bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of VRE meningitis due to haematogenous spread while on high-dose daptomycin therapy
Authors: Sanikommu Srivani , Lusardi Katherine , Burdine Lyle , Dare Ryan K 
Published: November 2023

Abstract

Introduction
Vancomycin-resistant Enterococcus faecium (VRE) meningitis accounts for only 0.3%–4.0% of bacterial meningitis cases and typically occurs following neurosurgical intervention. We describe a rare case of a patient without neurological devices in situ or a recent neurological procedure who developed VRE meningitis via haematogenous spread. Optimal treatment for VRE meningitis is unknown.

Case presentation
A 67-year-old male with end-stage liver failure underwent liver transplantation complicated by VRE bacteraemia and subsequently developed VRE meningitis while on high-dose daptomycin therapy (12 mg/kg/day). Due to clinical and microbiological failure with daptomycin, he was switched to linezolid and symptoms resolved rapidly. He completed 2 weeks of linezolid, fully recovered, and continued to do well without complications at the 5 month follow-up.

Conclusions
This case highlights the severity of VRE infections in solid organ transplant recipients and raises concerns about daptomycin penetration into the CNS. Linezolid could be considered the preferred treatment for VRE CNS infections rather than high-dose daptomycin.
Outcomes of pharmacy facility inspections: implications on pharmaceutical services
Authors: Singu Bonifasius Siyuka , Mutsambiwa Priscilla , Mvula Ester 
Published: November 2023

Abstract

Objectives
Good Pharmacy Practice (GPP) ensures access to quality medicines, a well-trained and adequate workforce of health professionals, and affordable healthcare. The Namibia Medicines Regulatory Council ensures the sale of medicines and the premises in which such sales are carried out comply with the Medicines and Related Substances Control Act of 2003. The purpose of this study was to report facility inspection outcomes.

Methods
This was a retrospective review of inspection records archived over a period of 5 years (2017–2021) by the Namibia Medicines Regulatory Council. Compliance by facilities to 13 indicators as stipulated in the Namibia Medicines Regulatory Council inspections checklist adopted from international GPP guidelines was the main measure of outcomes. Results were summarized using descriptive statistics such as median, range, and percentages in R. The Mann–Whitney U test was used to compare medians.

Key findings
General compliance by community pharmacies (operated by pharmacists) was statistically higher (P = .0043) than dispensaries at clinics (mostly operated by nurses) with median (range) values of 84% (30.8–100) and 38% (0.0–100), respectively. There was an improvement in compliance over the 5 years for both pharmacies and clinics.

Conclusions
The Ministry of Health & Social Services should implement policies that will ensure appropriately trained pharmaceutical cadres are stationed at all levels of the healthcare system to improve the delivery of pharmaceutical services. In addition, more inspectors need to be recruited for more frequent inspections.
Pneumatosis cystoids intestinalis in a patient with small bowel obstruction: a case report
Authors: Beyene Andinet , Bayissa Badhaasaa , Atalele Mezgebu , Umer Hamza , Alemu Addisu , Semahegn Agumasie 
Published: November 2023

Abstract
Pneumatosis cystoides intestinalis is a rare and usually benign condition in which multiple thin-walled cysts develop in the submucosa or subserosa of the gastrointestinal tract. While usually asymptomatic, severe cases can result in pneumoperitoneum, which can be managed surgically or medically depending on circumstances. A 35-year-old male patient presented with signs and symptoms of intestinal obstruction. Then the patient was diagnosed with pneumatosis cystoides intestinalis. The patient underwent surgery, and antibiotic treatment, and was discharged improved with no incident. Pneumatosis cystoides intestinalis is a surgical condition that resembles other life-threatening top surgical emergencies and affects clinicians’ decisions on diagnosis and treatment plans substantially, mainly in low-income countries. So, surgeons have to consider such kind of conditions and avoid the costs and morbidities associated with unnecessary bowel resection or surgery.
Quality of life after risk-reducing salpingo-oophorectomy in women with a pathogenic BRCA variant
Authors: Zilski Nicole , Speiser Dorothee , Bartley Julia , Roehle Robert , Blohmer Jens-Uwe , Keilholz Ulrich , Goerling Ute 
Published: November 2023

Abstract

Background
Risk-reducing salpingo-oophorectomy (RRSO) is recommended to women with a pathogenic BRCA variant, but as a main side effect, RRSO could lead to an early onset of menopause.

Aim
To evaluate the impact of RRSO and preoperative menopausal status on menopausal symptoms, sexual functioning, and quality of life (QOL).

Methods
The study was conducted between November 2019 and April 2020. Women were included who tested positive for a pathogenic BRCA1/2 variant between 2015 and 2018. Depression levels, QOL, and global health status were measured and compared with those of women who opted against RRSO. Furthermore, women who underwent RRSO treatment were asked to report menopausal complaints that they experienced at 1 month postsurgery and any current complaints.

Outcomes
RRSO had no significant impact on QOL, but women who were premenopausal at the time of surgery reported more sexual complaints than postmenopausal women.

Results
In total, 134 carriers of a BRCA mutation were included: 90 (67%) underwent RRSO and 44 (33%) did not. At the time of the survey, neither the control nor experimental group experienced significant changes in QOL (b = –0.18, P = .59). Women who underwent RRSO reported a significantly lower global health status (b = –0.66, P = .05). Women who were premenopausal at the time of surgery were bothered more by sexual symptoms (b = 0.91, P = .19) but experienced fewer vasomotor complaints (b = –1.09, P = .13) than women who were postmenopausal at the time of RRSO.

Clinical Implications
The decrease of sexual functioning after RRSO should be an integral part of preoperative counseling because it is important for BRCA carriers, especially for premenopausal women.

Strengths and Limitations
Some strengths of the present study were the long follow-up, a high response rate, and the existence of a control group, whereas defining menopausal status by last menstrual bleeding and self-report of data (eg, breast cancer history) increased the risk of errors.

Conclusion
Our study indicated that women who underwent RRSO experienced no difference in QOL when compared with women without RRSO and that patients with premenopausal status seemed to be at higher risk to experience sexual complaints after surgery.
Observed Warming Trends at U.S. Army Basic Combat Training Installations and Implications for Future Recruit Training
Authors: Patton Erik M , Doyle Martin W 
Published: November 2023

ABSTRACT

Introduction
Army recruits conducting BCT are among the most susceptible population of military personnel to experience exertional heat illness, a concern expected to become increasingly urgent due to steadily rising temperatures. In this study, we provide an empirical analysis of wet bulb globe temperature (WBGT) index trends at U.S. Army BCT installations and quantify the magnitude of these trends. Assuming these warming trends continue, the anticipated effects of increasing temperature trends are discussed in relation to potential impacts on recruit heat illness incidence and training disruption.

Materials and Methods
We obtained weather data beginning in the early 1960s, including WBGT index measurements derived by the U.S. Air Force 14th Weather Squadron. We apply these datasets to two classifications for high WBGT index days, including one classification accounting for heat illness susceptibility based on prior day heat exposure, to determine when recruits are most at risk of heat illness. The daily likelihood of extreme WBGT index values is described at each installation using a 30-year climatological average. Trends in the WBGT index are evaluated quantitatively during the warm season (May 1–September 30) and full year and compared between decades and by individual BCT classes.

Results
Trends in the WBGT index have increased at all four BCT installations. Between January 1960 and October 2022, the mean WBGT index value increased most quickly at Ft Jackson, SC (0.272°C decade−1, CI: 0.255–0.289) and least at Ft Moore, GA (0.190°C decade−1, CI: 0.170–0.210). Ft Moore experiences the greatest heat burden, with the daily likelihood of experiencing a “black flag” event (≥90°F WBGT index) peaking at nearly 50% in late July, while Ft Leonard Wood, MO, experiences the least heat burden. This heat burden is spread unevenly across installations and dependent on BCT class start date. Recruits beginning in mid-June will experience approximately 200 hours of hazardous heat during BCT at Ft Moore, GA; 100 hours at Ft Jackson, SC; 80 hours at Ft Sill, OK; and 61 hours at Ft Leonard Wood, MO.

Conclusions
Temperatures measured on the WBGT index have steadily increased at US Army basic training installations since at least 1960. In the future, adaptation to the BCT program will be required to maintain rigorous standards without incurring unacceptable risk of recruit heat illness. The analysis provided by this study can help inform medical, training, and policy implementations needed to ensure continued BCT in a warming world.
Rearfoot Strike Run Retraining for Achilles Tendon Pain: A Two-patient Case Series
Authors: Gunterstockman Brittney Mazzone , Carmel Jennifer , Bechard Laura , Yoder Adam , Farrokhi Shawn 
Published: November 2023

ABSTRACT

Introduction
Running-related injuries are prevalent in the military and are often related to physical fitness test training. Non-rearfoot striking while running is known to increase the risk of Achilles tendon injuries because of the high eccentric energy absorption by the elastic components of the planarflexor muscle-tendon complex. However, there is limited evidence to suggest benefits of converting runners with Achilles tendon pain to use a rearfoot strike.

Methods
This is a case series of two active-duty Service members with chronic, running-related Achilles tendon pain that utilized a natural non-rearfoot strike pattern. Both patients were trained to utilize a rearfoot strike while running through the use of real-time visual feedback from wearable sensors.

Results
The trained rearfoot strike pattern was retained for over one month after the intervention, and both patients reported improvements in pain and self-reported function.

Conclusions
This case series demonstrated the clinical utility of converting two non-rearfoot strike runners to a rearfoot strike pattern to decrease eccentric demands on the plantarflexors and reduce Achilles tendon pain while running.
The Perfect Med Bag is One that Doesn’t Fall Off a Cliff: A Combat Mass Casualty Case
Authors: Lenn David , Le Daniel T , Scheiber Christopher J , Smeltz Alan M 
Published: November 2023

ABSTRACT
Military trauma provides a unique pattern of injuries due to the high velocity, high kinetic energy ammunition utilized, and the high prevalence of blast injury. To further complicate this, military trauma often occurs in austere environments with limited logistical support. Therefore, military medical providers are forced to learn nonstandard techniques and when necessary, practice a level of improvisation not commonly seen in other medical fields. The case presented in this manuscript is a prime example of these challenges. At the onset of fighting both the medic’s rucksack, carrying with it the primary source of medical gear and the precious supply of cold-stored blood products are lost. The scenario was further complicated by rough mountainous terrain and a prolonged evacuation time. The medical provider was forced to utilize nonstandard devices such as an improvised junctional tourniquet which used a rock to focus the devices pressure. They also adapted their basic understanding of surgical procedures to conduct a vascular cutdown procedure for wound exposure and effectively pack an otherwise non-compressible wound to a major artery. Despite a significant loss of equipment, the medic and their team were able to successfully care for a number of patients in this mass casualty scenario.
12CO and 13CO observation of the low-metallicity dwarf galaxy DDO 154
Authors: Komugi Shinya , Inaba Miku , Shindou Tetsuo 
Published: November 2023

Abstract
The conversion factor from carbon monoxide (CO) intensity to molecular gas mass is a source of large uncertainty in understanding gas and its relation to star formation in galaxies. In particular, the conversion factor in low-metallicity environments have remained elusive, as currently only two galaxies have been detected in any CO isotopes in environments with 12 + log (O$/$H) &lt; 8.0. Here we report 12CO (J = 1–0) and 13CO (J = 1–0) observations towards a star-forming region in DDO 154, a low-metallicity dwarf irregular galaxy at 12 + log (O$/$H) = 7.67. This is a re-observation of a previous non-detection at higher angular and velocity resolution. No significant emission was detected. By estimating the molecular gas mass from associated star formation, we find that DDO 154 has a conversion factor of more than 103 times the Milky Way. Alternatively, if we estimate molecular mass using dust continuum emission, the conversion factor is at least 2 orders of magnitude larger than the Milky Way. These estimates signify a large amount of CO-dark molecular gas in this galaxy.
Surface demineralized freeze-dried bone allograft followed by reimplantation in a failed mandibular dental implant
Authors: Zhang Jing , Wang Jie , You Jiayi , Qin Xuan , Chen Huimin , Hu Xiantong , Zhao Yantao , Xia Yang 
Published: November 2023

Abstract
The removal of a failed implant with high torque causes significant damage to the surrounding tissue, compromising bone regeneration and subsequent osseointegration in the defect area. Here, we report a case of carrier screw fracture followed by immediate implant removal, bone grafting and delayed reimplantation. A dental implant with a fractured central carrier screw was removed using the bur-forceps technique. The resulting three-wall bone defect was filled with granular surface demineralized freeze-dried bone allograft (SD-FDBA). Cone-beam computerized tomography was performed at 1 week, 6 months and 15 months postoperatively and standardized for quantitative evaluation. The alveolar bone width and height at 15 months post-surgery were about 91% of the original values, with a slightly lower bone density, calculated using the gray value ratio. The graft site was reopened and was found to be completely healed with dense and vascularized bone along with some residual bone graft. Reimplantation followed by restoration was performed 8 months later. The quality of regenerated bone following SD-FDBA grafting was adequate for osseointegration and long-term implant success. The excellent osteogenic properties of SD-FDBA are attributed to its human origin, cortical bone-like structure, partly demineralized surfaces and bone morphogenetic protein-2-containing nature. Further investigation with more cases and longer follow-up was required to confirm the final clinical effect.
Latent Inhibition in Schizophrenia and Schizotypy
Authors: Myles Liam , Garrison Jane , Cheke Lucy 
Published: November 2023

Abstract

Background
The Salience Hypothesis posits that aberrations in the assignment of salience culminate in hallucinations and unusual beliefs, the “positive symptoms” of schizophrenia. Evidence for this comes from studies on latent inhibition (LI), referring to the phenomenon that prior exposure to a stimulus impedes learning about the relationship between that stimulus and an outcome.

Design
This article reviewed all published studies examining the relationship between LI and both schizophrenia and schizotypy.

Results
Contemporary literature suggests that LI is attenuated in both people with schizophrenia and those loading highly on measures of schizotypy, the multidimensional derivative of schizophrenia. This suggests that these individuals assign greater salience to stimuli than healthy controls and people scoring low on measures of schizotypy, respectively. However, several confounds limit these conclusions. Studies on people with schizophrenia are limited by the confounding effects of psychotropic medications, idiosyncratic parsing of samples, variation in dependent variables, and lack of statistical power. Moreover, LI paradigms are limited by the confounding effects of learned irrelevance, conditioned inhibition, negative priming, and novel pop-out effects.

Conclusions
This review concludes with the recommendation that researchers develop novel paradigms that overcome these limitations to evaluate the predictions of the Salience Hypothesis.
Combined Hip Procedure Versus Open Reduction and Internal Fixation for Displaced Acetabular Fractures in Patients Older than 75 years: A Matched Cohort Study
Authors: Kahhaleh Edward , Belzile Etienne L. , Reed-Métayer Thomas , Dartus Julien , Plante Dominic , Lesieur Martin , Lamontagne Jean , Bédard Luc , Pelet Stéphane 
Published: November 2023

Objective:
To compare surgical outcomes between combined hip procedure (CHP: open reduction and internal fixation [ORIF] with total hip replacement) and ORIF alone for the treatment of displaced acetabular fractures in a geriatric population.

Design:
Retrospective case–control study.

Setting:
Academic Level 1 trauma center.

Patients:
Consecutive patients from 2012 till 2020 with acetabular fractures fitting inclusion criteria were enrolled.

Intervention:
Combined hip procedure or ORIF alone for displaced acetabular fractures.

Main Outcome Measurement:
Revision surgery at the latest follow-up, defined as the need for implant revision in the CHP group and conversion to total hip replacement in the ORIF group.

Results:
The need for revision surgery was lower in the CHP group (12.5%) compared with the ORIF alone group (25%). The median time for conversion to total hip replacement in the ORIF alone group was 2.6 years. Ten-year survivorship was significantly higher in the CHP group (85.7% vs. 45.8%, P < 0.01). Patients in the CHP group presented with higher American Society of Anesthesiologists and Charlson index scores and had more marginal impaction and concomitant femoral head fractures.

Conclusions:
In patients older than 75 years presenting with a displaced acetabular fracture with marginal impaction or femoral head fracture, survivorship of CHP is higher than ORIF alone. A combined hip procedure should be considered in such patients.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
The long-term recovery of vision in pseudophakic macula-off rhegmatogenous retinal detachments.
Authors: Moussa George , Jalil Assad , Lippera Myrta , Ivanova Tsveta , Cristescu Irina , Ally Naseer , Jasani Kirti , Patton Niall , Dhawahir-Scala Felipe , Ferrara Mariantonia 
Published: November 2023

Abstract

Purpose:
To assess the long-term visual recovery in uncomplicated macula-off pseudophakic rhegmatogenous retinal detachment (PRRD) treated with pars plana vitrectomy (PPV) and gas tamponade in the absence of other visual co-morbidities.

Methods:
Single-centre retrospective longitudinal study on eyes with macula-off PRRD successfully treated with PPV between 2011 and 2020 and with at least two follow-ups (FU), first gas-free FU (first-FU) and a final FU, were included. Patients with subsequent ocular surgery or comorbidities affecting BCVA were excluded. The duration between operation date and final-FU was calculated (total days FU [TD]) and split into TD-quintiles: 1:≤57, 2: >57 and ≤77, 3:>77 and ≤152, 4:>152 and ≤508 and 5:>508 days. Multivariable regression was performed with logMAR gain between first and final-FU as the dependent variable.

Results:
In 209 eyes, we report association with increase of logMAR gain between first and final-FU, with reducing clock-hours of PRRD (p=0.041) and relative to the TD-quintile 1. Mean (standard deviation) LogMAR gain between first and final follow-up was 0.02 (0.07) in the first quintile, increasing to 0.14 (0.13) (p<0.001) by fifth quintile on multivariable regression. For patients not achieving 0.30 logMAR at first-FU, this was attained at final-FU with a sensitivity of 51.9% and specificity of 95.5% at a cut off ≤0.58 logMAR at first-FU (AUC 0.756 [95%CI 0.664 to 0.848], p<0.001)

Conclusions:
We report a significant time-dependent visual improvement after uncomplicated PPV with gas tamponade for macula-off PRRD without visual confounders, and provide important quantitative data for counselling patients with macula-off repair.
Tangential Retinal Displacement Increases After Macular Pucker Surgery: An Apparent Nonsense
Authors: Rossi Tommaso , Querzoli Giorgio , Cosimi Pamela , Ripandelli Guido , Steel David H. , Romano Mario R. 
Published: November 2023

AbstractPurpose:To measure the tangential retinal displacement and vision before and after macular pucker surgery and study if Pars Plana Vitrectomy (PPV) with EpiRetinal Membrane (ERM) peeling allows the reconstitution of previous anatomy or else it results in a different configuration.Methods:Retrospective series of patients undergoing PPV for ERM, with greater than 6-month follow-up before and after surgery, complete with best-corrected visual acuity (BCVA), Optical Coherence Tomography (OCT), M-charts, and InfraRed (IR) retinography. Tangential retinal displacement between Earliest visit (TE), time of surgery (T0) and latest available visit (TL) of the examined retina, concentric circles at 0.5, 1.5 and 4.5mm radii and the central horizontal and vertical meridian were measured. Tangential displacement was calculated as the optical flow of consecutive IR photos.Results:The study comprised 32 patients: 15 males and 17 females. Average pre- and post-operative follow-up were 23.4±27.9 months and 19.2±11.8 months. BCVA reduced before surgery (0.69 ± 0.16 Snellen to 0.46 ± 0.17; p<0.001) and increased after (0.866 ± 0.16 Snellen; p<0.001). Horizontal and vertical metamorphopsia increased between before surgery but only horizontal metamorphopsia significantly reduced after. Average tangential displacement before surgery was 35.6±29.9 µmversus56.6±41.3 µm after (p=0.023). Pre- and post-operative displacement within the fovea was less than over the entire area (p<0.001).Conclusion:Retinal tangential displacement between diagnosis and surgery (TE-T0) is less than the displacement occurring after surgery (T0-TL). Post-operative displacement does not represent the restoration of the anatomy existing before the disease ensued, but rather the resulting equilibrium of newly deployed forces.