bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of toric intraocular lens calculation with the integrated K method and three single biometric devices
Authors: Shah Yachana , Jacques Angela , Or Lior , Barrett Graham 
Published: November 2023

Purpose:To compare astigmatic outcomes using the Integrated K method and anterior surface keratometry from 3 different biometric devices.Setting:Lions Eye Institute, Perth, Australia.Design:Retrospective case series.Methods:Eyes of patients who underwent uneventful cataract surgery were analyzed. Predicted postoperative astigmatism was calculated for Integrated K method, IOLMaster 700, Lenstar and Pentacam. The mean centroid error in predicted postoperative refractive astigmatism (PE), mean absolute PE and percentage of eyes within 0.5 diopter (D), 0.75 D and 1 D of absolute magnitude of PE were compared. A subset analysis was done where the difference in cylinder magnitude between the 2 methods was more than 0.25 D. Spherical prediction outcomes were also analyzed.Results:241 eyes of 139 patients were included in the study. The mean centroid PE of Integrated K method (−0.07 @ 69) was significantly different from IOLMaster and Pentacam. The mean absolute PE with Integrated K method (0.33 ± 0.17) was significantly lower than all 3 devices. The percentage of eyes within 0.5 D and 0.75 D of absolute magnitude of PE was 82% and 99% for Integrated K method, 76% and 95% for IOLMaster and Lenstar, and 60% and 86% for Pentacam. In the subset analysis, the improvement in accuracy of the Integrated K method compared with a single device was greater in terms of the percentage of eyes predicted within 0.5 D. The Integrated K method did not impact the spherical prediction outcomes.Conclusions:The integrated K method is more accurate and precise than anterior surface keratometry from a single biometric device.
The “Hitch-Stitch” for Preventing High Tracheal Stent Migration
Authors: Bansal Sameer , Kumar Samiksha S. , Loknath Chakravarthi , Kalpakam Hariprasad , Singla Abhinav , Mehta Ravindra M. 
Published: November 2023

Background:
Airway stenting is a standard treatment option for tracheo-bronchial obstruction and other conditions like tracheo-esophageal fistula (TEF).

Methods:
To prevent stent migration, a percutaneous fixation strategy called the “hitch-stitch” was described in 2016 as an efficient technique. We describe an extended experience of the “hitch-stitch” for silicone stents in high tracheal stenting situations and expanding indications to metal stents.

Results:
Seventy-four percutaneous stitches were placed in 54 patients (36 males and 18 females). The mean age of the patients was 42 (±19) years. The indication for stenting was tracheal stenosis in 63/74 (85%) cases and TEF in 11/74 (15%) cases. Silicone stents were used in 56/74 (75.5%) cases while self-expanding metal stents (SEMS) were used in 18/74 (24.5%) cases. The majority of the stents (62/74, 85%) were high tracheal stents. The “hitch-stitch” as an anti-migration strategy had a high success rate, with distal stent migration in only 2 cases (2.7%) as the stitch had given way—these were repositioned and hitched with double stitches. Minor complications included delayed skin healing (2.8%) and suture site infection (1.4%), which was successfully managed with oral antibiotics. Stitch removal was easy with no complications.

Conclusion:
In this large series of percutaneous “hitch-stitch” as a stent migration prevention strategy, long-term data shows it is safe and effective in an expanded cohort of silicone stents. Its extended utility is the successful application to metal stents, especially in TEF, where the consequences can be deleterious. It is simple to do, with minimal extra requirements and not associated with any significant complications.
FIB-4 Reliability in Patients With Severe Obesity
Authors: Green Victoria , Lin Joanne , McGrath Morgan , Lloyd Aaron , Ma Pearl , Higa Kelvin , Roytman Marina 
Published: November 2023

Background:
Liver biopsy is the gold standard to evaluate hepatic fibrosis; however, it has many drawbacks, especially in patients with severe obesity. Noninvasive testing such as the FIB-4 score is increasingly being used as the initial screening tool to identify patients at risk for advanced fibrosis. The broader applicability of FIB-4 and the precision of its cutoff values remain uncertain in metabolic dysfunction-associated steatotic liver disease and patients with severe obesity. Our study explored the correlation between FIB-4 scores and intraoperative liver biopsy in patients with severe obesity undergoing bariatric surgery.

Methods:
A total of 632 patients with severe obesity underwent preoperative vibration-controlled transient elastography and intraoperative liver biopsy during bariatric surgery from January 2020 to August 2021. Variables collected included patient demographics, laboratory values, abdominal ultrasound, vibration-controlled transient elastography, and liver biopsy results. ANOVA 1-way test, χ2 tests, and Fisher exact tests were used for quantitative and qualitative variables, respectively. The 95% CIs for the mean FIB-4 scores were used to generate surrogate cutoff values. The proposed FIB-4 cutoffs for F0-1, F2, F3, and F4 were 0.62 (CI: 0.59, 0.64), 0.88 (0.74, 1.01), 1.24 (0.94, 1.54), and 1.53 (0.82, 2.24), respectively. Area under the curve (AUC) methods were used to compare traditional to proposed cutoff values.

Results:
Applying the traditional FIB-4 cutoffs to approximate advanced fibrosis yielded an AUC of 0.5748. Use of the proposed FIB-4 cutoffs increased the AUC to 0.6899. The proposed FIB-4 cutoffs correctly identified 40 patients with biopsy-proven advanced fibrosis (F3-F4), all of which would have been missed using traditional cutoffs.

Conclusion:
Our study revealed that the use of the currently accepted FIB-4 cutoffs as the screening modality for identifying patients with advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease is insufficient and will result in missing patients with histologically confirmed advanced fibrosis. Use of the revised FIB-4 scores should be considered to diagnose patients with severe obesity at high risk of liver disease progression.
Role of FDG PET/CT in definitive and presumed autoimmune encephalitis
Authors: Kalra Simran , Tripathi Madhavi , Tripathi Manjari , Sonar Roopal Sarraf , Pandey Anil Kumar , Jaleel Jasim , Singh Rajesh Kumar , Kumar Praveen , Damle Nishikant Avinash , Bal Chandrasekhar 
Published: November 2023

Objective
F-18 Fluorodeoxyglucose PET/CT (FDG-PET) is emerging as a useful imaging adjunct to MRI in the initial diagnostic evaluation of autoimmune encephalitis (AIE)-though presently it is not included in the diagnostic criteria.

Materials and methods
In this prospective study we enrolled a total of 52 patients with clinically diagnosed and treated AIE. MRI evaluation was done in each case along with CSF and EEG where feasible. FDG-PET was done for all and images were interpreted visually and using SPM.

Results
The mean age group of patients included was 38.5 ± 22.6 years with 31 females and 21 males. 23 antibody-positive cases underwent PET, the most common antibody detected was anti-NMDAR type followed by anti-LGI 1. Most common metabolic pattern in NMDARE was hypermetabolism in basal ganglia and hypometabolism in parieto-occipital cortices and ovarian teratoma was detected in two of these patients on whole-body PET. A metabolic pattern consistent with AIE was demonstrated in 22/29 (75.8%) antibody-negative patients with hypermetabolism in basal ganglia and mesial temporal cortices. The overall sensitivity of FDG PET was 86% (45/52). MRI abnormalities were detected in 22/52 (42%) cases, 10/23 antibody positive and 12/29 antibody negative cases. PET was positive in 23/30 (76%) MRI negative cases.

Conclusion
Sensitivity of FDG PET for supporting a diagnosis of AIE was higher compared to MRI in both antibody-positive (definitive) and antibody-negative (presumed) AIE. Specific metabolic patterns can be demonstrated on FDG PET in AIE, prompting an early diagnosis so that timely treatment can be instituted.
18F-FDG PET/MRI for restaging esophageal cancer after neoadjuvant chemoradiotherapy
Authors: Valkema Maria J. , de Lussanet de la Sablonière Quido G. , Valkema Roelf , Thomeer Maarten G.J. , Dwarkasing Roy S. , Harteveld Anita A. , Doukas Michail , Mostert Bianca , van der Zijden Charlène J. , van der Sluis Pieter C. , Lagarde Sjoerd M. , Wijnhoven Bas P.L. , Verburg Frederik A. , van Lanschot J. Jan B. 
Published: November 2023

Purpose
The purpose of this study was to investigate whether 18F-fluorodeoxyglucose (18F-FDG) PET/MRI may potentially improve tumor detection after neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer.

Methods
This was a prospective, single-center feasibility study. At 6–12 weeks after nCRT, patients underwent standard 18F-FDG PET/computed tomography (CT) followed by PET/MRI, and completed a questionnaire to evaluate burden. Two teams of readers either assessed the 18F-FDG PET/CT or the 18F-FDG PET/MRI first; the other scan was assessed 1 month later. Maximum standardized uptake value corrected for lean body mass (SULmax) and mean apparent diffusion coefficient (ADCmean) were measured at the primary tumor location. Histopathology of the surgical resection specimen served as the reference standard for diagnostic accuracy calculations. When patients had a clinically complete response and continued active surveillance, response evaluations until 9 months after nCRT served as a proxy for ypT and ypN (i.e. ‘ycT’ and ‘ycN’).

Results
In the 21 included patients [median age 70 (IQR 62–75), 16 males], disease recurrence was found in the primary tumor in 14 (67%) patients (of whom one ypM+, detected on both scans) and in locoregional lymph nodes in six patients (29%). Accuracy (team 1/team 2) to detect yp/ycT+ with 18F-FDG PET/MRI vs. 18F-FDG PET/CT was 38/57% vs. 76/61%. For ypN+, accuracy was 63/53% vs. 63/42%, resp. Neither SULmax (both scans) nor ADCmean were discriminatory for yp/ycT+ . Fourteen of 21 (67%) patients were willing to undergo a similar 18F-FDG PET/MRI examination in the future.

Conclusion

18F-FDG PET/MRI currently performs comparably to 18F-FDG PET/CT. Improvements in the scanning protocol, increasing reader experience and performing serial scans might contribute to enhancing the accuracy of tumor detection after nCRT using 18F-FDG PET/MRI.

Trial registration
Netherlands Trial Register NL9352.
Transfusion avoidance in myelodysplastic neoplasms
Authors: Griffiths Elizabeth A. 
Published: November 2023

Purpose of review
Myelodysplastic neoplasms (MDS) are diseases of stem cell aging associated with complications from inadequate hematopoiesis (red cells, neutrophils and platelets) and variable risk for transformation to acute myeloid leukemia. Those with low-risk disease also suffer and die from MDS-related complications. Among the most challenging is development of anemia and transfusion dependence, which impacts quality of life and is associated with reduced survival. Appreciating and measuring the quality-of-life impact, preventing (if possible), treating, and managing the complications from anemia in MDS are of critical importance.

Recent findings
Recent developments in basic science highlight the potential deleterious impact of iron overload within the developing red cell niche. Iron overload can compromise red cell maturation from healthy as well as malignant clones and produces an environment favoring expansion of mutant clonal cells, potentially driving disease progression. Observational studies in nontransfusion dependent MDS highlight that iron overload occurs even in the nontransfusion dependent. The newly approved (and established) therapies for management of MDS-related anemia work best when begun before patients become heavily transfusion-dependent.

Summary
Iron overload is detrimental to hematopoiesis. Understanding the benefit afforded by transfusion is critical to optimal application and patient reported outcomes can inform this. Recently developed therapies are active and optimized application may improve response.
Pediatric acute myeloid leukemia – novel approaches
Authors: Karol Seth E. , Gueguen Gwenaelle 
Published: November 2023

Purpose of review
Despite higher remission and survival rates than observed in adults, children with acute myeloid leukemia (AML) still suffer unacceptably high rates of treatment failure and late toxicities. Ongoing work aims to improve these long-term outcomes through improvements in the utilization of current therapies, the incorporation of novel chemotherapy agents, and improved use of current or novel cellular and immunotherapeutic approaches. In this review, we highlight recent advances and contextualize them within this evolving landscape.

Recent findings
Novel agents such as the B-cell lymphoma 2 inhibitor venetoclax and the menin inhibitors have shown promising results with implications for large portions of the pediatric AML population. Older agents are being used in novel combinations (e.g. gemtuzumab ozogamicin) or are expanding into pediatrics after longer use in adults (e.g. Fms-like tyrosine kinase 3 inhibitors). Finally, immunotherapeutic approaches offer new options for patients with high-risk or relapsed disease.

Summary
Recent findings have altered the landscape of pediatric AML therapy with exciting immediate and long-term implications. Ongoing studies may soon define this as standard as well. After many years in which few new therapies have become available for children with AML, recent and upcoming advances may soon dramatically alter the therapeutic landscape.
Effects of Daily Posttraumatic Stress Disorder Symptoms on Heart Rate Variability
Authors: Slavish Danica C. , Ruggero Camilo J. , Schuler Keke , Schwartz Joseph E. , Luft Benjamin , Kotov Roman 
Published: November 2023

ABSTRACT

Objective
Posttraumatic stress disorder (PTSD) is common, debilitating, and associated with an increased risk of health problems, including cardiovascular disease. PTSD is related to poor autonomic function indicated by reduced heart rate variability (HRV). However, very little work has tested the timescale or direction of these effects, given that most evidence comes from cross-sectional studies. Documentation of when effects occur and in what direction can shed light on mechanisms of cardiovascular disease risk and inform treatment. The present study of 169 World Trade Center responders, oversampled for PTSD, tested how daily PTSD symptoms were associated with autonomic function as reflected through HRV.

Methods
Participants (N = 169) completed surveys of PTSD symptoms three times a day at 5-hour intervals for 4 days while also wearing ambulatory monitors to record electrocardiograms to derive HRV (i.e., mean absolute value of successive differences between beat-to-beat intervals).

Results
HRV did not predict PTSD symptoms. However, PTSD symptoms during a 5-hour interval predicted reduced HRV at the next 5-hour interval (β = −0.09, 95% confidence interval = −0.16 to −0.02, p = .008). Results held adjusting for baseline age, current heart problems, and current PTSD diagnosis.

Conclusions
Findings underscore growing awareness that PTSD symptoms are not static. Even their short-term fluctuations may affect cardiovascular functioning, which could have more severe impacts if disruption accumulates over time. Research is needed to determine if momentary interventions can halt increases in PTSD symptoms or mitigate their impact on cardiovascular health.
Lifespan Socioeconomic Context Is Associated With Cytomegalovirus and Late-Differentiated CD8+ T and Natural Killer Cells: Initial Results in Older Adults
Authors: Reed Rebecca G. , Hillmann Abby R. , Presnell Steven R. , Al-Attar Ahmad , Lutz Charles T. , Segerstrom Suzanne C. 
Published: November 2023

ABSTRACT

Objective
Lower socioeconomic status (SES) can accelerate immune aging; however, it is unknown whether and how lifespan socioeconomic context (SEC)—the relative wealth and quality of the communities an individual lives in across their lifespan—impacts immune aging. We examined the effects of childhood and adulthood SEC on late-differentiated immune cells and investigated the mediating and moderating role of cytomegalovirus (CMV), a key driver of immune aging.

Methods
Adults 60 years and older (N = 109) reported their addresses from birth to age 60 years, which were coded for county-level employment, education, and income to construct a latent SEC variable, averaged across ages 0 to 18 years (childhood SEC) and 19 to 60 years (adulthood SEC). Blood was drawn semiannually for 5 years for CMV serostatus and flow cytometry estimates of late-differentiated CD8+ T and natural killer cells. Models were adjusted for chronological age, time, sex, and individual SES (current income and education).

Results
Lower childhood SEC was associated with higher percentages of late-differentiated CD8+ T and natural killer cells via CMV seropositivity (indirect effects, p values = .015–.028). In addition, an interaction between CMV serostatus and SEC on CD8+ T-cell aging (p = .049) demonstrated that adulthood SEC was negatively associated with immune aging among CMV− but not CMV+ adults.

Conclusions
Beyond current SES, SEC related to immune aging in distinct patterns by lifespan phase. Lower childhood SEC importantly may influence who acquires CMV, which in turn predicts higher levels of immune aging, whereas higher adulthood SEC was protective against immune aging among CMV− older adults. These initial results need to be explored in larger samples.
Health technology assessments and their roles in public health policy
Authors: Khalil Hanan 
Published: November 2023

Purpose of review
Health Technology Assessment (HTA) is a multidisciplinary practice that summarizes information about the medical, social, economic, and ethical issues related to the use of a health technology in a systematic, transparent, and balanced manner. Health technologies include drugs, medical devices, procedures, and systems used in healthcare. The aim of this review is to present a snapshot on its uses, methods and current challenges to inform future research.

Recent findings
HTA has been instrumental in identifying health priorities, monitor trends, resource allocation, policy development, program planning and evaluation, health disparities, emergency preparedness, advocacy and community engagement. It can also be used in research and health systems comparisons. Several countries have set up specific agencies for HTA to inform their decision making and adjusting the current tools to address their needs by developing specific methods suitable for their context.

Summary
The advantages and disadvantages of health assessment technology are interconnected, and many of the disadvantages can be mitigated with proper planning, training, and effective technology implementation. The use of health assessment technology should be guided by a commitment to patient safety, data security, and equitable healthcare access.
The Association Between Solid Organ Transplant and Recurrence of Acute Diverticulitis
Authors: Harrison Noah J. , Samuels Lauren R. , Dusetzina Stacie B. , Alexopoulos Sophoclis P. , Ziogas Ioannis A. , Hawkins Alexander T. 
Published: November 2023

Objective:
The aim of this study was to compare rates and severity of recurrent acute diverticulitis in patients with and without solid organ transplant.

Background:
Immunocompromised solid organ transplant recipients have been considered higher risk for both recurrence and severity of acute diverticulitis. Current guidelines recommend an individualized approach for colectomy in these patients, but these are based on single-center data.

Methods:
We identified patients with acute diverticulitis using the Merative MarketScan commercial claims data from 2014 to 2020. Patients were classified by history of solid organ transplant. The primary outcome was recurrence of acute diverticulitis with an associated antibiotic prescription ≥60 days from the initial episode. Secondary outcomes included hospitalization, colectomy, and ostomy in patients with recurrence. Analyses used inverse probability weighting to adjust for imbalances in covariates.

Results:
Of 170,697 patients with evidence of acute diverticulitis, 442 (0.2%) had a history of solid organ transplantation. In the weighted cohort, among people who had not been censored at 1 year (n=515), 112 (22%; 95% CI: 20%–25%) experienced a recurrence within the first year. Solid organ transplantation was not significantly associated with a risk of recurrence (hazard ratio=1.19; 95% CI: 0.94–1.50). There was also no statistically significant difference in the hospitalization rate for recurrent diverticulitis. Restricting the analysis to hospitalized recurrences, there was no statistically significant difference observed in either length of stay or discharge status.

Conclusions:
In this national analysis of commercially insured patients with acute diverticulitis we found no statistically significant differences in recurrence between those with and without a history of solid organ transplant. We do not support an aggressive colectomy strategy based on concern for increased recurrence rate and severity in a solid organ transplant population.
Timing, triage, and mode of emergency general surgery interfacility transfers in the United States: A scoping review
Authors: Silver David S. , Teng Cindy , Brown Joshua B. 
Published: November 2023

ABSTRACT
Interfacility transfer of emergency general surgery (EGS) patients continues to rise, especially in the context of ongoing system consolidation. This scoping review aims to identify and summarize the literature on triage, timing, and mode of interfacility emergency general surgery transfer. While common, EGS transfer systems are not optimized to improve outcomes or ensure value-based care. We identified studies investigating emergency general surgery interfacility transfer using Ovid Medline, EMBASE, and Cochrane Library between 1990 and 2022. English studies that evaluated EGS interfacility timing, triage or transfer mode were included. Studies were assessed by two independent reviewers. Studies were limited to English-language articles in the United States. Data were extracted and summarized with a narrative synthesis of the results and gaps in the literature. There were 423 articles identified, of which 66 underwent full-text review after meeting inclusion criteria. Most publications were descriptive studies or outcomes investigations of interfacility transfer. Only six articles described issues related to the logistics behind the interfacility transfer and were included. The articles were grouped into the predefined themes of transfer timing, triage, and mode of transfer. There were mixed results for the impact of transfer timing on outcomes with heterogeneous definitions of delay and populations. Triage guidelines for EGS transfer were consensus or expert opinion. No studies were identified addressing the mode of interfacility EGS transfer. Further research should focus on better understanding which populations of patients require expedited transfer and by what mode. The lack of high-level data supports the need for robust investigations into interfacility transfer processes to optimize triage using scarce resources and optimized value-based care.