bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Optimal Outcomes Reporting and Team Clinic Retention in Isolated Nonsyndromic Cleft Palate
Authors: Linkugel Andrew D. , Trivedi Prerak B. , Varagur Kaamya , Skolnick Gary B. , Menezes Maithilee D. , Dunsky Katherine A. , Grames Lynn M. , Locke Lauren C. , Naidoo Sybill D. , Snyder-Warwick Alison K. , Patel Kamlesh B. 
Published: October 2023

Objective Optimal Outcomes Reporting was recently introduced to categorize outcomes after cleft palate repair. We seek to propose an expanded version of Optimal Outcomes Reporting and to determine if correlation exists between the expanded outcomes and persistence with team care follow-up through age 9. Design Retrospective cohort study. Setting Cleft team at large pediatric hospital. Patients Patients with isolated nonsyndromic cleft palate (n = 83) born from 2001-2012. Main Outcome Measures Patients who continued to present at age 5 or greater were assessed for optimal outcomes. Optimal outcomes were: surgery - no fistula or velopharyngeal insufficiency; otolaryngology - no obstructive sleep apnea or signs of chronic middle ear disease; audiology - no hearing loss; speech-language pathology - no assessed need for speech therapy. Results Of the 83 patients identified, 41 were assessed for optimal outcomes. Optimal outcome in any discipline was not associated with follow-up through age 9 (0.112 ≤  p ≤ 0.999). For all disciplines, the group with suboptimal outcomes had a higher proportion of patients from geographic areas in the most disadvantaged quartile of social vulnerability index, with the strongest association in the group with suboptimal speech outcome (OR 6.75, 95% CI 0.841-81.1). Conclusions Optimal outcomes and retention in team clinic were not statistically significantly associated, but clinically relevant associations were found between patients in the most disadvantaged quartile of social vulnerability and their outcomes. A patient-centered approach, including caregiver education about long-term care for patients with cleft palate, would allow for enhanced resource utilization to improve retention for patients of concern.
Choroidal neovascularization and MEWDS like reaction in a child: A rare case
Authors: Desira M. , Fitoussi R. , Comet A. , Denis D. , Stolowy N. , David T. 
Published: October 2023

Purpose To report a case of choroidal neovascularization (CNV) associated with Multiple Evanescent White Dot Syndrome (MEWDS) in a child. Study Design Case report. Results A 13-year-old child visited us with a month-long history of blurred vision in his right eye. His right fundus showed several subretinal white dots and an atrophic macular lesion corresponding to a CNV. Angiography and optical coherence tomography (OCT) were consistent with the diagnosis of MEWDS. The patient's condition poorly improved after an intravitreal injection of anti-vascular endothelial growth factor (anti VEGF) in his right eye. Conclusions We reported the case of CNV associated with MEWDS like reaction. The hypothesis of a triggered-MEWDS was highly suspected but no cause was found, which is often the case in paediatric inflammatory eye disorders. Long-term follow-up is needed to judge the evolution.
Combination of Minimally Invasive Methods for the Treatment of Varicose Veins
Authors: Ren Hongcheng , Wang Bin , Shao Changgang , Chi Guoqing , Liu Rui , Jiang Yan , Wang Yufeng , Ding Mingchao , Wang Huaming 
Published: October 2023

Objective The aim of the study was to evaluate the efficacy and safety of the combination of minimally invasive methods for the treatment of incompetent great saphenous vein and perforating veins. Methods Between December 2019 and October 2020, F-care radiofrequency ablation combined with ultrasound-guided foam sclerotherapy and residual perforator ligation and concomitant microphlebectomy were adopted for all eligible patients. The clinical symptoms scores, complications, and quality of life were recorded. Results 49 patients (64 limbs) with a mean age of 63.29 ± 10.14 years, and 60.9% 4 were male. The 1-year truncal closure rate was 63/64 (98.4%). 1 A significant improvement in the Venous Disability Score, the Venous Segmental Disease Score, the Venous Clinical Severity Score and Chronic Venous Disease Quality of Life Questionnaire Score, at 12 months after the combination of minimally invasive treatment, were observed in the study. One patient developed intermuscular vein thrombosis that was successfully managed with rivaroxaban. Conclusions The combination of minimally invasive methods is a safe and effective method for the treatment of lower extremity varicose veins. Further large-scale, prospective, multi-center studies are needed to further verify the findings of this study.
Aneurysmal recurrence and retreatment modalities after Woven EndoBridge (WEB) device implantation: A systematic review and meta-analysis
Authors: Kobeissi Hassan , Ghozy Sherief , Pakkam Madona , Bilgin Cem , Tolba Hatem , Kadirvel Ramanathan , Brinjikji Waleed , Kallmes David F 
Published: October 2023

Background The Woven EndoBridge (WEB) device is used to treat wide-neck bifurcation aneurysms (WNBAs). We conducted a systematic review and meta-analysis to determine the retreatment rate strategies following aneurysmal recurrence of WEB device treated WNBAs. Methods This study is reported following the PRISMA 2020 guidelines. We conducted a systematic review of the literature using PubMed, Scopus, Embase, and Web of Science. Data were pooled using a random-effects model. We calculated pooled prevalence and corresponding 95% confidence intervals (CI). Results We included 11 studies. The overall retreatment rate was 171/1875 aneurysms (10.3%; 95% CI  =  8.3–12.9). Stent-assisted coiling was used to treat 59 aneurysms (36.7%; 95% CI  =  26.4–48.5), and flow diverters were used to treat 44 aneurysms (18.7%; 95% CI  =  9.9–32.5). Following retreatment, the complete occlusion rate was 57/91 aneurysms (62.8%; 95% CI  =  48.2–75.3) and the adequate occlusion rate was 24/91 aneurysms (26.4%; 18.4%–36.4%). The most common aneurysmal recurrence site was the anterior communicating artery (44/136 aneurysms, 32.4%; 95% CI  =  25.0–40.7). Conclusions Roughly 10% of WNBAs initially treated with the WEB device will undergo retreatment. Retreatment is an effective strategy for WEB-treated aneurysms, with high rates of adequate and complete occlusion. Future studies should work to identify risk factors for aneurysmal recurrence.
Assessing medication-related burden of community-dwelling individuals with chronic conditions in a small island state
Authors: Sacco Katya , West Lorna M Bonnici , Grech Lauren M , Krska Janet , Cordina Maria 
Published: October 2023

Objectives Medication taking in the management of chronic conditions causes a significant burden on individuals. The aim of this study was to explore the medication-related burden in ambulatory adult patients with chronic conditions in Malta. Methods A cross-sectional survey utilising the living with medicines questionnaire V3 (LMQ V3) was conducted in Maltese residents over the age of 18 years, taking at least 1 medication for a chronic condition and recruited through community events. The overall LMQ score, the domain scores and the visual analog scale data were analysed to determine relationships with the demographic factors. Results A total of 337 responses were analysed revealing a moderate (42.4%) to high medication (36.8%) related burden. The drivers of medication-related burden were primarily: ‘side-effects of prescribed medication’ (r = −0.843, p < 0.001), ‘attitudes/concerns about medicine use’ (r = −0.830, p < 0.001) and ‘impact/interferences to day-to-day life’ (r = −0.820, p < 0.001). Lack of autonomy to vary the dosage regimen resulted in a higher burden (r = −0.260, p < 0.001). Males experienced an overall higher burden ( p = 0.046) especially related to practical difficulties ( p = 0.04), cost-related burden ( p = 0.04) and side-effects of prescribed medication ( p = 0.01). Conclusion Medication-related burden is complex and multi-faceted as demonstrated by the findings of this study. Healthcare professionals should seek to identify and address factors causing this burden to improve patient outcomes.
Making a difference? A retrospective review of peripherally inserted central catheters: A single-center experience in Colombia
Authors: García-Zambrano Laura , Morales-Gómez Daniel , Dennis-Halley Michael J. , Román-Ortega Carlos F , Cabrera-Rivera Paulo A. , Parra Marcela 
Published: October 2023

Introduction: Peripherally inserted central catheters (PICCs) are an effective tool as a medical device in patients who require them. However, it is a procedure that has been associated with multiple complications and possible negative outcomes for the health of the patients. This paper seeks to describe the main complications derived from the insertion and maintenance of peripherally inserted central venous catheters (PICCs), based on the experience of a vascular accesses group in a cardiovascular center in Colombia. Methods: A retrospective cross-sectional analytical study of the adult population undergoing PICC insertion at the Fundación Cardioinfantil-Instituto de Cardiología, during the period between 2019 and 2020 by the vascular access program, was performed. Results: The frequency of any registered complication was 15.9% for 2019 and 11.2% for 2020. Bleeding at the procedure site occurred in 15.3% during 2019 and 7.0% in 2020, making it the most frequent complication during the procedure. All the variables of complications associated with infection (bacteremia, phlebitis, and catheter-related infection) showed a decrease in 2020 compared to the previous year. The central line-associated bloodstream infection registered for the year 2019 was 1.94 bacteremia’s/1000 catheters-day compared to 0.29 bacteremia’s/1000 catheters-day. Conclusions: There has been a 4.7% reduction in the frequency of any registered complication after the implementation of the vascular access groups. Global and specific complications decreased significantly from 2019 to 2020. Notably, bacteremia, a common post-procedure complication, showed a substantial decrease in frequency compared to national and worldwide literature. It is also been described that complications associated with infection showed a decrease in 2020 compared to 2019. Whether or not all these findings are directly or somewhat related to the results stemming from the vascular access groups still needs further investigation.
First report of Mycobacteria avium complex (Mycobacteria intracellulare) in a cat from Southeast Asia
Authors: Han Hock Siew , Gunn-Moore Danièlle 
Published: October 2023

Case summary A 3-year-old castrated male domestic shorthaired cat, with indoor–outdoor access, was presented for chronic, progressive multinodular to generalised subcutaneous nodules covering much of its body. Previous medical treatment with doxycycline had been unhelpful. Fine-needle aspiration of the nodules revealed intra- and extracellular multibacillary negative staining rods in pyogranulomatous inflammation. Bacterial culture and susceptibility studies isolated Mycobacterium intracellulare, with zimine as the drug of choice for treatment. Initial triple therapy with rifampicin, azithromycin and pradofloxacin was ineffective, and was changed to triple therapy with clofazimine, clarithromycin and doxycycline once drug susceptibility was known, which was given for 3 months, after which long-term therapy with clofazimine and clarithromycin was continued. Relevance and novel information Slow growing M intracellulare, a member of the Mycobacterium avium complex (MAC), has never been reported to cause disease in cats from Singapore and, by extension, Southeast Asia. The infection in this patient resulted in subcutaneous nodules, which started on the face, then spread to the feet and much of the rest of its body. This is in contrast to that commonly reported for infection with M avium, which is also a member of MAC, and may not only present with similar signs in cats, but also progress to systemic spread. Susceptibility studies suggest clofazimine as the drug of choice when treating this infection, and this case supports its use as empirical therapy for veterinarians treating this disease in this region while awaiting culture and sensitivity results.
Use of high-flow oxygen therapy in a cat with cardiogenic pulmonary edema
Authors: Pouzot-Nevoret Céline , Hocine Leïla , Allaouchiche Bernard , Her Jiwoong 
Published: October 2023

Case summary A 7-month-old female spayed domestic shorthair cat was presented for respiratory distress due to cardiogenic pulmonary edema. Despite initial treatment and oxygen delivery in an oxygen tent, the cat still showed signs of severe respiratory effort and oxygen saturation measured via pulse oximetry was below 85%. Because the owners declined mechanical ventilation, the cat was transitioned to high-flow oxygen therapy (HFOT). HFOT allowed significant improvement of the respiration parameters within 15 mins without causing clinical complications. The cat was briefly anaesthetised for the placement of the nasal cannula on initiation of HFOT, and the interface was well tolerated thereafter. The cat was transitioned to an oxygen cage after 16 h, weaned from oxygen 4 h later and was discharged after 3 days of hospitalisation. Long-term follow-up showed no abnormalities, and the leading hypothesis was transient myocardial thickening. Relevance and novel information The first use of HFOT in a dyspneic cat is described in this study. HFOT could be a life-saving option for cats with severe hypoxemia or do-not-intubate orders that fail to respond to conventional oxygen therapies.
Limb sparing in a cat with a humeral osteosarcoma using a customised three-dimensional printed endoprosthesis
Authors: Malak Anthony , Parr William CH , Levien Andrew S , Basa Rachel M 
Published: October 2023

Case summary A 12-year-old male neutered Bengal cat presented for a left thoracic limb lameness of several weeks’ duration. Abnormal advanced imaging findings depicted the presence of an irregularly marginated osteolytic lesion in the proximal-mid diaphysis of the left humerus. A histopathological evaluation of the humerus confirmed a diagnosis of osteoblastic osteosarcoma. Limb-sparing surgery was planned with a custom-designed three-dimensional printed endoprosthesis. Mild neuropraxia was noted immediately postoperatively and deemed to have resolved by the 2-week follow-up. Stereotactic radiation was planned, though pulmonary metastasis was noted on planning CT. The cat was euthanased 90 days postoperatively owing to the development of pulmonary clinical signs. Relevance and novel information This is the first reported case of a humeral limb salvage procedure in a cat using a custom-designed three-dimensional printed endoprosthesis. Although the survival time in this case was short, the patient maintained an adequate quality of life and limb function was preserved.
The spread of COVID-19 vaccine information in Arabic on YouTube: A network exposure study
Authors: Zeid Nour , Tang Lu , Amith Muhammad “Tuan” 
Published: October 2023

Objective The Arabic-speaking world had the lowest vaccine rates worldwide. The region's increasing reliance on social media as a source of COVID-19 information coupled with the increasing popularity of YouTube in the Middle East and North Africa region begs the question of what COVID-19 vaccine content is available in Arabic on YouTube. Given the platform's reputation for being a hotbed for vaccine-related misinformation in English, this study explored the COVID-19 vaccine-related content an individual is likely to be exposed to on YouTube when using keyword-based search or redirected to YouTube from another platform from an anti-vaccine seed video in Arabic. Methods Only using the Arabic language, four networks of videos based on YouTube's recommendations were created in April 2021. Two search networks were created based on Arabic pro-vaccine and anti-vaccine keywords, and two seed networks were created from conspiracy theory and anti-vaccine expert seed videos. The network exposure model was used to examine the video contents and network structures. Results Results show that users had a low chance of being exposed to anti-vaccine content in Arabic compared to the results of a previous study of YouTube content in English. Of the four networks, only the anti-vaccine expert network had a significant likelihood of exposing the user to more anti-vaccine videos. Implications were discussed. Conclusion YouTube deserves credit for its efforts to clean up and limit anti-vaccine content exposure in Arabic on its platform, but continuous evaluations of the algorithm functionality are warranted.
Shoulder and Elbow Injuries in National Basketball Association Athletes and Their Effects on Player Performance
Authors: Morikawa Landon H. , Tummala Sailesh V. , Brinkman Joseph C. , Crijns Tom J. , Lai Cara H. , Chhabra Anikar 
Published: October 2023

Background: Shoulder and elbow function is essential to basic basketball actions. Outside of anterior shoulder instability, injuries in these joints are not well characterized in National Basketball Association (NBA) players. Purpose: To describe the epidemiology and associated risk factors of shoulder and elbow injuries in NBA players and identify factors that influence player performance upon return to play. Study Design: Descriptive epidemiology study. Methods: Historical injury data from the 2015-2020 NBA seasons were retrieved from Pro Sports Transactions, a public online database. An injury was defined as a health-related concern resulting in an absence of ≥1 NBA games. Primary measures included pre- and postinjury player efficiency rating (PER) and true shooting percentage (TS%) with interquartile ranges (IQRs), stratified by extremity dominance. Multivariate logistic regression analyses with stepwise regression were performed to identify risk factors associated with return-to-play performance. Results: A total of 192 shoulder and elbow injuries were sustained among 126 NBA athletes, with incidence rates of 1.11 per 1000 game exposures (GEs) and 0.30 per 1000 GEs, respectively. Sprain/strain and general soreness were the most common injury types in both the shoulder and the elbow. In the 2 years after injury, baseline PER was achieved in all groups, except for players with dominant shoulder injuries (baseline PER, 16 [IQR, 14-18] vs 2-year PER, 13 [IQR 11-16]; P = .012). Younger age was associated with quicker return to baseline PER (odds ratio, 0.77 [95% CI, 0.67-0.88]). Shoulder and elbow injuries did not negatively influence TS% upon return to play (baseline TS%, 0.55% [IQR, 0.51%-0.58%] vs 1-year TS%, 0.55% [IQR, 0.52%-0.58%]; P = .13). Conclusion: Dominant shoulder injuries negatively influenced PER during the first 2 seasons upon return to play in NBA players. Therefore, expectations that players with this type of injury immediately achieve baseline statistical production should be tempered. Shooting accuracy appears to remain unaffected after shoulder or elbow injury.
Genetically determined blood pressure, antihypertensive medications, and risk of intracranial aneurysms and aneurysmal subarachnoid hemorrhage: A Mendelian randomization study
Authors: Liu Hanchen , Zuo Huiqin , Johanna Ospel , Zhao Rui , Yang Pengfei , Chen Weixing , Li Qiang , Lin Xiaolei , Zhou Yu , Liu Jianmin 
Published: October 2023

Introduction: Observational studies suggest that different classes of antihypertensive drugs may have different effects on the occurrence of intracranial aneurysms (IA) and subarachnoid hemorrhage (SAH). However, the reported results in previous studies are inconsistent, and randomized data are absent. We performed a two-sample Mendelian randomization (MR) analysis to study the causal effects of genetically determined blood pressure (BP) and genetic proxies for antihypertensive drug classes on the risk of IA and SAH. Materials and methods: Genetic instruments and outcome data were obtained from independent genome-wide association studies (GWAS) or published data, which were exclusively restricted to European ancestry. Causal relationships were identified using inverse-variance weighted MR analyses and a series of statistical sensitivity analyses. The FinnGen consortium was used for repeated analysis to verify results obtained from the above GWAS. Results: Two-sample MR analysis showed that genetically determined Systolic BP, Dystolic BP, and Pulse Pressure were related to a higher risk of IA and SAH. Based on identified single nucleotide polymorphisms (SNPs) that influence the effect of calcium channel blockers (CCB, 42 SNPs), beta-blockers (BB, 8 SNPs), angiotensin-converting enzyme inhibitors (ACEI, 2 SNPs), angiotensin receptor blockers (ARB, 1 SNPs), and thiazides (5 SNPs), genetically determined effect of CCBs was associated with a higher risk of IA (OR, 1.07 [95% CI, 1.03–1.10], p = 5.02 × 10−5) and SAH (OR, 1.06 [95% CI, 1.03–1.09], p = 1.84 × 10−3). No associations were found between other antihypertensive drugs and the risk of IA or SAH. The effect of CCBs on SAH was confirmed in FinnGenconsortium samples (OR, 1.04 [95% CI, 1.00–1.08], p = 0.042). Discussion and conclusion: This MR analysis supports the role of elevated blood pressure in the occurrence of intracranial aneurysms and subarachnoid hemorrhage. However, genetic proxies for calcium channel blockers were associated with an increased risk of intracranial aneurysms and subarachnoid hemorrhage. Further studies are required to confirm these findings and investigate the underlying mechanisms.
Hemodynamic significance of intracranial atherosclerotic disease and ipsilateral imaging markers of cerebral small vessel disease
Authors: Zheng Lina , Tian Xuan , Abrigo Jill , Fang Hui , Ip Bonaventure YM , Liu Yuying , Li Shuang , Liu Yu , Lan Linfang , Liu Haipeng , Ip Hing Lung , Fan Florence SY , Ma Sze Ho , Ma Karen , Lau Alexander Y , Soo Yannie OY , Leung Howan , Mok Vincent CT , Wong Lawrence KS , Xu Yuming , Liu Liping , Leng Xinyi , Leung Thomas W 
Published: October 2023

Introduction: Cerebral small vessel disease (CSVD) commonly exists in patients with symptomatic intracranial atherosclerotic disease (sICAD). We aimed to investigate the associations of hemodynamic features of sICAD lesions with imaging markers and overall burden of CSVD. Patients and methods: Patients with anterior-circulation sICAD (50%–99% stenosis) were analyzed in this cross-sectional study. Hemodynamic features of a sICAD lesion were quantified by translesional pressure ratio (PR = Pressurepost-stenotic/Pressurepre-stenotic) and wall shear stress ratio (WSSR = WSSstenotic-throat/WSSpre-stenotic) via CT angiography-based computational fluid dynamics modeling. PR ⩽median was defined as low (“abnormal”) PR, and WSSR ⩾ fourth quartile as high (“abnormal”) WSSR. For primary analyses, white matter hyperintensities (WMHs), lacunes, and cortical microinfarcts (CMIs) were assessed in MRI and summed up as overall CSVD burden, respectively in ipsilateral and contralateral hemispheres to sICAD. Enlarged perivascular spaces (EPVSs) and cerebral microbleeds (CMBs) were assessed for secondary analyses. Results: Among 112 sICAD patients, there were more severe WMHs, more lacunes and CMIs, and more severe overall CSVD burden ipsilaterally than contralaterally (all p < 0.05). Abnormal PR and WSSR (vs normal PR and WSSR) was significantly associated with moderate-to-severe WMHs (adjusted odds ratio = 10.12, p = 0.018), CMI presence (5.25, p = 0.003), and moderate-to-severe CSVD burden (12.55; p = 0.033), ipsilaterally, respectively independent of contralateral WMHs, CMI(s), and CSVD burden. EPVSs and CMBs were comparable between the two hemispheres, with no association found with the hemodynamic metrics. Discussion and conclusion: There are more severe WMHs and CMI(s) in the hemisphere ipsilateral than contralateral to sICAD. The hemodynamic significance of sICAD lesions was independently associated with severities of WMHs and CMI(s) ipsilaterally.