bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal oculomics and risk of incident aortic aneurysm and aortic adverse events: a population-based cohort study
Authors: Li Cong , Huang Yu , Chen Jian , Hua Guangyao , Yang Fan , Cai Dongqin , Kuang Yu , He Xue , Wang Yan , Jiang Jianrong , Du Zhenchao , Peng Jingyan , Li Heng , Peng Zhishen , Huang Tengda , Ren Yun , Zhang Wenli , Liu Lei , Shi Danli , Luo Jianfang , Yu Honghua , Yang Xiaohong 
Published: January 2025

Background:
The asymptomatic onset and extremely high mortality rate of aortic aneurysm (AA) highlight the urgency of early detection and timely intervention. The alteration of retinal vascular features (RVFs) can reflect the systemic vascular properties, and be widely used as the biomarker for cardiovascular disease risk prediction. Therefore, we aimed to investigate associations of RVFs with AA and its progression.

Methods:
In this prospective population-based cohort study, participants with eligible fundus images and without a history of AA at recruitment were included for analysis. A fully automated Retina-based Microvascular Health Assessment System was used to quantify multidimensional RVFs including the branching angle, caliber, complexity, density, length, and tortuosity. Univariable and multivariable Cox regressions were used to estimate the association of RVFs with the incidence of AA and aortic adverse events (AAE). Furthermore, propensity score matching was performed to mitigate the confounding effects of baseline characteristics.

Results:
During a median follow-up of 11.0 years, 306 incident AA (164 with abdominal AA and 108 with thoracic AA) and 48 incident AAE were documented. In the fully adjusted model, the retinal arterial branching angle (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.77 to 0.99) and the central tendency and variability of minimum venular caliber were significantly associated with the risk of incident AA (HR 1.13-1.15), while the venular minimum angular asymmetry (0.48, 0.30 to 0.77) was significantly associated with the incidence of AAE. Moreover, specific alterations of RVFs were observed in different AA subtypes (caliber in abdominal AA [HR 1.21]; caliber [HR 1.21-1.28], complexity, length, and tortuosity [HR 0.77-0.82] in thoracic AA). Similar results were obtained after propensity score-matched analysis, confirming the stability of these associations.

Conclusions:
We identified a significant association of certain RVFs with incident AA and AAE, implying that noninvasive, and convenient fundus photography could be a promising tool to facilitate the early detection of AA and subsequent preventative interventions.
Incidence and treatment of anastomotic leakage after esophagectomy in German acute care hospitals: a retrospective cohort study
Authors: Weber Marie-Christin , Jorek Nicolas , Neumann Philipp-Alexander , Bachmann Jeannine , Dimpel Rebekka , Martignoni Marc , Feith Marcus , Friess Helmut , Novotny Alexander , Berlet Maximilian , Reim Daniel 
Published: January 2025

Background:
Anastomotic leakage (AL) is a major concern following esophagectomy due to the associated morbidity and mortality. The impact of hospital volume on postoperative outcomes after esophagectomy has previously been reported. The aim of this study was to analyze the current trends in postoperative anastomotic leakage and associated failure-to-rescue after esophagectomy in relation to hospital volume in German acute care hospitals using real-world data from the German Diagnosis-Related Groups (G-DRG) database.

Materials and methods:
A retrospective secondary data analysis of the G-DRG database was performed for all in-hospital cases of patients undergoing esophagectomy from 2013 to 2021. AL and in-house mortality rates were assessed in relation to hospital case volume and endoscopic treatment modalities.

Results:
The study included 32 335 cases. The mean reported AL rate was 17.1% with a mean failure-to-rescue rate of 18.9%. AL rates did not differ between hospitals with an annual case-volume ≤ 25 procedures/year vs. >25 procedures/year (16.8% vs. 17.6%, OR 1.06, P = 0.07). However, in high-volume centers (> 25 procedures/year), in-hospital mortality for cases with AL (failure-to-rescue) was lower compared to medium-volume (10-25 cases/year) and low-volume (1-9 cases/year) centers (14.2% vs. 21.5% vs. 25.1%). The use of EVT increased over time, reaching 58.1% of AL cases in 2021 compared to 14.2% in 2013, while the use of self-expanding metal stents (SEMS) decreased from 37.0% in 2013 to 9.3% in 2021.

Conclusions:
AL rates after esophagectomy remain high. In-house mortality is significantly lower in high-volume hospitals highlighting the importance to consider improvements in centralization of procedures. Further efforts are needed to reduce AL rates and improve outcomes after esophagectomy.
A Brief Intervention for Injury-Related Traumatic Stress: Results From a Feasibility Study
Authors: Bull Chelsey , Urban Kelly , Rohm Laura , Rohrer Stephanie , McBain Sacha A. 
Published: January 2025

BACKGROUND:
Post-traumatic stress disorder (PTSD) significantly impacts post-injury quality of life; however, many injured patients struggle to access necessary psychosocial care. A brief intervention, Talk, Listen, Communicate to Recover (TLC to Recover), may facilitate access to psychosocial care in low resource trauma centers.

OBJECTIVE:
This study assessed staff and patient perceptions regarding the feasibility and acceptability of implementing TLC to Recover at a Level I trauma center.

METHODS:
This study used a mixed methods approach to examine the implementation of a brief dyadic intervention intended to mitigate the effect of potential post-injury mental health sequelae. The study took place from April 2021 to April 2024. Participants included adult patients who received post-injury care and were at risk for post-injury PTSD and/or depression. Outpatient trauma clinic staff participated in formative and summative evaluations of the intervention. Recruitment, retention rates, and engagement were assessed. Symptom measurements were administered to patients at baseline, two week follow-up, and one month to measure the effectiveness of TLC to Recover. Semistructured interviews and focus groups explored the acceptability of TLC to Recover among staff and patients. Summative template analysis was utilized to analyze qualitative data and integrated with the theoretical framework of acceptability.

RESULTS:
A total of N = 26 participants were included in the summative and formative evaluations, of which n = 15 were patients and n = 11 were clinic staff. The surgical clinic was an acceptable and feasible context to deliver a brief intervention to patients at risk for post-injury PTSD and/or depression.

CONCLUSION:
This study offers insight into opportunities for implementation of brief post-injury psychosocial interventions in a surgical context.
Gender-Based Analysis of Injury Types and Risk Factors in Professional Tennis Players – Insights for Prevention: A Concise Review
Authors: Nunes Espat Nikita , Breeding Tessa , Nasef Hazem , Amin Quratulain , Chin Brian , Elkbuli Adel 
Published: January 2025

BACKGROUND:
Tennis is a globally popular sport offering physical benefits but poses a high risk of injury due to its demands and prolonged gameplay. While injuries are common among professional players, detailed injury data for this group is limited.

OBJECTIVE:
This review aims to analyze trends in the incidence, type, region, and onset of injuries in professional tennis players, with particular attention to gender distribution, to improve guidelines and reduce injury impacts on performance and career longevity.

DATA SOURCES:
PubMed, Google Scholar, Cochrane, ProQuest, and Embase were reviewed for relevant literature.

STUDY SELECTION:
Included studies evaluated various features of injuries in professional tennis players.

DATA EXTRACTION:
Studies were selected and included by agreement among the authors. The extracted data included incidence, type, affected body regions, and timing of onset of injuries in professional tennis players.

DATA SYNTHESIS:
Tennis is widely popular and physically beneficial but carries a high injury risk, with limited detailed data on professional players.

CONCLUSION:
The findings indicate a high incidence of acute lower limb, muscle, and tendon injuries among professional tennis players, with significant gender differences in injury patterns. These insights highlight the need for improved injury prevention strategies and further research into gender-specific injury mechanisms.
Value of Spleen Dynamic Contrast-enhanced Ultrasound Parameters in Predicting Hepatic Vein Pressure Gradient for Patients With Liver Cirrhosis
Authors: Zhou Tie , Zhou Yan , Zhao Lin , Kan Yanmin , Ding Jianmin , Sun Cheng , Jing Xiang 
Published: January 2025

Goals:
To explore dynamic contrast-enhanced ultrasound (CEUS) parameters in predicting hepatic vein pressure gradient (HVPG) for patients with liver cirrhosis (LC).

Background:
Noninvasive diagnosis of HVPG remains a challenge.

Study:
This prospective study included patients with LC undergoing hepatic vein catheterization and pressure measurement at the hospital from May 2021 to January 2023. The CEUS images (Mindray Resona R9, 1-6-MHz probe frequency; mechanical index=0.08; image depth=10 cm; focus at the lowest point of the diaphragm; dynamic range=70 dB; optimal gain; single SonoVue bolus injection) were taken for 60 seconds after injection and analyzed using VueBox. HVPG (ie, the gold standard for portal hypertension) was measured routinely by catheterization.

Results:
Fifty patients with LC were included in the study. The rise time (r=0.6, P<0.01), the fall time (r=0.7, P<0.01), the peak time (r=0.6, P<0.01), wash-in area under the curve (AUC) (r=0.5, P<0.01), the wash-out phase AUC (r=0.4, P<0.01) and wash-in and wash-out phase AUC (r=0.4, P<0.01) of the dynamic spleen CEUS were positively correlated with HVPG. The optimal fall time cutoff levels to predict HVPG ≥10 mm Hg and ≥12 mm Hg were 27.0 and 36.4 seconds, with the AUC being 0.958 and 0.941, respectively. The optimal area under the wash-in area cutoff level to predict HVPG ≥10 mm Hg and ≥12 mm Hg was 1,658,967.38 (a.u) and 4,244,015.90 (a.u), with the AUC being 0.865 and 0.877, respectively.

Conclusions:
The fall time and wash-in AUC obtained by dynamic CEUS may help diagnose HVPG in patients with LC without requiring invasive hepatic vein catheterization.
Updated Adjustment of the HCAHPS Survey for New Modes of Survey Administration and Patient Mix
Authors: Elliott Marc N. , Beckett Megan K. , Hambarsoomian Katrin , Brown Julie , Cleary Paul , Lehrman William G. , Goldstein Elizabeth , Giordano Laura A. , Parast Layla 
Published: January 2025

Background:
Web-first multimode survey protocols increase HCAHPS survey response rates and representativeness but may result in different HCAHPS scores because of survey mode effects and selective email address availability. A variable absent from many patient-mix adjustment models that may result in more positive patient experiences is whether the hospital admission was planned; adjustment for planned stays may better measure hospital performance.

Objectives:
Develop adjustments for new Web-first survey protocols and planned admissions to facilitate comparisons across hospitals.

Research Design:
Using 2021 survey mode experiment data, we estimate survey protocol effects in linear models predicting HCAHPS top-box outcomes from protocol indicators (which incorporate email availability for Web-first protocols), patient-mix adjustors, and hospital intercepts. We evaluate the unique effect on scores of whether a stay was planned.

Results:
Phone-only and Web-Phone without email produce more positive responses than Mail-only, requiring negative adjustments. All other survey protocol effects and adjustments are mixed in direction and generally small. Planned stays are associated with more positive experiences for otherwise similar patients and make a unique contribution beyond other current patient-mix adjustment variables.

Conclusions:
It is important to adjust HCAHPS scores for survey protocol effects to ensure fair comparisons across hospitals and to enable hospitals to choose the survey protocol that best represents their patients. Incomplete email address availability necessitates that HCAHPS survey protocol adjustment control for email address availability when a Web-first protocol is used. Accounting for differences associated with planned stays may improve patient-mix adjustment.
Retrospective comparative cohort analysis of Darn and Lichtenstein repair methods for bilateral inguinal hernias in adult males in a low-resource setting: a single-centre study in Sudan
Authors: Suliman Alsadig , Mohamed Osman Reem , Suliman Hiba 
Published: January 2025

Background:
Inguinal hernias are a common surgical condition that, if untreated, can lead to severe complications. Bilateral inguinal hernias add challenges due to increased recurrence and postoperative risks. Although Lichtenstein repair, a mesh-based approach, is the gold standard for its low recurrence, Darn repair – a mesh-free technique – offers a cost-effective alternative in low-resource settings. This study assesses the applicability and effectiveness of both techniques for bilateral inguinal hernias in a resource-limited environment.

Materials and methods:
With Institutional Review Board (IRB) approval from Al-Waleedeen Specialized Hospital (IRB number WAD.12.01.2021), a retrospective cohort analysis was conducted on 75 adult males who underwent bilateral inguinal hernia repair from January 2021 to October 2023 in Sudan. Patients were divided into Group A (Lichtenstein, n = 30) and Group B (Darn, n = 45). Data on operative time, complications, hospital stay, return to normal activities, patient satisfaction, and economic impact were collected, with a three-month follow-up.

Results:
Darn repair showed fewer postoperative complications, particularly lower surgical site infections (SSI) (8% vs. 20%, P = 0.014). It also had shorter operative times (mean 30 minutes less), reduced hospital stays (1.5 vs. 2.8 days, P < 0.0001), and lower costs. Recurrence rates were comparable across both groups.

Conclusion:
While both methods yielded similar recurrence rates, Darn repair showed advantages in resource-limited settings, with fewer complications, shorter hospital stays, and lower costs, making it a practical option when mesh is not readily available. Limitations include retrospective design, convenience sampling, and possible recall bias from phone follow-ups. The three-month follow-up may not capture long-term outcomes like chronic pain or late recurrences. Future studies should extend follow-ups and conduct prospective trials to optimize Darn repair across diverse settings
Wavefront aberrations in aging measured with Hartmann-Shack at 3- and 5-mm pupil sizes
Authors: Clark Christopher A. , Parimi Vamsi , Elsner Ann E. 
Published: January 2025

SIGNIFICANCE
Visual acuity (VA) depends on many factors. When the goal is to assess retinal health rather than performance, then using a 3-mm pupil reduces unwanted wavefront aberrations. The axis of astigmatism can still potentially change with age.

PURPOSE
When VA measurements are intended to quantify the status of the retina, extraneous optical aberrations can make the measured VA worse and introduce variability, particularly in aging eyes. Our study quantifies wavefront aberrations for a 3-mm pupil, which is similar to the theoretical optical size for best VA, versus a 5-mm pupil.

METHODS
The wavefront aberrations of normally sighted adults (N = 39; age, 41.9 ± 16.3 years) were measured for a 3- and 5-mm pupil setting without pupil dilation, using a commercially available and semiautomatic instrument (Pentacam AXL WAV; Oculus Optikgeraete GmbH, Wetzlar, Germany). The mean wavefront errors from the average of three measurements with three samples each were computed for each Zernike term orders 1 to 6 and correlated with age. The difference of measurement 1 and measurement 2 provided the test-retest values.

RESULTS
Each 3-mm pupil measurements had a reduced average aberration for all 26 aberrations Zernike values, and 21 of 26 were statistically significant (p<0.05). The variability of the Zernike values was less for the 3-mm pupil than for the 5-mm pupil for all 26 measured aberrations pooled (Zernike orders 1 to 6), which was statistically significant (F = 54.625, p<0.001). Most mean aberrations did not vary significantly with age for a 3-mm pupil, except for vertical astigmatism, horizontal coma, spherical aberration, and vertical quadrafoil. Against-the-rule astigmatism was more common in subjects >60 than <40 years old (p=0.05).

CONCLUSIONS
The findings of this study indicate that measurements of VA to assess retinal health could be made less dependent on unrelated and unwanted anterior segment factors by using a 3-mm pupil, because the wavefront aberrations for a 3-mm pupil were less than those for a 5-mm pupil. The change with age in vertical astigmatism more than oblique is consistent with the expected increase in proportion of against-the-rule astigmatism.
Ultrasound-Guided Maxillary Nerve Block in Nasal Surgery
Authors: Vu Cindy , Willens Sierra Hewett , Alaniz Leonardo , Humphrey Ja’Neil G. , Shah Nikhil , Vyas Raj M. , Pfaff Miles J. 
Published: January 2025

Summary / Unstructured Abstract:
Emphasis on enhanced recovery after surgery (ERAS) protocols and opioid use reduction have led to a growing interest in alternative pain management strategies. This study describes and evaluates the ultrasound-guided suprazygomatic maxillary (SZM) nerve blocks for patients undergoing functional and cosmetic nasal surgery as an adjunct to postoperative pain management. A retrospective, multicenter analysis was conducted on patients who underwent functional nasal surgery and rhinoplasty and evaluated the impact of SZM blocks on intraoperative anesthetic and opioid use, postoperative pain scores recorded in the PACU, and PACU length. A total of 64 patients met inclusion criteria. Twenty-five patients received a SZM block prior to undergoing the procedure while the remaining patients underwent standard local anesthetic use. SZM blocks significantly reduced the amount of intraoperative pain medication used (p = 0.02), including hydromorphone (p=0.007), when compared to a traditional approach to local anesthetic use. SZM blocks also significantly reduced post-anesthesia PACU stay at one institution (p=0.016). SZM nerve blocks are a simple and effective way to deliver local anesthetic and are associated with decreased intraoperative opioid use and PACU stay.
Dynamic Contrast-enhanced MRI Processing Comparison for Distinguishing True Progression From Pseudoprogression in High-grade Glioma
Authors: Amer Ahmad , Ansari Shehbaz , Krayyem Apollo , Kundu Suprateek , Khose Swapnil , Pokhylevych Halyna , Calle Susana , Patel Chirag B. , Yang Zixi , Liu Ho-Ling “Anthony” , Johnson Jason M. 
Published: January 2025

Background:
Treatment-related changes may occur due to radiation and temozolomide in glioblastoma and can mimic tumor progression on conventional MRI. DCE-MRI enables quantification of the extent of blood-brain barrier (BBB) disruption, providing information about areas of suspicious postcontrast T1 enhancement. We compared DCE-MRI processing methods for distinguishing true disease progression from pseudoprogression in high-grade gliomas (HGGs).

Methods:
We identified 110 patients with HGG treated with surgery and chemoradiation who underwent DCE-MRI to further interrogate areas of new/increasing enhancement. All patients had confirmatory surgery/biopsy with pathology-confirmed progression or pseudoprogression. Scans were performed at 3T and analyzed using nordicICE. The MCA, SSS, and Parker models are three standardized processing methodologies used to create ktrans maps, a parameter that quantifies BBB permeability. Three equal regions of interest were placed at sites of peak contrast enhancement within each lesion. Data from each method was processed for mean and maximum ktrans. We conducted several rounds of analysis and finalized a strategy on penalized support vector machines based on engineered features with bootstrap sampling.

Results:
The Parker method was significant for ktrans maximum in the combined pathology and clinical as well as the pathology-only data sets. MCA and SSS did not perform well under the SVM classifier for pathology only. For clinical follow-up subjects, the Parker method yielded statistically significant results for maximum and mean ktrans.

Conclusions:
The Parker method was effective in distinguishing PD and PsP for pathology and clinical data sets. MCA and SSS techniques were effective for the clinical data set.
Different Imaging Evaluating Performances Between Glymphatic System and Motor Symptoms and Levodopa Responsiveness of Parkinson Disease
Authors: Deng Jin-Huan , Zhang Han-Wen , Lan Xin-Xin , Liu Yu-Feng , Liu Xiao-Lei , Deng Hua-Zhen , Luo Si-Ping , Yao Gui-Zhi , Wu He-Lv , Huang Biao , Lin Fan 
Published: January 2025

Background and Purpose:
Parkinson disease (PD) is defined by its unique motor symptoms, where responsiveness to levodopa (L-DOPA) is fundamental for management. Recent research has highlighted a significant relationship between PD symptoms and glymphatic dysfunction. This study endeavors to clarify the connection between glymphatic system functionality and initial motor symptoms in PD, utilizing imaging biomarkers to determine its predictive capacity for L-DOPA responsiveness (LR).

Materials and Methods:
Retrospective study of 86 PD patients with 3.0-T MRI scans (July 2019 to March 2021), assessing the diffusion tensor image analysis along the perivascular space (DTI-ALPS) methods, enlarged perivascular spaces (ePVSs) load, and choroid plexus volume (CPV). Analyzed metrics versus the third part of the Unified Parkinson Disease Rating Scale (UPDRSIII) scores and %LR using linear regression, creating a %LR prediction model for the L-DOPA challenge. Explored relationships with age, sex, Hoehn and Yahr stage, Montreal Cognitive Assessment scores, and Mini-Mental State Examination score. Examined DTI-ALPS index, ePVSs, and CPV interrelations.

Results:
Pre-L-DOPA, UPDRSIII inversely correlated with DTI-ALPS index (P=0.049), positively with bilateral basal ganglia ePVSs (P<0.001). Age-adjusted BG-ePVSs-UPDRSIII link (P<0.001). Post-L-DOPA, UPDRSIII correlated similarly and CPV was positive. %LR positively linked to DTI-ALPS index (P<0.001), negatively to BG-ePVSs (P=0.04), CPV (P<0.001). Adjusted %LR-DTI-ALPS index positive (P=0.005), %LR-CPV negative (P=0.04). DTI-ALPS index, CPV predicted LCT outcomes (%LR ≥33%) with area under the curves 0.78, 0.79; accuracies 86.01%, 81.4%. The combined model area under the curve is 0.82, with an accuracy of 87.2%. Significant linear correlations were observed (CPV-DTI-ALPS, CPV-ePVSs, DTI-ALPS-ePVSs).

Conclusions:
A study affirms the link between glymphatic impairment, motor symptoms, and L-DOPA responses in PD. As glymphatic function declines, symptoms worsen, and L-DOPA effectiveness diminishes. The DTI-ALPS index and CPV emerge as potential predictors of PD patient LCT outcomes.