bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiologic benefits of veno-pulmonary extracorporeal membrane oxygenation for COVID-19 ARDS: A single center experience
Authors: Grotberg John C , Greenberg Jon , Sullivan Mary , Pawale Amit A , Kotkar Kunal D , Masood Muhammad F 
Published: February 2024

Background: A subset of patients with COVID-19 acute respiratory distress syndrome (ARDS) require extracorporeal membrane oxygenation (ECMO). Veno-pulmonary (VP) ECMO provides support to the right ventricle and decreased risk of recirculation. Methods: A retrospective analysis of patients with COVID-19 ARDS and VP ECMO was performed. Patients were separated into groups by indication (1) “right ventricular (RV) failure,” (2) “refractory hypoxemia,” and (3) “recurrent suck-down events (SDEs).” Pre- and post-configuration vasoactive inotropic scores (VIS), fraction of inspired oxygen (FIO2), and resolution of SDEs were reported. A 90-day mortality was computed for all groups. Patients were also compared to those who underwent conventional venovenous (VV) ECMO. Results: Forty-seven patients underwent VP ECMO configuration, 18 in group 1, 16 in group 2, and 8 in group 3. Ninety-day mortality was 66% for the entire cohort and was 77.8%, 81.3% and 37.5% for groups 1, 2, and 3, respectively. Mean VIS decreased in group 1 (8.3 vs 2.9, p = 0.005), while mean FIO2 decreased in the group 2 and was sustained at 72 h (82.5% vs 52.5% and 47.5%, p < 0.001). Six of the eight (75%) of patients with recurrent SDEs had resolution of these events after configuration to VP ECMO. Patients with VP ECMO spent more days on ECMO (33 days compared to 18 days, p = 0.004) with no difference in mortality (66% compared to 55.1%, p = 0.28). Conclusion: VP ECMO in COVID-19 ARDS improves hemodynamics in patients with RV failure, improves oxygenation in patients with refractory hypoxemia and improves the frequency of SDEs.
Assessing the Landscape of Lactation Education: Results of a Pilot Survey
Authors: Lima Hope Katherine , Licata Ashley , Mattos Shondra 
Published: February 2024

Background: The field of lactation currently uses breastfeeding rates to measure effectiveness. While monitoring breastfeeding outcomes can provide insight into the successes of lactation consulting as a profession, the improvement of breastfeeding outcomes is a multifactorial issue. In order to facilitate the growth of lactation education processes, understanding experiences during training and perceptions of readiness of current International Board Certified Lactation Consultants (IBCLC) for clinical practice is necessary. Research Aim: The aim of this survey was to provide a baseline assessment of the current landscape of the lactation profession through data related to certification, job market, practice confidence after passing the International Board of Lactation Consultant Examiners (IBLCE) certifying examination, and perceptions of specializations. Methods: A cross-sectional study design was used to assess the experiences of practicing IBCLCs. Non-probability convenience sampling was implemented from December 2021 through January 2022. A total of 281 unique responses were recorded with complete data on variables of interest. Results: The majority of respondents were white females under age 50 located in the United States. The majority of respondents were certified through a Pathway 1. The largest barrier to certification was reported to be a lack of clinical/mentorship opportunities. Respondents were significantly more confident in providing entry-level support to dyads when mentored by four or more preceptors. Conclusion: Diversification of the field of lactation is necessary to provide appropriate support to lactating families in the United States. Additionally, addressing the barrier of accessing clinical/mentorship opportunities is essential for continued growth of the field of lactation.
Correlation between Cleft Width and Adjacent Teeth Inclination in Patients with Unilateral Cleft Lip and Palate Using CBCT: A Retrospective Study
Authors: Tayyar Reham Khaled , Khattab Tarek Z. 
Published: February 2024

Objectives To evaluate buccolingual and mesiodistal inclination of cleft-adjacent maxillary permanent central incisors (U1) and canines (U3) in patients with unilateral cleft lip and palate (UCLP) in the late mixed dentition and to investigate the correlation between the alveolar cleft width and cleft-adjacent teeth inclination using cone beam computed tomography (CBCT). Design Observational cross-sectional retrospective study. Setting Department of Orthodontics, Hama University Dental School. Patients 32 patients with UCLP (22 boys, 10 girls; mean age = 10.53 ± 1.51 years). Main Outcome Measure Buccolingual and mesiodistal inclination of maxillary central incisors and canines were measured on both sides. Then, the cleft and non-cleft sides were compared using the Wilcoxon signed-rank test. Pearson's correlation was used to explore the association between the alveolar cleft width and cleft-adjacent U1 and U3 buccolingual and mesiodistal inclination. Results The cleft-adjacent central incisors were significantly inclined lingually and distally compared with their non-cleft antimeres ( P = .003, P < .001, respectively). The cleft-adjacent canines were significantly inclined buccally and mesially compared with their non-cleft antimeres ( P < .001, for both). A positive correlation was found between the buccolingual inclination of cleft-adjacent U1 and the alveolar cleft width ( r = 0.49, P = .004). Conclusions Patients with UCLP demonstrated a significant lingual and distal inclination of cleft-adjacent U1 and a significant buccal and mesial inclination of cleft-adjacent U3. The buccolingual inclination of cleft-adjacent U1 tends to increase with increasing the alveolar cleft width; however, the correlation was weak.
Cataract surgery using two 3D visualization systems: Complication rates, surgical duration & comparison with traditional microscopes
Authors: Diakonis Vasilios F , Tsaousis Konstantinos T , Watson Caroline , Castellano Kirk , Weinstock Robert J 
Published: February 2024

Purpose To compare the complication rates and surgical duration of cataract surgery using two 3D visualization systems and a traditional binocular microscope among experienced and inexperienced surgeons. Methods This retrospective case series included 571 eyes that received cataract surgery using either heads up cataract surgery, via a 3D head mounted system ( N = 148–Group 1) or a 3D display screen ( N = 338 eyes–Group 2), or traditional binocular microscope ( N = 85 eyes–Group 3). The surgical records of consecutive patients who underwent cataract surgery by two groups of surgeons (experienced and inexperienced) were reviewed. Patients in all groups received either femtosecond laser assisted cataract surgery (FLACS) or traditional phacoemulsification. Complication rate, as well as duration of cataract surgery were evaluated between all three visualization approaches, between experienced and inexperienced surgeons. Results There was no statistically significant difference in duration of surgery between all 3 visualization approaches for both experienced and inexperienced surgeons ( p < 0.05). Furthermore, the type of surgical technique (manual or FLACS) did not affect the surgical duration for both experienced and inexperienced surgeons ( p < 0.05). No intraoperative complications were demonstrated in the current cohort. Conclusions The implementation of heads up–3D visualization either through a screen or a head mounted platform for cataract surgery seems to offer similar safety and efficiency as the traditional binocular microscope, and both experienced and inexperienced surgeons demonstrate the same outcomes in terms of safety and efficiency.
Characteristics associated with non-initiation and non-completion of human papillomavirus vaccination among Danish girls: a nationwide register-based cohort study
Authors: Algren Maria H. , Gazibara Tatjana , Valentiner-Branth Palle , Timmermann Amalie , Thygesen Lau C. , Tolstrup Janne S. 
Published: February 2024

Aim: The aim was to identify maternal and paternal socioeconomic and demographic characteristics for non-initiation and non-completion of the human papillomavirus (HPV) vaccination among Danish girls including time-trends. Methods: This nationwide register-based cohort study included all girls residing in Denmark who were offered free-of-charge HPV vaccination as a part of the childhood vaccination program between 2009 and 2018 (birth cohorts 1996–2005). The study samples included 296,461 daughter–mother dyads and 291,025 daughter–father dyads. Data from the Danish Vaccination Register were linked with socioeconomic and demographic data from Statistics Denmark. HPV vaccination status was classified as ‘non-initiation’ for girls who received no HPV vaccine and as ‘non-completion’ for girls who initiated the HPV vaccination program but did not receive all the scheduled HPV vaccines. Data were analyzed using logistic regression models. Results: Non-initiation of HPV vaccination was 13.7%, and non-completion was 24.2% among girls who initiated the HPV vaccination program. Girls of parents who were descendants of immigrants (adjusted odds ratio: 1.50; 95% confidence interval: 1.35–1.68), were at least 35-years old at time of birth, had basic or no education, had a low income, were not in the labor market, and were unmarried had the highest non-initiation and non-completion odds. The associations between socioeconomic and demographic characteristics and HPV vaccination uptake were similar for mothers and fathers. Conclusions: Despite free-of-charge availability to HPV vaccination in Denmark, we found disparities in non-initiation and non-completion of HPV vaccination among Danish girls by both mothers’ and fathers’ socioeconomic and demographic characteristics.
Validity and reliability of the Dutch version of the S3-NIV questionnaire to evaluate long-term noninvasive ventilation
Authors: Seijger Charlotte GW , Vosse Bettine AH , la Fontaine Leandre , Raveling Tim , Cobben Nicolle AM , Wijkstra Peter J 
Published: February 2024

Objectives Noninvasive ventilation (NIV) is an effective treatment for chronic respiratory failure (CRF). Patient-centered outcomes need to be evaluated regularly and the S3-NIV questionnaire seems an applicable tool. We translated this short, self-administered questionnaire into a Dutch version and tested its construct validity and reliability. Methods An observational study was conducted, including 127 stable long-term NIV users with CRF or complex sleep related breathing disorders due to different underlying diseases: chronic obstructive pulmonary disease (25%), slowly progressive neuromuscular disorders (35%), rapidly progressive neuromuscular disorders (12%) and ‘other disorders’ (28%) including complex sleep apnea and obesity hypoventilation syndrome. Construct validity and reliability were tested. Results The Dutch version of the questionnaire was obtained after a translation and back-translation process. Internal consistency of the total score was good (Cronbach’s α coefficient of 0.78) as well as for the ‘respiratory symptoms’ subdomain and the ‘sleep and side effects’ subdomain (Cronbach’s α coefficient of 0.78 and 0.69, respectively). The reproducibility was excellent with an intraclass correlation of 0.89 (95% CI 0.87-0.93). Construct validity was good for the ‘respiratory symptoms’ subdomain. Conclusion The Dutch S3-NIV questionnaire is a reliable and valid tool to evaluate symptoms, sleep, and NIV related side effects in long-term NIV users.
Which Tests Should Be Routinely Ordered Prior to Brachial Plexus Reconstruction? Results of a Delphi Panel
Authors: Dy Christopher J. , Antes Alison L. , Sisk Bryan A. ,   PLANeT Study Group
Published: February 2024

Background: There are notable differences in how adult patients with traumatic brachial plexus injuries (BPI) are evaluated and treated. Purpose: To better understand existing philosophies, we used the Delphi method to measure and foster consensus on routine use of electrodiagnostic testing, ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) myelograms prior to surgery. Panelists were 10 peripheral nerve surgeons board certified in their respective specialties at 5 academic medical centers in the United States. Methods: We presented 2 cases (1 complete/pan-BPI and 1 upper trunk BPI) to panelists and asked how often they would order the following preoperative diagnostic tests: electrodiagnostic studies; ultrasound of the brachial plexus; MRI of the brachial plexus; CT myelogram. Our Delphi process included an initial survey with videoconference discussion after the first round. A second survey/videoconference round was conducted to further probe the items that did not reach consensus during the first round. Results: Among the 10 surgeons, there was consensus that prior to brachial plexus surgery electrodiagnostic studies and MRI should be routinely ordered and ultrasound of the brachial plexus should not be routinely ordered. The group did not reach consensus on whether CT myelogram should or should not be routinely ordered. Conclusions: Based on our panel’s discussion, future work should focus on comparing the accuracy of CT myelogram and MRI for evaluation of cervical nerve root presence and viability.
A novel risk assessment tool for postoperative delirium in vascular surgery: The stress model (Siena posTopeRative dElirium in vaScular Surgery)
Authors: Pasqui Edoardo , de Donato Gianmarco , Brancaccio Brenda , Casilli Giulia , Ferrante Giulia , Palasciano Giancarlo 
Published: February 2024

Objective Postoperative delirium (POD) is a common complication with a high health-related impact. The creation of a model (Siena posTopeRative dElirium in vaScular Surgery) to identify high-risk patients with consecutive prompt diagnosis and correct management. Methods This is an observational retrospective study to evaluate POD incidence in patients who underwent elective vascular surgery procedures between 2018 and 2020. POD was detected using CAM and defined as the onset of an acute confusional state, clinically manifesting as a disturbed state of consciousness, cognitive dysfunction, or alteration in perception and behavior. The total population was divided in the development and validation subsamples. Multivariable logistic regression analysis was performed, identifying variables related to the occurrence of POD. An additive score was created and the STRESS score was internally validated using the Validation subgroup. Results A total of 1067 patients were enrolled. POD occurred in 111 cases (10.4%). Multivariable logistic regression analysis for POD occurrence revealed as significant predictors: age>75 years, CKD, dyslipidaemia, psychiatric disease, CAD, hospitalization in the previous month, preoperative NLR >3.59, preoperative Hb < 12 g/dl, preoperative Barthel score <75, major amputation, CLTI revascularization, general anesthesia, and postoperative urinary catheter. These variables were used to create the STRESS score. The model was applied to both development and validation subgroups; AUC was respectively 0.7079 ( p < .0001) and 0.7270 ( p < .0001). Conclusion The STRESS score has a good predictive potentiality for POD occurrence in elective vascular surgery procedures. However, implementation and external validation are needed to be correctly used in everyday clinical practice.
Epidemiology, clinical features and prognostic factors in patients with Covid-19 and acute limb ischaemia – A single center study
Authors: Ciumanghel Irina , Buzincu Iulian , Ciumanghel Adi Ionut , Barbuta Eliza , Cimpoesu Diana 
Published: February 2024

Background The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period. Methods This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1st, 2020 and February 28th, 2022 with ALI and Covid-19. Results During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1.14% of all with Covid-19) presented ALI. The mean age was 70.9 ± 10.23 and 67.3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22.6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3.3; 68, p < .01), lymphopenia 96% versus 70% (OR 10.2, CI 1.30; 80.9, p < .01), a NLR over 9.77% versus 30% (OR 7.5, CI 2.6; 21.4, p < .01), acidosis 65% versus 33% (OR 3.8, CI 1.4; 9.7, p < .01), abnormal AST, 69% versus 29% (OR 5.4, CI 2; 14.5, p < .01) and secondary amputation, 38.5 versus 11.1% (OR 5, CI 1.7; 14.7, p < 0.1). Overall, the mortality rate was 26.5%. Conclusion The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1.14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.
Exploring an Effective International Higher Education Partnership Model Through Virtual Student Mobility Programs: A Case Study
Authors: Enkhtur Ariunaa , Zhang (张希西) Xixi , Li (李明) Ming , Chen (陈丽兰) Lilan 
Published: February 2024

Purpose This study examined the role of virtual student mobility (VSM) programs in developing international education partnerships and explored key factors for building successful transnational partnerships. Design/Approach/Methods Drawing on Yin’s case study approach, we explored several VSM programs offered by a Japanese national university in partnership with four research universities in China. Data sources included an autoethnographic account of planning and organizing virtual exchange programs and interviews with the partner universities’ virtual exchange program coordinators as well as with students who took different virtual exchange courses under the partnership. Findings Our case study showed that VSM models require significant collaboration, support, and commitment from universities to offer high-quality exchange programs. The initial establishment of VSM programs relies on existing relationships, clear communication, and a commitment to collaborate; however, VSM programs’ success depends heavily on the quality of online support, as well as inter-university communication and collaboration between administrators and faculty and intra-university communication and collaboration with partner universities. Based on the research results and the previous literature on international higher education partnerships, we propose a renewed partnership model in VSM comprising three main characteristics: (1) effective coordination and support, (2) effective communication, and (3) a commitment to partnership. Originality/Value Amidst emerging VSM models in higher education, this study contributes to the literature by proposing a renewed partnership model for sustaining VSM programs.
What Is the Evidence Supporting Osteobiologic Use in Revision Anterior Cervical Discectomy and Fusion?
Authors: Muthu Sathish , Diniz Sara Elisa , Viswanathan Vibhu Krishnan , Hsieh Patrick C. , Abedi Aidin , Yoon Tim , Meisel Hans Jörg , Buser Zorica , Rodrigues-Pinto Ricardo , Knowledge Forum Degenerative AO Spine 
Published: February 2024

Study design Systematic literature review Objective To analyze the literature and describe the evidence supporting osteobiologic use in revision anterior cervical discectomy and fusion (ACDF) surgery. Methods A systematic search of PubMed/MEDLINE, EMBASE, Cochrane library, and ClinicalTrials.gov databases was conducted for literature reporting the use of osteobiologics in revision ACDF. We searched for studies reporting outcomes of using any osteobiologic use in revision ACDF surgeries (independently of the number of levels) in the above databases. Results There are currently no studies in the literature describing the outcome and comparative efficacy of diverse osteobiologic agents in the context of revision ACDF surgery. A majority of the current evidence is based only upon studies involving primary ACDF surgery. Conclusion The current study highlights the paucity of literature evidence on the role of diverse osteobiologics in revision ACDF, and foregrounds the need for high-quality evidence on this subject.
Fracture resistance evaluation of CAD/CAM zirconia and composite primary molar crowns with different occlusal thicknesses
Authors: Bolaca Arif , Erdoğan Yıldırım 
Published: February 2024

Objective: To evaluate the effect of different CAD/CAM materials and occlusal thicknesses on the fracture resistance of primary molar crowns. Methods: Sixty extracted primary molar teeth were prepared and randomly divided into six experimental groups according to the material and thickness. Primary molar crowns with a central groove thickness of 0.3 and 0.5 mm were fabricated from CAD/CAM zirconia (group Z), zirconia-reinforced lithium silicate (group ZLS), and pre-polymerized composite resin blocks (group C). Each crown was cemented with self-adhesive resin cement on the prepared tooth. All specimens were subjected to fracture tests until fracture. Fracture load values were recorded in Newtons (N). Data were statistically analyzed using a two-way analysis of variance (ANOVA) followed by Tukey multiple comparison test. Results: The highest fracture load values were obtained in group Z at 0.5 mm occlusal thickness and were significantly higher compared with the other experimental groups ( p < 0.05). Although the lowest fracture load values were obtained in group ZLS at 0.3 mm occlusal thickness, all the tested CAD/CAM primary molar crowns at both thicknesses demonstrated fracture load values exceeding reported chewing force in pediatric patients. Conclusion: CAD/CAM primary molar crowns with reduced occlusal thickness may be used for the full-coverage restoration of primary molar teeth.