bluuebunny/crossref_metadata_2025_split huggingface dataset:
P097 The Fate of Obstructive Sleep Apnea in Long-term
Authors: Jang H , Lee J , Ryu U , Park D , Mun S 
Published: October 2023

Abstract

Objective
This study aims to investigate the relationships of the severity of OSA and the long-term results of OSA in untreated patients and to compare them with the results of OSA patients who were operated.

Materials and Methods
The study retrospectively analyzed medical records of 79 individuals who were diagnosed with OSA, who either underwent surgical treatment or received no treatment from 2009 to 2022. Among the patients who underwent polysomnography (PSG) twice, the patients were subdivided by mild, moderate, severe groups according to apnea-hypopnea index (AHI) and the changes in OSA severity over time were compared.

Results
This study included 43 patients (54%) who received no treatment and 36 patients (46%) who had undergone surgery including tonsillectomy with or without uvula or palatopharyngeal procedures. Among the untreated patients, there was no significant changes in AHI values over time for the overall group, the mild and severe subgroups, but the moderate group showed a significant increase in AHI values (p=0.017). Surgical treatment, specifically tonsillectomy, resulted in a significant decrease in AHI values compared to untreated patients, particularly within 36 months after the procedure (p=0.000). However, for patients with a follow-up period of more than 36 months, the difference in AHI values was not statistically significant between those who underwent tonsillectomy and those who did not.

Conclusions
Untreated moderate OSA patients show worsening of AHI values over time, highlighting the need for proactive treatment. Surgical intervention can reduce AHI values within 36 months but may lead to worsening of symptoms afterwards.
P101 Brain Amyloid Burden and Autobiographical Memory in Obstructive Sleep Apnoea: A Cross-sectional Study.
Authors: Rawson G , Cavuoto M , Tolson J , O'Donoghue F , Barnes M , Howard M , Rowe C , Robinson S , Jackson M 
Published: October 2023

Abstract

Introduction
Emerging literature reports an increased risk of Alzheimer’s disease in individuals with obstructive sleep apnoea (OSA). Established characteristics of Alzheimer’s disease include increased brain amyloid burden and impairment to episodic and autobiographical memory. Investigating these constructs in individuals with clinically confirmed OSA will contribute to understanding of OSA and neuronal implications.

Aim
The aim of the study was to explore the relationship between brain amyloid burden and autobiographical memory in cognitively-healthy individuals with OSA.

Methods
Thirty-four participants with OSA (mean age=57.7, SD=8.5, 19 males), and 12 controls (mean age=57.1, SD=8.1, 6 males) participated in the study. Participants underwent a 11C-PiB positron emission tomography (PET) scan to quantify amyloid burden, and an assessment of autobiographical memory. Brain amyloid burden was quantified using the standardised uptake value ratio (SUVR), and the Autobiographical Memory Test (AMT) was used to assess the ability of participants to recall specific memories from their life.

Results
Individuals with OSA recalled significantly fewer specific autobiographical memories (M=6.66, SD=2.91) compared to controls (M=10.25, SD=2.09, t(45)=-3.930, p&lt;.001). There was no significant difference in SUVR between groups, t(44)=1.465, p=.150. Recall of non-specific memories was significantly positively correlated with SUVR, r=.331, p=.026.

Discussion
Levels of brain amyloid burden did not differ significantly between groups however the results support existing literature suggesting amyloid burden is associated with autobiographical memory in individuals with OSA. Longitudinal studies investigating the trajectory of these constructs in the context of disease development should be conducted to further explore the impacts of OSA.
P103 Utility of Capillary Blood Gases (CBGs) for measuring gas exchange in the Sleep Laboratory.
Authors: Slater D , Veldre T , Urban M , Figurski D , Huang H 
Published: October 2023

Abstract

Introduction
Arterial Blood Gases (ABGs) are used for assessing respiratory failure in clinical practice. ABGs also provide a useful verification tool for nocturnal Transcutaneous Carbon Dioxide (TcCO2) measurements. However, there are known complications to collecting ABGs. Conversely, CBG is less invasive and more accessible to clinical practice. We assessed CBGs as an alternative to ABGs to measure pCO2 and pO2, and its suitability for verifying TcCO2. We hypothesised that CBG sampling would be suitable for TcCO2 verification and would be a suitable ABG surrogate.

Methods
ABGs were sampled by Resident Medical Officers (RMOs) and CBGs were sampled by Sleep Scientists to validate TcCO2 at awake. Correlation between measures was assessed via Pearson and Spearman coefficients. ρ &gt; 0.6 demonstrate a moderate positive correlation, with strengthening correlation as ρ approaches 1. Agreement between measurements was assessed via Bland-Altman plots.

Results
There was a moderately strong correlation between CBG vs TcCO2 (n=125) (ρ = 0.694, p &lt; 0.001) and CBG vs ABG (pCO2) (n=29) (ρ = 0.725, p &lt; 0.001), with a strong correlation for ABG vs TcCO2 (n=81) (ρ = 0.847, p &lt; 0.001). Bland-Altman plots showed agreement between CBG, ABG and TcCO2.

Conclusions
There were strong positive correlations observed, with agreement seen across all measures of pCO2. This analysis demonstrates both the accuracy of nocturnal TcCO2 and the utility of CBG to verify TcCO2. Surrogate CO2 measures support positive patient outcomes and verification of gas exchange.
Hypoxemia Trajectory of Non-COVID-19 Acute Respiratory Distress Syndrome Patients. An Observational Study Focusing on Hypoxemia Resolver Status
Authors: Toal Connor M. , Fowler Alexander J. , Patel Brijesh V. , Puthucheary Zudin , Prowle John R. 
Published: October 2023

IMPORTANCE:
Most studies on acute respiratory distress syndrome (ARDS) group patients by severity based on their initial degree of hypoxemia. However, this grouping has limitations, including inconsistent hypoxemia trajectories and outcomes.

OBJECTIVES:
This study explores the benefits of grouping patients by resolver status based on their hypoxemia progression over the first 7 days.

DESIGN, SETTING, AND PARTICIPANTS:
This is an observational study from a large single-center database. Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC Chest X-ray JPEG databases were used. Mechanically ventilated patients that met the Berlin ARDS criteria were included.

MAIN OUTCOMES AND MEASURES:
The primary outcome was the proportion of hypoxemia resolvers vs. nonresolvers in non-COVID-19 ARDS patients. Nonresolvers were defined as those whose hypoxemia worsened or remained moderate or severe over the first 7 days. Secondary outcomes included baseline admission characteristics, initial blood gases and ventilation settings, length of invasive mechanical ventilation, length of ICU stay, and ICU survival rates across resolver groups.

RESULTS:
A total of 894 ICU admissions were included in the study. Of these, 33.9% were hypoxemia nonresolvers. The resolver groups showed no significant difference in age, body mass index, comorbidities, or Charlson score. There was no significant difference in the percentage of those with initial severe hypoxemia between the two groups (8.1% vs. 9.2%; p = 0.126). The initial Pao
2/Fio
2 ratio did not significantly increase the odds ratio (OR) of being a nonresolver (OR, 0.84; 95% CI, 0.65–1.10). Nonresolver mortality was 61.4%, comparable to the survival rates seen in nonresolvers in a previous large COVID-19 ARDS study.

CONCLUSIONS AND RELEVANCE:
Our study shows that resolver status is a valuable grouping in ARDS. It has significant advantages over grouping by initial degree of hypoxemia, including better mapping of trajectory and comparable outcomes across other studies. While it may offer insights into disease-specific associations, future studies should include resolver status analysis for more definitive conclusions.
Association of hepatitis delta virus with liver morbidity and mortality: A systematic literature review and meta-analysis
Authors: Gish Robert G. , Wong Robert J. , Di Tanna Gian Luca , Kaushik Ankita , Kim Chong , Smith Nathaniel J. , Kennedy Patrick T.F. 
Published: October 2023

Background and Aims:
Studies have suggested that patients with chronic hepatitis B, either co- or superinfected, have more aggressive liver disease progression than those with the HDV. This systematic literature review and meta-analysis examined whether HDV RNA status is associated with increased risk of advanced liver disease events in patients who are HBsAg and HDV antibody positive.

Approach and Results:
A total of 12 publications were included. Relative rates of progression to advanced liver disease event for HDV RNA+/detectable versus HDV RNA−/undetectable were extracted for analysis. Reported OR and HRs with 95% CI were pooled using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. The presence of HDV RNA+ was associated with an increased risk of any advanced liver disease event [random effect (95% CI): risk ratio: 1.48 (0.93, 2.33); HR: 2.62 (1.55, 4.44)]. When compared to the patients with HDV RNA− status, HDV RNA+ was associated with a significantly higher risk of progressing to compensated cirrhosis [risk ratio: 1.74 (1.24, 2.45)] decompensated cirrhosis [HR: 3.82 (1.60, 9.10)], HCC [HR: 2.97 (1.87, 4.70)], liver transplantation [HR: 7.07 (1.61, 30.99)], and liver-related mortality [HR: 3.78 (2.18, 6.56)].

Conclusions:
The patients with HDV RNA+ status have a significantly greater risk of liver disease progression than the patients who are HDV RNA−. These findings highlight the need for improved HDV screening and linkage to treatment to reduce the risk of liver-related morbidity and mortality.
Central corneal distortion after small-incision lenticule extraction
Authors: Moshirfar Majid , Zhang Stephanie , Pandya Shreya , Murri Michael , Hura Arjan , Zhu Dagny , Mehta Jod S. , Liu Yu Chi , Ganesh Sri , Kim Gene 
Published: October 2023

A 33-year-old woman with a prior history of small-incision lenticule extraction (SMILE) presented with gradual deterioration of vision in her right eye since the surgery. She had undergone bilateral SMILE for myopic correction (−7.00 diopters [D] in the right eye and −6.00 D in the left eye) 3 weeks prior. SMILE was performed with a Zeiss VisuMax femtosecond laser system, with a cap thickness of 120 µm, a cap diameter of 7.50 mm, and a lenticule diameter of 6.50 mm. At the completion of the surgery, loose epithelium was noted at the SMILE incision bilaterally, and bandage contact lenses were placed in both eyes.
On the first postoperative day, the patient's uncorrected distance visual acuity (UDVA) was 20/40 in both eyes. The bandage lenses were removed from both eyes, with the epithelium intact. At the first-week postoperative visit, her visual acuity was recorded as 20/30 in the right eye and 20/20 in the left eye. She noticed her vision in the right eye was not as sharp as that in her left eye. She denied experiencing any pain, redness, or ocular surface irritations. She was advised to return to the clinic for a 1-month postoperative visit and continue with aggressive lubrication in both eyes.
However, a week later, the patient returned for an emergency visit, citing significant central visual distortion in the right eye and difficulty working on the computer. At this visit, her UDVA and corrected distance visual acuity (CDVA) was 20/50 in the right eye and 20/15 in the left eye at both near and far distances. A slitlamp examination revealed mild central changes in the right eye. She once again denied any pain, redness, or irritation. She was advised to continue with artificial tears and return to the office in 1 week for further observation of the central distortion in her right eye.
Upon returning to the clinic at the third postoperative week, the patient still complained of central visual changes in the right eye, with a visual acuity of 20/70. Further slitlamp examination revealed a nonspecific central haze in the same eye, but there was no corneal staining or signs of epithelial defects. Anterior segment ocular coherence tomography (AS-OCT) and NIDEK topography were performed, showing the same central distortion in the right eye (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202311000-00016/figure1/v/2023-11-02T191830Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202311000-00016/figure2/v/2023-11-02T191830Z/r/image-tiff

).
Based on the examination and images provided, what is your working medical diagnosis? What other medical conditions are in your differential diagnosis? What medical and/or surgical interventions would you recommend, if any?
A systematic review of self and observer assessment of pain and related functioning in youth with brain-based developmental disabilities
Authors: Noyek Samantha , Jessa Jenna S. , Faulkner Violeta , Boerner Katelynn E. , Dewan Tammie , Doyle Dacey , Genik Lara , Grainger-Schatz Stacy , McMorris Carly , McMurtry C. Meghan , Nania Cara G. , Oberlander Tim , Lorenzetti Diane , Turner Kailyn , Birnie Kathryn A. 
Published: October 2023

Abstract
Pain experiences of youth with brain-based developmental disabilities are often overlooked and/or misinterpreted, increasing the risk for poor or inadequate pain assessment and management. Ample measures exist to assess acute and chronic pain, yet their utility and frequency of use in youth with brain-based developmental disabilities is unclear and available measures do not have strong measurement properties for this diverse group. This systematic review identified the scope of self-reported and observer-reported pain assessment in studies of youth (aged 3-24 years) with brain-based developmental disabilities (phase 1) and summarized other measures of pain-related functioning for acute and chronic pain (ie, physical, emotional, social, sleep, and quality of life, within the subset of quantitative studies focused primarily on pain, phase 2). A comprehensive search for English-language studies was conducted in August 2022 in Web of Science, CINAHL, MEDLINE, Cochrane CENTRAL, EMBASE, and APA PsychINFO (PROSPERO registration: CRD42021237444). A total of 17,029 unique records were screened. Of the 707 articles included in phase 1, most assessed chronic pain (n = 314; 62.0%) and primarily used observer-report (n = 155; 31%) over self-report (n = 67; 13%). Of the 137 articles included in phase 2, other outcomes assessed alongside pain intensity included motor ability (16.8%), adaptive functioning (11%), quality of life (8%), pain interference (6.6%), mental health (5.8%), and communication ability (2.9%). Cerebral palsy was the most common population in both phase 1 (n = 343; 48.5%) and phase 2 (n = 83; 59.7%). This review provides a foundational understanding of pain assessment in brain-based developmental disabilities and highlights continued inequities in holistic pain assessment for this population.
Effectiveness of neural mobilisation for the treatment of nerve-related cervicobrachial pain: a systematic review with subgroup meta-analysis
Authors: Lascurain-Aguirrebeña Ion , Dominguez Laura , Villanueva-Ruiz Iker , Ballesteros Javier , Rueda-Etxeberria Mikel , Rueda Jose-Ramón , Casado-Zumeta Xabat , Araolaza-Arrieta Maialen , Arbillaga-Etxarri Ane , Tampin Brigitte 
Published: October 2023

AbstractNeural mobilisations (NM) have been advocated for the treatment of nerve-related cervicobrachial pain; however, it is unclear what types of patients with nerve-related cervicobrachial pain (if any) may benefit. Medline, Web of Science, Scopus, PeDro, Cinahl, and Cochrane databases were searched from inception until December 2022. Randomised controlled trials were included if they assessed the effectiveness of NM in nerve-related cervicobrachial pain, and outcome measures were pain intensity and/or disability. Studies were classified according to their inclusion/exclusion criteria asradiculopathy,Wainner cluster,Hall,and Elvey clusterorother. Meta-analyses with subgroup analyses were performed. Risk of bias was assessed using Cochrane Rob2 tool. Twenty-seven studies were included. For pain and disability reduction, NM was found to be more effective than no treatment (pooled pain mean difference [MD] = −2.81, 95% confidence interval [CI] = −3.81 to −1.81; pooled disability standardized mean difference = −1.55, 95% CI = −2.72 to −0.37), increased the effectiveness of standard physiotherapy as an adjuvant when compared with standard physiotherapy alone (pooled pain MD = −1.44, 95% CI = −1.98 to −0.89; pooled disability MD = −11.07, 95% CI = −16.38 to −5.75) but was no more effective than cervical traction (pooled pain MD = −0.33, 95% CI = −1.35 to 0.68; pooled disability MD = −10.09, 95% CI = −21.89 to 1.81). For disability reduction, NM was found to be more effective than exercise (pooled MD = −18.27, 95% CI = −20.29 to −17.44). In most comparisons, there were significant differences in the effectiveness of NM between the subgroups. Neural mobilisations was consistently more effective than all alternative interventions (no treatment, traction, exercise, and standard physiotherapy alone) in 13 studies classified asWainner cluster. PROSPERO registration: CRD42022376087.
Surge of Midazolam Use in the Midst of Lorazepam Shortage
Authors: Liu Tonia T. , Frost Emma D. , Donlon Jack , Gandhi Roshni M. , Mohammadi Tarannum , Murray Briana P. , Shad Mujeeb U. , Koola Maju Mathew 
Published: October 2023

AbstractBackgroundLorazepam is a widely prescribed benzodiazepine that is used to manage anxiety, insomnia, and status epilepticus and is used for pre-anesthetic care as well as several off-label indications including aggression, alcohol withdrawal, panic disorder, chemotherapy-associated anticipatory nausea, and catatonia. Recent increases in demand, manufacturing changes, and quality control issues have resulted in a shortage of injectable and oral lorazepam, prompting clinicians to use alternatives. One such alternative is midazolam, a drug that has been used primarily in the intensive care unit and anesthesia settings.ProceduresThis article examines the significant pharmacologic differences between lorazepam and midazolam. In addition, this article provides dosage guidelines based on the current scientific knowledge and recommendations for conversion equivalencies.ResultsThe clinical preference for lorazepam can be attributed to its simpler metabolism with no active metabolites, better suitability for patients with less severe hepatic and renal impairment, less risk of adverse reactions, fewer drug-drug interactions, and greater desirability for special populations. In periods of shortages, midazolam has been shown to be effective for a number of off-label uses. To manage conditions that have not been extensively studied, clinicians may opt to use conversion equivalencies, with the caveat that guidelines may vary greatly between institutions and online sources; therefore, it would be best to start low and titrate slowly.ConclusionsOur goal is to aid clinicians in safely and effectively prescribing midazolam during the shortage of injectable lorazepam so that patients are provided the same effects and benefits.
Occupational Health Providers’ Perceptions of Employee Vaccine Hesitancy
Authors: Dooley Cara E. , Saif Nadia T. , Hodorowicz Mary T. , Doyle Mary L. , Gucer Patricia W. , Edwards Lori A. , Cloeren Marianne 
Published: October 2023

Objective
This study examined the perspectives of occupational health providers (OHPs) on the most frequently encountered clinically relevant reasons for employee vaccine hesitancy.

Methods
We conducted an anonymous, online, cross-sectional survey of US OHPs (N = 217). The survey asked OHPs about the major reasons that employees cite for being unwilling to receive the following three categories of vaccines: COVID-19, annual influenza, and others relevant to the workplace.

Results
Concern about adverse effects was the most frequently reported reason for employee vaccine hesitancy for each vaccine category. Mistrust was reported more frequently for COVID-19 than for the influenza vaccine or other vaccines (χ2
P < 0.05). Targets of employee mistrust included government and researchers or scientists, but mistrust of healthcare providers was uncommon.

Conclusions
These results can be used to inform interventions to address vaccine hesitancy in the occupational health setting.
Management of Patients Receiving Antiplatelet Therapy During Gastroenterological Surgery
Authors: Fujikawa Takahisa , Hasegawa Suguru , Takahashi Ryo , Naito Shigetoshi , Kaihara Satoshi , Uryuhara Kenji , Hirata Keiji , Tamura Toshihisa , Terajima Hiroaki , Kawai Takayuki , Okabe Hiroshi , Machimoto Takafumi , Tanaka Hirokazu , Honma Shusaku , Furumoto Katsuyoshi , Honda Goro , Uemura Shuichiro , Nishitai Ryuta , Hida Koya , Aoyama Ryuhei , Wada Seidai , Hirose Tetsuro , Obama Kazutaka 
Published: October 2023

Objective:
This study aimed to evaluate the effect of continuing preoperative aspirin monotherapy on surgical outcomes in patients receiving antiplatelet therapy (APT).

Summary Background Data:
The effectiveness of continuing preoperative aspirin monotherapy in patients undergoing APT in preventing thromboembolic consequences is mostly unknown.

Methods:
This prospective multicenter cohort study on the Safety and Feasibility of Gastroenterological Surgery in Patients Undergoing Antithrombotic Therapy (GSATT study) conducted at 14 clinical centers enrolled and screened patients between October 2019 and December 2021. The participants (n=1,170) were assigned to the continued APT group, discontinued APT group, or non-APT group, and the surgical outcomes of each group were compared. Propensity score matching was performed between the continued and discontinued APT groups to investigate the effect of continuing preoperative aspirin therapy on thromboembolic complications.

Results:
The rate of thromboembolic complications in the continued APT group was substantially lower than that in the non-APT or discontinued APT groups (0.5% vs. 2.6% vs. 2.9%; P=0.027). Multivariate investigation of the entire cohort revealed that discontinuation of APT (P<0.001) and chronic anticoagulant use (P<0.001) were independent risk factors for postoperative thromboembolism. The post-matching evaluation demonstrated that the rates of thromboembolic complications were significantly different between the continued and discontinued APT groups (0.6% vs. 3.3%; P=0.012).

Conclusions:
APT discontinuation following elective gastroenterological surgery increases the risk of thromboembolic consequences, whereas continuing preoperative aspirin greatly reduces this risk. The continuation of preoperative aspirin therapy in APT-received patients is considered one of the best alternatives for preventing thromboembolism during elective gastroenterological surgery.