fabric surfaces is challenging. This research experimentally studies the efficacy of dielectric barrier discharge (DBD) roll-to-roll plasma treatment with or without water vapor post-exposure as a novel method to modify polyethylene terephthalate (PET) surfaces to enhance hydrophilicity, color performance, and printing quality. The Response Surface Methodology (RSM) was used to design experiments, and the optimum conditions were analyzed through statistical calculations. Their results were examined using Optical Emission Spectroscopy (OES), Atomic Force Microscopy (AFM), field emission scanning electron microscopy (FESEM), Energy Dispersive X-ray (EDX), X-ray Photoelectron Spectroscopy (XPS), and Attenuated Total Reflectance Fourier Transform Infra-Red spectroscopy (ATR-FTIR) tests. Qualitative and quantitative tests for color performance and wicking test used for hydrophilicity assessment confirms the effectiveness of this Green inline pretreatment for industries to enhance direct sublimation inkjet printing quality on PET by a decrease in absorption time from 12051 to 202 s and an increase in the color depth to 12.49%, 25.89 and 18.07% for Cyan, Magenta and Key (black) respectively. One of the stable optimum conditions in which three printed colors: Cyan, Magenta, and Black (Key), show high-quality color performance is at 15 processing rounds, 2 m/min velocity in the absence or presence of water vapor post-exposure. Water vapor post-exposure exhibits a beneficial, economic effect along with plasma treatment. The results show that the chemical modification aspect of this treatment plays a more significant role in printing quality enhancement than its morphological modification.
Telesimulation Training for Endoscopic Mitral Valve Surgery: An Air-Pilot Training Concept for Distance Training
Authors: Cheheili Sobbi Shokoufeh , Imran Hamid Umar , Arjomandi Rad Arian , Fillet Marvin , Maesen Jos , Sardari Nia Peyman 
Published: April 2024

Objective: The aim of this study was to validate and assess the feasibility and impact of telesimulation training on surgical skills using a portable mitral valve telesimulator. Methods: A telesimulation course composed of 3 online modules was designed based on backwards chaining, preassessment and postassessment, performance feedback, hands-on training on a telesimulator, and the theoretical content. A fully 3-dimensional–printed and transportable telesimulator was developed and sent out to the participants with instruments that were needed. Feedback about the platform was obtained from participants to validate its value as a training tool. Theoretical and technical assessments were carried out before and after the course. Technical assessments were based on the accuracy and time taken to place sutures at the anterior and posterior mitral annulus. Results: In total, 11 practicing cardiac surgeons from Oceania, Asia, Europe, and North America completed the course. Theoretical preassessment and postassessment showed that participants scored significantly higher on postassessment (mean 87.5% vs 68.1%, P < 0.004). The participant evaluation scores of the simulator as a tool for endoscopic mitral valve surgery was 4 to 5 out of 5. There was a significant improvement in the speed (median 14.5 vs 39.5 s, P < 0.005) and the accuracy to place sutures in the mitral valve annulus following course completion ( P < 0.001). Conclusions: Here we validated the educational value of a novel telesimulation platform and validated the feasibility to teach participants at a distance the knowledge and skills for endoscopic mitral valve surgery. Future studies will be required to validate the improvement in skills during surgery.
Microsnare retrieval as a bail-out technique of Detached Woven EndoBridge device: Illustrative series
Authors: Chew Han Seng , Altibi Mohammad , Al-Ali Samer , Butler Benjamin , Butt Waleed , Chavda Swarupsinh , Lamin Saleh 
Published: April 2024

Background The Woven EndoBridge (WEB) device (MicroVention, Tustin, CA, USA) has an excellent safety profile. While major complications such as device malposition and migration are rare, they can have serious consequences if not addressed promptly. Our case series describes the safety and efficacy of Amplatz goose neck microsnare device (Medtronic in Irvine, CA, USA) in endovascular retrieval of a detached WEB device. Methods We retrospectively reviewed six consecutive patients who underwent endovascular WEB retrieval using Amplatz microsnare device between March 2012 and December 2022. Results All six WEB devices were successfully retrieved either directly from the aneurysm sac due to device malpositioning or from a distal branch following device migration. None of the patients experienced intra-operative aneurysm perforation, arterial dissection, or vasospasm attributable to the process of WEB extraction. Five out of six patients (83.3%) had a good functional outcome (mRS 0-1) upon discharge from the hospital and at 24 months. Conclusion Our experience suggests that detached WEB devices can be safely retrieved using an Amplatz microsnare. Apart from addressing device migration, direct removal of an undersized or malpositioned WEB from the aneurysm sac appears to be a safe option that can be considered when all other rescue techniques have been exhausted.
Stent-assisted Woven EndoBridge embolization for the treatment of pulsatile tinnitus caused by an ipsilateral high-riding jugular bulb
Authors: Zur Gil , Charbonnier Guillaume , Fageeh Areej , Diouf Ange , Brun-Vergara Maria Lucia , Lesiuk Howard , Drake Brian , Santos Marlise , Mikhael Nicole , Budiansky Dan , Rhodes Emily , Fahed Robert , Mendes Pereira Vitor 
Published: April 2024

Purpose Pulsatile tinnitus can be caused by a high-riding jugular bulb (HRJB), characterized by the superior position of the jugular bulb in the petrous temporal bone. The anatomical position and morphology of this entity make it challenging for endovascular treatment. We report our experience with two patients successfully treated with a stent-assisted Woven EndoBridge (WEB; Microvention, Tustin, CA, USA) device. Materials and Methods We describe two cases of HRJB in patients presenting with disabling pulsatile tinnitus. Temporary balloon occlusion of the jugular bulb prior to the intervention reduced tinnitus intensity. Both patients were subsequently treated under general anesthesia with the WEB device deployed in the HRJB which was held by a stent deployed in the sigmoid sinus. Results Both procedures were successful with good positioning of the WEB device and no procedural complications. Both patients had complete resolution of pulsatile tinnitus immediately after the procedure. Follow-up imaging showed successful occlusion of the venous cavity with a widely patent stent. Conclusion Among patients with pulsatile tinnitus caused by an ipsilateral HRJB, a stent-assisted WEB device seems to be a viable endovascular option with angiographic and clinical success.
Cladribine tablets after treatment with natalizumab (CLADRINA) – rationale and design
Authors: Sguigna Peter V. , Hussain Rehana Z. , Okai Annette , Blackburn Kyle M. , Tardo Lauren , Madinawala Mariam , Korich Julie , Lebson Lori A. , Kaplan Jeffrey , Salter Amber , Manouchehri Navid , Stuve Olaf 
Published: April 2024

Background: Individual disease modifying therapies approved for multiple sclerosis (MS) have limited effectiveness and potentially serious side effects, especially when administered over long periods. Sequential combination therapy is a plausible alternative approach. Natalizumab is a monoclonal therapeutic antibody that reduces leukocyte access to the central nervous system that is associated with an increased risk of progressive multifocal leukoencephalopathy and disease reactivation after its discontinuation. Cladribine tablets act as a synthetic adenosine analog, disrupting DNA synthesis and repair, thereby reducing the number of lymphocytes. The generation of prospective, rigorous safety, and efficacy data in transitioning from natalizumab to cladribine is an unmet clinical need. Objectives: To test the feasibility of transitioning patients with relapsing forms of MS natalizumab to cladribine tablets. Design: Cladribine tablets after treatment with natalizumab (CLADRINA) is an open-label, single-arm, multicenter, collaborative phase IV, research study that will generate hypothesis regarding the safety, efficacy, and immunological impact of transition from natalizumab to cladribine tablets in patients with relapsing forms of MS. Methods and analysis: Participants will be recruited from three different sites. The primary endpoint is the absolute and percent change from baseline of lymphocytes and myeloid cell subsets, as well as blood neurofilament light levels. The secondary endpoint is the annualized relapse rate over the 12- and 24-month trial periods. Exploratory endpoints include the expanded disability status scale, and magnetic resonance imaging outcomes. Discussion: The CLADRINA trial will generate data regarding the safety, efficacy, and immunological impact of the transition from natalizumab to cladribine. As the pace of immunological knowledge of MS continues, insight into disease modifying therapy transition strategies is needed.
Subclinical atherosclerosis in multiple sclerosis
Authors: Marrie Ruth Ann , Patel Ronak , Schaffer Stephen Allan 
Published: April 2024

Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.
Recalibration of a Non-Laboratory-Based Risk Model to Estimate Pre-Diabetes/Diabetes Mellitus Risk in Primary Care in Hong Kong
Authors: Cheng Will H. G. , Dong Weinan , Tse Emily T. Y. , Chan Linda , Wong Carlos K. H. , Chin Weng Y. , Bedford Laura E. , Ko Wai Kit , Chao David V. K. , Tan Kathryn C. B. , Lam Cindy L. K. 
Published: April 2024

Introduction/Objectives: A non-laboratory-based pre-diabetes/diabetes mellitus (pre-DM/DM) risk prediction model developed from the Hong Kong Chinese population showed good external discrimination in a primary care (PC) population, but the estimated risk level was significantly lower than the observed incidence, indicating poor calibration. This study explored whether recalibrating/updating methods could improve the model’s accuracy in estimating individuals’ risks in PC. Methods: We performed a secondary analysis on the model’s predictors and blood test results of 919 Chinese adults with no prior DM diagnosis recruited from PC clinics from April 2021 to January 2022 in HK. The dataset was randomly split in half into a training set and a test set. The model was recalibrated/updated based on a seven-step methodology, including model recalibrating, revising and extending methods. The primary outcome was the calibration of the recalibrated/updated models, indicated by calibration plots. The models’ discrimination, indicated by the area under the receiver operating characteristic curves (AUC-ROC), was also evaluated. Results: Recalibrating the model’s regression constant, with no change to the predictors’ coefficients, improved the model’s accuracy (calibration plot intercept: −0.01, slope: 0.69). More extensive methods could not improve any further. All recalibrated/updated models had similar AUC-ROCs to the original model. Conclusion: The simple recalibration method can adapt the HK Chinese pre-DM/DM model to PC populations with different pre-test probabilities. The recalibrated model can be used as a first-step screening tool and as a measure to monitor changes in pre-DM/DM risks over time or after interventions.
Arthroscopic Shoulder Stabilization in High School Football Players
Authors: Stambaugh Jessica R. , Bryan Tracey P. , Edmonds Eric W. , Pennock Andrew T. 
Published: April 2024

Background: Destabilizing shoulder injuries are common in high school American football players; however, the rate of recurrent glenohumeral instability and return to play after arthroscopic labral stabilization surgery remains unknown. Purpose/Hypothesis: The purpose of this study was to determine the rate of recurrent instability on return to competitive high school football after arthroscopic shoulder labral stabilization and capsulorrhaphy procedures. It was hypothesized that the instability rate would be greater in players with more years of eligibility remaining (YER) to play at the high school level. Study Design: Case series; Level of evidence, 4. Methods: Consecutive male high school football players with at least 1 YER who sustained at least 1 anterior traumatic inseason shoulder instability episode and underwent arthroscopic stabilization between 2012 and 2017 were identified. Patients and/or families were contacted by phone to discuss (1) recurrent instability episodes and (2) return to competitive sport and/or recreational athletic activity. Statistical analysis was conducted using chi-square tests to compare recurrent shoulder instability with return to play and YER. Results: A total of 45 football players aged 14 to 17 years were included, with a mean follow-up of 4.1 years. Most patients (60%) chose not to return to competitive football, due mainly to fear of recurrent injury. Overall, the recurrent instability rate was 15.6% (7/45). The instability rate in players who returned to football was 16.7%, with 66.7% requiring revision surgery. The instability rate in patients who did not return to football was 14.8%, with no revision procedures required. In players who returned to football, the instability rate in YER group 4 was significantly higher than that in YER groups 1 to 3 (42% vs 10.5%, respectively, P = .03), with each year of play conferring an additional 10% risk of reinjury. There was a significant difference in the type of recurrent instability in players who returned to any sport versus those who did not ( P = .029). Conclusion: High school football players who returned to competitive play after arthroscopic shoulder stabilization surgery experienced a higher rate of recurrent instability that was dependent on their YER. Over half of the players chose not to return to football, with fear of reinjury being the most common reason.
Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study
Authors: Bowling C Barrett , Faldowski Richard A , Sloane Richard , Pieper Carl , Brown Tyson H , Dooley Erin E , Burrows Brett T , Allen Norrina B , Gabriel Kelley Pettee , Lewis Cora E 
Published: April 2024

Background Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Chronic conditions included arthritis, asthma, atrial fibrillation, cancer, end stage renal disease, chronic obstructive pulmonary disease, coronary heart disease, diabetes, heart failure, hyperlipidemia, hypertension, and stroke. Trajectory patterns were identified using latent class growth curve models. Results Mean age (SD) at baseline (1985-6) was 24.9 (3.6), 55% were female, and 51% were Black. The median follow-up was 30 years (interquartile range 25-30). We identified six trajectory classes characterized by when conditions began to accumulate and the rapidity of accumulation: (1) early-fifties, slow, (2) mid-forties, fast, (3) mid-thirties, fast, (4) late-twenties, slow, (5) mid-twenties, slow, and (6) mid-twenties, fast. Compared with participants in the early-fifties, slow trajectory class, participants in mid-twenties, fast were more likely to be female, Black, and currently smoking and had a higher baseline mean waist circumference (83.6 vs. 75.6 cm) and BMI (27.0 vs. 23.4 kg/m2) and lower baseline physical activity (414.1 vs. 442.4 exercise units). Conclusions A life course approach that recognizes the heterogeneity in patterns of accumulation of chronic conditions from early adulthood into middle age could be helpful for identifying high risk subgroups and developing approaches to delay multimorbidity progression.