bluuebunny/crossref_metadata_2025_split huggingface dataset:
DELAYED CLOSURE OF A FULL-THICKNESS MACULAR HOLE AFTER PARS PLANA VITRECTOMY WITH INTERNAL LIMITING MEMBRANE FLAP
Authors: Ahmed Shahanaz B. , Shaikh Sufiyan , Ho Jason 
Published: December 2023

Background/Purpose:
The aim of this study is to describe a patient with delayed closure of a stage 3 full-thickness macular hole after pars plana vitrectomy.

Methods:
This is a retrospective case report. Details of the case were obtained from the electronic patient record system, Medisoft.

Results:
A 65-year-old man was referred with a left stage 3 full-thickness macular hole measuring 720 μm and visual acuity of 6/36. He underwent phacovitrectomy, internal limiting membrane peel with an inverted internal limiting membrane flap, and C3F8 gas tamponade. Seven weeks after surgery, the macular hole was smaller at 196 μm but remained open. The patient was listed for repeat surgery; however, another 13 weeks later, the full-thickness macular hole demonstrated type 2 closure without further intervention.

Conclusion:
Delayed macular hole closure after pars plana vitrectomy is rare. In cases where there has been a substantial decrease in the size of a full-thickness macular hole after surgery without full closure, a short period of observation to allow for further closure may be appropriate before reconsidering surgery.
A CASE OF HYPERTENSIVE UVEITIS WITH INTRAVITREAL FARICIMAB
Authors: Kitson Samantha , McAllister Andrew 
Published: December 2023

Purpose:
The aim of this study was to report a novel case of hypertensive uveitis with intravitreal faricimab.

Methods:
This is a case report. A 69-year-old woman undergoing treatment of bilateral diabetic macular edema with intravitreal faricimab presented for routine review. Ophthalmic examination was performed including VA, intraocular pressure, gonioscopy, and slitlamp examination. Findings consistent with hypertensive uveitis prompted further infectious/inflammatory/infiltrative uveitis screen.

Results:
The patient developed hypertensive uveitis in the left eye (four weeks after the third injection) with an intraocular pressure of 42 mmHg. Slitlamp examination revealed fine keratic precipitates and mild anterior uveitis. Anterior chamber angle was open on gonioscopy, and there was no vitritis or vasculitis. At the review a week later, the patient had developed hypertensive uveitis in the right eye (six weeks after the fourth injection) with intraocular pressure of 35 mmHg. Slitlamp examination revealed fine keratic precipitates, open angles, and mild vitritis. There was no vasculitis. At both presentations, the patient had preserved VA with no significant visual symptoms. The hypertensive uveitis resolved in both eyes with a course of steroid and antihypertensive eye drops. The uveitis screen was negative apart from elevated urine protein (negative beta-2 microglobulin), which could be explained by known diabetes and hypertension.

Conclusion:
Hypertensive uveitis is a potential adverse reaction to intravitreal faricimab. This case highlights the importance of monitoring intraocular pressure in patients undergoing treatment with faricimab and emphasizes the need for reporting other cases in the community.
What do health care professionals, students, and laypeople in Greece believe about informed consent for research on medical practices? Unleashing Pandora's box
Authors: Giannouli Vaitsa 
Published: December 2023

Abstract

Background:
Attitudes toward informed consent for research on medical practices has been little investigated in Greece in the general population as well as in health care students and professionals, and at the same time, undergraduate and postgraduate curricula with focus on informed consent issues are entirely missing.

Methods:
To explore attitudes toward informed consent for research on medical practices among students, doctors, and laypeople in Greece across several demographic variables. A total of 380 participants (180 first-year healthcare university students from various faculties including medicine, pharmacy, biology, nursing, physiotherapy, midwifery, health care engineers, 100 medical doctors of various specialties working in hospitals and private practice, and 100 laypeople) completed a survey questionnaire along with a detailed demographics questionnaire.

Results:
The results revealed that between the three groups, there were statistically significant differences in the responses for all aspects of attitudes toward informed consent. Overall, Greek participants reported more negative attitudes when compared with findings from the United States. In addition, most of the participants reported lack of educational experience regarding informed consent.

Conclusion:
The findings showed that the efforts and relevant initiatives by the Greek State, private institutions, and the Greek Medical Societies should refocus and emphasize on educational programs concerning the dissemination of relevant scientific information on informed consent processes, either as a provider or as a consumer. Future research should further investigate in more depth the complex influence of additional social and/or psychological factors for the reported differences.
Percutaneous gastrostomies in advanced cancer
Authors: Ferraz-Gonçalves José António , Amaral Susana , Pereira Filipa , Santos Lígia Rodrigues , Assis José Guilherme , Alves Sérgio , Martins Diana 
Published: December 2023

Abstract

Introduction:
Gastrostomies can be performed percutaneously by interventional radiology (PRG) or endoscopy (PEG).

Methods:
Retrospective analysis of patients with advanced cancer who underwent a gastrostomy in 2017 in an oncology center.

Results:
In 2017, 164 patients underwent gastrostomies, and 137 (84%) were male. The median age was 60 years (range: 38–91). The predominant Eastern Cooperative Oncology Group (ECOG) performance status stage was 1, with 73 (45%) patients. Head and neck cancer was the most common diagnosis, with 127 (77%) cases. The most frequent reason for performing a gastrostomy was dysphagia, 132 (81%). Most gastrostomies were PEG, 121 (74%), followed by PRG, 41 (25%), and surgery, 2 (1%). Early complications occurred in 86 (52%) patients, and the most frequent of them were local pain in 69 (80%) patients and minor local bleeding in 13 (15%). Late complications occurred in 90 (55%) patients, and the most frequent was also local pain in 57 (63%) patients, followed by local infection in 8 (9%), tube extrusion in 7 (8%), and stomal leakage in 7 (8%). In the multivariable analysis, the factors associated with survival were lymph node metastases and the ECOG performance status. Until June 30th, 2022, 123 (75%) patients had died, and 41 (25%) were still alive.

Conclusion:
Gastrostomies were performed predominantly in ECOG performance stage 1 patients with head and neck cancer and symptoms of dysphagia, and PEG was the most common procedure.
Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a Portuguese hospital
Authors: Ruas Rogério , Palma Pedro , Lamas Fátima , Ruivo Anunciação , Malheiro Rui , Ferraz Rita 
Published: December 2023

Abstract

Background:
Health care workers (HCW) are presumably exposed to a higher risk of infection by SARS-CoV-2 and could possibly represent a source of transmission to susceptible patients. Thus, characterization of SARS-CoV-2 infection among HCW is necessary to better understand the determinants of viral transmission and properly implement strategies to prevent dissemination and protect HCW and vulnerable patients. The aim of this study was to estimate the seroprevalence of antibodies against SARS-CoV-2 in a Portuguese tertiary hospital, in the period of July 2020 to March 2021, before the generalized use of the SARS-CoV-2 vaccine, characterize its evolution over time, and identify risk factors associated with seroconversion.

Methods:
HCW were approached to collect serum samples for qualitative SARS-CoV-2 antibody testing and completion of an online survey capturing demographics, previous symptoms, and details of health care and community exposure. Odds ratio with bivariable and multivariable logistic regression was used to assess characteristics associated with seroprevalence.

Results:
One thousand HCW were included for analysis. Two hundred nineteen HCW (22%) were seropositive for immunoglobulin G against SARS-CoV-2, and 166 (17%) were seropositive for immunoglobulin M, most of whom reported a previous diagnosis of SARS-CoV-2 infection. The risk factors associated with seroconversion included a previous COVID-19 diagnosis, contact with patients, occupational contact with colleagues, and outside contact. However, in a multivariate logistic regression analysis, only a previous diagnosis and outside contact were associated with seroconversion. Seropositivity decreased over time, especially 28 weeks after infection.

Conclusion:
HCWs have a high seroprevalence for SARS-CoV-2 infection, probably due to a combination of health care and community exposure. Seropositivity decreases over time, but further studies are needed to better understand our adaptive immune response.
Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance
Authors: Bachand Marie-Pier , Chennouf Mohamed-Anas , Malick Mandy , Beaudoin Annie 
Published: December 2023

Objectives:
Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy.

Methods:
We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS, from 2004 to 2018.

Results:
The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months (interquartile range [IQR] 28.6–73.3 months). Mean age at diagnosis was 65.5 years [27–90], 159 patients (42.8%) were male and 17 patients (4.5%) underwent resection of their lesion during their surveillance period. In our cohort, 132 patients (34.7%) had a follow-up of >5 years. Overall risk of malignancy was 2.1% [0.9%–4.1%]. During follow-up, neoplastic transformation was observed in 2 of 132 patients (1.5%) surveilled >5 years. Malignancy was significantly associated with cyst growth >2.5 mm/y (57.1% vs 5.8%; P < .001) dilated MPD (71.4% vs 4.9%; P < .001), solid component (71.4% vs 1.3%; P < .001), positive cytology (37.5% vs 0.5%; P < .001), development of high-risk stigmatas (87.5% vs 1.9%; P < .001), or worrisome features (87.5% vs 23.9%; P < .001) during follow-up and symptoms of jaundice (25% vs 0.5%; P = .002) and abdominal pain (50% vs 9.4%; P = .005).

Conclusion:
While overall malignancy risk remains low in presumed BD-IPMN, continuous surveillance should be pursued after 5 years in surgically fit individuals, particularly in patients who develop our identified risk factors.
The Effects of Pediatric Experiential Learning During a 1-Week Intensive
Authors: Lowe Leah , Flowers Meredith , Yates Charlotte 
Published: December 2023

Background and Purpose.
Growing evidence supporting the effectiveness of pediatric experiential learning (EL) in physical therapist education programs suggests that EL can aid in the development of students' clinical reasoning (CR) and self-efficacy (SE). Previous studies indicate that pediatric EL provides students with structured learning opportunities that may lead to meaningful gains in psychomotor skills, self-confidence, communication, and CR. Whether gains can be achieved during a pediatric intensive course rather than a semester-long course is unknown. The purpose of this research was to evaluate the change in perceived CR and SE experienced by physical therapist students who completed a high-dose (at least 15 hours) EL pediatric-intensive (1 week).

Case Description.
Second-year physical therapist students (n = 18) enrolled in the Advanced Pediatric Elective Intensive completed the Self-Assessment of Clinical Reflection and Reasoning (SACRR) and the Physical Therapy Self-Efficacy Scale (PTSE) on the first and last day of the course.

Outcomes.
A paired-samples t test revealed a statistically significant increase in SACRR scores from pre-test (M = 91.29, SD = 8.04) to post-test (M = 102.88, SD = 7.06), t (16) = 7.30, P < .001, as well as PTSE scores from pre-test (M = 13.44, SD = 2.64) to post-test (M = 19.00, SD = 2.06), t (17) = 9.70, P < .001. The results of this research suggest that active teaching methods, such as EL, may contribute to improvements in physical therapist students' perceived CR and SE.

Discussion and Conclusion.
Educators could consider a week-long EL intensive as a feasible and effective option to increase physical therapist students' perceived CR and SE related to pediatric physical therapy practice.
Anaphylactic shock following the mad honey consumption: a case report
Authors: Jha Bhaskar , Jha Apurwa , Karki Shailendra , KC Pooja , Pandey Anish , Ghimire Abishkar , Acharya Bimarsh 
Published: December 2023

Introduction:
Mad honey consumption is a common practice in Nepal for medicinal and consumption purposes, but it can lead to severe adverse effects. Grayanotoxin I and Grayanotoxin III isoforms found in rhododendron interfere with voltage-gated sodium channels resulting in gastrointestinal symptoms, and cardiovascular effects such as low blood pressure, abnormal heart rhythms, cardiac arrest, and abnormal electrical conduction in the heart, as well as rare central nervous system disorders. Here the authors report a case of Mad honey consumption leading to anaphylactic shock along with its investigations and management.

Case presentation:
The authors present a case of a 51-year-old female who developed anaphylactic shock after consuming mad honey. The patient experienced symptoms including nausea, vomiting, abdominal pain, sweating, dizziness, facial and lip swelling, but no chest pain, loss of consciousness, abnormal body movement, or dyspnoea. The patient had no prior medical conditions, regular medications, or history of allergic reactions to honey or pollen.

Discussion:
Mad honey intoxication is caused by grayanotoxins, with distinct cardiac effects for different types of grayanotoxins. Symptoms include bradycardia, hypotension, abdominal pain, dizziness, and nausea, which subsided within 24 h following the initial management. The presence of grayanotoxin can be detected using specialized instrumentation, but it may not be available in all medical facilities. Co-intoxication with alcohol or propolis may also occur.

Conclusion:
This case highlights the importance of recognizing and managing complications associated with mad honey consumption, particularly in regions where it is prevalent. Prompt medical attention is advised if unusual symptoms occur after honey consumption.
Antibiotics use among residents in Eastern Nepal: a community-based mixed method study
Authors: Acharya Rochana , Panthi Sagar , Khatiwada Pradeep , Bhattarai Bharosha , Singh Sweta , Bhattarai Karun , Aryal Rashmi , Neupane Durga , Thapa Anish , Karki Kamala , Basnet Lila Bahadur , Khanal Vijay Kumar , Ghimire Anup 
Published: December 2023

Introduction:
According to the WHO, more than two-thirds of all antibiotics are used in the community, of which about 30% are used inappropriately. The antimicrobial resistance (AMR) problem is a growing threat to Nepal because of indiscriminate and inappropriate use. However, exact data on the extent of inappropriate use of antibiotics in the community is scarce in Nepal.

Objectives:
To know the extent of inappropriate use of antibiotics among the community and their knowledge and practice towards the usage of antibiotics.

Methods:
A community-based cross-sectional study was conducted from 20 December 2017 to 20 March 2018 using a purposive sampling technique. A semi-structured questionnaire was used while conducting face-to-face interviews with 336 respondents to find out the knowledge and practice regarding antibiotic use. Investigators took different antibiotics (in all dosage forms) with them to show participants whether they knew and/or used the antibiotics in the last year.

Results:
The mean age of respondents with standard deviation was 39.87±13.67 years ranging from 18 to 84 years. Around 35.42% of respondents were farmers and 34.52% were homemakers. 28.87% of respondents were illiterate, 32.44% had primary education and 33.33% had secondary education. Almost half of them (48.51%) think that antibiotics are safe and can be commonly used. So, 43.15% of them preferred taking antibiotics when they had a common cold. The majority of the participants (81.84%) did not have any idea about antibiotic resistance. 94.6% of the respondents used antibiotics inappropriately.

Conclusion:
The results of the present study revealed that inappropriate use of antibiotics is high and associated with low earning wages in both males and females in the age group 18–39 years.
The Relationship Among Seasonality, Night Eating, and Chronotype in Bipolar Disorder
Authors: Sağlam Nazife Gamze Usta , Beştepe Engin Emrem , Sertler İlke , Kurnaz Samet , Ayık Batuhan , Poyraz Cana Aksoy 
Published: December 2023

Abstract
The purpose of the study was to explore the association among chronotype, seasonality, sleep quality, and night eating syndrome (NES) among patients with bipolar disorder (BD) and the mediating role of sleep quality in this relationship. Ninety-two individuals with BD type 1 who had been euthymic for at least 8 weeks and 87 healthy controls were included. In addition to sociodemographic/clinical data, chronotype, seasonality, sleep quality, and NES were evaluated using the Morningness-Eveningness Questionnaire (MEQ), Seasonal Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index, and Night Eating Questionnaire. The prevalence of NES (17.4%) was higher among BD than the controls. BD patients with NES had poorer sleep quality, greater seasonality, and lower MEQ scores. Chronotype had an indirect effect that was partially mediated by sleep quality on night eating symptoms in BD patients, in addition to a direct effect. Seasonality was found to have a direct effect on night eating symptoms. Therapeutic interventions that target both sleep and circadian disruption should be implemented when addressing NES in patients with BD.
Statistical Considerations for Subjective Visual Vertical and Subjective Visual Horizontal Assessment in Normal Subjects
Authors: Balaban Carey D. , Williams Erin , Holland Cynthia L. , Kiderman Alexander , Kontos Anthony P. , Hoffer Michael E. 
Published: December 2023

Objectives:
Judgments of the subjective visual vertical (SVV) and subjective visual horizontal (SVH) while seated upright are commonly included in standard clinical test batteries for vestibular function. We examined SVV and SVH data from retrospective control to assess their statistical distributions and normative values for magnitudes of the preset effect, sex differences, and fixed-head versus head-free device platforms for assessment.

Methods:
Retrospective clinical SVV and SVH data from 2 test platforms, Neuro-otologic Test Center (NOTC) and the Neurolign Dx 100 (I-Portal Portable Assessment System Nystagmograph) were analyzed statistically (SPSS and MATLAB software) for 408 healthy male and female civilians and military service members, aged 18–50 years.

Results:
No prominent age-related effects were observed. The preset angle effects for both SVV and SVH, and their deviations from orthogonality, agree in magnitude with previous reports. Differences attributable to interactions with device type and sex are of small magnitude. Analyses confirmed that common clinical measure for SVV and SVH, the average of equal numbers of clockwise and counterclockwise preset trials, was not significantly affected by the test device or sex of the subject. Finally, distributional analyses failed to reject the hypothesis of underlying Gaussian distributions for the clinical metrics.

Conclusions:

z scores based on these normative findings can be used for objective detection of outliers from normal functional limits in the clinic.
Study on the Incidence of Congenital Genitourinary System Malformations in Congenital Microtia Patients
Authors: Gao Dejin , Liu Tun , Wang Bingqing , Zhang Qingguo 
Published: December 2023

Objective:
Study the incidence of genitourinary malformations combined with microtia, find the regularity of the disease, and analyze the correlation between them.

Methods:
There is a total of 3143 microtia patients from January 2015 to December 2019 in Plastic Surgery Hospital. We examined their renal ultrasound, counted cases with genitourinary system deformities, and calculated the incidence of the disease.

Results:
Among 3143 patients with congenital microtia, there were 163 patients with congenital genitourinary system malformations, accounting for 5.2%. The side of congenital microtia is associated with the side of congenital genitourinary malformations.

Conclusions:
Genitourinary malformations occur more frequently in patients with microtia than in the general population. The 2 malformations are more likely to be ipsilateral. We believe it is necessary to complete the systemic physical and renal ultrasound examination for patients with microtia.
Prevalence of Person-First Language in Idiopathic Intracranial Hypertension: A Systematic Review of Case Reports
Authors: Vosoughi Amir R. , Pandya Bhadra U. , Mezey Natalie , Tao Brendan K. , Micieli Jonathan A. 
Published: December 2023

Background:
Person-first language (PFL) is a linguistic prescription, which places a person before their disease. It is considered an important tool to reduce stigma. However, PFL is not routinely used across the scientific literature, particularly in patients with overweight or obesity. Patients with idiopathic intracranial hypertension (IIH) face various stigmas through high rates of poverty, female gender, and frequent rates of comorbidities. Non-PFL language use intersects and worsen the health inequities faced by these patients.

Methods:
A systematic review of case reports. MEDLINE and EMBASE were searched for all case reports with “pseudotumor cerebri” [MESH] OR “Idiopathic Intracranial Hypertension” as key word between January 1974 and August 2022. The primary criterion was the article's inclusion of patients with overweight or obesity. The secondary criterion was the article's discussion regarding obesity as risk factor. Articles not meeting primary or secondary criteria were excluded.

Results:
Approximately 514/716 (71.8%) articles used non-PFL language. The publication year was predictive of non-PFL language: 1976–1991 (82.3%) vs 1992–2007 (72.3%, P = 0.0394) and 2008–2022 (68.3%, P = 0.0056). Non-PFL was significantly higher in obesity compared with other medical conditions (60.3% vs 7.3%, P < 0.001). The patient gender (P = 0.111) and ethnicity (P = 0.697), author's specialty (P = 0.298), and primary English-speaking status (P = 0.231), as well as the journal's impact factor (P = 0.795), were not predictive of non-PFL.

Conclusions:
Most literature focused on IIH use non-PFL when discussing overweight or obesity, regardless of the patient's gender and ethnicity, journal's impact factor, senior author's specialty, and English-speaking status. Non-PFL use is much more common when discussing obesity compared with other medical conditions. Appropriate use of PFL can decrease stigma and, more importantly, decrease the intersectionality of health stigma faced by patients with IIH.