bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of three-dimensional proton density-weighted sequence MRI in knee for the assessment of Anterolateral complex in Anterior cruciate ligament injury
Authors: Guruprasad Ankith , Sinha Upasna , Kumar Sudeep , Kumar Avinash , Ahmad Shamshad , Kumar Prem , Agrawal Prabhat 
Published: January 2024

Abstract

Objectives
To assess the proportion and pattern of injury of the anterolateral ligament (ALL) and the Kaplan fibre (KF) complex in knees with anterior cruciate ligament (ACL) injuries on MRI using three-dimensional (3D) proton density (PD) sequences.

Methods
A total of 88 patients having ACL injury were included in this cross-sectional study. 3D PD sequences were used to assess injury of ALL and the KF complex and were graded on a scale of 0 to 3. MR images were evaluated by two radiologists. Interobserver agreement was determined using Cohen Kappa.

Results
Femoral, meniscal, and tibial portions of ALL were visualized in 90.9%, 92%, and 94.3% of the study subjects, respectively. Proximal and distal KF were visualized in 92% and 93.2% of patients, respectively. Injury to ALL and KF was seen in 63.6% and 17% of the patients, respectively. Excellent interobserver agreement was noted for the identification and grading of ALL and KF complex injuries.

Conclusions
Oblique reformatted 3DPD MRI reliably detect ALC; however, ALL injury is better characterized than KF injury using this sequence.

Advances in knowledge
Given the potential role of anterolateral complex (ALC) in maintaining the rotational stability of the knee, ALC assessment using the 3D PD sequences and their oblique reformatted images should be incorporated as routine review area of the knee MRI, particularly in the setting of ACL tear.
A case of low-grade endometrial stromal sarcoma presented as an intramyometrial mass mimicking uterine leiomyoma on MRI
Authors: Tamada Soichiro , Edo Hiromi , Sakima Taishi , Tanaka Ryo , Shikata Kohei , Nishitani Soko , Miyamoto Morikazu , Takano Masashi , Kuboshima Keisuke , Miyai Kosuke , Ogata Sho , Shinmoto Hiroshi 
Published: January 2024

Abstract
A low-grade endometrial stromal sarcoma (ESS) has a pattern of presenting as an intramyometrial mass and is often misdiagnosed as cellular leiomyoma or degenerative uterine leiomyoma. A low-grade ESS is a malignant tumour that requires total hysterectomy with bilateral salpingo-oophorectomy; while a leiomyoma is a benign tumour and could be acceptable for enucleation. As the treatment strategies differ between a low-grade ESS and leiomyoma, radiologists should be familiar with the characteristic MRI findings of a low-grade ESS. A 51-year-old woman with abnormal uterine bleeding had been observed for 2 years at a previous hospital for a uterine leiomyoma based on MRI findings. A contrast-enhanced MRI demonstrated an intramyometrial mass composed of three components with the hypointense rim on T2-weighted images (T2WI): the first component was a homogeneous solid structure with mild hyperintensity on T2WI with a low apparent diffusion coefficient value; the second component was cystic; the third component was a structure of low signal intensity on T2WI similar to the muscle. Although a degenerative uterine leiomyoma was a differential diagnosis, these MRI findings were suggestive of a low-grade ESS. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy were performed. The pathological diagnosis was a low-grade ESS. In a low-grade ESS, there are three major patterns of MRI findings: one of these patterns is the less popular but clinically important intramyometrial mass pattern, which can be misdiagnosed as a leiomyoma, and this case conformed to this pattern.
Comparing the quality of ChatGPT- and physician-generated responses to patients’ dermatology questions in the electronic medical record
Authors: Reynolds Kelly , Nadelman Daniel , Durgin Joseph , Ansah-Addo Stephen , Cole Daniel , Fayne Rachel , Harrell Jane , Ratycz Madison , Runge Mason , Shepard-Hayes Amanda , Wenzel Daniel , Tejasvi Trilokraj 
Published: January 2024

Abstract

Background
ChatGPT is a free artificial intelligence (AI)-based natural language processing tool that generates complex responses to inputs from users.

Objectives
To determine whether ChatGPT is able to generate high-quality responses to patient-submitted questions in the patient portal.

Methods
Patient-submitted questions and the corresponding responses from their dermatology physician were extracted from the electronic medical record for analysis. The questions were input into ChatGPT (version 3.5) and the outputs extracted for analysis, with manual removal of verbiage pertaining to ChatGPT’s inability to provide medical advice. Ten blinded reviewers (seven physicians and three nonphysicians) rated and selected their preference in terms of ‘overall quality’, ‘readability’, ‘accuracy’, ‘thoroughness’ and ‘level of empathy’ of the physician- and ChatGPT-generated responses.

Results
Thirty-one messages and responses were analysed. Physician-generated responses were vastly preferred over the ChatGPT ­responses by the physician and nonphysician reviewers and received significantly higher ratings for ‘readability’ and ‘level of empathy’.

Conclusions
The results of this study suggest that physician-generated responses to patients’ portal messages are still preferred over ChatGPT, but generative AI tools may be helpful in generating the first drafts of responses and providing information on education resources for patients.
Immunogenicity, Reactogenicity, and Safety of AS01E-adjuvanted Respiratory Syncytial Virus (RSV) Prefusion F Protein-based Candidate Vaccine (RSVPreF3 OA) When Co-administered With a Seasonal Quadrivalent Influenza Vaccine in Older Adults: Results of a Phase 3, Open-Label, Randomized Controlled Trial
Authors: Chandler Reynaldo , Montenegro Nathali , Llorach Cecilia , Aguirre Lorena Noriega , Germain Sophie , Kuriyakose Sherine O , Lambert Axel , Descamps Dominique , Olivier Aurélie , Hulstrøm Veronica 
Published: January 2024

Abstract

Background
Co-administration of vaccines against respiratory syncytial virus (RSV) and influenza can be considered given their overlapping seasonality and may increase vaccine uptake and compliance. In this phase 3, open-label, randomized study, we evaluated the immunogenicity, reactogenicity, and safety of the AS01E-adjuvanted RSV prefusion F protein–based candidate vaccine (RSVPreF3 OA) when co-administered with a seasonal quadrivalent influenza vaccine (FLU-QIV) in older adults.

Methods
Participants aged ≥60 years (randomized 1:1) received either RSVPreF3 OA and FLU-QIV simultaneously on day 1 (Co-Ad group) or FLU-QIV on day 1 followed by RSVPreF3 OA on day 31 (sequential administration [SA] group). The co-primary objectives were to demonstrate noninferiority of RSVPreF3 OA in terms of RSV-A neutralization geometric mean titer (GMT) ratio and FLU-QIV in terms of hemagglutination inhibition GMT ratio for each FLU-QIV strain, when co-administered versus when administered alone at 1 month post-vaccination. Noninferiority was demonstrated if the upper limit of the 95% confidence interval of the group GMT ratio (SA/Co-Ad) was ≤1.5. Secondary descriptive objectives comprised additional immunogenicity assessments, reactogenicity, and safety.

Results
Of the 885 participants who received 1 dose of the study vaccines, 837 were included in the per protocol set. Demographic and baseline characteristics were balanced between the groups. Both co-primary objectives were met for both vaccines. Reported adverse events in both groups were mild to moderate, with a low frequency of grade 3 events.

Conclusions
Data from this study demonstrate that RSVPreF3 OA can be co-administered with FLU-QIV. Co-administration is well tolerated, with an acceptable safety profile.
Clinical Trials Registration. NCT04841577.
High-Sensitivity Cardiac Troponin and the Management of Congenital Heart Disease in Newborns and Infants
Authors: Ferraro Simona , Biganzoli Elia , Mannarino Savina , Lanzoni Monica , Zuccotti Gianvincenzo , Plebani Mario , Kavsak Peter 
Published: January 2024

Abstract

Background
Early cardiac interventions in newborns and infants suspected for congenital heart disease (CHD) decrease morbidity and mortality. After updating current evidence on the use of cardiac troponins (cTn) in the context of CHD for risk stratification at early ages, we discuss relevant issues, starting from the evidence that only the measurement of the cTnT form is useful in this population.

Content
In newborns/infants with CHD, the cTnT concentration increase is correlated with: (a) cardiac stress and hemodynamic parameters, but not with the type of CHD; (b) volume overload/right ventricular pressure overload; (c) postoperative hypoperfusion injury and mortality; and (d) effects of cardioprotective strategies. For infants with CHD, high-sensitivity cTnT (hs-cTnT) concentrations &gt;25 ng/L are an independent predictor of poor outcomes. Transitioning from cTnT to hs-cTnT in newborns/infants improves the identification of: (a) physiopathological mechanisms and factors that increased hs-cTnT early after birth; (b) myocardial injury, even when subclinical; (c) identification of patients requiring immediate therapeutic interventions; and (d) 99th percentile upper reference limits (URLs). However, no reliable URLs are currently available to allow the detection of myocardial injury associated with CHD in newborns/infants.

Summary
Additional data evaluating the clinical value of hs-cTnT in the risk stratification of newborns/infants with CHD who may suffer myocardial injury is needed. Validating the measurement, possibly in amniotic fluid samples, and improving the interpretation of hs-cTnT concentrations in the prenatal period, at birth and within 1 year of age are crucial to change CHD mortality/morbidity trends in the pediatric population.
Writing instruction with grade-level/college-bound secondary deaf students
Authors: Wolbers Kimberly , Dostal Hannah , Holcomb Leala , Spurgin Kelsey 
Published: January 2024

Abstract
In the current study, we used a sequential explanatory design to examine secondary writing instruction for deaf students in various school settings. An examination of secondary writing instruction was carried out in two cycles using a survey and subsequent focus group discussions. The first cycle (n = 222) presented an overview of secondary writing instruction for deaf students with diverse skill levels. The second cycle (n = 18) focused on writing instruction specific to grade-level or college-bound deaf students. We compared results from both cycles to investigate the similarities and differences in instructional practices and research needs between the two groups. We found that teachers are generally more prepared to instruct deaf students who are at grade level due to widely available curricula aligned with grade-level benchmarks. This contrasts with the challenges teachers face with creating or adapting materials for those who have experienced language deprivation. According to teachers, grade-level students receive 1.5 hr more weekly in writing instruction compared to the full sample. This study also indicates the importance of training teachers to teach skills in crafting arguments through writing, given its applicability to deaf students’ future academic and personal goals.
Diagnostic accuracy of ultrasonography in relation to salivary gland biopsy in Sjögren’s syndrome: a systematic review with meta-analysis
Authors: Martins Fernanda B , Oliveira Millena B , Oliveira Leandro M , Lourenço Alan Grupioni , Paranhos Luiz Renato , Motta Ana Carolina F 
Published: January 2024

Abstract

Objectives
To evaluate the accuracy of major salivary gland ultrasonography (SGUS) in relation to minor salivary gland biopsy (mSGB) in the diagnosis of Sjögren’s syndrome (SS).

Methods
A systematic review and meta-analysis were performed. Ten databases were searched to identify studies that compared the accuracy of SGUS and mSGB. The risk of bias was assessed, data were extracted, and univariate and bivariate random-effects meta-analyses were done.

Results
A total of 5000 records were identified; 13 studies were included in the qualitative synthesis and 10 in the quantitative synthesis. The first meta-analysis found a sensitivity of 0.86 (95% CI: 0.74-0.92) and specificity of 0.87 (95% CI: 0.81-0.92) for the predictive value of SGUS scoring in relation to the result of mSGB. In the second meta-analysis, mSGB showed higher sensitivity and specificity than SGUS. Sensitivity was 0.80 (95% CI: 0.74-0.85) for mSGB and 0.71 (95% CI: 0.58-0.81) for SGUS, and specificity was 0.94 (95% CI: 0.87-0.97) for mSGB and 0.89 (95% CI: 0.82-0.94) for SGUS.

Conclusions
The diagnostic accuracy of SGUS was similar to that of mSGB. SGUS is an effective diagnostic test that shows good sensitivity and high specificity, in addition to being a good tool for prognosis and for avoiding unnecessary biopsies. More studies using similar methodologies are needed to assess the accuracy of SGUS in predicting the result of mSGB. Our results will contribute to decision-making for the implementation of SGUS as a diagnostic tool for SS, considering the advantages of this method.
Use of a steerable delivery sheath to obtain coaxial alignment in left atrial appendage occlusion after mitral transcatheter edge-to-edge repair: a case report
Authors: Maiani Silvia , Nardi Giulia , Ristalli Francesca , Di Mario Carlo , Meucci Francesco 
Published: January 2024

Abstract

Background
Patients with atrial fibrillation (AF) have a five-fold increase in stroke events, and ∼90% of the thrombi develop in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) has emerged as a safe and feasible alternative to oral anticoagulation (OAC) for stroke prevention in selected patients with non-valvular AF and contraindications to OAC. Atrial fibrillation is closely associated with mitral disease, and there is a growing interest in combined procedures. More than half of patients undergoing a mitral transcatheter edge-to-edge repair (M-TEER) suffer of AF and many have high or unacceptable bleeding risk.

Case summary
We present a case of an 80-year-old woman suffering from paroxysmal AF, right carotid siphon aneurysm, and primary mitral regurgitation, with a high bleeding risk, who underwent a combined intervention of M-TEER and LAAO.

Discussion
The combination of these two procedures is a logical step once the access to the left atrium is obtained with a transseptal puncture (TSP) and a transesophageal echocardiography (TEE) is in place to guide both procedures. The turning point in LAAO procedure is a correct TSP allowing coaxial alignment of the sheath with the LAA neck. Steerable delivery sheaths are promising dedicated tools, particularly in challenging anatomy or during combined procedures requiring different TSP positions.
A giant left atrial appendage: a case report on the feasibility of closure with a custom-made device
Authors: Barocelli Federico , Gurgoglione Filippo Luca , Covani Marco , Cattabiani Maria Alberta , Vignali Luigi 
Published: January 2024

Abstract

Background
Transcatheter left atrial appendage occlusion (LAAO) is a valuable therapeutic option for stroke prevention in patients with atrial fibrillation (AF) at high bleeding risk. However, complex LAA anatomies sometimes preclude the adoption of commercially available LAAO devices. The design of a custom-made LAAO device is a promising strategy in these cases. However, few examples of custom-made devices in case of giant LAAs have been reported.

Case summary
An 85-year-old man with permanent AF with CHA2DS2-VASc 4 and recurrent active gastrointestinal major bleedings was referred for transcatheter LAAO at Parma University Hospital after multidisciplinary team evaluation. Pre-procedural coronary computed tomography angiography revealed a giant windsock LAA, with a maximum ostium diameter of 44 mm, a landing zone diameter of 34 mm, and maximal length of 49 mm. Patient’s management was particularly challenging given that available LAAO devices were too small to completely exclude the LAA. In accordance with the manufacturer, a custom-made LAmbre™ Closure System (Lifetech Scientific, Shenzhen, China), which specifically fitted with patient’s LAA anatomy, was designed and successfully deployed under transoesophageal echocardiography (TEE) and fluoroscopic guidance. Periprocedural TEE confirmed the appropriate position of the device and the absence of peri-device leaks. No adverse ischaemic and haemorrhagic events were reported at 3-months follow-up.

Discussion
We present a case of a successful transcatheter LAAO procedure by deploying a custom-made LAmbre device 38/46 mm to mechanically exclude a giant windsock LAA. This case illustrates the effectiveness of a custom-made device strategy, which potentially enables the closure of all complex LAA anatomies.
Key features in telehealth-delivered cardiac rehabilitation required to optimize cardiovascular health in coronary heart disease: a systematic review and realist synthesis
Authors: Gallegos-Rejas Victor M , Rawstorn Jonathan C , Gallagher Robyn , Mahoney Ray , Thomas Emma E 
Published: January 2024

Abstract
Telehealth-delivered cardiac rehabilitation (CR) programmes can potentially increase participation rates while delivering equivalent outcomes to facility-based programmes. However, key components of these interventions that reduce cardiovascular risk factors are not yet distinguished. This study aims to identify features of telehealth-delivered CR that improve secondary prevention outcomes, exercise capacity, participation, and participant satisfaction and develop recommendations for future telehealth-delivered CR. The protocol for our review was registered with the Prospective Register of Systematic Reviews (#CRD42021236471). We systematically searched four databases (PubMed, Scopus, EMBASE, and Cochrane Database) for randomized controlled trials comparing telehealth-delivered CR programmes to facility-based interventions or usual care. Two independent reviewers screened the abstracts and then full texts. Using a qualitative review methodology (realist synthesis), included articles were evaluated to determine contextual factors and potential mechanisms that impacted cardiovascular risk factors, exercise capacity, participation in the intervention, and increased satisfaction. We included 37 reports describing 26 randomized controlled trials published from 2010 to 2022. Studies were primarily conducted in Europe and Australia/Asia. Identified contextual factors and mechanisms were synthesized into four theories required to enhance participant outcomes and participation. These theories are as follows: (i) early and regular engagement; (ii) personalized interventions and shared goals; (iii) usable, accessible, and supported interventions; and (iv) exercise that is measured and monitored. Providing a personalized approach with frequent opportunities for bi-directional interaction was a critical feature for success across telehealth-delivered CR trials. Real-world effectiveness studies are now needed to complement our findings.
General practice pharmacist-led antipsychotic physical health monitoring: a prospective intervention scoping study
Authors: Johnson Chris F , Ingram Fiona , Thomson Fiona , Srireddy Pavan , Jani Bhautesh D , Greenlaw Nicola 
Published: January 2024

Abstract

Background
People with severe mental health illness die prematurely, often due to preventable cardiometabolic disease, which can be exacerbated by antipsychotic medicines that are effective for treating mental illness. Literature demonstrates that physical health monitoring, as recommended in guidelines, for people receiving antipsychotics is substandard. Therefore, we aimed to scope the potential of a general practice clinical pharmacist (GPCP)-led multidisciplinary intervention optimising adherence to cardiometabolic monitoring guidelines and delivering polypharmacy reviews.

Method
Prospective intervention scoping study in three urban general practices; one usual care, two intervention. Patients 18–65 years old prescribed oral antipsychotics were identified from records, and invited for cardiometabolic monitoring and GPCP medication review, from January to December 2022. Interventions and onward referrals were recorded and collated. Anonymised pre- and post-review data were analysed, and actions were graded for clinical importance.

Results
In total 1.5% (210/14,159) of patients aged 18–65 years met inclusion criteria; usual care practice (n = 58); and intervention practices (n = 152). From baseline, the usual care practice achieved an absolute 7% increase in the cardiometabolic monitoring care bundle (glucose/glycosylated haemoglobin, lipids, blood pressure plus body mass index) versus 19–58% in the intervention practices. Two-thirds (92/152) of patients participated in medication reviews, requiring pharmacological and/or non-pharmacological clinical actions. The majority of actions were graded as moderate importance. Seven percentage of patients were identified as new pre-diabetic/diabetic and 6% were at high risk of cardiovascular disease requiring statin initiation.

Conclusion
A pharmacist-led multidisciplinary general practice-based approach may be effective at optimising cardiometabolic monitoring; identifying and treating diabetic and cardiovascular risk factors.
Sweetening the Deal: The Strategic Value of Combining Inducements with Militarized Compellent Threats
Authors: Kwon Yewon 
Published: January 2024

Abstract
This study examines the impact of combining conditional inducements with threats in the context of militarized compellence. It introduces a novel variable to measure the presence of inducements and presents a theory and empirical tests supporting the hypothesis of an increased likelihood of successful outcomes when combining militarized compellent threats with inducements. This integration provides the target with a face-saving opportunity to exit impending militarized conflicts gracefully, and effectively signaling the coercer's sincere commitment and intention to bear associated implement costs. Statistical analysis addresses potential endogeneity and reveals a significant, positive association between inducement use and successful outcomes. Empirical evidence from a comprehensive statistical analysis underscores the effectiveness of adopting a simultaneous carrot-and-stick approach in militarized compellence. The result implies that perceived weaknesses linked to inducements can be mitigated by their combination with strong threats.